Having a muscular build and well-defined muscles has increasingly become synonymous with ‘manliness’ in South Africa, particularly for young men. Intensive physical training and gruelling gym workouts are slavishly pursued by those men that actively strive to achieve high muscle definition or the ‘ripped look’. However, some men supplement such physical exercise by consuming Anabolic Androgenic Steroids (AAS) as these substances produce both anabolic and androgenic effects. The former accelerates the accumulation of both muscle and strength. The latter results in beard growth, deepening of the voice and other masculinised characteristics.
The consumption of AAS in this regard is technically illegal in terms of the Medicines and Related Substances Act 101 (1965) (as amended). According to the Act, the manufacture, possession, distribution and/or sale of AAS without the necessary prescription or permit is prohibited. Violations may potentially result in arrest and a criminal record. Nonetheless, illegal AAS use is generally regarded as being trivial by law enforcement authorities, and they have therefore made minimal efforts to curb AAS usage and trade. There have also been numerous reports of doping violations involving elite and junior athletes. However, none of the doping incidents were presented in court, and all incidents were handled by the South African Institute for Drug-Free Sports (SAIDS).
General AAS use, although frowned on by most professional athletes and body-building purists, has a degree of social acceptability amongst gym-goers and non-professional athletes. There are, however, two significant dangers to AAS use, namely health outcomes for AAS users, and the stimulus it provides to organised crime in South Africa (which is characterised by high levels of violence).
Given the illegality of AAS consumption in South Africa, AAS users are unable to approach trusted and accredited sources and institutions for advice on the less hazardous consumption of AAS and the risks associated with it. This is a key concern as some side effects of AAS include increased aggression, hair loss, high blood pressure, infertility and depression. Continued AAS use can result in heart, liver and kidney diseases, as well as heart attack and stroke.
The highly publicised assassination of Brian Wainstein in Cape Town in 2017 exposed various connections between the illegal trade in AAS and organised criminal networks in South Africa and globally.
Wainstein, who was often referred to as ‘The Steroid King’, due to his alleged role as one of the major distributors of AAS in South Africa, had reported worked closely with various criminal gangs and prominent figures in South Africa’s criminal underworld that had previously been linked to perpetrating violent crime.
Consequently, those who use illegal AAS contribute directly to organised criminal activity in South Africa. Therefore, there is a need to seriously reconsider the approach to the regulation of AAS in South Africa.
One of the more practical options is for the South African government to amend the AAS regulations, and in particular to decriminalise AAD use (as has been the case with marijuana). The United Kingdom’s Misuse of Drugs Act (1971) (as amended) provides some useful guidance in this regard. According to the Act, the possession and use of AAS is not an offence. However, it is illegal to manufacture, distribute, sell, import and/or export steroids without a licence.
By decriminalising private AAS possession and use, South African authorities may be able to better curtail the associated organised crime by concentrating on major AAS infractions, such as the illegal manufacture and trade. Also, legalising AAS consumption may result in a safer, more knowledgeable steroid use.
Whilst not promoting AAS consumption, health advice may be offered by trained professionals in various settings, such as in clinics and gyms. Furthermore, the risk of contracting infectious diseases via needle sharing could be mitigated by establishing needle exchange clinics for free injection supplies and provide free access to healthcare professionals and medical testing.