Laws and Penalties: Concerns over growing illegal AAS abuse by teenagers, and many of the just discussed long-term effects, led Congress in 1991 to place the whole AAS class of drugs into Schedule III of the Controlled Substances Act (CSA). Under this legislation, AAS are defined as any drug or hormonal substance, chemically and pharmacologically related to T (other than estrogens, progestins, and corticosteroids) that promotes muscle growth. The possession or sale of AAS without a valid prescription is illegal. Since 1991, simple possession of illegally obtained AAS carry a maximum penalty of one year in prison and a minimum $1,000 fine if this is an individual’s first drug offense. The maximum penalty for trafficking (selling or possessing enough to be suspected of selling) is five years in prison and a fine of $250,000 if this is the individual’s first felony drug offense. If this is the second felony drug offense, the maximum period of imprisonment and the maximum fine both double. While the above listed penalties are for federal offenses, individual states have also implemented fines and penalties for illegal use of AAS. State executive offices have also recognized the seriousness of AAS abuse and other drugs of abuse in schools. For example, the State of Virginia enacted a law that will allow student drug testing as a legitimate school drug prevention program (48, 49).
The list of vitamins and minerals below can give you an understanding of how particular vitamins and minerals work in your body, how much of each nutrient you need every day, and what types of food to eat to ensure that you are getting an adequate supply. The recommendations in this vitamins chart are based largely on guidelines from the Institute of Medicine. Recommended amounts may be expressed in milligrams (mg), micrograms (mcg), or international units (IU), depending on the nutrient. Unless specified, values represent those for adults ages 19 and older.
DePalma and colleagues (2005) reviewed the evidence on the effectiveness of transforaminal epidural steroid injections (TFESI) or SNRBs to treat lumbosacral radiculopathy. These investigators concluded that there is moderate evidence in support of TFESI in treating painful lumbar radicular symptoms. The authors concluded that current studies support the use of TFESI/SNRB as a safe and minimally invasive adjunct treatment for lumbar radicular symptoms. In a critique of the systematic evidence review by DePalma et al, the Centre for Reviews and Dissemination (2008) stated that relevant data might have been missed as only published English language studies were included in the review. The CRD noted that the authors of this systematic review used published methods to assess the quality of the studies, but it is unclear how the studies were selected and how many reviewers performed the validity assessments; it is therefore difficult to assess the reliability, in terms of reviewer error or bias, of these review methods. The CRD observed that it appears that one study was initially included in the review, but then subsequently excluded from the analysis as it was not a true randomized controlled clinical trial. The CRD stated that, given the variability between the studies, in particular differences between the outcome measures and interventions, the authors' decision to use a narrative synthesis appears reasonable. The authors also noted a number of design problems with the included studies: the lack of a true placebo-control group and the lack of a sham control group. The studies were also limited in size, with only 2 studies having over 50 participants. The CRD concluded that, "[g]iven the variability between the studies, the lack of appropriate controls, and the limited number of studies and participants, the authors' cautious conclusions appear reliable."