Anabolic Steroids Are Easily Purchased Without a Prescription and
Present Significant Challenges to Law Enforcement Officials
(03-NOV-05, GAO-06-243R).
This report responds to a Congressional request that we
investigate whether anabolic steroids can be purchased without a
prescription and test whether such purchases are easily made.
Congress also asked us to identify common sources of illegal
anabolic steroids, and significant challenges law enforcement
officials encounter in investigating, prosecuting, and deterring
criminal anabolic steroid traffickers.
-------------------------Indexing Terms-------------------------
REPORTNUM: GAO-06-243R
ACCNO: A40958
TITLE: Anabolic Steroids Are Easily Purchased Without a
Prescription and Present Significant Challenges to Law
Enforcement Officials
DATE: 11/03/2005
SUBJECT: Controlled substances
Crime prevention
Criminal activities
Drug trafficking
Drugs
Internet
Law enforcement
Smuggling
Websites
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GAO-06-243R
November 3, 2005
The Honorable Tom Davis
Chairman
The Honorable Henry Waxman
Ranking Minority Member
Committee on Government Reform
House of Representatives
Subject: Anabolic Steroids Are Easily Purchased Without a Prescription and
Present Significant Challenges to Law Enforcement Officials
This report responds to your request that we investigate whether anabolic
steroids can be purchased without a prescription and test whether such
purchases are easily made. You also asked us to identify common sources of
illegal anabolic steroids, and significant challenges law enforcement
officials encounter in investigating, prosecuting, and deterring criminal
anabolic steroid traffickers.
To complete this work, we made purchases through the Internet of anabolic
steroids commonly used by athletes and bodybuilders, and had tests
performed on the products purchased by the National Medical Services, a
commercial laboratory, and the Food and Drug Administration (FDA). To
identify significant challenges law enforcement officials encounter in the
investigation and prosecution of illegal anabolic steroid traffickers, we
interviewed officials of federal agencies that have responsibility for
enforcement of laws relating to anabolic steroids--FDA, the Drug
Enforcement Administration (DEA), the Department of Justice (DOJ), and the
U.S. Customs and Border Patrol Agency (CBP)--- and we visited CBP
international mail facilities at two airports that receive significant
quantities of mail containing anabolic steroids, New York's Kennedy
Airport and at the Miami International Airport. Additionally, to obtain
the perspective of state and local officials on enforcement issues, we
interviewed officials of New York's Office of the Special Narcotics
Prosecutor, the only prosecutorial agency in the country that is
exclusively dedicated to the investigation and prosecution of felony drug
offenses. We also spoke with officials of the United States Sentencing
Commission and researched current and proposed legislation relating to
illegal anabolic steroid activity.
Summary
Our investigators easily obtained anabolic steroids without a prescription
through the Internet. After conducting Internet searches, they found
hundreds of Web sites offering anabolic steroids commonly used by athletes
and bodybuilders for sale. The investigators then used an e-mail account
in a fictitious name to place 22 orders. From these orders, we received 10
shipments of anabolic steroids; all were shipped from foreign countries.
We also received 4 shipments from within the United States but the
substances they contained, though marketed as anabolic steroids or other
"muscle building" products, were not anabolic steroids according to the
FDA.1 We are referring the evidence concerning our purchases to DEA and to
FDA for appropriate action.
The officials we spoke with told us that most anabolic steroids sold
illegally in the United States come from abroad, and that the Internet is
the most widely used means of buying and selling anabolic steroids
illegally. They also reported that, because of the foreign origin of the
steroids and the widespread use of the Internet in steroid trafficking,
extensive time and resources are usually required to investigate and
prosecute steroid cases. Further, the sheer volume of all types of imports
from abroad presents significant challenges in efforts to prevent anabolic
steroids from illegally entering the United States. Additionally, some
officials noted the relatively low sentences that result from application
of the federal sentencing guidelines to persons convicted of illegal
steroid trafficking.
Background
Anabolic steroids are synthetic forms of the male sex hormone testosterone
that can be taken orally, injected, or rubbed on the skin. Under U.S. law
they cannot be sold without a prescription, and are dispensed to treat
conditions associated with low testosterone levels, such as delayed
puberty or body wasting associated with AIDS. When used in combination
with exercise, training, and a high protein diet, anabolic steroids can
improve endurance and promote increased muscle size and strength. Because
of these effects, they are illicitly used as performance-enhancing drugs
by some athletes, bodybuilders, and others to improve competitiveness or
appearance.
However, steroid abuse can cause devastating side effects, including
liver, kidney, and heart disease; cancer, stroke, and behavioral changes
such as increased aggression and severe depression. The availability and
use of anabolic steroids in sports, particularly among adolescents, is a
growing concern. According to a National Institute of Health study, use of
steroids by American young people underwent a period of sharp rise in the
late 1990s, and continues to be at an all time high among 12th graders.
Moreover, in a recent study performed by the University of Michigan, more
than 42 percent of 12th graders reported that anabolic steroids are easy
or fairly easy to obtain without a prescription.
In 1990, Congress passed the Anabolic Steroids Control Act of 19902 adding
anabolic steroids to the federal schedule of controlled substances.3 The
act placed anabolic steroids on Schedule III of the Controlled Substance
Act and specifically identified 27 anabolic steroids. The maximum term of
imprisonment for a Schedule III controlled substance offense is 5 years,
or 10 years if the person has a prior felony drug offense conviction.4 The
Anabolic Steroid Control Act of 2004 added additional anabolic steroids to
Schedule III of the Controlled Substance Act.
1 Eight orders were never received.
2 Anabolic Steroids Control Act of 1990, Pub. L. No. 101-647, 104 Stat.
4851 (1990) (amending the Controlled Substances Act, 21 U.S.C. S: 812
(c)).
3 Prior to 1990, anabolic steroids were not classified as a controlled
substance under federal law, and their use was subject to regulation by
the FDA.
Purchases of Anabolic Steroids without a Prescription
Our investigators tested whether it would be easy for anyone who has
access to a computer to locate and make purchases from dealers who sell
anabolic steroids illegally.
To do this, they replicated what any athlete or bodybuilder of any age can
do on a home computer. First, they conducted Internet searches using the
words "anabolic steroids,"
or the names of specific anabolic steroids that DEA identified for us as
commonly used by athletes and bodybuilders. As a result, they found
hundreds of Web sites offering anabolic steroids for sale.
The investigators placed a total of 22 orders for anabolic steroids
through 22 of these Web sites that were selected randomly. Using an e-mail
account that they established in a fictitious name, the investigators
completed these orders and paid for them. As a result, we received 14
shipments. Of that number, 10 were anabolic steroids; the 4 additional
shipments contained substances that were not anabolic steroids.5
Steroids Received
The 10 orders of anabolic steroids we received were obtained through Web
sites that openly and boldly offer anabolic steroids for sale. Some of the
Web sites offer a variety of pharmaceutical drugs, while others sell
anabolic steroids exclusively. They typically offer "private and
confidential" sales of "discretely shipped" anabolic steroids that will
"shape your body the way . . . you want it to look." Many sites offer
dozens of anabolic steroids for sale. They promote anabolic steroid use
through claims that they have good affects on the body, touting, for
example, that one product is a "growth-promoting agent."
Other Web sites, including some of those from which we made purchases,
offer packages of different steroids for those who "cycle" or "stack"
their use of anabolic steroids. A cycle is a period of from 6 and 14 weeks
of steroid use, followed by a period of abstinence or gradual reduction in
use; stacking is using multiple anabolic steroids concurrently. The
packages offered by the Web sites are designed for a variety of
different users, from "beginning" muscle builders to advanced "mass"
builders, to customers interested in the "ladies lean stack."
4 Anti-Drug Abuse Act of 1986, Pub. L. No. 99-570 , 100 Stat. 3207
(codified at 21 U.S.C. S: 841(b)(1)(D); 21 U.S.C. S: 960(b)(4) (5-year
maximum term of imprisonment for import violations).
5 The National Medical Services laboratory tested the 10 products that
were anabolic steroids to confirm that they were in fact anabolic steroids
and to determine the type of anabolic steroid received; the FDA tested the
4 other products we received to determine their contents.
The Web sites do not indicate the country from which the steroids are
shipped, but we later learned from return addresses and postmarks on the
shipments that the anabolic steroids all came from outside the United
States. Although we placed these 10 orders at 10 different Web sites, the
shipments came from just three different countries: five were from
Trieste, Italy; four from Shanghai, China; and one from Athens, Greece.
The shipment from Athens, Greece came in a plain 5- by 6- inch envelope
bearing a return address label with an individual's name and address. It
contained one bottle of the anabolic steroid Testosterone Propionate in
liquid form. We paid $114.00 for the order using a credit card.
The five orders shipped from Trieste, Italy, came in plain 5 by 7 inch
envelopes bearing one of three different return address labels with an
individual's name and address. From one address we received two orders,
each containing 100 tablets of the anabolic steroid Methandrostenolone.
Using a credit card, we paid $109.20 for one of these orders and $107.90
for the other.
From a different return address in Trieste we received two other packages,
each containing one bottle of the anabolic steroid Testosterone Cypionate
in liquid form. Using a credit card, we paid $120.90 for one of these
orders. For the other, we followed instructions sent through e-mail
communications from the dealer to wire $144.00 through Western Union to an
individual in Vienna, Austria. From the third address in Trieste we
received a package containing 100 tablets of Methandrostenolone. We paid
$117.00 for the order and wired the money through Western Union to an
individual in Salzburg, Austria, as instructed.
Each of the four shipments from Shanghai came in a plain 6 by 9 inch
envelope. Each envelope had a return address label bearing a different
individual's name and address.
We paid for each of them by credit card. One package contained 150 yellow
tablets of the anabolic steroid Stanozolol for which we paid $200.00. A
second package containing 20 tablets of Stanozolol was also received, and
we paid $97.00 for them. Additionally, we received a package containing
crushed green tablets of the anabolic steroid Oxymetholone and paid
$124.00 for them. The fourth package from Shanghai contained 40 green
tablets of Oxymetholone and cost $323.00.
Other Products Received
We also received four shipments from dealers in the United States through
Web sites that claimed to sell anabolic steroids or products that have the
muscle-building effects of anabolic steroids. However, according to FDA,
none of these shipments contained anabolic steroids. We have referred the
results of our investigation concerning these products to the FDA.
Challenges Faced by Law Enforcement Officials When
Investigating and Prosecuting Illegal Steroid Trafficking Cases
Law enforcement officials identified significant challenges in their
efforts to investigate, prosecute, and deter criminal anabolic steroid
traffickers. These challenges arise from the foreign origin of many
illegally sold steroids, the widespread use of the Internet in steroid
trafficking, the volume of mail CBP must screen in its efforts to prevent
entry of anabolic steroids into the United States, and the relatively low
sentences that result from application of the federal Sentencing
Guidelines to illegal steroid offenders.
Most Illegally Sold Anabolic Steroids Come From Abroad
The law enforcement officials we spoke to reported that, in their
experience, most anabolic steroids distributed illegally in the United
States come from abroad. The results of our test purchases tend to confirm
this. Larger illegal anabolic steroid dealers in the United States
frequently have multiple overseas sources of steroids. Significant
quantities of anabolic steroids come from Mexico, as well as other
countries such as Russia, Romania, and Greece.
There is a readily available supply of steroids worldwide because, in most
countries, anabolic steroids can be sold legally without a prescription.
Thus, many foreign distributors do not violate the laws of their own
country when they sell these substances to people in the United States. As
a result, U.S. law enforcement agencies have difficulty in obtaining
assistance from their foreign counterparts in investigations of such
distributors.
Law enforcement officials also identified smuggling of anabolic steroids6
across international borders into the United States as an important part
of the illegal distribution network and described how smugglers typically
operate. A smuggler in the United States takes orders from steroid
customers in person, over the phone, or via e-mail. After obtaining
advance payment from customers, the smuggler will travel to the source
country, usually Mexico, to purchase the steroids. Some smugglers pay
someone else to perform this function or have a foreign source that will
ship the steroids. Smugglers who travel either carry the steroids back or
ship them to the United States. In Mexico and European countries,
smugglers usually buy anabolic steroids from pharmacies.
In some cases, the smuggler may ship the steroids to a partner in the
United States, known as a remailer, and provide the remailer with
addresses of specific U.S. customers.
The remailer repackages the steroids and sends them to the customers.
According to
6 An emerging issue identified by officials we spoke with is the illegal
importation of anabolic steroids in bulk powder form. Large quantities of
steroids can be smuggled in bulk powder form into the United States where
injectible forms of steroids can be reconstituted from them. These
shipments are more difficult to detect than steroids in tablet or liquid
form.
law enforcement officials, the remailer normally performs this task in
exchange for
money or free steroids. The customer may then use the steroids or resell
them to others in places such as gyms and at bodybuilding contests.7
The Internet Facilitates Illegal Anabolic Steroid Trafficking
Law enforcement officials reported that the Internet is a primary vehicle
for buying and selling anabolic steroids illegally. Internet Web sites,
usually foreign based, advertise steroids for sale. Customers access these
sites, inquire about purchases, and place orders. Sellers typically
require advance payment through Western Union, PayPal, money orders, or
credit cards. After receiving payment, sellers ship the steroids through
international mail or an express carrier. A remailer may also be used to
resend packages once they arrive in the United States.
The Internet also provides an easy means for sellers to market to young
people. Moreover, according to some of the law enforcement officials we
spoke to, sales of steroids and other synthetic drugs are used by some
sellers as a "gateway" to sales of narcotics, such as cocaine. Typically,
in such cases, the seller uses an initial series of steroid or designer
drug transactions to gauge whether the buyer is a legitimate customer and
is not an undercover law enforcement investigator. After the seller has
gained assurances that the customer is legitimate through the initial
steroid sales, narcotics are offered for sale.
To prosecute illegal steroid dealers, law enforcement officials must
identify them and gather evidence of their trafficking activity. However,
anabolic steroid dealers can capitalize on the anonymity afforded by the
Internet to thwart efforts to identify them. Internet sites can be
installed, moved, or removed easily and quickly, making it difficult for
law enforcement agencies to identify, track, monitor, or shut them down.
As a result, investigations of anabolic steroid dealers require
substantial time and resources.
Further, dealers operating through the Internet typically communicate with
individual customers through e-mail, and establish e-mail accounts using
fictitious identifying
information and mailing addresses with one of the free e-mail services.8
Some officials reported to us that the use of free e-mail accounts with
fictitious account holder identity
information is found frequently in investigations, and is many dealers'
preferred means of communication with customers. Such accounts add an
additional layer of
anonymity to the dealer and complexity to law enforcement efforts to track
down and identify them.
Of particular concern to some officials are offshore providers of free
e-mail services such as Hushmail,9 based in Ireland, and Operamail, based
in the Netherlands. Officials at one agency told us that they believe it
is too risky to approach these providers with requests for voluntary
cooperation because they can ignore nondisclosure requests with impunity,
and may intentionally or unintentionally tip off the subjects of
investigations.
7 You also specifically asked about the extent to which steroids are
illegally diverted from pharmacies and synthesized in clandestine
laboratories. The officials we spoke with indicated that, in their
experience, the number of pharmacy diversion and clandestine laboratory
cases is relatively small; the Internet, smuggling, and foreign source
anabolic steroids are the most significant anabolic steroid trafficking
issues.
8 Since there are no fees for these accounts, the service providers may
have no reason to verify the account holder's name, address, or other
identifying information.
Internet drug crime investigations are further complicated by service
providers who strip e-mail messages of information about their point of
origin. E-mail generally contains "header" information identifying various
Internet Protocol (IP) addresses, including "routing" and "originating" IP
addresses. IP addresses may prove useful in determining the identity of
the user of a particular e-mail account. However, in some cases,
investigators find that some service providers automatically eliminate
origination and routing IP addresses from e-mail sent through their
services. Hushmail, for example, strips origination IP addresses and
substitutes the IP Address of Hushmail's own computers on its customers'
communications. The result, for example, is that when a steroids dealer in
Florida sends an e-mail to a customer in Virginia, the e-mail that arrives
in Virginia has Hushmail's originating IP Address in Ireland rather than
the actual IP originating address of the dealer.
Challenges in Interdicting Entry of Steroids into the United States
All international mail entering the United States through the U.S. Postal
Service and private carriers is subject to inspection by the CBP at the 14
international mail facilities and 29 express consignment carrier
facilities located around the country. CBP inspects for illegally imported
controlled substances, such as anabolic steroids, contraband, and
other items that are inadmissible into the United States. Each year the
international mail and carrier facilities process hundreds of millions of
pieces of mail and packages. For example, the international mail facility
at John F. Kennedy Airport in New York alone receives approximately 1.3
million pieces of mail each day. The volume of mail, together
with the steps illegal steroid shippers use to disguise their product and
the labor-intensive nature of the inspection process itself, present
formidable challenges to the CBP in its efforts to interdict the entry of
anabolic steroids into the United States.
The inspection process is very labor and time intensive, and can include
visual examination, x-ray, and opening mail to physically inspect the
contents. At the international mail facilities we visited in New York and
Miami, mail goes through a series of processes before being released or
detained by the CBP. It passes through a portal monitor designed to screen
for nuclear and radiological materials, and is placed on a conveyer belt
where officers screen individual pieces of mail. CBP officers target
packages for inspection based on factors such as their knowledge,
intuition, and experience; whether the mail originated in suspect
countries; and intelligence gained from prior interceptions of controlled
substances. Suspicious mail is separated, x-rayed, opened by individual
inspectors, and searched.
The difficulty of detecting anabolic steroids is further increased because
dealers conceal them in items such as books or small electrical equipment
to avoid detection by CBP. Anabolic steroids are commonly secreted in
small electronic equipment, such as speakers, blenders, or alarm clocks,
or hidden in compact disk cases or in hollowed sections of books. We
observed examples of such shipments that had been intercepted by CBP
during our visits to U.S. Postal Service International Mail facilities in
Miami and in New York. Figure 1 is a photograph of a book in which CBP in
New York found a shipment of the anabolic steroid Testosterone Enanthate
from India.
9 Hushmail also offers free automatic encryption services.
Figure 1: Book From India Containing Anabolic Steroids Interdicted By CBP
The left side of figure 2 is a photograph of a box and radio that were in
a package shipped from Panama. CBP in Miami found that the radio had been
used to hide a shipment of the anabolic steroid Testosterone Cypionate.
The right side of figure 2 shows the opened radio with the steroid
secreted inside.
Figure 2: Radio From Panama Interdicted By CBP (left); Radio Opened To
Disclose Anabolic Steroids (right)
CBP officials noted that shippers and customers can also use an on-line
tracking system made available by the Postal Service to track packages
sent through express mail. This enables illegal traffickers in steroids to
determine whether and where a shipment has been detained by the CBP. This
is a disadvantage for law enforcement officials when they attempt to
conduct an investigation through what is known as a controlled delivery.
In a controlled delivery, a law enforcement employee poses as a Postal
Service employee and delivers the package to the intended recipient. This
may provide an opportunity to gather evidence or make an arrest. However,
the value of a controlled delivery as an investigative tool may be
compromised if the trafficker, through the tracking system, has notice
that the shipment was detained by the CBP.
Federal Sentencing Guidelines for Steroids Offenses Do Not Provide a High
Level of Deterrence
Law enforcement officials told us that although extensive time and
resources are required to locate, charge, and convict criminal anabolic
steroid dealers, the penalties under the Federal Sentencing Guidelines
faced by persons convicted of such offenses do not reflect the seriousness
of their crimes or provide adequate deterrence.10 Drug quantity is a
principal factor in determining offense level and sentence for drug
offenses under the sentencing guidelines. Quantity of anabolic steroids
and other Schedule III controlled substances under the sentencing
guidelines is based on a "unit" system. A unit of a Schedule III
controlled substance, other than anabolic steroids, is "one pill, capsule,
or tablet" or, if in liquid form, 0.5 grams. However, the sentencing
guidelines treat anabolic steroids differently from all other Schedule III
substances. One unit of an anabolic steroid is 50 pills, capsules, or
tablets or, if in liquid form, one unit equals a 10 cc vial of injectable
steroid. 11
As a result, an offender responsible for selling 40,000 pills of a
Schedule III substance other than an anabolic steroid, such as ketamine,
would face a sentence of 33 to 41 months under the drug quantity rules of
the sentencing guidelines. On the other hand, an offender convicted of
selling 40,000 pills of an anabolic steroid would face a sentence of 0 to
6 months under those rules. According to DOJ, DEA's laboratory seizure
analysis from 2003 suggests that anabolic steroid seizures in major cases
consist of quantities in the order of magnitude of 20,000 to 40,000
tablets and 2,000 to 6,000 milliliters. Thus, in the case of DEA's largest
seizure in 2003, in which 44,000 tablets of the anabolic steroid
Methandienone were seized, a defendant convicted of trafficking in those
steroids would face a sentence of 0 to 6 months under the drug quantity
rules of the current sentencing guidelines.
Section 3 of the Anabolic Steroid Control Act of 2004 directed the United
States Sentencing Commission to review and consider amending the Federal
Sentencing Guidelines with respect to steroids offenses.12 The Sentencing
Commission began its review of anabolic steroids offenses during its
2004-2005 amendment cycle.13 In February 2005, the Commission issued a
notice for public comment in the Federal Register on whether the
guidelines governing steroids offenses should be amended. The Sentencing
Commission received public comment from various parties and in April,
2005, held a public hearing at which it received testimony from the
Department of Justice, the Federal Public Defenders Service, the National
Association of Criminal Defense Lawyers, and the Practitioners Advisory
Group.14 After reviewing the information obtained, the Sentencing
Commission deferred promulgation of steroids-related amendments to the
federal sentencing guidelines because it concluded that it did not have
sufficient information on offenses involving anabolic steroids,
particularly anabolic steroids trafficking.
10 The state officials we spoke with informed us that penalties for
illegal steroid trafficking under New York law similarly do not provide
adequate deterrence.
11 U.S. Sentencing Guidelines Manual, S: 2D1.1, Notes to Drug Quantity
Table (G).
Instead, the Sentencing Commission decided to conduct further research and
outreach in order to determine the most appropriate course of action.15 It
also decided to seek "emergency amendment authority" from Congress that
would give the Sentencing Commission the option of promulgating an
amendment that would take effect immediately upon date of promulgation.
The Sentencing Commission submitted its request to Congress on April 20,
2005.16 On September 29, 2005, the President signed a bill17 which
provides that, if the Sentencing Commission determines that amending the
federal sentencing guidelines for anabolic steroids offenses is
appropriate, such amendments will take effect by March 29, 2006.
- - - - -
This report will be available on GAO's web page at http://www.gao.gov . If
you have questions, please contact me at (202) 512-7227 or [email protected]
. Barry Shillito,
12 Anabolic Steroid Control Act of 2004, Pub. L. No. 108-358, 118 Stat.
1661 (codified at 28 U.S.C.A. S: 994 Note (2004)).
13 The Sentencing Commission operates under "amendment cycles" that
culminate in the submission of proposed amendments to the federal
sentencing guidelines to Congress on or before May 1 of each calendar
year. The Sentencing Commission typically announces its list of final
priorities for consideration in the summer; works on policy issues related
to that list in the fall; publishes proposed amendments in the Federal
Register for public comment in the late winter; holds public hearings on
proposed amendments in the early spring; and votes to promulgate
amendments in April of every calendar year. Amendments are submitted to
Congress by May 1 and Congress has 180 days to take affirmative action
with regard to the proposed amendments. If Congress does not act, the
amendments become effective no later than November 1. See 28 U.S.C. S:
994(p)(2004).
14 The Practitioners Advisory Group is a standing advisory group to the
Sentencing Commission.
15 The Sentencing Commission prepared an extensive report on the use of
steroids in 1991 and will update that report as part of its review of
steroids penalties.
16 The Sentencing Commission also placed consideration of steroids
offenses on its Federal Register list of proposed priorities on which
public comment was requested. Public comment was received in August 2005
from the Food and Drug Administration, the Federal Public Defenders
Service, the DOJ, and the Practitioners Advisory Group.
17 United States Parole Commission Extension and Sentencing Commission
Authority Act of 2005, Pub. L. No. 109-76, 199 Stat. 2935 (2005).
Daniel Kaneshiro, Ramon Rodriguez, and Richard Egan made major
contributions to this report.
Robert J. Cramer
Associate General Counsel
(601322)
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