Non-medical users of anabolic steroids often “stack” different anabolic steroids over the course of a “cycle” of use. They also administer various ancillary drugs and substances to enhance the desired effects of anabolic steroids or to minimize adverse side effects. The most common liquid (injectable) anabolic steroids encountered in these cases are (oil-based) esters of testosterone (., testosterone cypionate, testosterone enanthate, and testosterone propionate, and a blend of testosterone esters called Sustanon 250) or nandrolone (., nandrolone decanoate). Also popular are Equipoise (boldenone undecylenate) and trenbolone acetate and trenbolone enanthate, as well as the water-based injectable Winstrol (stanozolol). Popular oral anabolic steroids include methandrostenolone (Dianbol), oxandrolone (Anavar) and oxymetholone (Anadrol 50).
GHB's unique attributes have some legitimate uses. In Europe, it is still used as an anesthetic, for alcohol and opiate addiction therapy, and for narcolepsy therapy. Only this last indication of narcolepsy is recognized by the US Food and Drug Administration, which recently approved GHB (ie, sodium oxybate [Xyrem]) to treat a small subset of patients with narcolepsy who have episodes of weak or paralyzed muscles (ie, cataplexy). Because of sodium oxybate's history of abuse as a recreational drug, the FDA approved it as a Schedule III Controlled Substance. A limited distribution program that includes physician education, patient education, a patient and physician registry, and detailed patient surveillance has been established. Under the program, prescribers and patients will be able to obtain the product only through a single centralized pharmacy.