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Evidence regarding the effects of recreational cannabis legalization on public health is inconsistent. Future research should assess heterogeneous policy design, differential effects on population subgroups, and effects related to characteristics of legal cannabis supply.

States are adopting policies that expand cannabis access to larger proportions of the US population than ever before, as described in an accompanying Health Affairs Health Policy Brief. Past-year cannabis use increased from 10.4 percent of US adults in 2002 to 15.3 percent in 2017, and the proportion of past-year users reporting near daily use doubled between 2006 and 2016. During that same period, perceived great risk from smoking cannabis declined among those ages twelve and older, going from 38.3 percent in 2002 to 26.1 percent in 2017. It is important to consider whether perceptions about risk are accurate and what may be the larger population health benefits and harms associated with expanded cannabis access.

In this brief, we summarize research on how cannabis legalization relates to use of the substance and key population health outcomes. We focus on recreational laws because of their broad application and ability to affect public health, although we include some studies on medical cannabis laws with generalizable or relevant findings. A detailed summary of representative studies in these domains is provided in supplemental appendix tables 1–7. We conclude by outlining areas ripe for future research and policy consideration related to safely legalizing cannabis.

Cannabis Use And Health

Research suggests that cannabis use is associated with both positive and negative health effects. The term cannabis refers to parts of or products derived from the plant Cannabis sativa that contain substantial amounts of tetrahydrocannabinol (THC)—the substance primarily responsible for cannabis’s high-inducing effect. Although it is claimed that cannabis and its derivative substances improve outcomes for many disorders, there is only strong scientific evidence suggesting that it is an effective treatment of three conditions: in treating chronic neuropathic pain in adults, as an antiemetic after chemotherapy treatment, and for improving patient-reported multiple sclerosis symptoms.

Demonstrated adverse effects of short-term cannabis use include impaired short-term memory, altered judgement that increases engagement in risky behaviors, and impaired driving. Heavy and long-term cannabis use in adolescents carries substantial risks, including altered brain development and cannabis dependence, which is correlated with elevated risk of using other illegal drugs. Emerging literature suggests that higher-potency cannabis—with a greater THC concentration—may intensify cognitive impairment, severity of dependence, and adverse psychological outcomes. Although cannabis use has been associated with poor educational outcomes and mental illness, it is challenging to attribute causality to these complex, multifactorial outcomes.

The mechanism of consumption likely affects cannabis’ health effects. Although large population studies have not identified an association between cannabis smoking and lung cancer, the link cannot yet be ruled out, as cannabis smoke contains carcinogens.

Effects of Cannabis Legalization

Evidence is emerging on the public health impacts of cannabis legalization. Here we summarize current research regarding the relationship between recreational and, to a lesser degree, medical cannabis legalization and various outcomes that is key to understanding the public health policy implications. We also highlight three areas ripe for future research: additional measures of cannabis use, use disorder, and product type; heterogenous policy design; and differential effects by population subgroups.

CANNABIS USE

Cannabis use is best operationalized through measures of both prevalence (past-month or past-year use) and intensity (for example, number of days used, total grams consumed, potency per dose). Findings on the relationship between recreational legalization and cannabis use among adults are inconclusive, and effects may differ by age group. Using a large, nationally representative survey across several years, two studies observed increased prevalence of past-month cannabis use and frequent use for adults ages twenty-six and older in states with recreational legalization but did not report similar changes among young adults ages 18–25. Other research has identified increases in cannabis use prevalence and intensity among college students who fall within the 18–25 age range. Evidence on the impact of legalization on youth cannabis use remains inconclusive, with research identifying increases, decreases, and no change in use prevalence and intensity measures.

As Rosanna Smart and Rosalie Pacula note, medical cannabis laws, which apply to more limited sectors of the population than do recreational laws, have not been associated with increases in the prevalence of youth (ages younger than eighteen) cannabis use. Although these laws appear to correlate with increased use among adults, subgroup analyses suggest that the evidence remains mixed for young adults ages 18–25. Some studies find that medical legalization has no effect on past-month use or use intensity for young adults, although Christine Mauro and colleagues observed increases in use intensity for males in this age range.

Notably, product characteristics of the legal supply affect the relationship between legalization and cannabis use and use intensity. Early research describes the evolution of product type, potency, and price after legalization in Washington State. Similar research is needed on the legal medical and recreational markets in other jurisdictions to capture how cannabis market characteristics affect consumption patterns.

CANNABIS USE DISORDER

Research on the effects of cannabis legalization on cannabis use disorder is relatively nascent, offering inconclusive findings and suggesting that effects may differ by age group. As Smart and Pacula summarize, medical legalization increases, decreases, or has no effect on self-reported prevalence of or treatment admissions for cannabis use disorder. The few studies that consider heterogenous policy effects of medical cannabis laws suggest that the presence of commercial dispensaries increases both overall and youth cannabis use disorder treatment admissions.

This literature is inconclusive partly because the common outcomes used to measure cannabis use disorder—self-reported symptoms or treatment admissions—are likely influenced by legalization without actually changing prevalence of cannabis use disorder. For instance, by changing social norms around problematic cannabis use, legalization may reduce the likelihood that an individual will self-report symptoms of cannabis use disorder. Similarly, given that treatment admissions for cannabis use disorder often occur through the criminal justice system, legalization may affect written and de facto policies governing law enforcement treatment referrals for cannabis use disorder with or without affecting cannabis use disorder prevalence.

CANNABIS-RELATED HOSPITALIZATIONS AND POISONINGS

Cannabis legalization may result in increases in hospitalization and emergency department visits related to cannabis abuse and dependence and injuries occurring under the influence of the substance. A 2020 narrative review reported that cannabis-related hospitalizations in Colorado increased after recreational legalization, above and beyond earlier additions associated with medical legalization. A rigorously designed study found that the presence of recreational cannabis dispensaries, but not enactment of a recreational cannabis law, is statistically positively associated with poisonings involving cannabis dry plant products overall and in those younger than twenty-one. However, because of data limitations, this study fails to consider exposures to other cannabis product forms that are of particular concern for youth, such as edibles.

DRIVING SAFETY

Potential increases in car accidents involving cannabis use are a chief concern among those disfavoring legalization. Simulation studies suggest that cannabis intoxication impairs driver reaction time, spatial perceptions, and decision making. Detection of cannabis in drivers has tripled from 4.2 percent of fatally injured drivers in 1999 to 12.2 percent in 2010, although it remains unclear how much of this increase can be attributed to cannabis policy liberalization.

Research investigating the relationship between cannabis legalization and driving safety typically leverages fatal crash data. However, less than 0.5 percent of crashes are fatal, so research using data sets that fail to capture nonfatal injuries underreport traffic accidents associated with driving under the influence of cannabis.

Even among studies that use fatality data and consider policy heterogeneity, findings vary from significant positive to significant negative to insignificant relationships between medical cannabis laws and traffic fatalities. Research on recreational cannabis laws is similarly mixed, likely as a result of methodological differences and confounding variables.

USE OF OTHER SUBSTANCES

The extent to which cannabis interacts with other substances heavily influences the public health implications of legalization. In particular, whether cannabis is a complement or substitute to alcohol, tobacco, or opioids is a critical consideration for legalization policy. The effect of legalization on substance use likely differs by substance and user age.

Overall, the literature on the effects of cannabis laws on alcohol use remains mixed for both adolescents and adults, suggesting both substitution and complementary relationships. Studies of recreational cannabis laws have identified both significant declines and insignificant effects on alcohol use with cannabis and without cannabis, as well as intensity of alcohol use. The emerging literature on tobacco is similarly inconclusive but has begun to assess differential effects of legalization across tobacco products. For example, Rebekah Coley and colleagues find that recreational legalization increases e-cigarette use among adolescents but has no effect on cigarette use. Early evidence on medical cannabis laws suggests that the complementary or substitutive nature of the relationship between alcohol or tobacco and cannabis depends on policy restrictiveness and the age of the consuming population.

Research has also focused on the potential for cannabis legalization to address opioid-related harms. A growing minority of states recognize opioid dependence as a qualifying condition for medical cannabis access. Although older studies identified a negative association between medical cannabis laws and opioid mortality, subsequent replications using additional data years have suggested that omitted variable bias may have driven earlier findings. More recent research highlights the importance of considering policy dimensions in evaluations of legalization policies. For example, the existence of dispensaries in medical or recreational legal markets, not legalization alone, may contribute to any observed effect on opioid mortality. Although researchers find (with important exceptions) that opioid prescribing is negatively associated with medical legalization or certain features of medical cannabis markets, this literature may inadequately control for changes in public and private policies and programs targeting opioid misuse.

For more detailed information about legalization and noncannabis substance use, we refer readers to reviews from Gabrielle Campbell and colleagues, Smart and Pacula, and Meenakshi Subbaraman.

Future Research Directions

Although more research is needed regarding the public health consequences of a legal cannabis supply for adults, we have elucidated what is known about four key health outcomes: cannabis use and use disorder, cannabis-related hospitalizations and poisonings, driving safety, and other substance use. Expansion of cannabis research into understudied areas may help address some of the existing inconsistent evidence.

For instance, future research should evaluate specific provisions that govern the legal market. Features of medical and recreational cannabis laws, such as whether a jurisdiction allows dispensaries, likely affect health outcomes and explain discrepancies between studies that do not stratify states by relevant provisions. Although some studies assess the effect of recreational dispensaries on cannabis use, unintentional cannabis exposure, motor vehicle fatalities, and opioid mortality, differentiating states by provisions is not as common in recreational legalization research compared with the more established literature on medical cannabis laws. Further, many studies only evaluate provisions related to legal supply methods (for example, dispensaries, home cultivation), ignoring other elements of the regulatory framework that may have significant implications for public health outcomes. These include provisions such as taxation and advertising restrictions. Evaluations of provisions that govern legal markets could benefit from a categorization system that differentiates states on the basis of multiple characteristics. In addition, analyses should distinguish between policy implementation and effective dates.

Researchers should also consider the public health effects of different characteristics of the legal cannabis supply, including product type, price, potency, and sourcing. Cannabis legalization, particularly commercialization, has the potential to transform the cannabis market. For instance, there has been a proliferation of high-potency products in legal cannabis markets, both in the US and abroad. Novel extracts also make up a rapidly growing market segment. Given public perceptions that alternatives to smoked cannabis products are healthier and more efficient to consume, it is critical to assess their public health effects. Use will also be shaped by the post-tax retail price, and as anticipated, cannabis prices have fallen steeply in states that have legalized recreational use. Thus, researchers should prioritize evaluating the effects of different taxation approaches (for example, ad valorem or based on THC content) on use.

Further, the 2020 vaping crisis associated with diluted THC-containing products raises concerns around unregulated cannabis markets in both legalized and nonlegalized states, heightening the need to study the public health effects of legally versus illegally produced cannabis products. Notably, cannabis markets vary at the local level, and the cannabis industry will continue to evolve in response to federal and state policy changes. Thus, establishing data systems capable of capturing local characteristics of cannabis markets over time will be essential.

It is also critical that researchers expand the study of heterogeneous policy effects across population groups. Our review highlights several studies that evaluate differential effects by age. Researchers should also build on the notable research studying effects by race and ethnicity to investigate why legalization may exert differential effects on cannabis and other substance use for different populations. Cannabis legalization is promoted as a tool to advance social equity, yet legalization has the potential to create or exacerbate socioeconomic and health inequities. Having a criminal record has implications both for health and for economic well-being. Although declines in adult arrests follow cannabis legalization, racial disparities in arrest rates persist, and more research is needed on how the financial and remaining criminal penalties for cannabis violations are distributed across demographic groups. Whether health and other harms associated with cannabis-related criminal justice contact continue to be concentrated among racial and ethnic minorities after legalization deserves careful study.

Beyond criminal justice contact, the design of cannabis markets has health equity implications. Low-income and racial/ethnic minority communities, as well as youth, are especially vulnerable to the commercialization of cannabis. For instance there is some evidence that cannabis dispensaries are concentrating in minority communities. Researchers should prioritize an examination of the differential impact of attributes of legalized markets—including taxation mechanisms, location of cannabis outlets, marketing strategies, product design, and potency—
by social class, race, ethnicity, and age. Further, recent controversies over the effectiveness of social equity provisions embedded within cannabis policy reform call for researchers to evaluate whether these initiatives are achieving their intended effects or producing new inequities.

Even if researchers fill these gaps in the literature, data and methodological challenges limit our ability to draw conclusions about other impacts of legalization. For instance, research could be strengthened by adoption of a clear, consistent, and expansive definition of cannabis “use” across data sources. As Beau Kilmer and Rosalie Pacula highlight, research must move beyond measures of prevalence to include measures of use intensity, such as days used, total grams consumed, and potency per dose. Although researchers should work to develop standardized definitions for and methods to collect dosage information that is comparable across products, it is important to acknowledge that these measurement improvements may add significant costs to study designs and must be weighed against feasibility.

Another important area for methodological and data improvements is in understanding how cannabis legalization relates to driving safety. There exist challenges to reliably measuring THC impairment in drivers (for example, in blood), and uncertainty remains over what level of THC in the blood leads to impairment. In addition, future research should clarify how alcohol and cannabis co-use affects driving impairment. Improved data sources that include information on crashes and fatalities by substance type are essential to fully assessing the impact of legalization on driving safety.

Policy Implications

As policy makers design or revise legal markets, it is important to note that research on early recreational legalization adopters may not be generalizable to all states and localities. The states subject to the most research so far (Colorado, Oregon, and Washington) all had expansive medical programs established before recreational legalization and mostly adopted commercial approaches toward the recreational market. It is unclear whether states with less commercialized medical programs or that adopt different supply chain architectures for recreational supply will experience similar effects on use and public health outcomes.

Nevertheless, there are opportunities for policy makers to incorporate a public health perspective in the design of legal cannabis markets. These include suggestions based on lessons learned from tobacco and alcohol policy and recommendations that focus on youth cannabis use. Other important policy goals may include minimizing drugged driving, unwanted contaminants, and co-substance use. Policy makers may also consider adopting alternative legalization models beyond commercial markets and should thoughtfully incorporate social equity considerations into legalization design and oversight through provisions that address socioeconomic and health disparities. Finally, policy makers should work with researchers to evaluate the impacts of their own legalization schemes as they unfold.

(Editor's Note: This article was conceived and drafted when Haffajee was employed at the RAND Corporation, and the findings and views in this article do not necessarily reflect the official views or policy of her current employer, the US Department of Health and Human Services, nor the US government.)

What marijuana research in humans tells us so far about the drug’s benefits and drawbacks.

It’s mid-October, and Staci Gruber is preparing to testify before Congress. It’s not the first time she’s brought her expertise before policymakers; she’s studied marijuana in brains young and old for the better part of three decades.

Besides being on the psychiatry faculty at Harvard University, Gruber is the director of Marijuana Investigations for Neuroscientific Discovery (MIND) and the director of the Cognitive and Clinical Neuroimaging Core at McLean Hospital outside of Boston. Her research focuses on clinical studies in marijuana users, often employing functional MRI (fMRI) technology to see exactly what parts of the brain the drug affects.

“The important part is to try to leave the emotional rhetoric aside,” she says, ahead of her testimony before lawmakers. “What matters is what the data and the science tell us.”

And the research landscape, so far, is about as complicated as the drug itself. Some studies show that marijuana may provide relief for patients with a slew of conditions, such as anxiety, chronic pain and even cancer. Yet others find that the drug can slow cognitive function and may worsen some mental health conditions.

We also still don’t have a clear picture of how marijuana works in different people, Gruber says. Just five years ago, when she started MIND, Gruber spotted a research gap — virtually no clinical studies were conducted on the effects of medical marijuana on the brain. “I could find nothing in the literature,” she says. 

Data on how marijuana works in people over time are sparse. U.S. research on cannabis remains bottlenecked because of limitations on studying the Cannabis sativa plant, some parts of which remain a Schedule I drug. Even though medical marijuana containing the psychoactive compound THC is legal now in 33 states and the District of Columbia, the Drug Enforcement Administration still defines it as a substance with “no currently accepted medical use” and a “high potential for abuse.” Policymakers, eager to better understand how to regulate the drug, occasionally hold sessions with scientists, including Gruber. But with scarce clinical results, she and her American peers find it hard to draw broad conclusions. In countries like Israel and Canada, where barriers to studying cannabis are lower, piecing together the puzzle of who marijuana affects, and how, is only slightly easier.

Complicated Cognition

How does weed affect cognition? That might depend on how and when people use it. Some teenagers who use marijuana recreationally appear to have slower brain function and lower IQs. On the other hand, people with medical conditions who stay slightly baked to manage their symptoms may actually see an increase in brain function. 

In a 2011 report on recreational users, Gruber and her team recruited 34 chronic marijuana smokers and divided them into two groups according to when they started using. They were then given a number of cognitive tests. The team found that those in the study who started using marijuana before age 16 had the worst test performances — and smoked twice as often as other users.

But a 2018 clinical study on medical marijuana users showed very different effects on the brain. The study looked at patients with a variety of conditions, including pain, anxiety, sleep disorders and gastrointestinal problems, before and after taking marijuana via their preferred method of use — smoking, eating or topically applying. Three months after patients started treatment, varying from one or two doses a week to multiple doses per day, the researchers observed that their brains had more activity in the prefrontal cortex, the area associated with cognition, decision-making and executive function. They also saw an increase in task performance among the users, signifying a boost in cognitive function. 

In addition, the treatment quelled their symptoms — most medical marijuana users in the study saw an increase in quality of life and alleviation of their ailments. The results weren’t a huge shock for Gruber. 

“Recreational consumers and medical users just aren’t the same,” she says. “The goal of use is totally different.”

That could explain why some recreational users seek out super-loaded quantities of tetrahydrocannabinol (THC) in the strains they smoke. THC is what makes users high; its sister component, cannabidiol (CBD), does not. From 1995 to 2014, THC content in recreational marijuana increased from 4 to 12 percent, while the CBD content in modern-day weed is barely 0.15 percent.

CBD, on the other hand, is growing in popularity as a medicinal treatment for inflammation, pain and anxiety. But the jury’s still out on how well the compound works as a remedy. In 2018, Gruber’s team began the first clinical trial on CBD in patients with anxiety, with results expected as early as this year.

Mind Under Matter

Our understanding of marijuana’s effect on mental health is murky. Some studies suggest it might exacerbate conditions like schizophrenia or psychosis, but the results aren’t always black and white.   

In a 2017 clinical trial of 88 patients with schizophrenia, researchers in the U.K. administered 1,000 milligrams of CBD each day to about half of the study participants. They took the supplement along with their typical regimen of antipsychotic medications. At the end of six weeks of treatment, the people who received CBD reported greater alleviation of symptoms than those who only stuck to their normal medications. 

But another study from just this year found that weed might actually correlate with an onset of psychosis. Researchers in the U.K. surveyed more than 900 patients who had been diagnosed with their first psychotic episode, and over 1,200 participants who had not been diagnosed with psychosis. They asked about lifetime cannabis use and found that daily marijuana users had the highest risk of developing the condition.

That risk may be linked to the concentration of THC in a particular cannabis product, however. In the same study, researchers split weed users into two groups: those who typically smoked marijuana with a THC concentration of less than 10 percent, and those who used high-potency pot with a concentration of 10 percent or higher. They found that high-potency users had a fivefold increased chance of developing psychosis. Taken together, these findings help show that our brains have very different reactions to CBD and THC — which might be why medicinal users often experience such different results from recreational users.

Grandpa’s Weed

Marijuana use is skyrocketing among the elderly — reports have suggested it has increased as much as tenfold among seniors over the past decade. And the drug might be an effective measure to treating chronic pain and chemotherapy side effects like nausea, which could explain the climbing usage rates.  

A small clinical study published in the German journal Der Schmerz indicated that an oral medication form of synthetic marijuana, known as dronabinol, helped relieve pain in patients older than 80. According to the results, released in October, more than half of patients experienced some level of pain relief after a year of taking the medication. 

And a much larger study found positive results among a slightly younger crowd. In Israel, a team of researchers administered a questionnaire about quality of life before and after patients at a specific clinic started using cannabis. The results compiled data from over 2,700 patients older than 65, most of whom had chronic pain or cancer symptoms. More than 90 percent of patients noted an improvement in their condition after six months of using the drug.

In another study, the same researchers also analyzed data from cancer patients who routinely used medical marijuana to manage their symptoms. Drawing results from just over 1,200 patients, they found that over 95 percent reported an improvement in their symptoms, which ranged from sleep problems and lack of appetite to weakness, nausea and pain. 

The German and Israeli studies concluded that the drug was safe and effective in older populations seeking relief from pain or cancer-related symptoms. Marijuana might be a positive alternative for older folks looking for relief — although not every medical condition responds as drastically to treatment as others.

A Mixed Bag for MS

While a handful of studies have found marijuana to be a potential treatment for the pain and spasticity that come with multiple sclerosis (MS), not all clinical research shows a benefit.

The largest randomized clinical study on MS and marijuana to date, according to the National Multiple Sclerosis Society, found that different oral THC medications helped patients manage symptoms like spasticity and sleep struggles, while there was no improvement in tremor or bladder symptoms. And another clinical study done in the U.K. in 2013 showed that oral THC, while not unsafe, didn’t slow the progression of the disease. 

But a 2012 study did find that short-term marijuana use may help with those physical symptoms. Researchers at the Center for Medicinal Cannabis Research at the University of California, San Diego, studied the effects of inhaled cannabis on pain levels and spasticity control. Thirty participants smoked marijuana once a day for three days, and noted that their spasticity and pain levels decreased more than for those who took a placebo. 

Preliminary results from a 2019 study show the picture is different when it comes to the mental effects of marijuana on MS patients. Researchers in Canada followed study participants, who had been smoking at least four times a week for many years, as they abstained from marijuana for 28 days. The research team took fMRI scans as they were weaned off the drug, and noted that they showed an increase in cognitive function. Certain areas of the brain that were normally inactive in the participants started to reawaken, and their performances improved in cognition tests.

Smoke in the Wind

The bottom line is this: Research on marijuana remains inconclusive. Results differ from person to person, depending on why and how they use the drug.

To date, only a few medications — dronabinol, nabilone and cannabidiol — have received FDA approval. But they’re intended for use by a select group of patients: those with rare forms of epilepsy, those who have side effects from chemotherapy or those with severe weight loss caused by AIDS. Dronabinol and nabilone, which are both oral synthetic forms of cannabis, are defined as Schedule II and III drugs. That means the DEA sees a moderate to high potential for dependence or abuse, although certain patients are still allowed to use the drug for its medicinal benefits. In 2018, a CBD-derived oral medication called Epidiolex was approved as a Schedule V, meaning it is regulated as a drug with the least potential for abuse. 

But with recreational marijuana use on the rise, researchers like Gruber are pushing for more concrete evidence on the drug’s effects. She’s certain that it’s far from vanishing from the public eye. 

The many benefits of steroids have created a culture of abuse in sports like weightlifting, bodybuilding and cycling. Yet you can improve your health without using these dangerous drugs. Learn healthy ways to quickly recover, build muscle and get stronger to safely enhance your performance in any sport.

Doing resistance exercises like weightlifting can give you many of the positive effects of steroids without the long term risks. And exercise can increase the natural steroid content of your muscles, according to a January 2015 review in the Journal of Steroid Biochemistry and Molecular Biology.

Types of Steroids

Your body makes natural steroids from the sterols present in the food you eat each day. Scientists can also make synthetic steroids in a laboratory.

Athletes most often abuse anabolic (testosterone-based) steroids, but corticosteroid (cortisol-based) drugs like prednisone have become increasingly common in sports too. This dramatic increase has brought corticosteroids under greater scrutiny. An athlete should thus avoid these steroids as well, unless there's an imperative medical reason to use them, advises an October 2012 report in the Scandinavian Journal of Medicine and Science in Sports.

There are also two distinct categories of anabolic steroids, according to a February 2019 fact sheet from StatPearls. The 17 alpha alkyl derivatives like oxandrolone make up one group. The 17 beta ester derivatives like nandrolone phenpropionate make up the other. The latter drug was one of the first steroid substances used for its benefits, and the International Olympic Committee banned it in 1974. It's important to note that the U.S. Drug Enforcement Agency deems all anabolic steroids are controlled substances, with a harsh penalty for manufacture, possession or use.

Build Muscle Mass

The many side effects of anabolic steroids make it unethical to give them to healthy adults. However, scientists can test their impact by studying the archival data of admitted users. The authors of a September 2014 report in PLoS One used this method to measure the benefits of steroids on muscle mass. The researchers compared the data of 10 steroid users to seven control subjects. Results indicated several positive effects of steroids, including greater muscle mass and larger fiber area. The authors believe that these changes would likely enhance the performance of the users.

Yet you can get similar results without taking anabolic steroids. The September 2014 report in PLoS One tested middle-aged, male subjects who were active and fit. A February 2013 paper in the Annals of Endocrinology showed similar results in similar subjects. These researchers found that eight weeks of moderate weight training resulted in increases in muscle strength and size in eight healthy, middle-aged men. That training also increased the subjects' circulating levels of the natural steroid testosterone.

Increase Exercise Capacity

Anabolic steroids have several legitimate medical uses, and some of those uses would offer a competitive advantage to an athlete. For example, the authors of an April 2014 report in Nutrition in Clinical Practice tested 32 people with chronic obstructive pulmonary disease, or COPD. Such patients are often not in good shape fitness-wise because of their decreased lung capacity. Compared to baseline, six weeks of anabolic steroid use increased the exercise capacity and life quality of these patients.

However, you can get nearly identical results with water-based training. A June 2013 article in the European Respiratory Journal discussed the evaluation of 53 COPD patients. These researchers had the subjects do water-based aerobics and weightlifting for eight weeks. This treatment increased exercise capacity and life quality, compared both to the baseline and a control group. Interestingly, water-based training also outperformed land-based training. Water-based exercise also tends to cause less injury because the water's buoyancy both increases resistance and offers more limb support.

Gone are the days when women used to maintain one or two handbags and carry it everywhere. Things have changed and various fashion trends have emerged. Handbag is not just a bag anymore; it is much more than that. An appropriate bag can make you look elegant and add to your overall personality. Designers have come up with different types of bags for multiple uses and occasions. One should pick up a bag which suits their personality best and which is apt for that particular instance. At some point in time, you may have seen someone with a fashionable handbag and loved it or perhaps you got a complement for yours. This tells you that handbag is definitely something which gets noticed by everyone. It is time we get into details about different types of bags every woman should have in her wardrobe. Let's have some fun knowing about the stylish and trendy bags.

Hand Bag:
Handbag is a medium to large bag which can hold all the items like wallet, comb, cosmetics, jewelry, mobile, pen etc. It is the finest option to carry anywhere when in doubt. Previously handbags were used for practical purposes but now they are quite good to fit into fashion.

Tote Bag:
Tote bag is a large bag which is often used by college going girls and working women. It is quite comfy to carry it as it has parallel handles from it sides. Not only that, but it has ample space for all your things.

Cross Shoulder Bag:
Cross Shoulder is the most chic and hip bag which every woman would love to have. When you don't want to hold anything in your hand but have things you are supposed to carry, cross shoulder bag acts as a savior.

Sling Bag:
A slim looking bag with a single strap which you can wear over your shoulder is a sling bag. If you have to walk around or drive a bike, you can carry it on your shoulder securely. Sling bags are also used for protecting cameras, tablets, iPod etc.

Sports Bag:
Call it a sports bag or gym bag; it is very important for all fitness freaks. It is one bag where you can put all your necessary items when you go to gym or play a game.

Backpacks:
If you are going for a long weekend trip, hiking, long distance trips etc. you may have to carry some heavy luggage or even basic items like water, food, clothes etc. Backpack is a proper fit for all of it. There used to be unisex backpacks before but now exclusive women backpacks have come up.

Shopping Bag:
Women love shopping, be it a hairpin or a necklace. It is something we do often, don't we? When you go for shopping, it is ideal to carry a shopping bag to fill in all the things you shop. Various Shopping bags are now available with lovely themes which can make you look chic and fashionable.

Beach Bag:
Beach bag is a bag which we can carry for any beach outing. It is supposed to be sturdy and durable so that you can dump your swimwear, flip-flops, hat, books, magazines etc. These bags are perfect to carry around in a beach.

Wallet:
Every woman needs a wallet to carry cash, credit cards, business cards etc. It is also quite handy when you have to go to nearby places and grab something quickly. You can either have a heavy or slim wallet based on your requirements. There are many trendy and designer wallets available in the market.

Clutch:
A clutch is a classy purse with no straps and can be carried in the hand. Though it cannot carry many items, you can have your basic things like credit card, driver's license, visiting cards etc. comfortably. There are many shapes and varieties of clutches in the market and it is quite difficult to choose one from the so many wonderful options.

Potli:
Potli bags are quite famous in India and go a long way back. It is made up of satin, velvet or silk cloth and is fixed with a drawstring which is used for opening and closing the bag. Potli is used mainly in Indian functions and weddings as it goes very well with ethnic wear. These bags are decorated with jewels, stones, gems etc. and strike the perfect style.

Män tror inte att skadan av Viagra kan vara mycket mer betydande än dess korta varaktighet. I vår tid är problem med potensen ganska vanliga bland det starkare könet. Det finns många anledningar till detta fenomen: dålig ekologi, konstant stress, inaktiv livsstil, dåliga vanor.

Mirakulösa blå piller kommer till undsättning och gör en man till en alfahane. Utan tvekan är Viagra det mest populära botemedlet bland läkemedel som ökar styrkan. Men är läkemedlet säkert för män? Nåväl, låt oss ta reda på vad Viagra ger - nytta eller skada?

Viagra - allmän information om läkemedlet

Läkemedlet avser läkemedel som ökar styrkan. Efter absorptionen av tabletten i kroppen expanderar blodkärlen i den manliga penisen. I sin tur leder processen till ökat blodflöde och uppkomsten av en erektion.

Effekten av läkemedlet är begränsad till perioden för samlag. Så fort det kommer försvinner den terapeutiska effekten omedelbart.

Genom att jämföra detta läkemedel med andra kan du lyfta fram några av fördelarna med Viagra. Läkemedlet återställer en erektion endast under den nödvändiga tiden. Till exempel har injektioner i penis en långtidseffekt och kräver hjälp av medicinsk personal.

Viagra kan endast tas enligt bipacksedeln. Okontrollerad användning av läkemedlet kan orsaka erektil dysfunktion. Män som tar läkemedlet bör också komma ihåg att det förbättrar styrkan, men bekämpar inte orsakerna till dess frånvaro.

Viagra ska inte användas när patienten genomgår behandling med erektil dysfunktion medan han tar mediciner med nitrater.

Om det uppstår problem med potensen på grund av en minskning av testosteronnivåerna ska du inte ta Viagra, eftersom det inte hjälper på något sätt ändå. Det manliga hormonet är normalt fram till 25 års ålder, och sedan minskar dess koncentration gradvis.

Därför, i de flesta fall, för män, är problemet med potens efter 40 år mycket bekant.

Kontraindikationer och potentiell skada

Varje läkemedel har ibland en negativ effekt på människokroppen. Viagra är inget undantag.

För att inte skada sin egen kropp måste en man i vissa fall vägra att ta drogen.

Sådana fall är:

• patologier i det kardiovaskulära systemet;

• sjukdomar i det hematopoetiska systemet;

• inre blödning;

• kroniska leversjukdomar;

• instabilt blodtryck;

• anatomiska deformiteter av penis;

• ålder under 18 år.

Vissa läkemedel kan antingen öka eller minska effekten av Viagra. Ketokonazol, Cimetidin och Erytromycin orsakar en ökning av dess verkan, och Rifampicin orsakar en försämring.

En man måste vara medveten om de möjliga skadliga effekterna av läkemedlet, vilket utlöser negativa processer:

• utveckling av en urinvägsinfektion;

• hudutslag som en manifestation av allergier;

• dyspeptisk störning;

• huvudvärk och yrsel utvecklas;

• en ström av blod till ansiktet, försämrad syn ett tag;

• nästäppa uppstår.

Fall har registrerats när en erektion varade i cirka fyra timmar hos dem som tog Viagra. Ibland ledde detta till skada på penis, vilket krävde omedelbar läkarvård.

Ingen skada observerades av drogen när den togs då och då. Biverkningar uppstår när en man ofta dricker piller som ökar styrkan.

Med tiden påverkar läkemedlet sammansättningen av spermier negativt, vilket kan bli ett hinder för ett par som vill skaffa barn.

Fördelar och skador med Viagra

Läkemedlet har både positiva och negativa sidor. Därför kommer ett kategoriskt svar på frågan om Viagra är skadligt, i det här fallet, inte att fungera.

Ibland gynnar läkemedlet en mans hälsa. Detta manifesteras genom att stimulera blodkärlen som finns i könsorganet.

Läkemedlet är mycket lättare att ta och mindre skadligt än andra droger. Detta beror på verkan av piller endast under sexuell upphetsning.

Läkemedlet har sådana positiva effekter:

1. Ganska snabbt återställer styrkan.

2. Förbättrar erektion med en psykologisk barriär.

För att inte skada sin hälsa måste en man besöka en specialist som kommer att ta reda på orsakerna till försämringen av styrkan och ordinera nödvändiga doser av Viagra.

Nyligen är erektil dysfunktion inte förknippad med fysiologiska faktorer, utan med mentala. Med rätt tillvägagångssätt och behandling av detta problem kan du sluta använda piller.

Moderna läkare jämför Viagra med alkohol: om vi dricker det i små mängder påverkar det inte vår hälsa nämnvärt. Men okontrollerad användning av drogen kan spela ett grymt skämt på mäns hälsa.

Viagra-analoger som ökar styrkan

Om det finns behov av Viagra, men hälsotillståndet inte tillåter att det tas, är det okej.

Idag finns det många andra sätt att förbättra erektionen. Till exempel, på  www.manligapotek.com/generisk-levitra.html  kan du köpa Generisk Levitra.

De mest kända är:

1. Afrodisiaka är naturliga ämnen som inte bara ökar manlig styrka, utan också hjälper kroppen att fylla på sina näringsreserver. Detta verktyg har länge använts av våra förfäder före tillkomsten av moderna läkemedel. Även om effekten av afrodisiaka är mycket värre än Viagras, har de absolut inga kontraindikationer och biverkningar. Dessa inkluderar livsmedel som honung, mörk choklad, kokos, vitlök, dadlar, vilda svampar, olivolja, kaffe och mer. Afrodisiaka måste tas dagligen, inklusive flera av dessa livsmedel i kosten.

2. Manlig aktivitetsstimulator - ett verktyg som du kan göra själv. För att göra detta, ta en medelmogen vattenmelon och citron. 1 liter juice pressas ur vattenmelonmassan, filtreras genom ostduk i en kastrull och kokas upp. Så snart vätskan kokar, pressa en halv citron i den och låt den stå i brand tills 200 milliliter finns kvar i behållaren. Ta bort det vita skummet med en hålslev. Efter beredning kyls produkten och hälls i en glasburk. Det tas efter måltid en timme före samlag eller tre gånger i veckan i förebyggande syfte. Det är mycket viktigt att dricka läkemedlet efter en måltid, eftersom citronsaft negativt påverkar slemhinnan i mag-tarmkanalen.

Sådana medel kommer att vara ett bra alternativ när det inte är tillåtet att använda Viagra. Dessutom bör du inte oroa dig för den negativa påverkan på kroppen.

Call recording is a common component of running a successful business. For decades, organisations have implemented recording functionality into their contact centre technology to drive better outcomes for both customers and their brand.

But what exactly is call recording for companies, and why is it so valuable? Can every organisation benefit from a phone recording system? How cautious should companies be about things like GDPR and compliance? What are the merits of a voice recording system in the first place?

Today, we’re going to answer all those questions.

What is Call Recording?

Call recording is the process of collecting audio (and sometimes screen activity) connected with phone calls. A company which records phone calls can collect conversations and use the insights found within to drive better customer experiences and intelligent business decisions.

Call recording solutions are often bundled with cloud-based contact centres, AI-powered analytics, and even agent coaching systems. They can be a vital part of quality management, helping supervisors to understand whether agents are correctly following call flows and cross-selling products.

A company recording phone calls can assess the impact of new promotions and strategies on customer sentiment, as well as identify experience trends and show you which agents need extra support. According to call recording law, UK companies in certain industries are required to collect specific pieces of information for compliance purposes. Knowing how to record a call effectively ensures companies can comply with laws regarding customer consent and notification. Recorded data is also effective when disputes arise about things like customer service standards.

Evolution of Call Recording – a Century in the Making

Data capture solutions and accompanying customer service call recording laws have been around for more than a century. Recordings started with a wax disk device created in 1903, and the first tape recorder appeared in the 1930s. Since then, numerous pieces of technology have emerged to simplify and improve the recording process.

Call Recording has Become Digital

Best-in-class call recording systems today are entirely digital. They integrate with the existing contact centre and business telephony platform, leveraging the cloud for storage. A phone recording system for small business users today may even come with additional features. Some solutions are equipped with technology to capture screen and video information, as well as audio. Others have advanced technology baked into the software to support compliance with PCI and GDPR.

The Cloud – More Features, Less Hardware

Hosted call management and recording solutions based on the cloud allow for a more flexible communication stack for modern companies. There aren’t any on-site equipment costs to worry about, and because the solution is fully hosted there is also no limit to the number of recordings that you can conduct simultaneously.

Cloud and hosted call recording solutions are becoming increasingly popular in the age of the agile business. With this technology, you can support your call centre agents working from anywhere. On top of that, the simplicity of the cloud empowers same-day deployments and easy onboarding for new team members. Because the out-of-the-box dashboards and single pane of glass interfaces are so intuitive and easy to use, anyone can get started instantly.

Cloud call recording systems also come with the option to access native integrations to both existing and future technology. You can combine your call recording with agent coaching and CRM systems, or enable AI-powered opportunities in the future.

Can a Business Record Calls Legally?

A call recording system isn’t a new concept in the modern marketplace. However, as customers continue to demand more privacy and protection for their sensitive data, many are often left wondering how legal call recording really is. Importantly, a phone recording system for small business use isn’t the same as a person recording calls themselves.

Some Companies are Legally Required to Record Calls

Companies in many industries are often required to record calls for data protection and compliance purposes, and to ensure that they can protect themselves against disputes in court. However, imposed regulations such as GDPR do mean that organisations also need to make sure that their customers are aware of the recording, and that they permit it to happen.

Ask Permission to Responsibly Record Customer Phone Calls

Successful call recording processes in any business require the permission of the customer, as well as a careful commitment to storing and managing data safely. Customers should be able to request a copy of any recorded call that a business has featuring their data. Organisations also need to be sure that they can access the recordings they collect and release it as evidence for legal reasons.

Since different industries and parts of the world have their own unique rules and regulations around call recording, it’s best to work with an expert when setting up your system. This way, you can ensure that you have the right tools in place to protect your brand and your customers.

Why is it Important to Record Calls?

A phone line recording system requires careful planning and implementation from the business in question. It’s important to ensure that you know what customer service recording laws look like for your industry before you begin implementing any solution.

So, if the initial set-up is so complicated, why do companies record phone calls in the first place?

First, some industries are required to record conversations to remain compliant with the guidelines for their sector. However, even if you don’t have to record conversations, it’s often beneficial to do so.

Six Business Benefits of Call Recording

With call recording, you can:

1. Identify problem areas

Call recording allows you to determine which problem areas in your processes and conversations are negatively impacting the business. For example, you can pinpoint communication issues that lead to a drop in customer sentiment. It’s also possible to see where roadblocks might be preventing you from delivering quick solutions to your customers. Call recording is the initial investigation process before you improve customer service.

2. Keep valuable records

Leading call recording solutions will integrate with your CRM and other information systems. This is helpful for companies collecting customer information to deliver more personalised and relevant experiences, enabling you to automatically store call information in the appropriate customer file. Some tools even allow you to remove or anonymise personal details from calls if you’re concerned about GDPR.

3. Overcome potential disputes

Even the best companies can end up handling complaints. If a customer says that you’ve done something inappropriate, or that you offered them something, you can go back and listen to the recording. This is a helpful way to protect yourself against problems that could potentially lead to a legal dispute.

4. Quality assurance

Quality monitoring is one of the most common reasons to use call recording solutions. Recorded calls allow you to determine the general satisfaction levels of your customers. You can even use artificial intelligence tools to determine sentiment both historically and in real time. Call recording systems can send alerts to engineers when call quality begins to suffer and give you the information you need to make intelligent decisions in the future.

5. Continuous improvement

Recording calls is an effective way to determine exactly which parts of your customer service strategy are having the best impact on your customers. You can essentially check the health of your CX strategy, and even determine which of your employees need the most support and training to get them on par with your top performers. When the time comes to train employees, call recordings with redacted personal details offer an excellent learning opportunity.

6. Improved decision making

With call recording you get an accurate look at your customer’s journey, preferences, and the steps they go through to make a purchase. With AI tools to help you sort through trends in thousands or millions of calls, it’s easy to leverage insights. You may be able to quickly determine which strategies will help you to delight your customers and improve your brand reputation.

Look at your hands! If one is on the mouse and the other on the keyboard, you have all the prerequisites for speeding up your work. Today I will share with you my experience of using mouse and keyboard together in everyday tasks.

For brevity, I will use the following abbreviations:

• RMB  - right click

• LMB  - left mouse button click

• 2xLMB  - double click left mouse button

Programs Pinned to the Taskbar

Pinning shortcuts to the taskbar not only  speeds up your work with jump lists , but also provides more options for launching programs. Also at https://cpscounter.org/right-click-cps-test.html you can test the right click speed of the mouse.

1. Calling the context menu of the executable file:  Shift + RMB

Sometimes you need to open the classic file context menu instead of the jump list. I use this combination to change the command line options in the shortcut properties or run the program as a different user.

2. Launching a new instance of the program:  Shift + LMB

This combination can be used to open another browser or command prompt window. Unfortunately, not all developers fully implement support for the new Windows taskbar, so the combination does not work in some programs.

Reader  YaNkEE  suggests that it is enough to press the middle mouse button (wheel).

3. Opening a file in the program:  Shift + dragging to a shortcut

A simple drag and drop pins the file to the jump list, so the keyboard comes in handy here.

I often use this technique on other people's computers while working in portable Notepad++. In principle, you can do without pressing a key, but then you need to throw the file into the window, and not onto the shortcut.

4. Run the program as an administrator:  Ctrl +  Shift + LMB

I most often use this combination to call Total Commander and the command line with full rights. By the way, it also works in the Start menu, including search results. Also at https://cpscounter.org/ you can find out how fast you can click your gaming mouse.

Window management

The Windows shell has many prerequisites for managing windows with a mouse and keyboard tandem. Let's continue with the taskbar theme!

5. Switching to the last opened window:  Ctrl + LMB

I have  thumbnails disabled on the taskbar  when switching between windows with the mouse. Therefore, the combination has the opposite effect, i.e. displays window thumbnails. However, I use it on other people's computers to save time.

6. Calling the menu with options for displaying windows:  Shift + RMB

Usually, I use this combination to place two windows side by side, or to minimize multiple windows of the same application.

7. Selecting one of the open windows:  Alt ++  Tab scroll wheel

[Does not work on Windows 10] Each movement of the wheel is equivalent to pressing the key  Tab. Obviously, scrolling allows you to get to the desired window faster than successive keystrokes.

8. Switch to a specific window:  Alt +  Tab + LMB

I have many windows open, and in this case it is easier and faster to click on the desired thumbnail than to switch between them.

I really love these two features of Windows 7!

Curiously, this utility allows you to return to the past - to the window view  Alt +  Tab times of Windows 2000/XP. However, there is no point in this, since the charms described above do not work in it. By the way,  do you know how to call an old window in Windows 7 and 8 without third-party programs?

Working with files and folders

File Explorer encourages the use of a mouse, but some actions are faster with two hands.

9. Opening a folder in a new window:  Ctrl + 2xLMB

Agree that this is faster than calling the context menu and searching for the treasured item in it.

10. Opening the properties of a file or folder:  Alt + 2xLMB

As in the previous case, the acceleration is achieved by bypassing the context menu. By the way, if the folder is already selected, you can just press  Alt +  Enter.

These two combinations work in the main Explorer window, but not in the Navigation Pane.

11. Change the scale or view of the folder:  Ctrl + scroll wheel

This feature can be used not only in browsers or word processors and editors to see something better. I also use it very often in File Explorer to change the look of a folder.

For example, I find scrolling very useful in image folders when I need to maximize thumbnail size. This is useful both when viewing photos and screenshots, and in the "Open" dialog box when uploading to a website or attaching to a letter.

By the way, try this combination on your desktop.

12/13. Selection of elements:  Shift + LMB and  Ctrl + LMB

These combinations respectively select a range of files or only selected files.

I am sure that these two combinations are well known to you, which does not negate their usefulness. After all, you can use them not only to manage folders and files, but also in other programs (for example, to select cells in Excel).

By the way,  do you know how to select several non-consecutive files or folders on a tablet without a mouse and keyboard?

14. Display hidden items of the context menu:  Shift + RMB

Including more items appear  in the "Send" menu . I very often use this combination to  open a command prompt in the desired folder , or copy the address of a file or folder as a path.

I did not set out to list all the possible options for sharing a mouse and keyboard, but only shared those that speed up my work in Windows. Do you use these or other combinations?  Think about what combinations speed up your work in the system or  programs  and  share your experience in the comments!

A set of manicure tools is a universal solution that will help you take care of your nails yourself at any time convenient for this. Often, it is a manicure set that is chosen as a gift to a loved one - such a present is both practical, useful and pleasant. How to choose a manicure set ? There are many sets of different companies on the market. They differ in price, number of items, appearance. Which manicure sets are better to buy ? Is there a difference between them and what is it?

CHOOSING A MANICURE SET FOR A GIFT AND FOR YOURSELF

How Do I Pick a Good Manicure Set ? Regardless of the purpose for which you are buying a kit - for your own use or for a gift, be sure to pay attention to the quality of each of the elements and their purpose. You should not purchase a set of a large number of items, because few people use all of them at home. Typically, a person uses only a few tools for nail and cuticle care . And in large sets there are only a few scrapers, and many elements generally have an unknown purpose for a layman.

So, one of the important criteria for choosing a manicure set is its practicality. Don't overpay for unnecessary tools. For home use, a set of 5 main components will be universal:

• cuticle scissors ;
• scissors for the nail plate;
• files ;
• tweezers;
• master.

In some kits, nippers may be used in place of skin or nail scissors . This kit is quite enough to create a high-quality manicure. Excess items will interfere, increasing the weight of the kit and creating confusion during the procedure.

There is another question that most women ask when choosing a manicure set - how to choose the best quality set? After all, even an expensive kit may turn out to be completely unsuitable for use - scissors will tear the skin, a file will cause delamination. The selection of tools should be done taking into account important parameters:

• type of material - steel will be the best solution;
• quality of sharpening - be sure to make sure it is correct.

How to choose the right manicure set ? Do not save - this rule should be strictly adhered to. Good kits from reputable brands cannot be cheap. The cost is influenced by the quality of the material and the professionalism of the sharpening masters. Such instruments retain their sharpness for a long time, do not damage nails and skin.

When answering the question " How to choose a manicure set for the home ", do not overlook the safety criterion. Premium instruments can be disinfected and sterilized, they do not create difficulties in processing and do not lose their functionality for a long time. Such items for manicure are easy to clean, can be processed under the influence of high temperatures or chemicals.

A manicure set should be comfortable. Choose kits packed in a practical case with a clasp. It will not only prevent contamination of objects, but also prevent them from getting lost. Sets in cases are convenient to take with you on a trip, they do not take up much space.

There is another category of manicure sets - professional tools. Such kits include a much larger number of items, have a larger case, and the weight of the kit is greater. If you choose a set for yourself, you are unlikely to need a very diverse arsenal. Giving such kits is also not practical. These are products for nail design professionals and manicurists.

How not to be mistaken when choosing a set of manicure tools? If you do not know exactly which offer in the store to give preference to - ask questions to the consultant. Market employees will clarify the purpose of the purchase and the specifics of nail care, so they will be able to give the most accurate and useful recommendations for the purchase.

Steroids play a critical role in your journey to leading a healthy life. This mainly applies to fitness enthusiasts and bodybuilders. On the other side, abusing steroids could end up causing havoc on your health. But before you start using steroids, it is prudent to do some due diligence so that you only use products that are beneficial to your health.  

Ideally, steroids are specially formulated to improve stamina and metabolism levels. There are several options to consider when it comes to purchasing legal steroids. For starters, it is prudent to get some professional opinion from your doctor concerning which steroid brand you can use and those that you should avoid. It is easy to buy steroids online today.

Price

Of course, you should know the cost of buying steroids before placing an order. When it comes to buy steroids online, always go for a product that gives you value for money. Ensure you compare prices from several online stores. But as you compare the prices, you also need to ensure that you do not compromise on quality.

Quantity and Quality

For starters, the chances are that you are not ready to use large amounts of steroids. Therefore, it is advisable to order a small amount when buying steroids for the first time. And if you are happy with the quality of the product, you can always request more. Ideally, starting with a small quantity allows you to evaluate the quality of the steroid without committing too much money.

Safety

You need to take precautions when planning to buy steroids. This means you need to understand how the steroid works, the features, and possible side effects. Some steroids cause cell replication effects. Factors such as age and sex can also have an impact on the safety or effectiveness of the steroid. Furthermore, the overuse of steroids might have some adverse effects on your body. It is, therefore, crucial that you understand what you are getting into first before placing an order online.

Buying steroids from an online store is convenient in many ways. But looking at the number of online stores or websites selling steroids, you need to do your homework before you place an order. When you follow the tips shared above, then you will improve your chances of getting the right product.