Introduction

Anabolic Steroids are any drugs chemically related to testosterone, a male hormone that promotes muscle growth. There are more than 100 varieties of anabolic steroids but only a limited number have been approved for human use. Anabolic Steroids are Schedule III substances and require a prescription in order to be used medically in the United States.

Illicit steroid use is linked to athletic competitions and/or an athlete trying to gain a competitive edge. Some individuals may use steroids to alter their to increase their muscle mass.

How common is steroid abuse?

  • It has been estimated that 2.9 million to 4.0 million individuals in the United States, nearly all of whom are male, have used steroids at some time in their lives.
  • The same study estimated that about 1 million men in the United States have experienced steroid dependence.

What are the common types of steroids?

Oral preparations:

  • Anadrol (oxymetholone)
  • Oxandrin (oxandrolone)
  • Dianabol (methandrostenolone)
  • Winstrol (stanozolol)
  • Androstendion
  • Mibolerone
  • Methandienone
  • Mesterolone

Inject-able preparations: 

  • Deca-Durabolin (nandrolone decanoate)
  • Durabolin (nandrolone phenpropionate)
  • Depo-Testosterone (testosterone cypionate)
  • Equipoise (boldenone undecylenate)
  • Tetrahydrogestrinone (THG)
  • Methenolone enanthate
  • Trenbolone acetate

Why do people use steroids?

  • Anabolic steroids are used to increase muscle mass and athletic performance.
  • Anabloic steroids use is more common among youth, athletes, police and correctional staff members.
  • In short-term, they improve users’ self-esteem and mood too.
  • This substances are highly used among individuals with histrionic, narcissitic, antisocial and boderline personality disorders.

How are they abused? Cycling, stacking and pyramiding.

Cycling
Steroids are often abused in patterns called “cycling,” which involve taking multiple doses of steroids over a specific period of time, stopping for a period, and starting again.

 

Stacking 

Users also frequently combine several different types of steroids in a process known as “stacking.” Steroid abusers typically “stack” the drugs, meaning that they take two or more different anabolic steroids, mixing oral and/or injectable types, and sometimes even including compounds that are designed  for veterinary use. Abusers think that the different steroids interact to produce an effect on muscle size that is greater than the effects of each drug individually, a theory that has not been tested scientifically.

Pyramiding

Pyramiding is a process in which users slowly escalate steroid abuse (increasing the number of steroids or the dose and frequency of one or more steroids used at one time), reaching a peak amount at mid-cycle and gradually tapering the dose toward the end of the cycle. Often, steroid abusers pyramid their doses in cycles of 6 to 12 weeks. At the beginning of a cycle, the person starts with low doses of the drugs being stacked and then slowly increases the doses. In the second half of the cycle, the doses are slowly decreased to zero. This is sometimes followed by a second cycle in which the person continues to train but without drugs. Abusers believe that pyramiding allows the body time to adjust to the high doses, and the drug-free cycle allows the body’s hormonal system time to recuperate. As with stacking, the perceived benefits of pyramiding and cycling have not been substantiated scientifically.

What are the risks related to steroid abuse?

Short-term health effects: 

  • Acne
  • Fluid retention
  • Rapid weight gain
  • Increased blood pressure and cholesterol levels
  • Insomnia (inability to sleep)
  • Headaches
  • Reduced sexual functioning
  • Increase in muscle size
  • Swelling of feet and ankles
  • Impaired healing
  • Improved appetite
  • Reduced sperm count
  • Damage to the heart
  • Impotence
  • Difficulty or pain while urinating
  • Breast reduction in women
  • Excessive hair growth

 

Long-term health effects:

  • Liver disease or liver cancer
  • Development of breasts
  • Shrinking of the testicles
  • Enlarged clitoris in women
  • Abnormal menstrual cycles in women
  • Blood clotting difficulties
  • Development of cholesterol patterns associated with coronary heart disease, obstructed blood vessels, or stroke
  • Heart attacks
  • Clotting disorders
  • Cardiovascular, liver, and reproductive organ damage
  • Premature heart attacks and strokes
  • Reduced sexual functioning
  • Stunted growth in adolescents
  • Increased chance of injuring ligaments, tendons and muscles
  • When injecting: bacterial infections, abscesses, cellulitis, and HIV/AIDS
  • Increase in muscle size

 Psychological Effects

  • Increase aggressiveness or lead them to become more violent
  • Extreme mood swings can also occur.
  • Depression
  • Hypomania
  • Mania
  • Irritability
  • Recklessness
  • Paranoid jealousy, extreme irritability, delusions, and impaired judgment stemming from feelings of invincibility.
  • Delusions

Signs and symptoms of steroid abuse

  • Very low body fat, extreme muscularity, disproportionately large upper torso
  • Acne on face, shoulders, back
  • Pigmented striae on skin
  • Excessive facial or body hair
  • Superficial confidence; feelings of invincibility or grandiosity
  • Restlessness
  • Anxiety
  • Frustration or excessive argumentativeness to the point of rage
  • Obsession with weight training, conditioning, body image, appearance
  • Dissatisfaction with appearance despite what others perceive
  • Extremely baggy or loose clothing

Are steroids addictive?

An undetermined percentage of steroid abusers may become addicted to the drugs. Such individuals may present with:

  1. continued abuse despite physical problems and negative effects on social relations.
  2. spend large amounts of time and money obtaining the drugs
  3. experience withdrawal symptoms when they stop taking steroids, such as mood swings, fatigue, restlessness, loss of appetite, insomnia, reduced sex drive, and steroid cravings.
  4. Severe depression that sometimes leads to suicide attempts.

What treatments are effective for anabolic steroid abuse?

Clinical studies have found that supportive therapy is sufficient in some cases. Patients are educated about what they may experience during withdrawal and are evaluated for suicidal thoughts. If symptoms are severe or prolonged, medications or hospitalization may be needed. Some medications that have been used for treating steroid withdrawal restore the hormonal system after its disruption by steroid abuse. Other medications target specific withdrawal symptoms—for example, antidepressants to treat depression and analgesics for headaches and muscle and joint pains. Some patients require assistance beyond pharmacological treatment of withdrawal symptoms and are treated with behavioral therapies.

 

References

  • Kuhn, C., Swartzwelder, S., and Wilson, W. (1998). Buzzed: The Straight Facts About the Most Used and Abused Drugs from Alcohol to Ecstasy. New York: W.W. and Norton Company.
  • Kanayama, G., Cohane, B.A., Weiss, R.D., and Pope, H.G., Jr. Past anabolic-androgenic steroid use among men admitted for substance abuse treatment: An underrecognized problem? Journal of Clinical Psychiatry 64(2):156–160, 2003.
  • Grassley, C. The Abuse of Anabolic Steroids and Their Precursors by Adolescent and Amateur Athletes. Opening remarks to a hearing before the Senate Caucus on International Narcotics Control, July 13, 2004. drugcaucus.senate.gov/steroids04grassley.html
  • Volkow, N.D. Consequences of the Abuse of Anabolic Steroids—Before the Committee on Government Reform—United States House of Representatives: Statement for the Record, May 17, 2005. Bethesda, MD: National Institute on Drug Abuse. www.drugabuse.gov/testimony/3-17-05testimony.html
  • Johnston, L.D., O’Malley, P.M., Bachman, J.G., and Schulenberg, J.E. Monitoring the Future: National Results on Adolescent Drug Use—Overview of Key Findings, 2004. NIH Publication No. 05-5726. Bethesda, MD: National Institute on Drug Abuse, 2005, p. 4.
  • Brower, K.J. Anabolic steroid abuse and dependence. Current Psychiatry Report 4(5):377–387, 2002.
  • Pope, H.G., Jr., and Brower, K.J. Anabolic-androgenic steroids. In: Galanter, M., and Kleber, H.D., eds. The American Psychiatric Publishing Textbook of Substance Abuse Treatment, 3d ed. Arlington, VA: American Psychiatric Publishing, Inc.,2004, pp. 301–309.
  • Thiblin  I, Garmo  H, Garle  M,  et al.  Anabolic steroids and cardiovascular risk: a national population-based cohort study. Drug Alcohol Depend. 2015;152:87-92.
  • Pope  HG  Jr, Wood  RI, Rogol  A, Nyberg  F, Bowers  L, Bhasin  S.  Adverse health consequences of performance-enhancing drugs: an Endocrine Society Scientific Statement. Endocr Rev. 2014;35(3):341-375.
  • Leder BZ, et al. Oral androstenedione administration and serum testosterone concentrations in young men. JAMA 283(6):779–782, 2000.
  • The Medical Letter on Drugs and Therapeutics. Creatine and androstenedione—two “dietary supplements.” 40(1039):105–106. New Rochelle, NY: The Medical Letter, Inc., 1998.
  • Verroken M. Hormones and Sport. Ethical aspects and the prevalence of hormone abuse in sport. J Endocrinol 170(1):49–54, 2001.
  • Daly RC, et al. Neuroendocrine and behavioral effects of high-dose anabolic steroid administration in male normal volunteers. Psychoneuroendocrinology 28(3):317–331, 2003.
  • Berning JM, Adams KJ, Stamford BA. Anabolic steroid usage in athletics: facts, fiction, and public relations. J Strength Conditioning Res 18(4):908–917, 2004.
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