Anabolic Steroid Abuse And Addiction

Medically reviewed by

John Schaffer, LPCC

February 15, 2019

What Are Anabolic Steroids?

Anabolic steroids are synthetic drugs closely related to the male sex hormone testosterone. Anabolic steroids are widely recognized and abused in the realm of professional sports and bodybuilding. A subject of great controversy, scandal, and careers that rose, then fell even faster from steroid abuse.

Steroids extend far past the realm of professional sports, and many Americans abuse it in an attempt to increase their capabilities as an athlete or to change their physical appearance. The Center for Substance Abuse Research (CESAR) noted that over 100 types of anabolic steroids exist, but only a fraction have been made available for medical purposes.

Though used heavily as an illicit drug, steroids have a prescribed for the use in several medical applications, most notably to treat hormone imbalances in men, delayed-onset puberty, muscle deterioration attributed to various diseases, osteoporosis, and malnutrition, among others, as outlined by MedlinePlus and Medical News Today. It is important to note that this drug is different from another class of steroids, typically called corticosteroids, which are used in the medical field to treat various disorders, such as asthma, and various skin conditions.

Steroids are complex. In brief, anabolic steroids activate certain components of DNA within muscle cells, dictating the increased production of certain proteins. These protein are the building blocks of muscle tissues and fibers, which increase muscle growth and mass. The chemical components of steroids work towards increasing bone mineral and impact the function of the immune, reproductive, various organ, and central nervous systems.

Why Do People Abuse Anabolic Steroids?

Many people abuse steroids to build muscle, hone athletic potential, and increase the competitive edge. Though anabolic steroids are generally abused more with men, abuse with women is on the rise, particularly in young women. At the core of this illicit use, anabolic steroids, known as “roids” or “juice,” are used as a performance-enhancing drug. Steroids may also be used to alter a person’s outward appearance, most typically due to “distorted perceptions” regarding a person’s self-image; which is a behavioral disorder called muscle dysmorphia.

Muscle dysmorphia is the dissatisfaction with a person’s body size, in terms of being either obese or underweight; their measure of perceived strength, or lack thereof; or other inaccurate perceptions they have of themselves. Sadly, in these cases, a person may see themselves as quite the opposite of what is true, for instance, believing that they are overweight and shapeless when in reality, they are thin with good muscle tone.

The Endowment for Human Development (EHD) tells us that in other cases, an individual with a traumatic history of physical or sexual abuse may take these drugs in an attempt to boost their size, muscle mass, and strength, as a means to protect themselves. They also note that in high-school populations, individuals may choose to do these “as part of a pattern of high-risk behaviors.” Research indicates that most anabolic steroid abusers are “psychologically normal” when they begin using the drug.

How Are These Drugs Used Illicitly?

While prescription anabolic steroids are diverted and used illicitly, a predominant portion of these illicit versions actually stem from those that are smuggled in from outside of the U.S. or created in clandestine laboratories. When abused, anabolic steroids are most commonly injected one of two ways, either intravenously (directly into the bloodstream) or intramuscularly (into the muscle). Beyond this, a person may use steroids in pill or gel tab form, or topically as a cream. Regardless of the illicit method used, a person could be self-administering ten to 100 times the dose of what would be considered safe in a medical setting.

While steroids may be used in one large, singular dose, CESAR notes several different methods of steroid abuse which include:

• Stacking — Stacking occurs when an individual, in an attempt to compound the effect, abuses two or more forms of the drug by two different means of administration (i.e. orally and intravenously).
• Pyramiding — This method most often occurs in cycles revolving around six to 12 week periods. Initially, an abuser may begin by stacking the drugs in smaller doses, before gradually increasing the amounts of the drugs, plateauing, then slowing decreasing the dosage.
• Cycling — Intense doses are followed by a drug-free cycle before dosing is started again.

According to the EHD and NIDA, none of these methods have been backed by scientific research, nor do they decrease the risks of anabolic steroid abuse.

What Are The Implications Of Abuse?

Developed to mimic a very critical and impactful human hormone, anabolic steroids may vastly change a user’s physical appearance, creating what can be many adverse and unwanted effects. Despite the fact these drugs are based off male hormones, a male taking these drugs illicitly will not be exempt from the detrimental effects of the drug abuse.

In addition to physical and physiological changes, a person using steroids may experience unwanted and disruptive mental or emotional shifts. While the good news is that the majority of these ill effects are reversible when drug abuse ceases, some may be permanent or even deadly.

The following are ways that steroid abuse may cause changes or dangers with prolonged abuse:

Hormonal Impact — Both men and women may experience decreased sexual functioning. Men may witness impotence, a decreased sperm count, testicular shrinkage, enlargement of their breasts (gynecomastia), and male-pattern baldness. Some of the effects steroids have on men are irreversible.

Women may have changes in their menstrual cycle, and experience masculinization (developing male-like attributes). Steroids can cause women to develop a larger clitoris and/or smaller breasts, deeper voice, decreased body fat stores, coarse skin, large amounts of body hair, and loosening hair on the head. As with men, with prolonged steroid abuse, some of the side effects may be permanent.

Cardiovascular Concerns — There may be an increased risk of blood clots, blood pressure, and high cholesterol. Other cardiovascular concerns with steroids include an enlarged heart, stroke, and heart attack, even in athletes under 30.

Additional Organ Damage — May create liver tumors, disease, or cancer and kidney complications or failure.

Musculoskeletal Changes — Damage to muscles and connective tissues such as injury to tendons and ligaments. During adolescence, these drugs may cause a person’s bones to prematurely stop growing.

Mental Changes — May result in mood instability, including euphoria or bouts of aggression and violence. These are commonly referred to as “roid rage;” which is cognitive difficulty and confusion, delusions, paranoia, and impaired judgement.

Other Risks — May cause various skin conditions, including cysts and acne; fluid retention, swollen extremities, insomnia, and rapid weight gain. Injecting steroids may result in various transmissible diseases, including HIV and Hepatitis C.

Are Anabolic Steroids Addictive?

Though the exact number of addicted steroid users, is “undetermined,” addiction is supported by continued abuse despite physical problems and negative effects on social relations. In addition, an abuser’s tendency to spend an excess of money and time to procure the drug and continued use despite detriment or adverse physical effects, also speaks of addiction. Withdrawal symptoms may occur if a person suddenly stops using steroids; also supporting the drug’s potential for dependence and addiction.

Anabolic steroid addiction may be marked by:

• moods swings
• decreased appetite
• insomnia
• fatigue
• restlessness
• irritability
• decreased libido
• cravings

As NIDA writes, the most severe symptom of steroid addiction is depression, due to the fact these intense feelings may persist for a prolonged period of time after quitting the drug and increases the risk of suicide.

Fortunately, through research on the subject is ongoing, treatment is possible, and as NIDA writes, certain behavioral therapies have shown promise. In addition, certain antidepressant drugs may help within medication-assisted treatment to alleviate any accompanying depression, while other drugs may help to re-establish the hormonal equilibrium.

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