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Updated on September 27, 2021

Anabolic-Androgenic Steroids

What Are Anabolic-Androgenic Steroids?

Anabolic-androgenic steroids are synthetic hormones designed to mimic male sex hormones. Doctors prescribe them to help with certain conditions, such as anemia or low testosterone (low-T) levels. But they are also used illegally to enhance muscle growth. People in good health take steroids to promote muscle growth, decrease body fat, and enhance athletic performance.

Although it might seem as if the benefits of using steroids are positive, they are harmful and potentially fatal. Steroid addiction can affect the body long after they are no longer in use, especially when taken by adolescents.

Some common street names for steroids include:

  • Gear
  • Juice
  • Roids
  • Stackers

Uses of Steroids

Legally, steroids are prescribed by doctors to boost testosterone levels in the body for men who are out of balance. This might happen because of metabolic issues or due to certain illnesses. Anabolic steroids are also used to treat:

  • Anemia
  • Hereditary angioedema
  • HIV wasting syndrome
  • As an adjunct treatment for some types of breast cancer
  • For children with growth problems

But these are only the legal uses of steroids. People also use steroids without a doctor’s prescription to enhance performance and “improve” their bodies.

Steroids come in pill form or injection that goes directly into muscles. When used properly and under the supervision of a doctor, they are relatively safe. But people using steroids illegally have a higher risk of overusing them. Injecting steroids can also increase the risk of contracting or transmitting HIV or hepatitis.

Common patterns of steroid misuse include:

  • Stacking — People who abuse steroids take doses up to 100 times the regularly prescribed amount or use more than one type of steroid at a time. Known as “stacking,” the practice results in faster increases in muscle mass. Some abusers even have a system in which they cycle their steroid use, gradually increasing their dosage over a six to 12-week period. 
  • Cycling — when a person takes multiple doses for a certain amount of time, stops taking them, and then starts using again. 
  • Plateauing — when drug tolerance begins to build, a person takes higher doses to achieve the same effects. When it comes to steroids, they may overlap, alternate, or substitute with a different steroid to avoid building a tolerance. 

People who abuse steroids take doses up to 100 times the regularly prescribed amount or use more than one type of steroid at a time. Known as “stacking,” the practice results in faster increases in muscle mass. Some abusers even have a system in which they cycle their steroid use, gradually increasing their dosage over a six to 12-week period. 

There is no scientific evidence that stacking is effective, but it’s a common process among those with steroid use disorder.

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Side Effects

Steroid use produces several side effects.

Steroids lead to the development of acne and hair loss. They can trigger breast growth in males and beard growth in females. They can also cause liver tumors and heart problems. People who misuse steroids also have a higher risk of experiencing uncontrolled “roid rage” and violent mood swings.

Anabolic steroids are synthetic variations of the male sex hormone testosterone. Introducing them into a balanced body throws things into an imbalance. This is dangerous for anyone, but it’s especially risky for adolescents. Hormones are an important part of adolescent development. Introducing them into a developing body creates confusion. 

Teen boys who use steroids have a higher risk of reduced sperm count and shrunken testicles, in addition to gynecomastia. Steroids oppositely affect teen girls by interfering with the development of feminine traits. Young female steroid users have deeper voices, male pattern hair growth, and decreased breast size.

The use of steroids might positively affect muscle growth, but it comes at a significant price and major health risks. Not only do steroids affect muscles, but they also affect organs and cause individual cells to create proteins. This is how tumors develop.

Steroids can also cause peliosis hepatis, which triggers blood-filled cysts in the liver. Internal bleeding can occur if these cysts rupture.

Are Anabolic Steroids Addictive?

Steroid use disorder is possible when abusing steroids. Someone with a steroid use disorder will continue to use even with negative consequences. The physical problems, mood swings, and other negative side effects won’t deter their use. They might also prioritize steroids over other responsibilities, such as family obligations, financial security, and work or school. Some even try to quit steroid use and fail.

Withdrawal can occur if a person is dependent on steroids. According to research, approximately 32 percent of people who misuse anabolic steroids become dependent and will experience withdrawal upon stopping steroid use.

Steroid withdrawal symptoms include:

  • Headaches
  • Muscle aches
  • Depression
  • Fatigue
  • Insomnia
  • Loss of appetite
  • Mood swings
  • Reduced sex drive
  • Restlessness
  • Steroid cravings

What Is Estrogen Rebound?

Steroids work as mood elevators. This leads to similar effects as anti-depressants. Once someone stops a steroid cycle, especially a man, estrogen rebound may occur.

Estrogen rebound leads to the production and release of the female hormone estrogen at fast, elevated levels. Side effects of estrogen rebound can include symptoms of depression. The higher the dosage of anabolic steroids and the longer they are abused, the more severe the symptoms of estrogen rebound will be.

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Abuse & Addiction Symptoms

Long-term steroid misuse can impact brain pathways and chemicals affected by other drugs, such as dopamine, serotonin, and opioid systems. Someone abusing steroids will experience physical and psychological signs of addiction. These include:

  • Steroid cravings
  • Tolerance
  • Mood swings
  • Physical effects of extended steroid use that vary by gender
  • Prioritizing steroid use over other things in life

Other Risks & Dangers of Steroids

In addition to the expected risks of abusing anabolic steroids, there are other concerns. These are issues that were likely present when steroid use began, and the person tried steroids as a result. For example:

  • Poor self-esteem
  • Depression
  • Suicidal thoughts or behaviors
  • Ignorance about health
  • Focus on weight or shape encouraged by peers, parents, and others
  • Eating disorders
  • Abuse of other substances
  • Some steroid users have muscle dysmorphia, which is a disorder that results in a man thinking he looks weak or small even if the opposite is true. It is similar to what those with eating disorders experience when they believe themselves to be overweight even if they are significantly underweight.

Addiction Treatment & Recovery

Treatment is available for steroid abuse, but it’s not often used. Research shows most people don’t discuss their steroid use with their doctors. Misleading information is available online. Steroid users also turn to their peers for information. In both cases, steroid users tend to be dissuaded from seeking professional help, even though it’s available.

To treat a steroid use disorder effectively, a program needs to address the physical dependence and the underlying causes of steroid use. Successful treatment includes:

  • Support for muscle dysmorphia and other psychological issues that drive steroid use
  • Endocrine therapy to restore the body’s natural function
  • Medication to alleviate depression (endocrine therapy might help with this)
  • Medication and support for co-occurring conditions
  • Behavioral therapy and medications to manage withdrawal symptoms

It’s also important for a program to begin with withdrawal support. Easing the symptoms of withdrawal improves the chances a person will not relapse quickly.

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Resources

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National Institute on Drug Abuse. “Are Anabolic Steroids Addictive?” Drugabuse.Gov, 2019

Wedro, Benjamin. “Steroid Abuse Symptoms, Side Effects & Treatment.” MedicineNet, 2008

Kanayama, Gen et al. “Anabolic-androgenic steroid dependence: an emerging disorder.” Addiction (Abingdon, England) vol. 104,12 (2009): 1966-78

AlShareef S, Gokarakonda SB, Marwaha R. Anabolic Steroid Use Disorder. [Updated 2020 Dec 23]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2021 Jan

Ganesan K, Rahman S, Zito PM. Anabolic Steroids. [Updated 2021 Jun 4]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2021 Jan-

Kanayama, Gen et al. “Long-term psychiatric and medical consequences of anabolic-androgenic steroid abuse: a looming public health concern?.” Drug and alcohol dependence vol. 98,1-2 (2008): 1-12.

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