Anabolic Steroid Use, Abuse & Addiction
Last Updated Dec 2, 2021
Anabolic steroid abuse can have serious health consequences. The group of people who use anabolic steroids is different than those who generally abuse other types of drugs. Young male weightlifters are most at risk, especially those with low self-esteem and other self-image issues.
Stats of Steroid Abuse
The people most likely to abuse anabolic steroids are very different in some key ways when compared to those most likely to abuse other types of drugs. The majority of people who abuse steroids fit the following groups:
- Young adults, ages 20 to 30
- Non-athlete weightlifters
A 2019 study examining anabolic steroid use among resistance trainers found that 9.1 percent of the 5,773 individuals examined with self-administered questionnaires had formerly used steroids, 3.4 percent currently were using them, and 4.3 percent intended to use them. Prevalence of use was much higher among men (16.9 percent compared to 6.5 percent for women).
Generally, beginners were not interested in steroid use. Those who trained longer tended to abuse them at a higher rate.
An older study of adolescent users found that steroid use among men held a particular pattern, with the rate of use higher for those with the following attributes:
- Poor self-esteem
- Depression and/or previous suicide attempts
- Poor knowledge and attitudes about health
- Participation in sports that emphasize body shape and weight
- Higher parental concern about their weight
- Disordered eating
- Previous substance abuse
While more research is needed, the average profile for female users is less clear. Some studies have suggested sexual abuse might both increase a woman’s chance of a desire to become a bodybuilder and their likelihood of using steroids. The general reasoning appears to be either a desire to become more intimidating and difficult to overwhelm or to become unattractive.
Overall, the pressure for women, including athletic women, to use steroids seems to be lower, in part because a very muscular body type is culturally more desirable for men than women in the United States and most other parts of the world.
Notably, the National Institute on Drug Abuse has stated estimating steroid abuse rates is difficult because many surveys meant to gather information on drug use don’t mention steroids. Evidence does suggest steroid use among teens has declined after an alarming peak in 2000, although use among 12th graders remains somewhat high at over 1 percent.
What Are Anabolic Steroids?
Anabolic steroids are synthetic versions of testosterone, a hormone that plays a significant part in the development and maintenance of “male” sex characteristics, such as these:
- Facial hair
- Deepened voice
- Muscle growth
These steroids have legitimate uses, such as to treat hormone problems, muscle loss, and sometimes as part of the hormone therapy used to help some transgender people (generally transgender men) achieve the level of masculinization they desire.
Why Do People Abuse Steroids?
The ability of steroids to encourage muscle growth is usually why a person chooses to abuse them. Steroids can make gaining muscle mass easier and generally can help a person achieve an overall greater level of muscle mass than they could normally achieve, especially with the same level of effort lifting weights and engaging in similar athletic activities.
Sometimes, this is to gain a competitive edge in sports, allowing someone to better compete than they normally would be able to. It should be noted, however, that this type of drug abuse is almost universally against the rules in a sporting context and may result in a person being banned for cheating.
Other people may have low self-esteem about their bodies or may want to get stronger for some other non-sport-related reason. Because male, non-athlete weightlifters are the largest group of steroid users, it seems likely that the majority of abusers fall into this last category of use despite the fact that many people typically associate steroids with cheating in sports competitions.
Side Effects of Steroid Use
Normal, prescribed steroid use generally has mild, controllable side effects, which may include the following:
- Changes to blood pressure
- Sleeping problems
- Irritability and mood swings
- Changes to the menstrual cycle
- Abnormal facial and body hair growth
More serious side effects that may warrant seeing a doctor include the following:
- Severe mood changes
- Violent outbursts
- Changes to sex drive
- Reduced sperm count
- Testicle and penis shrinkage
- Growth of the clitoris
- Hair loss
- Long-lasting erections
- Stretch marks on the chest and arms
- Prematurely aged skin, with skin taking on a leathery appearance
As with most medications, any side effect that seriously impacts your quality of life or seems severe should be reported to a doctor, even if it would be considered “normal” in ordinary circumstances.
Effects of Abuse
Abusing steroids makes the side effects listed above much more likely. It also means a person likely isn’t consulting with a doctor about how to most safely use the drugs or the signs that there might be a serious problem. Many people who abuse steroids also consult forums populated by other proponents of steroid use, where users often make unscientific and outright false claims.
Long-term abuse can cause a number of problems, including these:
- Liver disease or damage
- Heart disease or damage
- Kidney disease or damage
- Damage to the testicles or ovaries
- Extreme outbursts of aggression, often called roid rage
- Paranoia, severe mood swings, and potentially suicidal depression
- Severe acne, which may cause scarring
- High blood cholesterol and blood pressure
- Tendon injuries, as a result of increased strength outpacing their ability to function
- Nerve damage from needle use
- Potential exposure to unsafe needles, which can spread infections such as HIV and hepatitis B
What Is Estrogen Rebound?
Estrogen rebound can occur after prolonged periods of steroid use. When steroids are used regularly, estrogen production is often reduced. After steroid use is stopped, the body reacts by producing elevated levels of estrogen.
Negative effects of estrogen rebound include depression and mood swings.
Risks of Steroid Use
Steroids can damage a person’s organs and cause serious mental health problems. Prolonged use can hurt a person’s liver, heart, and kidneys.
This is especially important considering steroid users are often pushing their bodies already, meaning they are taking a substance that can tax the heart and then performing activities that can further tax the heart. This can and has resulted in very serious health problems, including heart attacks, which may be fatal.
Steroids can also cause a person to act irrationally and even violently. While the risk of extreme violence as a result of steroid abuse may be overblown, it is a legitimate possibility. It increases the chance a person will at least become aggressive enough that they damage social relationships and hurt people in ways they wouldn’t have if they didn’t abuse drugs.
There’s also a risk users may harm themselves when using steroids. Many people who use steroids already have low self-esteem, which can be a dangerous combination with the ability of steroids to cause mood swings and severe depression.
Can You Overdose on Anabolic Steroids?
Overdosing on anabolic steroids isn’t generally a major concern, even among those who struggle with drug abuse. While taking excessive amounts of the drug can potentially cause serious health concerns, as discussed above, it’s unusual for this to be done in such a way it’d be considered an “overdose” rather than just the consequences of long-term abuse.
With that said, at least one 2006 research article did attribute a death to self-administered androgen, a type of hormone that includes testosterone.
Overdosing on anabolic steroids is admittedly understudied. While uncommon, it seems to at least sometimes be possible.
Excessive steroid use in a short period is at least likely to tax a person’s liver, heart, and kidneys.
Treatment Options for Steroid Abuse
A dependence on steroids is different from some other types of drug use in that the drugs themselves don’t typically produce any kind of strong physical dependence or any kind of relaxing, euphoric effect. Withdrawal symptoms are usually comparatively mild to some other drugs. They include the following:
- Loss of appetite
- Decreased sex drive
- Depression (potentially suicidal depression, which should be taken seriously and warrants talking with a doctor immediately)
- Steroid cravings
If a person is trying to quit steroids, they should consider entering a behavioral therapy program and working with a professional who specializes in addiction treatment. They can also work with a mental health professional on determining what drew them to abuse drugs in the first place and finding healthier ways to deal with those same issues.
Brief Overview of Recovery Timeline
Addiction recovery is a complex process that can be different for everyone. Depending on how much steroids a person used and for how long, the body can take up to four months on average to return to its natural levels of testosterone. Before that, they may produce less than normal, as their body had adjusted to the testosterone it was getting from the abuse, lowering its natural level of production. In rare instances, testosterone discrepancies are seen for years.
If a person’s organs have been damaged, some of that damage may be permanent. However, stopping drug use is still an excellent change for overall long-term health, as it greatly reduces the likelihood of further damage.
Even once a person has managed to control their drug abuse and stopped using steroids, they will benefit from continued therapy. This can help them better resist drug use in the future, as well as help them confront any mental health issues they may be dealing with, such as improving their sense of self-worth.
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Steroid Use Among Adolescents: Findings from Project Eat. (April 2002). The Journal of Adolescent Health.
What Are Anabolic Steroids? (August 2018). National Institute on Drug Abuse.
Who Uses Anabolic Steroids? (February 2018). National Institute on Drug Abuse.
Steroid Hormones and Their Action in Women’s Brains: The Importance of Hormonal Balance. (May 2018). Frontiers in Public Health.
Multi-Organ Damage Induced by Anabolic Steroid Supplements: A Case Report and Literature Review. (October 2008). Journal of Medical Case Reports.
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