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Anabolic Steroids

Anabolic steroids (also called anabolic-androgenic steroids or AAS), unlike other illicit substances, are used to enhance physical appearance and/or performance rather than for mind-altering effect. These drugs are synthetic variants of the male hormone testosterone and are taken orally or injected. Many different trade forms of AAS are used and are easily purchased over the internet and sold in gymnasiums. Trade forms of AAS often encountered include andro, oxandrin, dianabol, winstrol, deca-durabolin, and equipoise. Common street names for AAS incluide "roids," "juice," and "gym candy." Individuals using AAS for performance enhancement typically use injectable forms.
According to the 2010 Monitoring the Future survey, 2.0% of current 12th graders reported ever having used anabolic steroids, 1.5% reported use in the past year, and 1.1% reported use during the past month. [Johnston: 2011] The percentages of use by 8th, 10th, and 12th graders have generally decreased slightly, with some fluctuations, over the past few years. Males report significantly higher rates of AAS use than females.
Adverse effects of AAS use include:
  • Mental health symptoms: aggression, irritability, manic episodes, paranoia, delusions, and impaired judgment resulting from feelings of invincibility
  • Hepatic dysfunction
  • Hypertension
  • Dyslipidemia with increased LDL and decreased HDL cholesterol
  • Tumors of the liver and kidney
  • Severe acne
  • If injected, blood borne-infection such as HIV, hepatitis B and C
  • In men: testicular atrophy, azoospermia, infertility, hair loss, gynecomastia, increased risk for prostate cancer
  • In women: growth of facial hair, male-pattern baldness, menstrual changes, clitoromegaly, deepened voice
  • In adolescents: early puberty, accelerated skeletal maturation with possible stunted growth and reduced ultimate height if AAS are taken prior to pubertal growth spurt
  • Withdrawal symptoms such as mood swings, fatigue, restlessness, loss of appetite, insomnia, reduced sex drive, and severe depression if discontinued abruptly.
[Casavant: 2007]
Although anabolic steroids are not associated with an immediate "high," but rather a delayed effect of muscle and/or performance enhancement, persistent use can lead to a dependence syndrome similar to opioid dependence. [Kanayama: 2009]

Resources

Helpful Articles

Hartgens F, Kuipers H.
Effects of androgenic-anabolic steroids in athletes.
Sports Med. 2004;34(8):513-54. PubMed abstract

Brower KJ.
Anabolic steroid abuse and dependence.
Curr Psychiatry Rep. 2002;4(5):377-87. PubMed abstract

Johnston, L. D., O'Malley, P. M., Bachman, J. G., & Schulenberg, J. E.
Monitoring the Future National Survey on Drug Use, 1975-2008. Volume 1: Secondary School Students.
Bethesda, Md: National Institute on Drug Abuse; 2008: NIH Publication No 09-7402.; (2009) http://www.monitoringthefuture.org/pubs.html. Accessed on 5/1/2010.

Authors

Author: Catherine Jolma, MD - 5/2010
Content Last Updated: 6/2011

Page Bibliography

Casavant MJ, Blake K, Griffith J, Yates A, Copley LM.
Consequences of use of anabolic androgenic steroids.
Pediatr Clin North Am. 2007;54(4):677-90, x. PubMed abstract

Johnston, L. D., O'Malley, P. M., Bachman, J. G., & Schulenberg, J. E.
Monitoring the Future National Survey on Drug Use, 1975-2010. Volume 1: Secondary School Students.
Bethesda, Md: National Institute on Drug Abuse; 2011: NIH Publication No 09-7402.; (2011) http://www.monitoringthefuture.org/pubs/monographs/mtf-vol1_2010.pdf. Accessed on 6/12/2011.
For steroid use, see Table 2-1 (p. 47) and 4-2 (p. 107).

Kanayama G, Brower KJ, Wood RI, Hudson JI, Pope HG Jr.
Anabolic-androgenic steroid dependence: an emerging disorder.
Addiction. 2009;104(12):1966-78. PubMed abstract / Full Text