Everyone wants to look good, and for some, doing whatever it takes to make that happen is worth it. This includes taking and abusing steroids, which are commonly used to enhance appearance and improve athletic performance. 

The National Institute on Drug Abuse (NIDA) cites research that an estimated 3 million to 4 million Americans have used anabolic-androgenic steroids (testosterone or synthetic derivatives of testosterone) to gain muscle mass for sports or to enhance their appearance. 

There are concerns that excessive steroid abuse can cause long-lasting health problems as well as a psychological dependence that is hard to break.

What are Steroids?

There are two kinds of steroids. One kind is corticosteroids, which are prescribed to treat overactive immune responses and reduce swelling that is present with allergic reactions. They are given to patients who have asthma, rheumatoid arthritis, autoimmune diseases, such as lupus, chronic obstructive pulmonary disorder (COPD), and other medical conditions. They also are used to treat eczema and other skin problems. 

Then there are anabolic steroids, the manmade versions of the male hormone testosterone. It is this group that often is the subject when the topic of steroid abuse comes up. Anabolic steroids are in a class of drugs called “appearance and performance-enhancing drugs,” or AEPDs. Despite the fact that they misused and abused, there still are proper medical reasons that doctors prescribe anabolic steroids. They have used them to treat patients with anemia, delayed puberty, testicular function loss, hormonal imbalances, and muscle loss, a condition seen in people with AIDS and other diseases.

However, when they are abused, anabolic steroids are habit-forming and addictive. Chronic misuse and abuse can lead to a chemical and psychological dependence on these medications. Anabolic steroids can be taken as injectable liquids, pills, creams, or topical gels. It is illegal to use these drugs in a manner inconsistent with their purpose.

As NIDA explains, anabolic steroids work differently in the brain from other abused drugs. They do not trigger the dopamine highs that commonly occur when other drugs are taken, which is a common side effect. Instead, it is long-term steroid abuse that does the actual harm. NIDA says abusing steroids over time can affect the same brain pathways and chemicals, which include dopamine, serotonin, and opioid systems, that are other drugs affect. “This may result in significant effect on mood and behavior,” the agency says.

Street names for anabolic steroids include gear, juice, roids, and stackers.

How are Steroids Abused?

Some steroid users are aware that there are unwanted side effects that come with using the drugs, so they use them in different ways to circumvent those or enhance the effects they get from taking them.

NIDA explains these practices. They are:

Cycling – Users take doses for a period, and then stop for a time before taking them again

Pyramiding – Slowly increasing the dose or frequency of the steroid and then gradually tapering off after a peak amount is reached

Stacking – When users combine two or more kinds of steroids

“There is no scientific evidence that any of these practices reduce the harmful medical consequences of these drugs,” NIDA writes.

Steroid Addiction: What are the Signs?

The National Institute on Drug Abuses says that an “undetermined percentage” of people who abuse steroids may become addicted to the drugs.

It explains that while steroids themselves are not considered intoxicating, chronic steroid use can affect dopamine receptors in the brain in ways that are similar to those of other addictive substances. In many cases, steroid users take other substances, such as stimulant drugs, with their steroids as part of a performance-enhancing routine. Steroid users may use marijuana (cannabis), alcohol, and opioids, to help manage effects related to pain, sleep disturbances, and mood.

Signs of Steroid Addiction Include:

  • Unusually fast muscle mass growth
  • Unusually greasy hair or oily skin
  • Track marks on the skin from injections
  • Sudden outbreaks of red or purplish acne
  • Halitosis (bad breath)
  • Excessive hair loss, shedding
  • Drastic appetite changes 
  • Joint pain

Steroid abusers may also exhibit personality and emotional changes, including:

  • Extreme mood swings
  • Poor decision-making
  • Increased aggression, irritability
  • Paranoia, jealousy
  • Changes in personal, professional relationships
  • Impaired judgment
  • Delusions

There are side effects of steroid abuse that affect health and well-being and noticeable changes that differ between men and women. WebMDadvises that men who abuse steroids may experience

  • Breast development
  • Painful erections
  • Shrunken testicles
  • Decreased sperm count
  • Infertility
  • Impotence

Women Who Take Anabolic Steroids May Experience:

  • Excessive face, body hair
  • Voice changes (deeper voice)
  • Irregularities with menstrual cycle
  • Reduced breast size

Teenagers who abuse steroids are also at risk of stunted growth and stunted height. NIDA explains that stunted growth can occur when high hormone levels from steroids signal to the body to stop bone growth too early. Stunted height can occur if teens use the drugs before their growth spurt.

Many of these side effects could become irreversible if misuse isn’t stopped. Excessive steroid use can increase the risks of liver disease and liver cancer. Because steroids are administered via injection, contracting HIV or hepatitis from an unsterile needle or syringe is possible.

Steroid Addiction Treatment

Steroid abuse needs to be addressed like any other substance abuse issue. People who struggle with ending dependence on their own may want to consider entering professional drug rehab. The first sign that addiction has set in is the inability to stop on one’s own. If they do stop, they likely will experience drug withdrawal. If you or someone you know is experiencing physical and mental symptoms after stopping steroid use, consider seeking help at a reputable drug rehabilitation center. Such a facility has the medical staff and addiction specialists available to help people address their addiction the right way. 

Substance treatment should start with a 24-hour monitored medical detox that weans steroid users off the drug gradually as they manage withdrawal in the care of professionals. Such withdrawal symptoms for steroids include weakness, nausea, vomiting, diarrhea, abdominal pain, decreased appetite, dizziness, and fainting among others. Detox, which can last three to seven days, also helps ensure users won’t have a dangerous relapse and return to using steroids.

After detox ends, clients should have achieved medical stability before entering a recovery program. This program allows the time and space to address steroid addiction with behavioral therapy and strategies that promote a life of sobriety. NIDA writes that some people who seek treatment for steroid abuse have found behavioral therapy helpful.  Still, it says more research is needed to identify the most effective treatment options.

The agency also writes, “In certain cases of severe addiction, patients have taken medicines to help treat symptoms of withdrawal. For example, health care providers have prescribed antidepressants to treat depression and pain medicines for headaches and muscle and joint pain. Other medicines have been used to help restore the patient’s hormonal system.” 

Medication management also can be a part of addiction treatment. Medicines are also administered during the detox period.

Treatment will not look the same for everyone, so the program chose depends on factors that are unique and specific to one’s situation. 

Common recovery options include inpatient treatment, residential treatment, and outpatient treatment. Residential treatment requires at least a 30-day stay and therefore requires more commitment than an outpatient program. While there is no one way to do treatment, the National Institute on Drug Abuse (NIDA) recommends that recovery takes place in the treatment environment for at least 90 days or three months. Longer periods in a recovery setting can increase the chances of stopping drug use.

Once clients have completed inpatient or outpatient treatment, their efforts to managing addiction do not end.  Recovering steroid users may find they have post-acute withdrawal syndrome, known as PAWS, but this depends on how severe their addiction was. Depression, drug cravings, and other symptoms can happen during this period. An inpatient or outpatient treatment program can help users figure out how to best manage PAWS as they move forward.

Recovering stimulant users are encouraged to use aftercare services, which include joining a 12-step program, attending support group meetings, and aligning themselves with people in a treatment alumni group or joining a sober living facility as they transition back into the real world.

How Dangerous are Steroids?

NIDA cites research showing that long-term use of anabolic-androgenic steroid use can damage heart function. The agency also writes, “AAS users also had significantly more atherosclerotic plaque in their coronary arteries than did nonusers. This effect was more pronounced the longer they had taken AAS and did not seem to be reversible after discontinuing AAS use.” 

Steroid Abuse Statistics

  • Globally, about 1 in 15 men have tried steroids at some point in their lives, according to a 2014  analysis of 200-plus studies.
  • An estimated 3 million to 4 million Americans have used anabolic-androgenic steroids.
  • People who abuse steroids reportedly take 10 to 100 more times of the drug that would be prescribed by a doctor to treat a condition or illness.
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