Anabolic Steroids

Anabolic steroids (also called anabolic-androgenic steroids or AAS) are clincically used to treat endocrine conditions, such as delayed puberty, weight loss from chronic illness, hypogonadism, osteoporosis, and anemia. Unlike other abusable or controlled substances, anabolic steroids are sought to enhance physical appearance and performance rather than for mind-altering effect. These drugs are synthetic variants of the male hormone testosterone and are taken orally or injected. Anabolic steroids are easily purchased over the internet and sold in gymnasiums.

Trade forms of anabolic steroids often encountered include:

Androl-50 (oxymetholone)
Oxandrin (oxandrolone, formerly Anavar)
Dianabol (methandrostenolone)
Winstrol (stanozolol)
Durabolin and Deca-Durabolin (nandrolone and nandrolone decanoate)
Clen (clenbuterol, used for weight loss)
Trenbol75 (trenbolone)
Equipoise (boldenone, now only legally available in veterinary medicine formulations)

Common street names include:

'Roids
Juice
Gym candy
Andro
Pumpers
Stackers

Individuals using anabolic steroids for performance enhancement typically use injectable forms. “Stacking” is a practice of using more than one type of steroid. “Pyramiding” refers to using different doses to minimize side effects and improve effectiveness. Many athletes will also use combinations of anabolic steroids, dietary supplements, and illicit drugs which can further increase risk of renal and liver problems. [Bordin: 2017]

According to the Monitoring the Future 2016 Survey (NIH), 1.6% of current 12th graders reported ever having used anabolic steroids, 1% reported use in the past year, and 0.7% reported use during the past month. Use by 8th, 10th, and 12th graders has decreased slightly, with fluctuations that correlate with the classification of androstenedione as a controlled substance. Males report significantly higher rates of use than females.

Adverse effects of anabolic steroids use include:[Casavant: 2007]

Mental health symptoms (aggression, irritability, manic episodes, paranoia, delusions, and impaired judgment resulting from feelings of invincibility)
Hepatic dysfunction
Renal dysfunction
Hypertension
Heart attacks
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 children and adolescents, early puberty, accelerated skeletal maturation with possible stunted growth and reduced ultimate height if anabolic steroids are taken prior to pubertal growth spurt
Withdrawal symptoms such as mood swings, fatigue, restlessness, loss of appetite, insomnia, and severe depression if discontinued abruptly

Although anabolic steroids are not typically associated with an immediate "high," but rather with a delayed effect of muscle and 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 & Reviewers

Initial publication: May 2010; last update/revision: May 2017

Current Authors and Reviewers:

Author:	Catherine Jolma, MD
Reviewer:	Mary Steinmann, MD

Page Bibliography

Bordin DM, Bettim BB, Perdona GC, de Campos EG, De Martinis BS.
Understanding alterations on blood and biochemical parameters in athletes that use dietary supplements, steroids and illicit drugs.
Toxicology. 2017;376:75-82. PubMed abstract

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

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