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National Institute on Drug Abuse -  NIDA NOTES
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Volume 12, Number 4
July/August 1997

Questions and Answers About Anabolic Steroids

What Are They?

Anabolic steroids are drugs derived from the male hormone testosterone. They promote muscle growth and increase lean body mass. Although anabolic steroids have many approved medical uses, they are abused by some athletes and others seeking to improve performance and physical appearance. These nonmedical uses are illegal and carry many health hazards.

How Are They Used?

Anabolic steroids are taken as pills or injected. Steroid abusers may take hundreds of times more than the medically recommended dose. Users often combine several different types of steroids to boost their effectiveness-a method called stacking. In another method, called cycling, users take steroids for 6 to 12 weeks or more, stop for several weeks, and then start again.

How Many People Use Them?

In 1994, 1,084,000 Americans, or 0.5 percent of the adult population, said that they had used anabolic steroids, according to the Substance Abuse and Mental Health Services Administration's National Household Survey on Drug Abuse. In the 18 to 34 age group, about 1 percent had ever used steroids; for ages 35 and older, that figure went down to 0.2 percent. More men than women had used the drugs: 0.9 percent of men and 0.2 percent of women said they had ever taken steroids..

NIDA's Monitoring the Future study has tracked anabolic steroid use among middle school and high school students in the United States since 1989. From 1989 to 1996, there was a slight, gradual decline in the number of 8th, 10th, and 12th graders who had ever used steroids or used them in the past year. In 1996, 1.8 percent to 2.4 percent of these students had ever used steroids, and 0.9 percent to 1.5 percent had used them in the last year.

How Do People Get Them?

Under Federal law it is illegal to possess or distribute anabolic steroids for nonmedical uses. However, heavy demand has generated a black market with estimated sales of up to $400 million a year, according to a NIDA Research Report, Anabolic Steroids: A Threat to Body and Mind. Anabolic steroids are manufactured legally or illegally outside the United States and smuggled in, usually through the mail; manufactured legally and diverted to the black market; or manufactured illegally in the United States. Many substances sold as anabolic steroids are diluted, contaminated, or simply fake.

What Are the Health Hazards?

Some of the main side effects of anabolic steroid abuse are trembling, severe acne, fluid retention, aching joints, high blood pressure, lower HDL (the "good" form of cholesterol), jaundice, and liver tumors. Also, people who inject steroids with shared needles run the risk of contracting or transmitting hepatitis or HIV, the virus that causes AIDS.

Other side effects include:

  • for men, shrunken testicles, reduced sperm count, impotence, infertility, baldness, development of breasts, difficulty or pain in urinating, and an enlarged prostate;

  • for women, growth of facial hair, changes in or cessation of the menstrual cycle, enlargement of the clitoris, deeper voice, and smaller breasts; and

  • for adolescents, premature skeletal maturation and accelerated puberty leading to stunted growth.

NIDA-funded studies have shown that steroid abuse can cause wide mood swings including uncontrolled anger and aggressiveness that can lead to violent episodes. Users often become clinically depressed when they stop taking the drugs - a withdrawal symptom that may contribute to dependence. Users also may experience paranoid jealousy, extreme irritability, delusions, and impaired judgment stemming from feelings of invincibility.

Do They Really Work?

Athletes, as well as some coaches, trainers, and physicians, report significant increases in muscle mass, strength, and endurance from steroid use, according to a 1991 NIDA Research Report. In acknowledgment of these effects, the International Olympic Committee has placed 20 anabolic steroids and related compounds on its list of banned drugs. However, no well-controlled studies have documented that the drugs improve agility, skill, cardiovascular capacity, or overall athletic performance.

Where Can I Find Out More?

The NIDA Research Report, Anabolic Steroids: A Threat to Body and Mind (NIH Publication No. 96-3721).

From NIDA NOTES, July/August 1997


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