Anabolic Steroids are widely consumed in the Western world to gain muscle bulk, reduce fat, and enhance body image in a short period. It is a go-to product for many gym enthusiasts, athletes, and individuals who are struggling with body image issues- the reason being promptness of the results associated with the use of steroids. However, excessive use of these synthetic hormones can lead to the development of addiction albeit addiction to steroids varies greatly in comparison to addiction to classic illicit drugs such as alcohol, marijuana, etc. 

Steroid Addiction does not cause feelings of euphoria and individuals do not experience the ‘high’, induced by psychoactive compounds. Nevertheless, addiction to anabolic steroids is equally damaging to the body and the side effects of these drugs manifest in the long run, and then it is too late to revert the harm caused by steroids.

Steroids are synthetic compounds that imitate the action of certain endogenous hormones. Hormones are chemicals that are naturally present in the body that plays a pivotal role in the regulation of prime metabolic functions that are occurring day in and day out in the human system. 

Corticosteroids and Anabolic Steroids are two different types of steroids and you need not confuse the two as they both are generally referred to as ‘steroids’. Looking at the context of the discussion you can gain insight as to which category of steroids is being discussed.

Corticosteroids mimic the action of the hormone ‘cortisol’ which is popularly known as the ‘stress hormone’ as it is responsible to control inflammation and infection in the body through various mechanisms. Moreover, it is also involved in the breaking down of glycogen into glucose, hence it is catabolic which means that it breaks long chains of an organic compound into smaller units. Corticosteroids such as Prednisone, Dexamethasone, and Hydrocortisone among others are used to treat an array of medical conditions that arise on the background of inflammation; these include- rheumatoid arthritis, asthma, COPD, and skin infections.

Contrarily, Anabolic Steroids, as the name depicts, are responsible for building up substances- as in this case they build up proteins by incorporating them into muscles. Anabolic Steroids are referred to as Anabolic-Androgenic Steroids or AAS for short, as they imitate the action of the male hormone, ‘testosterone’ and it is associated with the development of male secondary sexual characteristics hence the term ‘Androgenic’ which means pertaining to the development of male characteristics.

Anabolic Steroids are popularly known as ‘performance and image enhancing drugs’ owing to their effect on the increased production of red blood cells which improves the oxygen-carrying capacity and thus promotes stamina in an individual. In addition, steroids are known for increasing the DNA signaling for the synthesis of protein thereby promoting the build-up of new muscles. Steroids are known to fasten the healing process after muscle tearing thus helping those, who are training hard and excessively using their muscles vigorously.

Apart from legitimate medical reasons for which anabolic steroids are prescribed, these drugs are widely used illegally to build muscle bulk, to get a leaner body shape, and to get rid of all the excess fat. People with low self-esteem and those who are conscious about their body images such as coaches, gym freaks, or athletes use steroids. Moreover, younger individuals who are dealing with body dysmorphia also use anabolic steroids excessively to reach their ‘goal physique’ in less time.

The use of anabolic steroids dates back to the 20th century when it was first used to treat individuals who had low testosterone levels and later it was used in World War II to treat and rejuvenate the weak soldiers by providing them the stamina to fight in the battleground and to help in building up their muscles. It was not surprising when athletes started using steroids to boost their performance and to attain bulkier and more muscular bodies. 

By the 1950s, steroids were widely popular among athletes who used these drugs during the Olympics. However, during the 1970s the use of steroids by sportsmen to improve their performance was banned. Nevertheless, people could not give up on steroids as they were quick fixes and a shortcut to attain ripped and a muscular body, therefore, illegal means were used to get hold of the drugs and they remain widely popular among certain groups of the population.

Western culture and media have played a crucial role in the current increase demand for anabolic steroids since social media promotes perfect body images of male muscularity thereby setting a standard to idealize. This has deteriorated the minds of children and youngsters alike who have become insecure about their physique, finding their bodies insignificant and small. For the past few decades, children action toys such as ‘GI Joe’ in America and ‘Action Man’ in British Commonwealth have begun to adopt the bodies of AAS users, thus children inculcate what they observe and this has lead to the widespread illicit use of anabolic steroids by children and individuals to enhance their body image.  

Anabolic Steroids come in the form of pills, injectable liquids, topical gels, and creams. They are known on the street by various names such as Stackers, Juice, Hype, and Roids.

 Anabolic Steroids are used to treat the following medical conditions:

  • Delayed puberty in males with naturally low levels of testosterone
  • Anemia- e.g. Aplastic Anemia
  • Osteoporosis
  • Hypogonadism
  • Endometriosis
  • Muscle wasting in HIV
  • Individuals recovering from major illnesses that require increased protein
  • Used as an adjunctive treatment in breast cancer
  • Hereditary angioedema
  • Short stature in children

Individuals who misuse anabolic steroids meaning that they use steroids for reasons other than prescribed to them and those who take increased doses of the drug are aware of the negative consequences of using them for too long. Hence they have devised different techniques to mitigate the side effects caused by steroids. Following are the techniques used by people who are often abusing steroids:

  • Cycling: In this method, individuals use steroids for a defined period mostly between 8 to 16 weeks, followed by a drug-free period, which can last for months or years. 
  • Stacking: In this method, different types of steroids are used simultaneously such as injectable and pill forms of AAS are administered with the presumption that the concomitant use of different forms of steroids will yield better and quicker results. However, this theory has no scientific grounds. 
  • Pyramiding: In this method, individuals go through two cycles of steroid use. In the first cycle, they start with the lowest dose of steroids and gradually increase it up to the maximum dose followed by the second cycle where they start tapering the dose from the maximum to the lowest possible dose before starting the cycle again. 

There is no scientific ground to the assumptions that these methods mitigate the side effects of anabolic steroid abuse.

Anabolic Steroids are labeled as illegal in many countries including the US, the UK, Australia, Argentina, Brazil, Portugal, and Saudi Arabia. The US passed the Anabolic Steroid Control Act in 1990 that classified Anabolic Steroids as Schedule III drugs. Moreover, there are penalties on people such as coaches and physical trainers who persuade the individual to use anabolic steroids. 

However, access to steroids through the black market and online market is quite rampant. Steps are needed in this direction to ensure that no illegal sales of anabolic steroids take place.

There is a variety of steroids that are used for bodybuilding, healing of muscles, and enhancement of stamina. For medical and illegal reasons steroids can be administered in multiple ways such as by pills, injections, pellets- be implanted under the skin, and through topical cream or gel. 

Anabolic Steroids that are taken orally include:

  • Mesterolone (Proviron)
  • Methandienone (Dianabol)
  • Methyltestosterone (Virilion)
  • Mibolerone (Cheque)
  • Oxandrolone (Anavar. Oxandrin)
  • Fluoxymesterone (Halotestin)

Anabolic Steroid that comes in injectable forms include:

  • Methenolone enanthate (Primobolan)
  • Boldenone undecylenate (Equipoise)
  • Nandrolone decanoate (Deca Durabolin)
  • Testosterone cyopionate (Depotest)
  • Testosterone propionate (Testex)

Anabolic Steroids act by traversing through the bloodstream and binding to the androgen receptor, which interacts with the DNA and increases the production of protein thereby promoting the buildup of new muscles.

Anabolic Steroids have potential side effects; however, these side effects vary from person to person. Moreover, certain factors such as age, gender, duration of steroid use determine the degree of presentation of these negative effects. 

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These include:

  • Fluid retention
  • Acne
  • Hormonal imbalances
  • Mood swings
  • Increased blood pressure
  • Paranoia
  • Reduced sperm count
  • Lethargy
  • Impotence
  • Excessive hair growth
  • Irritability
  • Aggressiveness
  • Restlessness

Since 13% of anabolic steroid users share the needles for injecting anabolic steroids there is a heightened risk of acquiring transmissible infections such as HIV and Hepatitis. Moreover, anabolic steroids cause damaging results on the liver, cardiovascular system, and reproductive system.  

Anabolic Steroids are indeed addictive but this addiction is quite different from the mainstream addiction caused by illicit psychoactive drugs such as cocaine, marijuana, or addiction due to opioids or benzodiazepines as these psychoactive drugs are known to alter the brain chemistry by interfering in the brain’s reward pathway and increasing various neurotransmitter that induces a ‘high’ and causes euphoria. 

This effect is not seen in steroid addiction, since steroids have other mechanisms through which it causes dependence. When individuals use steroids, they get accustomed to the effect caused by these drugs that include muscle strengthening, increase in stamina, and this result in outstanding performances that garners praise and appreciation for them. This effect of steroids leads the user to continue taking the drug since they become physically dependent on it and when these steroids are not consumed then withdrawal symptoms sets in which is a hallmark of addiction to these substances. 

Moreover, tolerance and dependence on steroids develop and the user feels the need to take greater doses of steroids to achieve the same benefit in terms of gaining muscle mass and to attain the boost of energy that results after administering steroids. According to research, 32% of steroid users develop a dependence on the drug making them take higher doses, and often these doses are ten to thousand times higher than the actual dose. 

It is observed that addiction to steroids is prevalent in individuals who are struggling with body dysmorphia also called bigorexia that is a condition in which an individual loses self-esteem and finds their body size small and inadequate. People struggling with body dysmorphia perceive themselves as less muscular than they originally are, and so they abuse steroids to build a bigger, stronger, and bulkier version of themselves.

Individuals who are fitness enthusiasts, gym freaks which may include physical trainers and pro athletes, and people who have undergone sexual abuse are all at an increased risk of developing an addiction to steroids. When someone is addicted to steroids, they feel a compulsion to continue using the drug despite the negative consequences they face. This is because they lose confidence and become anxious at the thought of losing their physique if they deprive themselves of steroids and hence they never stop using these drugs. 

Steroid Addiction has taken over many parts of the world and the trend is on the rise. According to Food and Drug Administration (FDA), 375,000 young men and 175,000 young women in high school abuse Anabolic steroids every year. This reflects that steroid use is not restricted to males only and that females too abuse these drugs albeit to a lesser degree as compared to males. 

According to statistics, in 2014, 1 of every 50 students in 12th grade was using steroids, and this accounts for a large sum of people who became addicted to steroids. In a survey of the National Football League (NFL), 9.1% of the players reported having used anabolic steroids during their careers. 

Research that estimated the global lifetime prevalence rate of anabolic steroids revealed that the prevalence rate was 3.3%. It also mentioned that the prevalence rate for males was 6.4% which was significantly higher as compared to females which had a prevalence rate of 1.6%. 

Following are the red flag findings associated with steroid abuse that you need not overlook as early treatment can help you and your loved ones come off this addiction. The symptoms of anabolic steroid abuse include:

  • A sudden increase in lean mass in individuals hints towards steroid use
  • Track marks due to the administration of steroids through injection 
  • Bottles of pills lying in their gym bag
  • Sudden breakout of acne
  • Having oily skin and hair
  • A peculiar odor from the use of steroid creams 
  • Forgetful about events
  • Long hours in the gym 
  • Sudden urge to work out 
  • Experience cravings for steroid
  • Being irritable and aggressive
  • Being secretive and attending private phone calls
  • Facing hair loss
  • Poor decision making 
  • Frequent mood swings

Steroids Abuse has a plethora of side effects that are often permanent and cannot be reversed even after quitting steroid use. Individuals who use steroids appear very strong on the surface whereas, they are quite weak internally courtesy to the prolonged steroid use that wreaks havoc in their system while they remained oblivious to the damage it caused. 

The negative effects associated with steroid use affect various parts of the body. Many cardiac problems manifest due to the development of atherosclerosis, which is the deposition of fatty substances in the vessels thereby impeding the flow of blood which increases the risk of myocardial infarction (heart attack) and strokes by many folds. Moreover, steroids are known to increase the thickness of the muscular wall of the heart- this alteration in the shape of the heart is known as cardiomyopathy and it is irreversible damage. Cardiomyopathy increases the risk of cardiac arrest. 

Steroids are known to disrupt the natural hormonal balance as the production and release of testosterone are greatly affected by the prolonged use of steroids. This is because exogenous administration of hormones such as testosterone impedes the endogenous production of this hormone. This results in reduced sperm counts thereby decreasing male fertility and shrink the testes in size. It is further noticed that discontinuing steroids result in erectile dysfunction owing to low levels of testosterone. 

Steroid abuse affects multiple sites such as it causes liver problems and disturbs the cholesterol metabolism with lower levels of HDL, which is the good cholesterol, and higher levels of LDL, which is the bad cholesterol. Steroid abuse causes acne, greasy hair and skin, and baldness. 

In males, there is an increased risk of the development of prostate cancer following steroid abuse. Additionally, increased use of steroids causes gynecomastia in males which is referred to as enlarged breasts. 

In females, the effects of anabolic steroids are slightly different as it causes a reduction in the breast tissue, causes menstrual irregularities, swelling of the clitoris, and results in deepening of the voice. 

Steroids’ effects on the brain are not studied adequately but what is known from the current data is that steroids do have an effect on the brain and they alter the brain functioning in several ways. Aggressive behavior is frequently noticed in steroid users that is referred to as ‘Roid’s rage’- this is a condition in which individuals who are abusing steroids respond in a very furious manner to a given condition. Psychosis is often observed in these individuals. The greatest risk associated with steroid abuse is depression as it can lead to suicidal tendencies. 

In younger individuals who have not achieved puberty, steroid use restricts their bone growth thereby resulting in stunted height and premature aging.  

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