Two types of steroids exist. One is a medically prescribed variety known as corticosteroids, which are used to treat those with asthma, skin allergies, and rheumatoid arthritis. This particular variety does not cause dependence. The second type, anabolic steroids, are commonly abused. They are used in sports to “bulk up” athletes and most commonly obtained illegally. Anabolic steroids are synthetic substances intended to mimic the effects of certain androgens, also known as male sex hormones, in particular testosterone.
The History of Anabolic Steroids
Anabolic steroids originated in the 1930s as a treatment for hypogonadism, which occurs when the testes do no produce sufficient amounts of testosterone for proper growth and development as well as sexual function. Primarily, they were used to treat delayed puberty, wasting, and certain types of impotence. In laboratory testing conducted on animals shortly after the discovery of anabolic steroids, researchers discovered they stimulate growth of skeletal muscle mass.
Steroid Use in Today’s World
Today, very few anabolic steroids are prescribed and only for a limited number of conditions, such as HIV. Individuals, especially athletes and bodybuilders, often obtain them illegally and abuse them to boost their performance and build muscle. They are more popular than ever as denoted by a study cited by the US Department of Justice. The study indicated 1,084,000 Americans used anabolic steroids in 2004 alone.
Another study compared the use of steroids in three different years and determined a gradual increase in steroid use. In 1991, only 2.1 percent of 12th-grade students abused steroids in comparison to 2002 when 4 percent of 12th graders abused them. Professional and Olympic athletes are more likely to use steroids than the general population.
According to Sutter Health’s Palo Alto Medical Foundation, 5-12 percent of all male high school students and 1 percent of all female high school students have used steroids. This particular statistic is just one of the many that suggest a higher steroid abuse rate in males and in school-aged students.
The National Institute on Drug Abuse published information related to steroid abuse and past sexual or physical abuse. Sexually or physically abused women, in particular weightlifters, were more like to abuse steroids and so were men with a history of abuse during childhood when compared to members of the same sex who did not have a history of abuse. These individuals often believed if they increased their muscle mass and became stronger, they would be able to discourage attackers and abusers.
How Are Steroids Abused?
Most often, a person may take steroids in pill form or inject them. Although they are available in patches, gels, and creams, people do not find these routes of administration as effective. It is more common to inject them directly into the muscle – known as intramuscular injection – than it is to take them orally. They are not intended to be taken intravenously due to the possibility of a pulmonary embolism. Doses when abused are usually much higher than doses given as medical treatments, sometimes even 100 times greater than a prescribed dose.
Those who use steroids tend to use them in cycles. According to NIDA, the cycle usually lasts between six and 12 weeks, and it is said to decrease the individual’s chances for developing a tolerance. It also said to reduce adverse effects and assist with heightening the person’s performance during competition. “Cycling,” also known as “pyramiding,” consists of the person starting at lower dosages and heightening the dosage over a period of time, then lowering the dosage toward the end of the cycle.
Some individuals opt to “stack,” which entails using two or more steroids together, oftentimes one injectable and one oral, or one short-acting and one longer-acting steroid. Doctors never prescribe synthetic hormones this way. Someone who stacks might opt to stack in a cycle.
Types of Anabolic Steroids
Several anabolic steroids exist. Even insulin is considered an anabolic steroid that may help improve athletes’ and bodybuilders’ bodies. Winstrol is one of the most – if not the most –commonly abused steroid. It originated in the 1950s and is an anabolic androgenic steroid derived from dihydrotestosterone (DHT). It has the ability to continue to strengthen a person during a calorie deficit. It preserves lean tissue as well. Generally, it is not a base steroid but used as a secondary layer when stacking. It is commonly used when cutting, but that is not its only purpose.
Anadrol is a dihydrotestosterone used for bulking. Primobolan is commonly used as a fat burner. Deca-Durabolin is one of the most commonly used steroids. This 19-nor anabolic steroid builds muscle mass more efficiently, and men tolerate it better than many other steroids. It is also used in cutting cycles.
Because steroids affect hormone levels, individuals may experience side effects specific to their gender.
Males may experience:
- Testicle shrinkage
- Growth of breast tissue
- Male pattern baldness
Women may experience:
- Excessive hair growth
- Decrease in breast size
- Menstrual irregularities
- Deepening of the voice
- Female pattern baldness
The long-term damage done by steroids causes serious side effects that cannot be reversed in most cases. Some of the effects are:
- Heart problems
- Fertility issues in both men and women
- Mania (“roid rage”)
- Stunted growth in adolescence
- Blood clotting issues and disorders
Long-Term and Serious Effects
Some individuals experience serious consequences from steroids, including stroke, heart attack and death due to suicide.
It’s possible to overdose on steroids, but the effects of an overdose are not usually immediate since acute overdoses are rare. A majority of steroid users who overdose do it chronically, and the negative health effects occur over time. These individual may have kidney or liver damage, an enlarged heart, dangerous cholesterol level changes, major mood swings and delusions.
Steroids and Addiction
Despite the non-euphoric effect steroids have, they do appear to have addictive properties. In fact, a person may develop physical and psychological addiction to steroids. Physical dependence is signified by withdrawal when the drug is not present in the system. Symptoms of withdrawal arise because of a depletion in natural levels of testosterone. The symptoms continue until the individual’s body restores natural levels of the hormone. Due to the psychological aspect of the addiction, a person may continue to use steroids despite the negative effects associated with their use, like mood changes, irritability, changes in social relations, and financial problems.
Physical withdrawal takes a toll. Individuals may experience restlessness, fatigue, mood swings, loss of appetite, insomnia, reduced sex drive, strong urges to take more steroids, and depression. Depression has the potential to lead to a suicide attempt. The longer a person uses steroids and does not receive treatment, the longer the symptoms of withdrawal will likely last and the more severe they will be. In order to ensure a safe withdrawal process, medical detox is recommended.
Those who are addicted do not always see the signs of addiction, or they see them and continue using due to the psychological pull steroids have on users. They may even begin abusing another substance, such as opioids, barbiturates, benzodiazepines, alcohol, or stimulants.
Comprehensive Addiction Treatment
Studies regarding treatment of steroid abuse and addiction are not extensive enough to outline an exact course of action that is ideal for most people. The recovery process is unique for each individual and should be determined on a case-by-case basis by treatment professionals. Before devising a treatment plan, an extensive evaluation of the client’s background and health will be conducted to identify all factors that may affect the recovery process.
The choice between inpatient or outpatient addiction treatment is determined by a variety of factors. Those who have struggled with long-term or severe steroid abuse, polydrug abuse, or co-occurring mental health issues may find inpatient treatment to be most effective. The round-the-clock care provided allows for full emersion in the recovery process and significantly decreases the chance of relapse while in treatment. For many people, outpatient addiction treatment will be sufficient, particularly if they have familial or work obligations that don’t allow them to take a full break from life to focus wholly on treatment. A range of outpatient treatment options are available, and many are nearly as intensive as inpatient care offerings.
While treatment often begins with medical detox – to allow the body to process out all substances of abuse under medical supervision – further treatment is needed. Detox on its own does not constitute addiction recovery treatment; it must be followed by a comprehensive treatment program that includes intensive therapy. In some instances, medications may be prescribed to address specific issues, such as insomnia or anxiety, or to stabilize hormone levels.
In therapy, clients will address underlying issues that led to the initial substance abuse. Issues related to a person’s past, familial situation, self-worth, and social environment will be discussed extensively. Triggers for use will be identified, and clients will work with therapists to devise healthy ways to address those triggers that don’t involve substance abuse of any kind.