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According to the book Steroids: High-Risk Performance Drugs, anabolic steroids are substances that originate from male hormones (androgens). These substances increase the production of protein and help to build tissue. Artificial anabolic steroids have been used for medicinal purposes, but they have also been misused in athletics, particularly in bodybuilding and sports where muscle mass and strength are advantageous.

Anadrol (oxymetholone) is an anabolic steroid that has been used to treat different types of anemia due to its ability to increase the production of red blood cells. It is also used to help individuals who have diseases that result in the loss of muscle tissue, such as HIV, or those who have been treated with chemotherapy and lost weight, to pack on muscle mass. While various forms of Anadrol are available on the Internet and through other suppliers, oxymetholone is classified as a Schedule III controlled substance by the United States Drug Enforcement Administration (DEA).

Use and Abuse of Anadrol and Other Steroids

Per the Centers for Disease Control and Prevention (CDC):

  • About 4 percent of high school student athletes report steroid use despite not having a prescription for the drugs.
  • Male athletes are far more likely to use steroids like Anadrol than females.
  • The trend of steroid use among high school students has decreased, but it is still concerning.

Actual figures regarding the use and abuse of Anadrol are not available, but the United States Justice Department has reported that over 1 million adults have actively admitted to using steroids without having a prescription for the drugs. The most common nonprescription uses of Anadrol include individuals involved in bodybuilding or athletics. Most of these individuals are attempting to increase muscle mass or strength. There may be a portion of the estimated 1 million illicit users of anabolic steroids who have an actual psychiatric disorder (e.g., body dysmorphia); however, this proportion of individuals is most likely very small. Instead, athletes are driven to find shortcuts to increase their performance, and individuals in bodybuilding are driven by goals and ideals that result in them discounting the well-known dangers of these substances.

There is no formal diagnosis of a steroid use disorder (a substance use disorder that would include the specific abuse of different types of steroids); however, there certainly is the possibility that individuals who abuse Anadrol or other steroids have a substance use disorder based on the overall generalized criteria for such disorders as documented by the American Psychiatric Association (APA). It would be diagnosed under the Other Substance-Related Disorder category.

The development of any substance use disorder would include the use of the drug for nonmedical reasons, the development of significant distress or dysfunction associated with use of the drug, and meeting certain generalized criteria associated with substance abuse. These criteria include:

  • Issues with controlling use of a substance
  • Continuing to use a substance despite such use producing problems with physical or emotional functioning
  • Continuing to use a substance despite its use leading to problems with one’s occupation, education, or personal relationships
  • The development of physical dependence (tolerance and withdrawal)

The above criteria could certainly apply to many individuals who abuse anabolic steroids like Anadrol. Personal use of an anabolic steroid such as Anadrol to increase athletic performance or to pack on muscle mass as a bodybuilder is not an intended medical use of the drug; thus, using it in this manner could be described as misuse or abuse. In addition, the National Institute on Drug Abuse (NIDA) has reported that the abuse of anabolic steroids can result in the development of physical dependence, although the formal withdrawal timeline that occurs with specific types of anabolic steroids like Anadrol does not appear to be well documented at the current time. Nonetheless, a person who has developed physical dependence on a drug they have used without having a prescription for it would certainly meet the diagnostic criteria for a substance use disorder, according to APA. It should be noted that the formal diagnosis of any substance use disorder can only be made by a licensed mental health professional.

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Effects of Anadrol Use

Anadrol and other anabolic steroids are intended to be used under the supervision of a physician due to the potential for significant complications or side effects associated with their use. Numerous sources, including WebMD, report that the potential effects of Anadrol can include:

  • Hypertension
  • Cardiac damage
  • Increased risk for stroke or heart attack
  • High cholesterol levels
  • Acne
  • Fluid retention (edema) in various tissues
  • Hair loss or thinning hair
  • Kidney damage
  • Liver damage
  • Increased risk to develop cancer
  • Problems with growth in younger individuals who are still developing

Behavioral effects as a result of Anadrol use and abuse can include:

  • Problems with mood, such as mania, depression, anxiety, and mood swings
  • Significantly impaired judgment
  • Increase in aggression and hostility
  • Delusional behaviors that are often feelings of being invincible

Specific problems that may develop in men who abuse Anadrol can include:

  • Testicular atrophy and/or sterility
  • Loss of libido
  • Breast enlargement
  • Enlargement of the prostate gland
  • Decreased level of other hormones

Some of the specific problems occurring in women abusing Anadrol are:

  • Development of masculine characteristics, such as a deep voice, facial hair, diminished breast size, etc.
  • Irregular menstrual cycles
  • Problems with infertility
  • In pregnant women, developmental problems with the fetus

Physical Dependence on Anadrol

As reported above, physical dependence on anabolic steroids is believed to occur. NIDA reports that tolerance to anabolic steroids develops relatively quickly, and some individuals who discontinue the use of these drugs do experience withdrawal symptoms. The timeline and the actual withdrawal syndrome associated with abusing Anadrol are not known, but overall, the withdrawal symptoms that occur as a result of the discontinuation of anabolic steroids include:

  • Severe fatigue and lethargy
  • Significant mood swings
  • Irritability, restlessness, and even aggressive behaviors
  • Depression that may be severe and lengthy
  • Problems with judgment
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Treating Someone for Anadrol Abuse

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Treatment for any substance use disorder follows a set of generalized principles that are individualized to meet the needs of the specific person being treated. Individuals being treated for Anadrol abuse or other anabolic steroid abuse may need an initial physician-assisted medical detox program (a withdrawal management program). Observation, monitoring, and the use of medicines to deal with lethargy, mood swings, aggression, etc., would be implemented by the physician, and behavioral interventions using therapists and counselors are also extremely useful. Long-term recovery includes substance use disorder therapy or counseling, support obtained in peer support groups (e.g., 12-Step groups), support from family and friends, continued medical management, and treatment for any co-occurring conditions that are identified in a formal and thorough assessment that should be performed at the beginning of the process.

Therapy would be particularly useful to help the individual address their irrational/dysfunctional beliefs regarding their body and their need to use drugs to enhance their physical appearance or performance. It should also help the client to develop coping strategies and alternatives to help them reach their goals. Therapy would most likely be of a cognitive-behavioral nature and could be performed in groups or in individual sessions.

Therapy and the continued treatment for the substance abuse issue should be long-term, and the individual would be expected to remain involved in treatment-related activities for years following discontinuation of Anadrol. The individual would not be required to stop participating in bodybuilding or other athletics, but through the use of therapy and psychoeducation, they would develop a new approach and attitude regarding their participation.