There are a number of different kinds of steroids – cortisol, progesterone, estrogen, etc. – but anabolic steroids are the type most commonly abused and the focus of addiction disorders involving this drug. Also called roids, gear, stackers, and juice, among other slang terms, anabolic steroids are synthetic versions of testosterone, the male sex hormone.
Technically called anabolic-androgenic steroids, they are sold under the brand names Equipoise, Oxandrin, Winstrol, Androsterone, Deca-durabolin, and Dianabol. The word anabolic refers to the ability of the drug to help increase muscle mass, and the word androgenic refers to the increase in male characteristics that result from using the drug regularly.
These drugs can be safely used when prescribed by a doctor for the purposes of treating medical issues experienced by men, including delayed puberty, hormonal issues, and muscle loss triggered by certain chronic ailments. However, these drugs are also commonly abused, taken without a doctor’s prescription or monitoring, with the goal of increasing athletic ability or creating a heavily muscular appearance. This is illegal use of the drugs and exceedingly unsafe, both for the individual’s mental health as well as physical health.
Serious mental and physical effects can be seen even with short-term abuse of anabolic steroids. Long-term use can yield even more devastating effects, including an increased risk of sudden death due to heart attack or stroke. The good news is that steroid abuse and addiction are highly treatable issues, and with comprehensive care that includes medical detox as well as a number of therapies and long-term support, it is possible to build a new and healthier life in recovery.
Who Struggles with Steroid Addiction?
Steroids are most commonly abused by those who would like to alter their physical appearance drastically and rapidly, building muscles as well as increasing their physical strength. Though banned by official bodybuilding competitions, many amateur bodybuilders abuse the drug in order to gain the hoped-for results more quickly.
Those who abuse anabolic steroids will usually take the drugs in pill form or inject a liquid version of the drug directly into their muscles, though it is also available in lower concentrations in a patch, gel, or cream. In order to achieve a greater effect, many take doses that are 10-100 times higher than the average therapeutic dose prescribed for medical treatment.
It is well known that abuse of steroids can have serious and deadly effects on the user; thus, many attempt to manage the risk by abusing the drugs using specific methods. For example, according to the Drug Enforcement Administration (DEA), these methods may include:
- Stacking: Stacking is a practice by which an individual uses two or more steroids together, something that is never done in medical treatment. In some cases, individuals may combine the use of short-acting and long-acting steroids, or they may take some steroids in pill form and inject others.
- Cycling: Cycling is a terms that refers to the practice of using anabolic steroids at high doses then following up with a period of no use or use of low doses. Cycling generally lasts 6-16 weeks, and many report taking part in this practice in an effort to manage tolerance that may develop, to attempt to limit adverse effects of steroid use, and/or to avoid failing a drug test for a competition.
- Pyramiding or stacking the pyramid: Pyramiding is the practice of steadily increasing the types and dosing of steroids during phase one of the cycle, followed by steadily decreasing the types and dosing of steroids used during phase two of the cycle. The goal is to get the most body-development assistance while decreasing the likelihood of getting caught.
It is important to note that though all of the steroid abuse practices described above are done in an effort to minimize the negative effects of steroid use, there is no research to support that they have any positive impact in cutting down on the serious and often deadly consequences.
Signs of Steroid Addiction
Use of steroids does not cause a high as is typically seen with other drugs of abuse, like alcohol or heroin. They are, however, addictive substances. Many who use them regularly demonstrate a number of signs of addiction that are commonly seen in those who struggle with any other substance addiction, including:
- Extreme mood swings
- Restlessness and irritability
- Disrupted sleep patterns
- Altered eating patterns
- Cravings for steroids
- Altered sex drive
- Financial difficulties
- Relationship problems
- Use of other illicit substances to balance out the negative side effects of steroid use (e.g., using sedatives, benzodiazepines, or painkillers to manage insomnia caused by steroid use)
- Health problems
- Continued use of steroids despite negative consequences
- Experience of significant withdrawal symptoms when without steroids, including depression and/or suicidal thoughts or actions
Short-term Effects of Steroid Use
Anabolic steroids have a significant short-term effect on users that is unlike other drugs of abuse. Rather than triggering the release of chemicals in the brain associated with a high, steroid use simply increases muscle-building and physical performance. For many, this experience is a high in itself and plays a large role in the development of cravings, a sign of psychological dependence that indicates addiction. With regular use, there can be changes in mood and behavior that occur as well, happening to different degrees and after different periods of use for different people. After only a short period of use, many people who abuse anabolic steroids experience:
- Aggressive behavior and irritability
- Extreme mood swings (e.g., “roid rage”)
- Paranoia (usually unreasonable)
- Jealousy (often unfounded)
- Impaired decision-making ability
Additionally, it is not uncommon for heavy users of steroids to have severe acne and to experience swelling of the extremities.
Long-term Effects of Steroid Abuse
There are serious health and other effects associated with long-term steroid abuse. These can include:
- Changes in cholesterol levels
- High blood pressure
- Kidney damage
- Kidney failure
- Liver damage
- Enlarged heart
- Increased risk of stroke
- Increased risk of heart attack
Additionally, those who use needles to inject steroids may be at an increased risk of contracting HIV/AIDS, a communicable virus that can be transmitted by sharing needles with someone who has the disease.
There are also a number of health issues and effects that are specific to gender or more commonly seen in young people who abuse steroids.
- Lower sperm count
- Hair loss
- Shrinking testicles
- Breast development
- Increased risk of cancer, especially prostate
- Hair loss
- Altered menstrual cycle
- Lower voice
- Enlarged clitoris
- Facial hair or increased body hair
- Early stop to bone growth
- Stunted height, especially if steroids are taken before the final growth spurt
Steroid Addiction Treatment Options
Steroids can be both physically and psychologically addictive; thus, traditional treatment programs that provide medical detox as well as long-term therapeutic treatment can be extremely effective in helping someone to safely stop using steroids.
Each person is different, using steroids for different reasons and with different underlying or co-occurring disorders complicating the problem. This means that treatment will be a unique experience for each client in recovery, requiring an intensive evaluation and diagnostic process at the onset of treatment that will inform the creation of a unique treatment plan with directed therapies and treatments.
If withdrawal symptoms are present when the client is without steroids, medical detox is recommended. Round-the-clock medical care can ensure that any complications are managed in a timely manner and that the patient has ongoing access to therapeutic support and care.
It may be appropriate during detox to make use of different pharmacological treatments to address hormonal imbalances caused by steroid use and to manage withdrawal symptoms. For example, if the patient is dealing with headaches and joint pain, then nonaddictive pain medications may be administered.
Traditional therapy options such as personal therapy and support groups are an important part of treatment for steroid abuse or addiction, but so too are a range of alternative and holistic therapies that provide coping mechanisms for the athlete who is highly motivated to succeed and perform at optimum levels. Outdoor and adventure therapies, nutritional therapy, and working with a personal trainer can help the client in recovery from steroid abuse to redefine success as well as learn new ways of living a healthy and balanced life, both physically and mentally.
It is not uncommon for someone going through treatment for steroid addiction to struggle with depression. If this is the case, it is necessary for the client to have access to comprehensive care for this disorder in addition to addiction treatment. Depression can be as deadly as steroid abuse and addiction, and treatment should begin during drug rehab and extend for as long as needed, well after returning home.
Continued engagement with addiction treatment, treatment for co-occurring disorders, and alternative therapies are recommended to engrain the new positive habits and make sure that the old habits do not recur when the client transitions back home.