Steroid Addiction: Symptoms, Causes, Risks, Treatment, and Prevention

Steroid addiction is a complex issue that involves the compulsive use of anabolic-androgenic steroids, a class of synthetic hormones often used to enhance physical performance or appearance. According to a 2022 article published in the National Health Service titled “Anabolic Steroid Misuse,” Anabolic steroids are highly addictive substances. This means that people who use them develop a strong craving or compulsive desire to keep taking the drugs, even in the face of experiencing negative physical side effects.

The symptoms of steroid addiction manifest both physically and psychologically, ranging from increased muscle mass and acne to mood swings and aggressive behavior. Uncovering the root causes is key, whether it’s a desire for enhanced athletic performance, body image concerns, or deeper mental health struggles.

The risks of steroid addiction include cardiovascular issues, hormonal imbalances, organ damage, and increased cancer risk. The dangers are far-reaching and noticeably impact your overall well-being.

Fortunately, there are effective treatment approaches available for steroid addiction, including detoxification, behavioral therapies, and even medication-assisted options. 

Prevention of steroid addiction involves educational campaigns, promoting healthy body image, and strengthening anti-doping policies in sports and fitness communities. 

What is Steroid Addiction?

Steroid addiction refers to the compulsive and problematic use of anabolic-androgenic steroids, which are synthetic derivatives of the male hormone testosterone. The same 2022 article by NHS suggests that despite experiencing unpleasant physical side effects, such as acne, oily skin, and reduced testicle size in males, individuals addicted to anabolic steroids may continue to use them. This behavior is driven by psychological dependence and the desire to maintain the perceived benefits of steroid use. 

Steroid addiction is primarily observed in individuals who use the drugs for bodybuilding, athletic performance enhancement, or physical appearance, not medical purposes. It leads to serious health issues like liver damage, cardiovascular problems, and psychiatric symptoms such as aggression and mood disturbances.

Treatment typically involves a combination of behavioral therapy, counseling, and, in some cases, medication to manage withdrawal symptoms and cravings, as well as tackling the root motivations and psychological factors that drive the addictive behavior.

What are the Symptoms of Steroid Addiction?

The symptoms of steroid addiction include experiencing withdrawal symptoms when discontinuing use, continuing to use steroids despite negative consequences, exhibiting behavioral changes like increased aggression and mood swings, suffering from depression, etc.

1. Aggression and Violence 

Based on the information shown in the PubMed article titled  “Behavioral Manifestations of Anabolic Steroid Use”,  Anabolic steroid use has been associated with increased aggression. This suggests that individuals who are addicted to steroids may exhibit more aggressive behavior compared to non-users.

Some of these aggressive behaviors that come with steroid addiction include uncharacteristic anger, irritability, and hostility that are markedly different from their baseline personality. The link between steroid use and aggression has been well-documented in the literature, with studies showing that steroid users are more prone to physical altercations, verbal outbursts, and other violent acts compared to non-users. 

2. Mania

Steroid abuse leads to the development of manic symptoms in some individuals. These manic symptoms include elevated mood, increased energy, and impulsivity. Users may experience periods of grandiose thinking, decreased need for sleep, and a sense of euphoria that is markedly different from their typical emotional state. 

The manic episodes experienced by steroid users are severe and disruptive to their daily functioning, leading to poor decision-making, risk-taking behavior, and strained interpersonal relationships.

3. Psychosis

Although less common than aggression and mania, steroid abuse has been linked to the emergence of psychotic symptoms. These psychotic symptoms include hallucinations, delusions, and disorganized thinking. Users may experience false beliefs, sensory disturbances, and a loss of touch with reality that is highly distressing and disruptive. 

The psychotic episodes associated with steroid use are acute and may require immediate medical intervention to stabilize the individual and prevent harm to themselves or others. 

4. Depression 

Steroid users experience persistent sadness, loss of interest, changes in appetite, and sleep disturbances. These depressive symptoms persist even after discontinuing steroid use, as part of the withdrawal process. 

The transition from the heightened emotional state of steroid use to a depressive state is challenging for users and may increase the risk of suicidal ideation or attempts. 

5. Withdrawal Symptoms

Long-term steroid users develop a dependence on these substances and experience withdrawal when they stop using them. Withdrawal symptoms include fatigue, irritability, insomnia, decreased appetite, and depression. 

The severity and duration of withdrawal symptoms vary depending on the individual’s steroid use pattern and overall health. Withdrawal is a difficult and uncomfortable process and may require medical intervention and support to manage the physical and psychological distress associated with it. 

What are the Causes of Steroid Addiction?

The 5 main causes of steroid addiction include hormonal imbalance, desire for physical transformation, performance enhancement in sports, availability, and underlying mental health issues. Let’s get into them in detail: 

1. Hormonal imbalance

Prolonged steroid use disrupts the body’s natural production of hormones, particularly testosterone. This leads to a physiological dependence on exogenous steroids as the body struggles to maintain hormonal homeostasis.

2. Desire for physical transformation

Many individuals turn to steroids to achieve a specific physical appearance, such as increased muscle mass or a more defined physique. This obsession with the desired physical outcome evolves into a psychological dependence on steroid use.

3. Performance enhancement in sports

In some athletic and fitness communities, the use of performance-enhancing substances, including steroids, may be perceived as a necessary or even expected means of gaining a competitive edge. This social pressure contributes to the initiation and perpetuation of steroid use.

In a 2010 study by Brennan P. Brennan, MD, MSc et al. titled “Human Growth Hormone Abuse in Male Weightlifters” and published in the American Journal on Addictions, researchers found that among 231 experienced young male weightlifters, 12% reported illicit use of human growth hormone (HGH). Notably, all of these HGH users also engaged in anabolic-androgenic steroid (AAS) use, with 81% meeting the criteria for AAS dependence. Furthermore, 56% of the HGH users reported dependence on other substances, such as opioids, cocaine, and ecstasy. 

4. Underlying mental health issues

Some individuals may use steroids as a means of coping with underlying mental health problems, such as body dysmorphia, low self-esteem, or depression. The temporary physical and psychological effects of steroid use provide a sense of relief, reinforcing the addictive behavior.

5. Availability and accessibility

The ease of obtaining steroids, either through legal or illegal channels, facilitates the initiation and continuation of steroid use. The normalization of steroid use within certain social circles further contributes to the accessibility and acceptability of these substances.

What are the Risks Associated with Steroid Addiction?

The risks of steroid addiction include hormonal imbalances, liver damage, psychological problems, and physical issues. According to a study by Angell et al. published in the journal Sports Medicine in 2012, the use of anabolic steroids, particularly in non-medical and unsupervised settings, has serious and potentially life-threatening consequences for cardiovascular health. 

What are the Physical Effects of Steroid Addiction?

The physical effects of steroid addiction are hormonal imbalances, liver damage, musculoskeletal problems,  and cardiovascular issues. 

1. Hormonal imbalances: Steroids disrupt the body’s natural production of hormones like testosterone, leading to issues like decreased libido, sexual dysfunction, fertility problems, and abnormal menstrual cycles.

2. Liver damage: Many steroids are processed through the liver, and long-term use causes liver inflammation, the development of tumors and cysts, and other potentially life-threatening liver diseases.

3. Musculoskeletal problems: Findings published in the New York State Department of Health article titled “Anabolic Steroids and Sports: Winning at any Cost” reveal that the use of steroids leads to rapid muscle growth and increased strength. However, this rapid physical change puts a strain on the musculoskeletal system, potentially resulting in joint pain, tendon and ligament injuries, muscle cramps, and overall musculoskeletal discomfort.

4. Cardiovascular issues: Steroids cause the body to retain fluid, increasing blood pressure and putting stress on the heart. They also negatively impact cholesterol levels and increase the risk of heart attacks and strokes.

What are the Mental Effects of Steroid Addiction?

The mental effects of steroid addiction include mood swings, anxiety, delusions, and impaired judgment. According to a review article published in PubMed by Ryan C.W. et al. titled “Psychiatric Complications of Anabolic Steroid Abuse,” the abuse of anabolic steroids can have detrimental effects on mental health. These effects may include depression, mania, psychosis, aggression, and potential withdrawal symptoms.

1. Mood swings and aggression: Steroids cause dramatic fluctuations in mood, leading to irritability, hostility, and violent outbursts. This “roid rage” phenomenon is one of the most well-known and concerning mental effects of steroid abuse.

2. Depression and anxiety: Long-term steroid use has been linked to the development of clinical depression, as well as heightened anxiety and paranoia. The hormonal imbalances caused by steroids disrupt normal brain chemistry and contribute to these mental health issues.

3. Psychosis and delusions: In extreme cases, steroid abuse has been associated with the onset of psychotic episodes, including delusions, hallucinations, and detachment from reality.

4. Impaired judgment and risk-taking: Steroids negatively impact cognitive functioning and decision-making, leading users to engage in reckless or dangerous behaviors.

What are the Treatment Options for Steroid Addiction?

The 5 treatment options for steroid addiction include medication-assisted treatment, behavioral therapies, harm-reduction strategies, rehabilitation programs, and peer counseling. If you or your loved one is struggling with steroid addiction, you may want to look into the details below: 

1. Medication-Assisted Treatment

Medication-assisted treatment (MAT) refers to the use of medications in combination with counseling and behavioral therapies to provide a holistic approach to the treatment of substance use disorders, including opioid and alcohol addiction.

The information from the American Addiction Centers in an article titled “Anabolic Steroid & Corticosteroid Withdrawal: Signs, Symptoms & Treatment” indicates that in some cases, medication may be prescribed to manage withdrawal symptoms or treat co-occurring mental health conditions. For example, small amounts of antipsychotic or anti-manic medications may be prescribed if manic or psychotic symptoms occur during the detox process. SSRIs (selective serotonin reuptake inhibitors) may be used to treat depression that persists after detox.

2. Behavioral therapies

A study published in the Journal of Substance Abuse Treatment in 2013 titled “Cognitive-behavioral therapy reduces substance use among men with anabolic steroid dependence” found that cognitive-behavioral therapy was effective in reducing steroid use and improving psychological outcomes in individuals with steroid dependence.

Cognitive-behavioral therapy (CBT) helps individuals develop healthy coping mechanisms and address the underlying psychological factors that drive their steroid use. 

3. Harm reduction strategies

Harm reduction strategies are another important component of tackling steroid addiction. For example, needle exchange programs provide clean injection equipment and reduce the risks of infections and other complications associated with steroid administration. Counseling on proper dosing, cycling, and post-cycle therapy also helps mitigate some of the negative health consequences of steroid use.

4. Comprehensive rehabilitation programs

These programs combine medical, psychological, and social support services to address the various aspects of steroid addiction. Inpatient programs offer a structured and controlled environment, while outpatient programs provide a more flexible approach, allowing individuals to receive treatment while maintaining their daily routines.

4. Support groups and peer counseling

Peer-led support groups offer a sense of community and shared experiences, which is beneficial for individuals struggling with steroid addiction. Peer counselors who have successfully overcome steroid addiction offer guidance and role modeling for those in treatment.

5. Aftercare and relapse prevention strategies

These are crucial for sustaining long-term recovery. Ongoing follow-up care and monitoring help individuals maintain their progress and prevent relapse. Developing coping mechanisms and identifying high-risk situations is important in maintaining abstinence from steroids.

How Do You Prevent Steroid Addiction?

You can prevent steroid addiction by prioritizing your health; the temporary boost in performance or appearance that steroids may provide is not worth the lifelong consequences. Also, instead of turning to steroids, focus on building strength and muscle mass through proper nutrition, exercise, and rest.

For preventing steroid abuse in high school athletes, a 2023 review by the NIH titled “Anabolic Steroids and Other Appearance and Performance Enhancing Drugs (APEDs)” shows that one effective way to prevent steroid use among high school athletes is to have their peers and parents disapprove of it. This suggests that involving the athlete’s social circle, such as their peers and parents, can be a strong strategy in steroid use prevention efforts.

What are some effective aftercare and relapse prevention strategies for steroid addiction?

Effective aftercare for steroid addiction includes ongoing counseling, support group participation, lifestyle changes, relapse prevention planning, continued medical monitoring, contingency management, and holistic approaches. This comprehensive approach addresses the physical and psychological aspects of addiction, equipping individuals with the tools to manage triggers, maintain abstinence, and support long-term recovery, ultimately preventing relapse.

What are the different forms of steroids?

The main forms of steroids are oral steroids, injectable steroids, and topical steroids. 

  1. Oral steroids:  These are pills or capsules taken by mouth, like Dianabol, Anadrol, and Winstrol.
  2. Injectable steroids: These are liquids injected into the muscle, such as testosterone cypionate, Deca-Durabolin, and trenbolone acetate.
  3. Topical steroids:  These include creams, gels, and patches applied to the skin, like testosterone transdermal patches.

There are also less common forms like prohormones, which the body converts into steroids, and over-the-counter supplements that claim to be “natural” steroids. Steroids come in different ester forms that affect how fast they’re absorbed and how long they last in the body. Users often “stack” multiple steroid types to try to maximize the performance-enhancing effects.

How long does it take to recover from steroid addiction?

Fully recovering from the physical and psychological impacts of steroid addiction takes anywhere from 6 months to 2 years or more, depending on the severity and duration of the individual’s substance abuse. Even after the initial withdrawal period, maintaining long-term abstinence and preventing relapse requires ongoing dedication, lifestyle changes, and a commitment to a sustainable recovery plan. 

What are the law enforcement efforts and legal implications of steroid addiction?

Steroid abuse and trafficking have been the target of significant law enforcement crackdowns. Agencies like the Drug Enforcement Administration (DEA) have made the investigation and prosecution of steroid-related crimes a priority. 

This has included targeting dealers and distributors, conducting raids on underground steroid labs and seizure of illicit shipments, monitoring the online black market for steroids, and pursuing those involved in internet-based sales.

The possession and distribution of anabolic steroids without a valid prescription is illegal in many countries. In the United States, steroids were classified as Schedule III controlled substances under the Controlled Substances Act in 1990. This means:

  • Individuals found in possession of steroids without a valid prescription will face criminal charges, fines, and potential jail time.
  • The manufacture, sale, or distribution of steroids is also a criminal offense, with penalties that include lengthy prison sentences.
  • Depending on the scale and nature of the offense, steroids-related crimes are often prosecuted at both the state and federal levels.
  • Beyond the direct legal penalties, steroid addiction also has collateral consequences, such as difficulties securing employment or professional licenses.

The legal framework and enforcement actions surrounding steroids aim to disrupt the supply chain and deter both users and traffickers.

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