Anabolic steroid abuse facts

 Picture of a person taking anabolic steroid injection

In one study, about 3% of high school students admitted to taking steroid pills or injections without a prescription.

  • Anabolic steroids are used illegally to increase muscle, decrease fat, and enhance athletic performance and body appearance.
  • Anabolic steroids act by increasing the androgenic testosterone effects within the body.
  • Anabolic steroids can lead to potentially fatal side effects.
  • Anabolic steroids may be addictive, and users may go through withdrawal.
  • Prevention requires community education, as well as reviewing why adolescents may want to start using the drugs and understanding the risks involved.

What are anabolic steroids?

Anabolic steroids are one type of performance-enhancing drug or medication. They mimic testosterone in the body to enhance performance by making muscle cells larger and by allowing the body to recover more quickly from the stress of exercise. Slang for anabolic steroids is roids.

Performance-enhancing drugs are no longer just for bodybuilders or pro athletes who are willing to try illegal and potentially dangerous means to improve their body’s function. These drugs are being used every day by people of all ages, from middle-school, high-school, and college students to older recreational athletes.

There are two types of steroids that the body naturally produces:

Catabolic steroids or glucocorticoids are part of the body’s response to stress. The word catabolic comes from the Greek word meaning to “throw down,” and these steroids help break down large chemicals into smaller ones. For example, cortisol helps glycogen (a large molecule that is stored in the liver) metabolize into glucose, a small molecule that can be used for energy by the body. The adrenal glands naturally manufacture cortisol, and it is required for many of the basic functions of the body, including glucose metabolism, the immune response to infection, and protein, fat, and carbohydrate metabolism. Prescription medications, such as prednisone (Deltasone, Liquid Pred), hydrocortisone (Westcort), and dexamethasone (Decadron [discontinued], DexPak), are examples of steroids that are used to reduce inflammation and treat a range of illnesses from asthma and COPD to rheumatoid arthritis and allergic reactions. Low-dose hydrocortisone is the active ingredient in creams that help treat the inflammation from insect bites, poison ivy, eczema, and other local skin irritations.

Anabolic androgenic steroids are steroids that mimic testosterone in the body. Anabolic refers to the properties of these drugs to increase production of proteins that act as building blocks for muscle cells, bone, and other tissues within the body. The androgenic response (andro=male + genic=formation) describes the increased male features (secondary sexual characteristics) that occur as a result of androgenic steroids, including facial, body, and pubic hair, deepened voice, and increased sex drive or libido.

There are medical indications for prescribing these medications. Some include the following:

  • Inadequate testosterone production in the body, either because of inborn errors of metabolism or because of illnesses that decrease production
  • Certain types of anemia
  • Recovery from major illness or injury, including burns, where the body’s metabolism needs to be increased to produce more protein
  • An adjunct treatment for certain types of breast cancer
  • Hereditary angioedema
  • HIV wasting syndrome
  • Growth failure and short statures in the pediatric population

Some physicians believe that the decreased testosterone levels that occurs normally with aging is an indication for replacement therapy with anabolic steroids, but their use in otherwise healthy older patients is still controversial because of the potential serious side effects.

Chemists have manufactured many different types of anabolic steroids over the past decades. The goal of chemists is to promote the anabolic effect of the drug while decreasing the androgenic side effects that can be life-threatening. Examples of anabolic steroids include the following: