03. Anabolic Steroids Abuse

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03. Anabolic Steroids Abuse

 

CATEGORY: Anabolic Steroids 100 Courses

COURSE NUMBER: 03

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Syllabus

Preface………………… vii
Geraline C. Lin and Lynda Erinoff
Abuse Liability of Anabolic Steroids and Their Possible
Role in the Abuse of Alcohol, Morphine, and Other
Substances………………… 1
Theodore J. Cicero and Lynn H. O’Connor
History of Anabolic-Androgenic Steroids………………. 29
Charles D. Kochakian
Anabolic-Androgenic Steroids………….. 60
John A. Lombardo
Anabolic Steroids: An Ethnographic Approach…………… 74
Paul J. Goldstein
Incidence of the Nonmedical Use of Anabolic-Androgenic
Steroids……………. 97
Charles E. Yesalis, William A. Anderson,
William E. Buckley, and James E. Wright
Androgens: Endocrine Physiology and Pharmacology…………. 113
Stephen J. Winters

The Androgen-Induced Phenotype……………131
C. Wayne Bardin, James F. Catterall, and
Olli A. Jänne
Reappraisal of the Health Risks Associated With the
Use of High Doses of Oral and Injectable
Androgenic Steroids……………….142
Karl E. Friedl

Androgen Interaction Through Multiple Steroid Receptors……. 178
Olli A. Jänne
Anabolic-Androgenic Steroids Profoundly Affect Growth
at Puberty in Boys…………… 187
Alan D. Rogol, Paul M. Martha, Jr., and
Robert M. Blizzard
Indications of Psychological Dependence Among
Anabolic-Androgenic Steroid Abusers………….. 196
C.E. Yesalis, J.R. Vicary, W.E. Buckley,
A.L. Streit, D.L. Katz, and J.E. Wright
Anabolic-Androgenic Steroid-Induced Mental
Status Changes…………… 215
David L. Katz and Harrison G. Pope, Jr.
Anabolic Steroids and Behavior: A Preclinical
Research Prospectus…………….. 224
Bruce B. Svare
List of NIDA Research Monographs…………. 242

What are the Anabolic Steroids abuse?

Anabolic steroids are synthetic, or human-made, variations of the male sex hormone testosterone. The proper term for these compounds is anabolic-androgenic steroids. “Anabolic” refers to muscle building, and “androgenic” refers to increased male sex characteristics. Some common names for anabolic steroids are Gear, Juice, Roids, and Stackers. Health care providers can prescribe steroids to treat hormonal issues, such as delayed puberty. Steroids can also treat diseases that cause muscle loss, such as cancer and AIDS. But some athletes and bodybuilders misuse these drugs in an attempt to boost performance or improve their physical appearance.

The majority of people who misuse steroids are male weightlifters in their 20s or 30s. Anabolic steroid misuse is much less common in women. It is difficult to measure steroid misuse in the United States because many national surveys do not measure it. However, use among teens is generally minimal. The 2016 NIDA-funded Monitoring the Future study has shown that past-year misuse of steroids has declined among 8th and 10th graders in recent years, while holding steady for 12th graders.

How do people misuse anabolic steroids?

People who misuse anabolic steroids usually take them orally, inject them into muscles, or apply them to the skin as a gel or cream. These doses may be 10 to 100 times higher than doses prescribed to treat medical conditions.

Commons patterns for misusing steroids include:
• cycling—taking multiple doses for a period of time, stopping for a time, and then restarting
• stacking—combining two or more different steroids and mixing oral and/or injectable types
• pyramiding—slowly increasing the dose or frequency of steroid misuse, reaching a peak amount, and then gradually tapering off to zero
• plateauing—alternating, overlapping, or substituting with another steroid to avoid developing a tolerance
There is no scientific evidence that any of these practices reduce the harmful medical consequences of these drugs.

How do anabolic steroids affect the brain?
Anabolic steroids work differently from other drugs of abuse; they do not have the same short-term effects on the brain. The most important difference is that steroids do not directly activate the reward system to cause a “high”; they also do not trigger rapid increases in the brain chemical dopamine, which reinforces most other types of drug taking behavior.

Misuse of anabolic steroids might lead to negative mental effects, such as:
• paranoid (extreme, unreasonable) jealousy
• extreme irritability and aggression (“roid rage”)
• delusions—false beliefs or ideas
• impaired judgment
• mania

What are other health effects of anabolic steroids?
Aside from mental effects, steroid use commonly causes severe acne. It also causes the body to swell, especially in the hands and feet.

Long-Term Effects
Anabolic steroid misuse might lead to serious, even permanent, health problems such as:
• kidney problems or failure
• liver damage and tumors
• enlarged heart, high blood pressure, and changes in blood cholesterol, all of which increase the risk of stroke and heart attack, even in young people
• increased risk of blood clots

Several other effects are gender- and age-specific:
• In men:
• shrinking testicles
• decreased sperm count
• baldness
• development of breasts
• increased risk for prostate cancer
• In women:
• growth of facial hair or excess body hair
• decreased breast size
• male-pattern baldness
• changes in or stop in the menstrual cycle
• enlarged clitoris
• deepened voice
• In teens:
• stunted growth (when high hormone levels from steroids signal to the body to stop bone growth too early)
• stunted height (if teens use steroids before their growth spurt)
Some of these physical changes, such as shrinking sex organs in men, can add to mental side effects such as mood disorders.

Are anabolic steroids addictive?
Even though anabolic steroids do not cause the same high as other drugs, they can lead to a substance use disorder. A substance use disorder occurs when a person continues to misuse steroids, even though there are serious consequences for doing so. The most severe form of a substance use disorder is addiction. People might continue to misuse steroids despite physical problems, high costs to buy the drugs, and negative effects on their relationships. These behaviors reflect steroids’ addictive potential. Research has further found that some steroid users turn to other drugs, such as opioids, to reduce sleep problems and irritability caused by steroids.

People who misuse steroids might experience withdrawal symptoms when they stop use, including:
• fatigue
• restlessness
• loss of appetite
• sleep problems
• decreased sex drive
• steroid cravings
One of the more serious withdrawal symptoms is depression, which can sometimes lead to suicide attempts.

How can people get treatment for anabolic steroid addiction?
Some people seeking treatment for anabolic steroid addiction have found a combination of behavioral therapy and medications to be helpful.
In certain cases of addiction, patients have taken medicines to help treat symptoms of withdrawal. For example, health care providers have prescribed antidepressants to treat depression and pain medicines for headaches and muscle and joint pain. Other medicines have been used to help restore the patient’s hormonal system.

What are the Most Common Side Effects That May Occur with Anabolic Steroid Use?
There is a wide array of serious side effects associated with abuse of anabolic steroids; an example listing can be found here.4 Steroid use can alter the normal hormonal production in the body. Most side effects can be reversed if the drugs are stopped, but some, such as a deepened voice in women may persist. Data on long-term side effects primarily come from case reports and not from well-controlled, long-term epidemiological studies, which might be more reliable.

Common side effects with anabolic steroids may include:
• severe acne, oily skin and hair
• hair loss
• liver disease, such as liver tumors and cysts
• kidney disease
• heart disease, such as heart attack and stroke
• altered mood, irritability, increased aggression, depression or suicidal tendencies
• alterations in cholesterol and other blood lipids
• high blood pressure
• gynecomastia (abnormal development of mammary glands in men causing breast enlargement)
• shrinking of testicles
• azoospermia (absence of sperm in semen)
• menstrual irregularities in women
• infertility
• excess facial or body hair (hirsutism), deeper voice in women
• stunted growth and height in teens
• risk of viral or bacterial infections due to unsterile injections

Are Anabolic Steroids Addictive?
Users of anabolic steroids can become both physically and psychologically dependent upon the drugs, as evidenced by a drug-seeking behavior, continued use even with adverse effects, and physical withdrawal symptoms such as mood swings, fatigue, restlessness, loss of appetite, insomnia, reduced sex drive, and steroid cravings. Severe withdrawal can lead to depression and possible suicide. Depressive symptoms can persist for up to one year after the user stops taking the steroid.

Supportive treatments and medication interventions may be needed for severe anabolic addiction. Medications that have been used for treating anabolic steroid withdrawal allow the natural hormonal system to restore. Other medications target specific withdrawal symptoms. For example, antidepressants may be prescribed to treat depressive episodes and analgesics, such as acetaminophen or ibuprofen, may be used for headaches and muscle and joint pains. Some patients may also undergo behavioral therapies.

What is Being Done to Combat Anabolic Steroid Abuse?
Awareness and educational efforts are working to help prevent anabolic steroid abuse in schools and communities. The Adolescents Training and Learning to Avoid Steroids (ATLAS) and the Athletes Targeting Healthy Exercise and Nutrition Alternatives (ATHENA) programs, funded by the NIDA, and supported by the Oregon Health & Science University programs, are scientifically-proven programs that teach athletes they do not need steroids to build powerful muscles and improve athletic performance.

These programs provide:
• weight-training and nutrition alternatives
• increase healthy behaviors
• less likelihood to try steroids
• less likelihood to engage in other dangerous behaviors such as drinking and driving, use of marijuana and alcohol, and and improved body image.
Both Congress and the Substance Abuse and Mental Health Services Administration endorsed these model prevention programs.

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