Drug: Anabolic SteroidsDrug: Anabolic Steroids

ReferencesReferencesNIDANIDAIowa Health SystemsIowa Health Systems

Anabolic SteroidsAnabolic Steroids

• Aavailable legally only by prescription, to Aavailable legally only by prescription, to treat conditions that occur when the body treat conditions that occur when the body produces abnormally low amounts of produces abnormally low amounts of testosterone, such as delayed puberty and testosterone, such as delayed puberty and some types of impotence.some types of impotence.

• They are also prescribed to treat body They are also prescribed to treat body wasting in patients with AIDS and other wasting in patients with AIDS and other diseases that result in loss of lean muscle diseases that result in loss of lean muscle mass.mass.

• Abuse of anabolic steroids, however, can lead Abuse of anabolic steroids, however, can lead to serious health problems, some irreversible.to serious health problems, some irreversible.

TermsTerms• Bending - mixing different drugs  Bending - mixing different drugs  • Bulking up - increasing muscle mass through steroids Bulking up - increasing muscle mass through steroids • Cycling - taking multiple doses of steroids over a specific Cycling - taking multiple doses of steroids over a specific

period of time, stopping for a time and starting again period of time, stopping for a time and starting again • Doping - using drugs and other non-food substances to Doping - using drugs and other non-food substances to

improve athletic prowess improve athletic prowess • Ergogenic drugs - performance-enhancing substances  Ergogenic drugs - performance-enhancing substances  • Megadosing - taking massive amounts of steroids by injection Megadosing - taking massive amounts of steroids by injection

or pill or pill • Plateauing - when a drug becomes ineffective at certain levels Plateauing - when a drug becomes ineffective at certain levels • Roid rages - uncontrolled outbursts of anger, frustration or Roid rages - uncontrolled outbursts of anger, frustration or

combativeness combativeness • Shotgunning - taking steroids on a hit-or-miss basis Shotgunning - taking steroids on a hit-or-miss basis • Stacking - using a combination of anabolic steroid, often Stacking - using a combination of anabolic steroid, often

taken in combination with other drugs taken in combination with other drugs • Tapering - slowly decreasing steroids intake Tapering - slowly decreasing steroids intake

SteroidsSteroids• Three typesThree types

– anabolic (male hormone/most frequently abused), cortical, anabolic (male hormone/most frequently abused), cortical, and estrogenic (female hormone).and estrogenic (female hormone).

• Anabolic steroidsAnabolic steroids– synthetic derivatives of the male hormone testosterone. The synthetic derivatives of the male hormone testosterone. The

full name is androgenic anabolic steroids and they promote full name is androgenic anabolic steroids and they promote growth of the skeletal structure and increase lean body mass.growth of the skeletal structure and increase lean body mass.

• Anabolic steroids are taken orally or injected. They are Anabolic steroids are taken orally or injected. They are taken in continuous patterns called "cycling," which occur taken in continuous patterns called "cycling," which occur by starting, stopping and starting again over a period of by starting, stopping and starting again over a period of weeks or months and changing the dosages of the steroids.weeks or months and changing the dosages of the steroids.

• Users will combine anabolic steroids (“stacking”)often Users will combine anabolic steroids (“stacking”)often times with other drugs (stimulants, depressants, times with other drugs (stimulants, depressants, painkillers, anti-inflammatories) to maximize their painkillers, anti-inflammatories) to maximize their effectiveness while minimizing negative effects.effectiveness while minimizing negative effects.

Anabolic SteroidsAnabolic Steroids

• Short term effects: Short term effects: – Increase strength Increase strength – Increase muscle size Increase muscle size – Help muscle recover Help muscle recover

Signs of Addiction/Indications Signs of Addiction/Indications of Misuseof Misuse

• Quick weight and muscle gain Quick weight and muscle gain • Increased combativeness and Increased combativeness and

aggressiveness aggressiveness • Jaundice Jaundice • Purple or red spots on body; Purple or red spots on body;

unexplained darkness of skin unexplained darkness of skin • Persistent unpleasant breath odor Persistent unpleasant breath odor • Swelling feet or lower legs Swelling feet or lower legs • Severe acne and/or rashes Severe acne and/or rashes

Clinical Effects: Physical RisksClinical Effects: Physical Risks

• Stunted growth Stunted growth • Increased cholesterol Increased cholesterol • Sexual function problems Sexual function problems • Heart disease Heart disease • Liver tumors Liver tumors • Jaundice Jaundice • Fluid retention Fluid retention • High blood pressure High blood pressure • Cancer Cancer • Cataracts Cataracts • Men experience shrinking of the testicles, reduced sperm count, Men experience shrinking of the testicles, reduced sperm count,

impotence, premature baldness, enlarged prostate gland, gynecomastia impotence, premature baldness, enlarged prostate gland, gynecomastia (breast enlargement) and difficulty or pain in urinating (breast enlargement) and difficulty or pain in urinating

• Women take on masculine traits, develop hairiness, deepening of voice, Women take on masculine traits, develop hairiness, deepening of voice, enlargement of clitoris, breast reduction, change or cessation of enlargement of clitoris, breast reduction, change or cessation of menstrual cycle menstrual cycle

• Death Death • Extreme irritability Extreme irritability • Delusions Delusions • Impaired judgement stemming from feelings of invincibility Impaired judgement stemming from feelings of invincibility • "Roid" rage or wild mood swings "Roid" rage or wild mood swings • Manic-like behavior that can lead to violent, even homicidal, episodes Manic-like behavior that can lead to violent, even homicidal, episodes • Depression Depression

DSM-IV Diagnostic Criteria for DSM-IV Diagnostic Criteria for Substance AbuseSubstance Abuse

• Recurrent substance use resulting in failure Recurrent substance use resulting in failure to fulfill major role obligations at work, to fulfill major role obligations at work, school, or home. school, or home.

• Recurrent substance use in situations in Recurrent substance use in situations in which it is physically hazardous. which it is physically hazardous.

• Recurrent substance-related legal problems. Recurrent substance-related legal problems. • Continued substance abuse despite having Continued substance abuse despite having

persistent or recurrent social or persistent or recurrent social or interpersonal problems caused by or interpersonal problems caused by or exacerbated by the effects of the substance. exacerbated by the effects of the substance.

DMS-IV Diagnostic Criteria for DMS-IV Diagnostic Criteria for Substance DependenceSubstance Dependence

• Tolerance, ad defined by either of the following: Tolerance, ad defined by either of the following: – The need for marked increased amounts of the substance to achieve The need for marked increased amounts of the substance to achieve

intoxication or desired effect. intoxication or desired effect. – Markedly diminished effect with continued use of the same amount of the Markedly diminished effect with continued use of the same amount of the

substance. substance. • Withdrawal, as manifested by either of the following: Withdrawal, as manifested by either of the following:

– The characteristic withdrawal syndrome for the substance. The characteristic withdrawal syndrome for the substance. – The same (or closely related) substance is taken to relieve or avoid withdrawal The same (or closely related) substance is taken to relieve or avoid withdrawal

symptoms. symptoms. • Taking the substance often in larger amounts or over a longer period Taking the substance often in larger amounts or over a longer period

than was intended. than was intended. • A persistent desire or unsuccessful effort to cut down or control A persistent desire or unsuccessful effort to cut down or control

substance use. substance use. • Spending a great deal of time in activities necessary to obtain or use the Spending a great deal of time in activities necessary to obtain or use the

substance or to recover from its effects. substance or to recover from its effects. • Giving up social, occupational or recreational activities because of Giving up social, occupational or recreational activities because of

substance abuse. substance abuse. • Continuing the substance use with the knowledge that it is causing or Continuing the substance use with the knowledge that it is causing or

exacerbating a persistent or recurrent physical or psychological problem. exacerbating a persistent or recurrent physical or psychological problem.

Abused Steroids Abused Steroids

• More than 100 different anabolic More than 100 different anabolic steroids have been developed, but steroids have been developed, but they require a prescription to be they require a prescription to be used legally in the United States. used legally in the United States. Most steroids that are used illegally Most steroids that are used illegally are smuggled in from other are smuggled in from other countries, illegally diverted from countries, illegally diverted from U.S. pharmacies, or synthesized in U.S. pharmacies, or synthesized in clandestine laboratories. clandestine laboratories.

Abused SteroidsAbused Steroids