A Guide to Anabolic Steroids

By The Fix staff 07/08/14

Anabolic steroids - also known as "roids" or "the juice" -  and formally known as anabolic-androgenic steroids, are Schedule III synthetic substances as listed by the U.S. Drug Enforcement Administration. Abuse may lead to moderate or low physical dependence or high psychological dependence. 

Steroids were developed in the 1930s for men not producing sufficient testosterone. They are commonly used to promote skeletal muscle, to combat certain cancers, and for male characteristic development. Additional uses have been to help commence puberty, to "cure" impotence, and to ameliorate body waste created by HIV infection or other diseases. Steroidal compounds in low dosages are sold at gyms and used for competitions. High dosages have been obtained via mail or smuggling. In the U.S. steroids require a prescription for use but some pharmacies and laboratories have illegally diverted the substance. Other countries that do not require prescriptions are popular sources for smugglers. 

How are anabolic steroids abused?

Steroids can be taken orally, injected, or used in the form of topical creams and gels. There are also patches, drops, and implants. Use of anabolic steroids in doses ten times or higher than medically necessary is considered excessive and/or abusive. Shortly after the discovery of its medicinal purposes, bodybuilders, weightlifters, and other athletes began abusing the drug to improve their athletic performance, increase muscle growth, and decrease body fat. In addition to athletes, other known anabolic steroid abusers have been those with muscular dysmorphia, individuals with a history of physical or sexual abuse, and some teens exhibiting high risk behavior.

The most common methods of abuse are:

•Cycling: taking multiple doses over a specific time period, stopping, and restarting the cycle.

•Stacking: using several different types and doses of steroids at once in an attempt to receive bigger results faster.

•Pyramiding: slowly upping the anabolic steroid dose, or amount, over a 6-12 week period at which the peak is hit mid-cycle and intake is decreased until it is zero at the end of the time period. 

Since its creation, anabolic steroid use has grown, intensified, and diversified. Now that rules and regulations have been put in place to deter the illegal performance enhancing steroid use in sports, abusers and providers are getting creative. New steroids are being produced to go undetected in drug tests. 

How Anabolic Steroids Affect the Brain

Those who abuse anabolic steroids suffer from increased aggressive behavior or "roid rage" due to the drug’s effect on triggers in the brain. Abuse can also cause users to be more violent or to experience hypomania (literally just below mania and sometimes known as the "up" side of being bipolar: energetic, talkative, euphoric, creative, sometimes irritable). The drug prevents rapid increase in the neurotransmitter dopamine so unlike other drugs, there is no “high” achieved by abusing anabolic steroids. With different types of steroids, various doses and methods of abusing the drug, the brain’s response will vary. With long term abuse, there can be adverse effects on the brain’s pathways and chemicals (dopamine, serotonin, opioids).

It’s possible that some steroid use (androgen, not anabolic) can actually help with learning, cognition, and mood but this is usually only in people using the drug for medical purposes. Upon stopping anabolic steroid abuse, users may experience depression, suicidal thoughts and behavior. Although anabolic steroid abuse is relatively popular, scientists are still trying to understand the full scope of its effects on the brain.

Signs of Abuse

Anabolic steroid abuse is present most obviously in appearance and behavior. Rapid, increased muscle growth and decreased body fat are seen in most users, along with deepened voices, acne or other changes in skin health and appearance. They experience roid rage, or have warped ideas of their appearance and physique. They will appear to be more irritable or sometimes delusional. Signs can differ with long term abuse and not all anabolic steroids have the same side effects.

Depending on how the drug is being used, paraphernalia can range from containers of gels or creams, needles used for injection, or pills.

Long-Term Effects of Abuse

The long-term effects differ for males to females and are influenced by the manner in which the drug was abused. Some effects are permanent and will persist even if the user stops abuse while others are simply temporary. However, the effects of anabolic steroid abuse are not typically life threatening.



•Gynecomastia (male breast development)

•Disrupted hormone production

•Decreased sperm production

•Testicular atrophy

•Male-pattern baldness



•Rough skin

•Enlarged clitoris

•Deepened voice

•Increased body hair



•Suspended growth

Most long-term abusers are at an increased risk for jaundice, cardiovascular disease and decreased liver health. With oral steroids, low-density lipoprotein increase and high-density lipoprotein decrease are common side effects which can affect cell functioning. Higher risk of atherosclerosis and stroke are also linked to anabolic steroid abuse, as well as to cysts, acne, oily hair and skin, liver tumors, and to peliosis hepatis (which can lead to internal bleeding). Injecting steroids carries similar risks, and others all its own. This includes infections and diseases due to non-sterile or shared needles, contaminated or illegal production. Common infections are HIV and AIDS, hepatitis B and C. 

Anabolic Steroid Overdose

As with any drug, an overdose is a very real risk. However, since anabolic steroids are synthetic substances used in place of testosterone, the adverse effects are a little different. With a possible overdose, abusers run the risk of severe liver damage, increased susceptibility to different types of cancer, and disruptions in adolescent growth - all of which are side effects of any type of anabolic steroid use. Be on the lookout for shaking and changes in behavior leading to anxiety as well. 

In any case, if it is suspected that someone has overdosed on steroids or any drug, call 911 or seek medical attention immediately. 

Mixing with Other Drugs

Mixing anabolic steroids is common, though it is usually done with other types of steroids to enhance and intensify the desired effects. When this drug is mixed with other classes of drugs, the outcome can lead to additional hazards. When mixed with alcohol, the effects can be damaging and increase the chance of liver damage and cancer. Combining anabolic steroids with marijuana can influence mood and actions in users. The combination of the drug with cocaine or methamphetamine will only intensify adverse effects like aggression and depression. With many drugs, anabolic steroids can exacerbate the body’s reaction to each chemical leading to increased heart rate, increased pain, nausea, changes in mood and behavior, headache, and stroke. 


Steroid abuse usually happens over a long period of time during which the body is receiving large amounts of hormones. During detox, depression is a major issue, as well as how the body physically handles the withdrawal and severe changes in hormone levels. While undergoing detox, a person should get professional help from an endocrinologist who can safely monitor detox and prescribe a steroid taper and/or medicine for depression. During detox, a person may experience weakness and fatigue, changes in appetite, sickness and pain, and other changes in mood and behavior. Since many anabolic steroid abusers have body image issues (muscle dysmorphia) or have had a history of sexual or physical abuse, additional side effects of detox may occur. 

Drug Tests

Depending on the method of administration, steroids can be detected for up to a few days (pills) or as long as 18 months (injections). Other things that factor into detection are the type, amount, and length of time the anabolic steroid was used.

Legal Status

Anabolic steroids have been classified as a Schedule III drug under the Classified Substance Act since 1991. When not prescribed by a doctor or used by someone other than who it has been prescribed for, it is illegal to possess or purchase the drug. 

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From Drug Abuse websites:




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