Anabolic steroids are synthetic derivatives of the male hormone testosterone. The full name is androgenic (promoting masculine characteristics) anabolic (building) steroids (the class of drugs). These derivatives of testosterone promote the growth of skeletal muscle and increase lean body mass. Anabolic steroids were first abused by athletes seeking to improve performance. Today, athletes and others abuse anabolic steroids to enhance performance and also to improve physical appearance.

Anabolic steroids are taken orally or injected, and athletes and other abusers take them typically in cycles of weeks or months, rather than continuously, in patterns called cycling. Cycling involves taking multiple doses of steroids over a specific period of time, stopping for a period, and starting again. In addition, users frequently combine several different types of steroids to maximize their effectiveness while minimizing negative effects, a process known as stacking.

Health Hazards

Reports indicate that use of anabolic steroids produces increases in lean muscle mass, strength, and ability to train longer and harder, but long-term, high-dose effects of steroid use are largely unknown. Many health hazards of short-term effects are reversible. In addition, people who inject anabolic steroids run the added risk of contracting or transmitting hepatitis or the HIV virus that leads to AIDS.

The major side effects of anabolic steroid use include liver tumors, jaundice (yellowish pigmentation of skin, tissues, and body fluids), fluid retention, high blood pressure, increases in LDL (bad cholesterol) and decreases in HDL (good cholesterol); others are severe acne and trembling. Additional side effects include the following:

• For men - shrinking of the testicles, reduced sperm count, infertility, baldness, development of breasts.
• For women - growth of facial hair, changes in or cessation of the menstrual cycle, enlargement of the clitoris, deepened voice.
• For adolescents - growth halted prematurely through premature skeletal maturation and accelerated puberty changes.

NIDA-supported research shows that aggression and other psychiatric side effects may result from anabolic steroid abuse. Many users report feeling good about themselves while on anabolic steroids, but researchers report that anabolic steroid abuse can cause wild mood swings including manic-like symptoms leading to violent, even homicidal, episodes. Depression often is seen when the drugs are stopped and may contribute to steroid dependence. Researchers reported also that users may suffer from paranoid jealousy, extreme irritability, delusions, and impaired judgment stemming from feelings of invincibility.

Extent of Use

Anabolic steroids are abused primarily by boys, but since the early 1990s, their abuse by girls has dramatically increased.

In 1997, about 175,000 teenage girls reported taking anabolic steroids at least once within the past year, an increase of 100 percent since 1991.

The rate among teenage boys has also continued to rise, to the current estimated level of 325,000.*

Monitoring the Future Study (MTF)**

The MTF assesses drug use among adolescents and young adults across the country. Because of growing professional and public concern over the misuse and abuse of anabolic steroids by adolescents and young adults, questions regarding anabolic steroid use were added to the MTF in 1989 to afford a better understanding of the extent of the problem.

• Between 1989 and 1998, lifetime prevalence of anabolic steroid use among high school seniors fluctuated between a 3 percent high in 1989 and a 1.9 percent low in 1996. Annual prevalence rates for this period remained relatively stable.

• Among the class of 1998, 2.7 percent of high school seniors had used anabolic steroids at least once in their lifetimes - up from the class of 1997's 2.4 percent lifetime use. The rates also increased for past year and past month use from 1.4 percent in 1997 to 1.7 percent in 1998 and from 1.0 percent in 1997 to 1.1 in 1998, respectively.

• In 1998, 2.3 percent of 8th graders and 2.0 percent of 10th graders had used anabolic steroids at least once in their lifetimes, and 1.2 percent of 8th and 10th graders had used anabolic steroids within the past year.

In addition to data regarding use, the 1998 survey reported seniors' attitudes toward steroid use. Students' perceptions about the harmfulness of taking steroids and the trends in their disapproval of the use of steroids have remained relatively stable in the 1990s.

• 68.1 percent of 12th-graders perceive great risk in taking steroids.

• 91.4 percent of seniors say they disapprove of people who use steroids.

• 44.5 percent of seniors feel it would be fairly or very easy for them to get steroids.

Anabolic Steroid Use by Students, 1998:
Monitoring the Future Study