Multiple: Steroid Use

Definition
Description
Demographics
Causes and Symptoms
Diagnosis
Treatment
Prognosis
Prevention
The Future
For more information

Definition

Steroid use usually refers to the abuse of synthetic hormones to build muscles, raise athletic performance, or improve one's appearance. There are, however, two major types of steroids that are used in medicine. The synthetic hormones used to build muscles are called anabolic or androgenic steroids. They are human-made drugs related to male sex hormones or androgens.

The other group of steroid medications are known as corticosteroids or glucocorticoids. They are synthetic forms of hormones that are produced naturally by the adrenal glands when the body is stressed. Corticosteroids are often prescribed to treat inflammation in disorders like eczema, arthritis, or asthma, or to treat immune system disorders like lupus or multiple sclerosis. Although corticosteroids are strong drugs with side effects and require a doctor's prescription, they cannot be used for muscle building. The remainder of this entry will focus on anabolic steroids.

Description

Anabolic steroids are synthetic drugs modeled on the chemical structure of male sex hormones. Anabolic steroids boost the rate of protein

formation in cells, which is why they are effective in building muscle tissue and increasing physical strength. These compounds were first made in European laboratories in the 1930s; they were recommended in bodybuilding magazines as early as 1938. Anabolic steroids were given to German soldiers during World War II (1939–1945) to increase their aggressiveness, and Adolf Hitler (1889–1945) asked his personal physician for steroid injections.

Anabolic steroids do have legitimate uses in treating bone diseases in older men as well as the wasting of muscle tissue that occurs in AIDS and certain types of cancer. They are also given to boys with delayed puberty to help them mature. What is controversial about these drugs is their use (and abuse) in amateur and professional sports to improve performance. Anabolic steroids have serious psychological as well as physical side effects in females as well as males, and can lead to long-term damage to the heart and liver as well as unattractive changes in appearance.

Anabolic steroids can be taken by mouth in the form of pills or by injections. More recently, some users have tried using steroids in the form of transdermal patches, which deliver the drug into the body through the skin.

People who use anabolic steroids have several methods for trying to speed up the effects of the drugs on building muscle. One method, called

stacking, involves using several different steroids at the same time. The other method, called cycling, involves taking the drugs for six or twelve weeks at a time and not using the drugs for brief periods in between cycles. Neither stacking nor cycling makes steroids more effective, however.

Demographics

One reason for concern in the early 2000s is the young age of steroid abusers, as well as their numbers. Although the average age of people who use anabolic steroids for nonmedical purposes is twenty-five, about 2.7 percent of high school students are reported to use these drugs. Boys are more likely than girls to use steroids, and athletes are more likely to use them than high schoolers who are not athletes. According to a study conducted by the National Institutes of Health (NIH) in 2002, 2.5 percent of eighth graders have tried steroids; 3.5 percent of tenth graders; and 4 percent of high school seniors. College students are less likely than high schoolers to use steroids—about 1 percent.

Males between the ages of nineteen and forty are the heaviest users of anabolic steroids in the United States as of the early 2000s. The American College of Sports Medicine (ACSM) conducted a survey in 2005 of 500 young adults who use anabolic steroids. The survey found that most steroid users (78 percent) are noncompetitive bodybuilders and nonathletes who use the drugs to improve their appearance rather than to gain an edge in sports competitions. Thirteen percent of these users reported such unsafe injection practices as reusing needles, sharing needles, and sharing multidose vials of injectable steroids.

Causes and Symptoms

The cause of nonmedical steroid use in adolescents and young adults is usually dissatisfaction with one's appearance or a strong desire to excel at sports. One former user interviewed by an NIH researcher said, “When I walked into a room, I wanted heads to turn…. My whole priority was, I wanted people to say, ‘That guy's huge’.” Another former user said, “Steroids were the easy way to get big and to be respected, especially at the gym and they were very easy to obtain…. I see all these people who are built up on TV and stuff and I'm always comparing myself to them all the time, like, ‘I’m bigger than him,' or ‘I’m more cut up than he is.'”

The symptoms of steroid use are different for males and females. In males, steroid use can lead to:

• Loss of head hair
• Shrinking of the testicles and lowered sperm count
• Enlargement of the left ventricle of the heart, which can lead to heart problems in later life
• Increased risk of heart attack and stroke
• High blood pressure
• High blood cholesterol levels
• Weakening of joints and increased risk of rupturing tendons
• Liver damage
• Stunted growth
• Depression, increased aggressiveness, and rapid mood changes

Females who use anabolic steroids may undergo virilization, a process in which they develop certain physical characteristics associated with males:

• Growth of facial hair
• Deepening of the voice
• Irregular menstrual cycles and eventual loss of fertility
• Loss or thinning of scalp hair
• Shrinking of the breasts

Other risks related to steroid use include hepatitis or HIV infection from needle sharing; dangerous side effects from contaminated steroids or fakes (other substances sold as steroids) purchased over the Internet; and legal penalties for purchasing or possessing steroids without a prescription. Anabolic steroids are classified as Schedule III drugs, in the same group as narcotic painkillers and barbiturates. Simple possession of any Schedule III substance without a valid prescription is a federal offense punishable by up to one year in prison and/or a minimum fine of $1,000.

Diagnosis

The diagnosis of steroid use may be based on changes in the person's physical characteristics or behavior. A routine medical checkup may indicate liver damage or high blood pressure. Family members or others may notice oily skin or acne on the user's upper back, needle marks, hair

falling out, jaundice or yellowing of the skin (a sign of liver damage), changes in the person's figure, extreme mood swings, or angry outbursts.

The most common medical test for steroid abuse is a urine sample. Other laboratory tests that the doctor may order are blood tests for blood sugar levels (higher than normal may indicate steroid abuse); cholesterol levels; and liver function.

Treatment

It is important for someone who has been using steroids to talk to a doctor about quitting rather than simply stopping the drugs. Steroids are powerful hormones and can produce such side effects as nausea, vomiting, joint pain, abdominal cramps, dizziness, and low blood pressure when they are stopped abruptly. In many cases the doctor will work out a schedule to taper the patient's use of steroids gradually. The user should be completely honest with the doctor about the following details:

• All the drugs that were taken and where and how they were purchased. This information is important to help the doctor find out whether the drugs might have been contaminated or counterfeit.
• The user's dosing schedule.
• Length of usage.
• A description of any physical and mental side effects that were experienced.

A person who is coming off steroids should not stop exercising or working out. Physical exercise helps in avoiding depression as well as maintaining good general health and fitness. A balanced diet is also important, as is drinking plenty of water.

In some cases the doctor may recommend psychotherapy to treat the emotional dimension of steroid addiction.

Prognosis

The prognosis of steroid use depends on the user's gender, length of use, types and amounts of steroids used, and the age at which use began.

Prevention

The most important preventive measure is good communication between parents and children, particularly during adolescence, when concerns about appearance and achievement become critical to many teens. In many cases athletic coaches or physical education teachers can help by

talking frankly about the dangers of steroids to young people who may be experimenting with them.

The Future

Further research needs to be done about the long-term effects of anabolic steroids—including their psychological effects—at all stages of the life cycle. Beginning in 2005, a number of steroid activists began to push for decriminalization of anabolic steroids, claiming that they are not as harmful to mature adults as previous studies have indicated. It is difficult to see, however, how adults could be permitted to use steroids freely without the drugs becoming available to teenagers whose bodies are still developing and could be damaged by long-term steroid use.

SEE ALSO AIDS; Tendinitis

WORDS TO KNOW

Anabolic: Referring to tissue building. Anabolic steroids build up muscle and bone tissue.

Androgens: Male sex hormones.

Cycling: Using steroids in periods of several weeks or months (a time cycle) separated by short rest phases of not using the drugs.

Hormone: Any chemical produced by living cells that stimulates organs or tissues in parts of the body at some distance from where it is produced.

Stacking: Using several different types of steroids at the same time.

Virilization: The development of male sexual characteristics in females.

For more information

BOOKS

Fitzhugh, Karla. Steroids. Chicago, IL: Heinemann Library, 2005.

Freedman, Jeri. Steroids: High-risk Performance Drugs. New York: Rosen Publishing Group, 2009.

Schaefer, Adam Richard. Steroids. Ann Arbor, MI: Cherry Lake Publishing, 2008.

PERIODICALS

American College of Sports Medicine. “Steroid Survey Reveals Dangerous Trends among Users.” News release, June 1, 2005 (accessed July 11, 2008).

Mitchell, George. “The Steroids Era.” The New Atlantis 19 (Winter 2008): 139–141. Available online at http://www.thenewatlantis.com/publications/thesteroids-era (accessed July 11, 2008). This article is a series of excerpts from a

former Senator's testimony before a House Committee on the illegal use of steroids in major league baseball. Mitchell's testimony wasgiven on January 15, 2008.

WEB SITES

Hormone Foundation. Hormone Abuse Prevention and What You Need to Know. Available online at http://www.hormone.org/Abuse/prevention.cfm (accessed July 11, 2008).

National Institute on Drug Abuse (NIDA) InfoFacts. Steroids (Anabolic-Androgenic). Available online at http://www.nida.nih.gov/infofacts/steroids.html (accessed July 11, 2008).

Nemours Foundation. Steroids. Available online at http://kidshealth.org/parent/fitness/safety/steroids.html (accessed July 11, 2008).

NIDA for Teens. Facts on Drugs: Anabolic Steroids. Available online at http://teens.drugabuse.gov/facts/facts_ster1.asp (accessed July 11, 2008).

PBS In the Mix. Steroids: The Hard Truth. Available online at http://www.pbs.org/inthemix/shows/show_steroids.html (accessed July 11, 2008). Page contains a link to four video clips from the television program. Each clip takes about a minute and a half to play.