Anabolic Steroids Addiction: Signs and Symptoms, Causes, Effects and Treatment

Anabolic steroids artificially enhance certain physical attributes associated with male characteristics, by promoting muscle growth and physical development. While originally developed for medical use, anabolic steroids are misused to enhance body mass and muscle growth, especially in competitive sports and bodybuilding. This pattern of misuse leads to anabolic steroid addiction, where individuals become increasingly dependent on these substances, affecting both their physical health and psychological well-being. Around 3 to 4 million Americans have reportedly used anabolic-androgenic steroids, according to a study by AlShareef S et al. 2023, titled “Anabolic Steroid Use Disorder,” primarily to boost muscle mass for athletic performance or to improve physical appearance.

The signs and symptoms of anabolic steroid addiction are varied, affecting the user’s physical, psychological, and behavioral health. Physically, symptoms range from severe acne to more serious issues like hair loss, infertility, and altered sexual characteristics. Psychological symptoms include mood swings, aggression, and paranoia, while behavioral signs involve compulsive use, disregarding negative health consequences, and isolation from others. 

The causes of anabolic steroid addiction involve a mix of physical, psychological, and social factors. Some individuals are motivated by the desire for a muscular physique or to enhance athletic performance, while others struggle with body dysmorphia or peer pressure in competitive environments. According to Leifman H et al. 2011, titled “Anabolic androgenic steroids–use and correlates among gym users–an assessment study using questionnaires and observations at gyms in the Stockholm region,” about 6% of gymnasium users use anabolic steroids illegally. Additionally, those with a history of substance abuse or certain co-occurring mental health disorders are at greater risk of developing a dependency on steroids.

The effects of anabolic steroid addiction impact multiple bodily systems. Short-term effects include headaches, nausea, and rapid heart rate, while long-term use leads to severe consequences such as heart problems, liver damage, and psychological disturbances. Addiction to anabolic steroids compromises physical health, emotional stability, and interpersonal relationships, significantly lowering quality of life.

Effective treatments for anabolic steroid addiction involve a combination of medical and therapeutic interventions. Detoxification, cognitive-behavioral therapy (CBT), and support groups are part of the recovery process, providing individuals with strategies to manage cravings and rebuild their lives. In some cases, medications are also prescribed to address withdrawal symptoms or co-occurring mental health issues. These treatments aim to help individuals overcome dependency and develop healthier coping mechanisms, fostering sustainable recovery.

What are Anabolic Steroids? 

Anabolic steroids are synthetic drugs designed to mimic testosterone, the male sex hormone. Anabolic steroids fall under a category called anabolic-androgenic steroids (AAS), where “anabolic” refers to muscle-building properties, and “androgenic” pertains to masculinizing effects. These steroids are commonly used to promote increased muscle growth and enhance physical performance by boosting body mass.

Street names for anabolic steroids include “roids,” “juice,” and “pumpers.” These substances come in various forms, such as oral tablets, injectable liquids, and topical gels or creams. Injectable anabolic steroids are the most effective for muscle growth and performance enhancement, according to a study by Ganesan K et al. 2023 titled “Anabolic Steroids.” 

In the United States, anabolic steroid use is notable among athletes and bodybuilders, though it also extends to non-athlete populations seeking physical enhancement. In a survey conducted by Hoseini R. and Hoseini Z.et al. 2024, titled “Exploring the prevalence of anabolic steroid use among men and women resistance training practitioners after the COVID-19 pandemic,” of 3,603 resistance training practitioners, it was found that 53.05% of men and 41.99% of women reported using anabolic-androgenic steroids. Among male users, 29.47% opted for Testosterone, while 31.20% of female users preferred Winstrol. Additionally, 50.30% of men used steroids via injection, compared to 49.05% of women who took them orally.

The most commonly used anabolic steroids include Anavar, Anadrol-50, and Dianabol. Medically, anabolic steroids are prescribed to treat conditions that lead to muscle loss, such as chronic diseases, certain cancers, and hormone deficiencies. They help promote muscle gain, improve appetite, and support recovery in patients facing severe weight loss.

What is the Difference Between Steroids and Anabolic Steroids? 

The main difference between steroids and anabolic steroids is primarily in their purpose and effects on the body. Steroids are a broad category that includes both corticosteroids and anabolic steroids. Corticosteroids are synthetic drugs that mimic hormones produced by the adrenal glands. They are primarily used to reduce inflammation and manage immune responses in conditions such as asthma, arthritis, and allergic reactions. Steroids are not related to muscle growth but instead aim to relieve symptoms of medical conditions.

In contrast, anabolic steroids, commonly referred to as anabolic-androgenic steroids (AAS), mimic sex hormones, particularly testosterone. They are primarily used to promote muscle growth and increase body mass, which is why they are commonly associated with athletic performance enhancement. According to a study by Malve HO et al. in 2018 titled “Sports Pharmacology: A Medical Pharmacologist’s Perspective,” the prevalence of performance-enhancing substance use among athletes ranges from 5% to 31%. 

Anabolic steroids have androgenic effects as well, meaning they produce masculinizing characteristics, such as increased facial hair and deeper voice, especially in female users. The overall prevalence of anabolic-androgenic steroid (AAS) use among women was estimated at 4%, according to a study by Piatkowski T et al. 2024, titled “What is the prevalence of anabolic-androgenic steroid use among women? A systematic review.”

While both types of steroids have medical applications, corticosteroids are primarily prescribed for their anti-inflammatory properties, whereas anabolic steroids are prescribed for conditions that cause muscle loss, such as chronic illnesses or hormone deficiencies. The misuse of anabolic steroids is seen in sports and bodybuilding contexts, while corticosteroids are strictly managed to avoid long-term side effects.

What is Anabolic Steroid Addiction? 

Anabolic steroid addiction occurs when individuals develop a dependency on anabolic-androgenic steroids due to their effects on strength, physical appearance, and mental well-being. Users start anabolic steroids to improve physical appearance and increase muscle mass, but over time, they develop dependence as they feel compelled to keep using these substances despite potential health risks. 

Anabolic steroids stimulate feel-good chemicals in the brain, making some people feel more confident or energized, which contributes to their addictive potential, according to a study by Mhillaj E et al. 2015, titled “Effects of anabolic-androgens on brain reward function.” This dependency also leads to obsessive-compulsive behaviors, where users are unable to stop even when experiencing adverse effects.

The risk of addiction is real: a study by Kanayama G. et al. 2009, titled “Anabolic-androgenic steroid dependence: an emerging disorder,” found that 30% of anabolic steroid users develop dependence as they feel psychologically compelled to maintain their muscle gains and body image. Users also experience withdrawal symptoms, such as mood swings and fatigue, which reinforce the cycle of addiction. 

What are the Signs and Symptoms of Anabolic Steroid Addiction?  

The signs and symptoms of anabolic steroid addiction include physical, psychological, and behavioral changes. Physical signs include visible bodily changes, while psychological symptoms involve mood and mental health shifts, and behavioral signs show changes in routines and priorities.

The physical signs and symptoms of anabolic steroid addiction are:

• Acne and oily skin: Severe acne, particularly on the back and shoulders, is a common sign of anabolic steroid addiction, stemming from increased testosterone levels that stimulate oil production. This symptom manifests quickly, within weeks of steroid use, and becomes quite severe, leading to significant distress and skin damage.
• Rapid muscle growth: Unusually fast muscle gain serves as a hallmark of steroid use, as the body responds dramatically to elevated testosterone levels. This rapid increase in muscle mass occurs within just a few weeks of starting steroids and creates a cycle of dependency as users chase further physical changes.
• Liver damage indicators: Signs of liver strain, such as jaundice characterized by yellowing of the skin and eyes, are indicators of anabolic steroid misuse. This symptom emerges over time with prolonged steroid use and indicates serious health risks, according to a study by Petrovic A. et al. 2022, titled “Anabolic androgenic steroid-induced liver injury: An update.” 
• Fluid retention: Anabolic steroids significantly alter the balance of electrolytes and water in the body, as well as impact how the body processes and stores carbohydrates, proteins, fats, and glucose, as studied by University Hospitals titled “Understanding Steroid-Related Weight Gain.” These physiological changes lead to symptoms such as fluid retention, an increase in appetite, and the accumulation of fat, particularly noticeable in areas like the face, neck, and abdomen. This symptom appears relatively quickly and leads to discomfort and potential complications, heightening the need for user awareness.
• High blood pressure: Steroid use elevates blood pressure significantly, posing an increased risk for cardiovascular issues. The onset of high blood pressure occurs soon after starting steroids, leading to severe health risks if left unchecked.
• Hair loss or thinning: Excess testosterone from steroid use leads to premature hair loss, particularly in males. Testosterone produces a hormone called dihydrotestosterone, which is responsible for balding in both males and females, as studied by Skin Kraft titled “The Link Between Testosterone And Hair Loss In Men And Women.” Hair loss manifests gradually and is highly distressing for users, impacting self-image and reinforcing the cycle of addiction.
• Gynecomastia: Some male users develop breast tissue, a condition known as gynecomastia, due to hormonal imbalances caused by steroid use — specifically testosterone and estrogen, according to a study by Johns Hopkins Medicine titled “Gynecomastia.” This symptom is particularly alarming and leads users to seek additional steroids to counteract the changes in their bodies.

The psychological signs and symptoms of anabolic steroid addiction are:

• Mood swings: Intense mood fluctuations, ranging from irritability to euphoria, occur due to hormonal changes linked to steroid use. These swings appear early in the anabolic steroids addiction process and escalate in severity, impacting daily functioning and relationships.
• Aggression: Heightened aggression, commonly referred to as “roid rage,” is a well-documented effect of anabolic steroid abuse. This symptom surfaces quickly and leads to violent outbursts, contributing to further social and personal issues.
• Depression and anxiety: The psychological dependency on steroids frequently results in anxiety and depressive symptoms, particularly during withdrawal attempts. This distress becomes profound, influencing the user’s overall mental health and well-being.
• Obsessive focus on body image: An unhealthy obsession with physical appearance, leading to body dysmorphia, is common among users of anabolic steroids. This psychological symptom develops over time and becomes increasingly severe as users strive for unattainable ideals.
• Insomnia: Disrupted sleep patterns, characterized by difficulty falling or staying asleep, result from elevated testosterone levels. This symptom appears shortly after anabolic steroid use begins and severely impacts daily life and recovery.
• Euphoria: Users experience an initial sense of well-being, which leads to psychological dependency. This euphoric effect of anabolic steroids quickly diminishes, prompting users to increase their intake to recapture that feeling, reinforcing the cycle of addiction.
• Paranoia and distrust: Some users report heightened feelings of paranoia or exaggerated fears due to anabolic steroids addiction, affecting interpersonal relationships. This symptom develops alongside other psychological issues, further complicating the addiction’s impact on daily life.

The behavioral signs and symptoms of anabolic steroid addiction are:

• Secretive behavior: Individuals hide their anabolic steroid use, avoiding open communication with family and healthcare providers. This behavior emerges early in the anabolic steroid addiction and indicates a growing dependency on steroids, complicating recovery efforts.
• Continued use despite negative consequences: Many users persist in taking anabolic steroids, even when facing serious health or legal risks. This behavior highlights the compulsive nature of addiction and intensifies the overall impact of steroid use.
• Excessive time in the gym: A noticeable increase in gym attendance and focus on muscle-building activities signify anabolic steroid dependency. This symptom develops quickly and leads to neglect of other life responsibilities.
• Compulsive purchasing of supplements and steroids: A prioritization of steroid-related products over other financial obligations indicates a growing dependency. This behavior escalates as users become more entrenched in their anabolic steroid addiction.
• Relationship strain: Increased aggression, mood swings, and secretive behaviors due to anabolic steroid use lead to significant friction with family and friends. This symptom intensifies as anabolic steroid addiction deepens, resulting in social isolation.
• Ignoring personal responsibilities: Users of anabolic steroids neglect duties at work, school, or home as their focus shifts solely to steroid use and bodybuilding. This symptom quickly manifests and leads to severe life disruptions.
• Difficulty stopping use: Many users struggle to quit anabolic steroid use despite wanting to do so, facing intense cravings and withdrawal symptoms. This difficulty is a key indicator of addiction severity and highlights the need for professional help.

What are the Causes of Anabolic Steroid Addiction? 

The causes of anabolic steroid addiction include a mix of physical, psychological, and social factors. Anabolic steroid users are driven by a desire for enhanced physical appearance and strength, fear of losing hard-earned muscle, or to address underlying psychological issues such as body dysmorphia. Additionally, individuals with a history of substance abuse, co-occurring mental health disorders, or competitive aspirations in sports are at higher risk.

The main causes of anabolic steroid addiction include:

• Desire for Physical Appearance and Strength: Many individuals turn to steroids to rapidly increase muscle mass and enhance their physical look, aiming for an idealized physique or strength level. According to a study by the President’s Council on Physical Fitness and Sports titled “Anabolic-Androgenic Steroids: Incidence of Use and Health Implications,” 4–6% of high school males have experimented with anabolic steroids, with some research indicating usage rates as high as 12% among teenage males to improve their physical appearance and strength.
• Fear of Losing Muscle Mass: Once users achieve significant gains from the use of anabolic steroids, the fear of losing muscle drives continued use, creating dependency to maintain size and strength.
• Substance Abuse History: A personal or family history of substance abuse increases vulnerability to steroid addiction as a continuation of dependency habits.
• Co-occurring Disorders, Especially Body Dysmorphia: Conditions like body dysmorphia fuel compulsive behaviors focused on perceived body flaws, leading to steroid use to “correct” these imagined issues. Body dysmorphia is more prevalent among bodybuilders. About 10-12% of professional male weightlifters suffer from body dysmorphia, according to a survey published by The Guardian titled “Gym, eat, repeat: the shocking rise of muscle dysmorphia.”
• Competitive Edge in Sports: Athletes use steroids to boost performance, stamina, and recovery, seeking an advantage in competitive settings. Between 14% and 39% of current adult elite athletes use anabolic steroids for performance enhancement, according to a study published by Invigor Medical titled “Percentage Of Athletes Who Use Performance-Enhancing Drugs.”
• Peer Pressure and Influence: Social circles that prioritize muscle growth and strength push individuals towards anabolic steroid use to fit in or gain respect within the group.
• Power Knowledge: Some individuals view anabolic steroids as a tool for empowerment, using them to gain control over their physical appearance, which contributes to addiction.

What are the Effects of Anabolic Steroid Addiction? 

The effects of anabolic steroid addiction are widespread, impacting physical, psychological, and social health. Physically, long-term use leads to liver damage, cardiovascular problems, and hormonal imbalances, with risks of heart disease, stroke, and liver cancer rising significantly. Psychologically, addiction triggers mood swings, aggression, depression, and anxiety, which worsen as dependency grows. Socially, individuals face strained relationships and a decline in quality of life, as addiction fosters isolation and a focus on body image over well-being. These combined effects are severe, requiring professional intervention to reverse.

The physical and psychological effects of anabolic steroid addiction are as follows:

Physical Effects

Anabolic steroid addiction has numerous physical effects on both men and women, which are profound and damaging. For men, physical impacts disrupt normal reproductive function and increase the risk of various health complications, while women experience masculinizing effects due to hormonal imbalances. These physical changes, tied to the prolonged use of steroids, reflect the body’s response to artificially elevated testosterone levels and have lasting health consequences.

The physical effects of anabolic steroid addiction in men include:

• Reduced sperm count: Anabolic steroid abuse disrupts the natural production of testosterone, leading to a lower sperm count and shrunken testicles. This effect is linked to hormone imbalances that impair sperm production, which ultimately reduces fertility. While some men recover sperm production after ceasing steroid use, for others, the effect can be long-lasting or even permanent, depending on the duration and dosage of steroids used. Research by El Osta R et al. 2015 titled “Anabolic steroids abuse and male infertility” shows that the negative impact of corticosteroids on semen is reversible, while prolonged anabolic steroid use significantly reduces sperm motility and normal morphology in bodybuilders. However, sperm production normalizes in former steroid users who abstain for at least 4 months.
• Infertility: Prolonged use of anabolic steroids suppresses the body’s natural hormone production, making it difficult for men to produce viable sperm. This infertility persists long after stopping steroid use, with the severity and duration depending on factors like age, steroid type, and duration of use.
• Shrunken testicles: Shrunken testicles, known as testicular atrophy, is a condition that arises from the body’s reduced testosterone production in response to the influx of synthetic steroids. This shrinkage is reversible, but recovery varies, with some men experiencing permanent atrophy after long-term abuse.
• Erectile dysfunction: Anabolic steroid addiction impacts hormone levels, leading to erectile dysfunction (ED). The disruption in the balance of natural hormones makes it difficult for men to achieve or maintain an erection, affecting sexual performance and self-esteem, according to a study  by Azevedo RA et al. 2024, titled “Abusive use of anabolic androgenic steroids, male sexual dysfunction, and infertility: an updated review.” ED related to steroid use requires prolonged treatment and persists after cessation.
• Hair loss: High levels of synthetic testosterone accelerate hair loss, especially in men who are genetically predisposed to male pattern baldness. This effect is irreversible, with users experiencing significant hair thinning or balding that does not recover after stopping steroid use.
• Breast development (gynecomastia): Anabolic steroids cause gynecomastia, or the development of breast tissue, due to the body’s conversion of excess testosterone into estrogen. This condition is distressing and requires surgical intervention if the breast tissue becomes permanent.
• Increased risk of prostate cancer: Prolonged steroid use is associated with heightened risks of prostate issues, including the development of benign prostatic hyperplasia (BPH) and potential prostate cancer. Synthetic testosterone accelerates the growth of prostate cells, making users more susceptible to cancerous development. This risk factor is particularly concerning for long-term steroid users.
• Severe acne: Anabolic steroids increase oil production in the skin, leading to clogged pores and severe acne, particularly on the back and shoulders. This side effect is difficult to treat, leaving permanent scarring even after the user stops taking anabolic steroids.
• Stomach pain: Long-term anabolic steroid use is linked to gastrointestinal issues, with users reporting stomach pain and digestive discomfort. This effect is due to the liver processing high levels of synthetic hormones, which lead to liver strain or even damage over time.

The physical effects of anabolic steroid addiction in women include:

• Facial and body hair growth: Women who abuse anabolic steroids experience hirsutism, or excessive hair growth on the face and body, due to the masculinizing effects of increased testosterone. This effect is permanent, even after stopping steroids, causing significant distress.
• Loss of breast tissue: Elevated testosterone levels lead to a reduction in breast tissue, as anabolic steroids alter the body’s natural balance of hormones. This change is partially reversed, but some women experience permanent breast tissue reduction, depending on the duration and dosage of steroid use.
• Swelling of the clitoris (clitoromegaly): Anabolic steroids lead to clitoromegaly, a condition where the clitoris enlarges due to increased testosterone. This effect is irreversible and causes discomfort or changes in sexual sensitivity.
• Deepened voice: The masculinizing effect of steroids on women’s vocal cords leads to a permanently deepened voice. Once the voice changes, it usually cannot revert, making this one of the more lasting and noticeable effects of steroid use.
• Increased sex drive: Higher levels of testosterone increase libido, but mood swings and psychological effects also accompany this heightened drive. Anabolic steroid use, which elevates testosterone levels in the body, often leads to increased sexual interest (libido). This effect on libido typically becomes noticeable after about three weeks and reaches its peak around six weeks, with no further increases expected beyond this point, according to a study by Saad F et al. 2011, titled “Onset of effects of testosterone treatment and period until maximum effects are achieved.” This effect diminishes when steroid use stops, although the accompanying psychological impact lingers.
• Menstrual irregularities: Steroid addiction disrupts the hormonal balance that regulates menstruation, leading to irregular or missed periods. This disruption may take months or even years to normalize after discontinuing steroid use, with some women experiencing persistent reproductive health issues.
• Hair loss: Similar to men, women also experience significant hair thinning or balding from anabolic steroid use. This effect is generally irreversible and is psychologically distressing.
• Severe acne: Increased testosterone levels contribute to acne, especially on the back, chest, and face. Acne from steroid use leads to scarring and persists even after stopping steroid use, requiring extensive dermatological treatment to manage.

Psychological Effects

Psychologically, anabolic steroid addiction has equally concerning impacts. Users experience severe mood swings, anxiety, aggression, and depression. Over time, dependence on steroids leads to obsessive behavior centered around body image, potentially resulting in a decline in mental health and quality of life.

The psychological effects of anabolic steroid addiction include:

• Aggression and irritability: Anabolic steroid users exhibit heightened aggression, referred to as “roid rage,” where irritability becomes excessive and difficult to control. This effect arises from increased testosterone levels, which amplify impulsive behavior and lead to violent outbursts or confrontations. Neuroimaging techniques in adult males were presented in a study by Batrinos ML. et al. 2012, titled “Testosterone and aggressive behavior in man,” have shown that testosterone activates the amygdala, enhancing its emotional activity and its resistance to prefrontal restraining control. The severity varies, but for some, the aggression damages relationships and leads to legal issues.
• Anxiety and paranoia: Persistent use of anabolic steroids causes intense fear and paranoia, as the hormonal imbalance disrupts normal emotional regulation. Users feel an exaggerated sense of distrust or believe that others are targeting them. This paranoia is severe enough to impact daily life, with users isolating themselves or becoming defensive in interactions.
• Mood swings: Rapid changes in mood, from euphoria to anger or sadness, are common due to fluctuating hormone levels. Users feel on top of the world in one moment and are deeply frustrated or sad the next. These mood swings are unpredictable and lead to strained relationships as loved ones struggle to manage the erratic behavior.
• Depression: Coming off steroids or experiencing dependency leads to severe depression, as the body struggles to regulate mood without the aid of artificial testosterone. This effect worsens over time, sometimes leading to suicidal thoughts or actions, especially when combined with withdrawal symptoms.
• Delusional thinking or psychosis: In extreme cases, prolonged anabolic steroid use leads to delusions or even psychosis, where users lose touch with reality. They experience hallucinations, believe things that aren’t true, or display irrational fears. This is a severe effect and requires professional intervention.
• Obsessive focus on physical appearance: Many anabolic steroid users develop body dysmorphia, an obsessive concern with physical appearance, where they are never satisfied with their physique. This focus becomes compulsive, with users spending excessive time working out or scrutinizing their appearance, driven by an internalized pressure to maintain or enhance muscle mass.
• Withdrawal symptoms: When attempting to stop steroid use, users experience withdrawal symptoms like extreme fatigue, mood disturbances, and a diminished sense of well-being. These symptoms make it challenging to quit, as the body has adapted to the presence of high testosterone levels and struggles to recalibrate naturally, leading to relapse.

What are the Long-Term Effects of Anabolic Steroid Addiction?  

The long-term effects of anabolic steroid addiction include strains of the heart, liver, and kidneys, leading to chronic conditions that become life-threatening. These long-term effects emerge as the body struggles to maintain balance with artificially elevated levels of testosterone and other hormones, significantly increasing the risk of cardiovascular, renal, and hepatic issues.

The long-term effects of anabolic steroid addiction include:

• Heart attack or stroke: Prolonged anabolic steroid use places intense strain on the cardiovascular system, increasing the risk of heart attacks and strokes due to blood flow disruptions and elevated stress on the heart, according to a study by Vanberg P, Atar D. et al. 2010 titled “Androgenic anabolic steroid abuse and the cardiovascular system.” Over time, the heart weakens, heightening the risk of severe cardiovascular events, even in younger users.
• Liver or kidney problems: Anabolic steroids require the liver and kidneys to work harder to process the synthetic hormones, leading to potential damage or organ failure. This strain causes liver tumors, cysts, or kidney dysfunction, making these organs less effective at filtering toxins and regulating the body’s chemical balance.
• High blood pressure (hypertension): Fluid retention and changes in vascular pressure cause chronic high blood pressure. This increases the workload on the heart and arteries, elevating the likelihood of heart-related issues and making everyday stressors more hazardous to the cardiovascular system.
• Blood clots: Anabolic steroids alter blood composition and cholesterol levels, making it easier for clots to form. Blood clots block blood flow, causing severe health risks like pulmonary embolisms or strokes. This effect occurs even in users with no prior clotting issues, putting steroid users at increased risk for life-threatening complications.
• Fluid retention: Anabolic steroids cause the body to retain excess water, leading to noticeable swelling, especially in the extremities. This fluid retention exacerbates high blood pressure and places extra strain on the heart and kidneys, intensifying the risk of other long-term health complications.
• High cholesterol levels: Steroid use increases LDL (bad cholesterol) and reduces HDL (good cholesterol), leading to a buildup of arterial plaque. Over time, this imbalance heightens the risk of atherosclerosis, heart attacks, and other cardiovascular diseases due to restricted blood flow and artery damage.

What are the Treatments for Anabolic Steroid Addiction?  

The main treatments for steroid addiction include Detoxification, Partial Hospitalization Program (PHP), Intensive Outpatient Program (IOP), Cognitive Behavioral Therapy (CBT), and Support Groups. Each treatment option provides a specific approach to help individuals overcome their dependence on anabolic steroids, addressing both physical and psychological aspects of addiction.

Detoxification

Detoxification is the process of removing steroids from the body while managing withdrawal symptoms under medical supervision. This treatment involves monitoring by healthcare providers, who offer medications and therapies to ease symptoms like mood swings and cravings. Detox is essential for stabilizing the patient before they transition into ongoing therapy, as it reduces physical dependence and sets the foundation for further recovery efforts.

Partial Hospitalization Program (PHP)

A Partial Hospitalization Program (PHP) offers structured treatment during the day, where patients attend sessions for counseling, therapy, and education on managing anabolic steroid addiction but return home in the evenings. PHPs are ideal for those who need intensive support but prefer not to reside in a treatment facility. For anabolic steroid addiction, PHPs are helpful as they combine medical care with emotional and psychological support, addressing issues like body image and withdrawal symptoms in a comprehensive approach.

Intensive Outpatient Program (IOP)

An Intensive Outpatient Program (IOP) allows individuals to receive treatment while maintaining daily responsibilities like work or family. IOPs include multiple weekly sessions that focus on therapy, relapse prevention, and developing coping skills. For steroid addiction, IOPs help individuals gradually transition to normal life, with support in managing triggers and the psychological need for steroids. IOPs are effective for those with a solid support system at home, offering flexibility while ensuring consistent treatment.

Cognitive Behavioral Therapy (CBT)

Cognitive Behavioral Therapy (CBT) is a form of psychotherapy that helps individuals identify and change harmful thought patterns and behaviors associated with steroid use. CBT sessions focus on understanding the emotional triggers that drive steroid addiction, like low self-esteem or body image issues, and replacing them with healthier coping strategies. CBT is particularly beneficial for anabolic steroid addiction as it addresses underlying psychological factors and equips patients with skills to prevent relapse.

Support Groups

Support groups, such as those modeled after 12-step programs, provide a community-based approach to recovery, where individuals share experiences, gain encouragement, and learn from others facing similar struggles. These groups offer a safe space for discussing challenges, including the pressure to use steroids for body image or athletic performance. Support groups are helpful in maintaining long-term recovery, as they provide ongoing motivation and accountability for individuals working to overcome steroid addiction.

What Medications Are Used to Treat Anabolic Steroid Addiction?  

The medications used to treat anabolic steroid addiction are antidepressants, Selective Serotonin Reuptake Inhibitors (SSRIs), and anti-inflammatory medications. These medications address both the psychological and physical effects of steroid withdrawal, helping to manage mood-related issues, aggression, and potential physical inflammation or pain.

For those experiencing depression or mood swings as part of withdrawal, antidepressants help stabilize mood and reduce depressive symptoms that arise from the body’s decreased production of natural hormones like testosterone. In particular, SSRIs, a class of antidepressants, work by increasing serotonin levels in the brain, helping to control feelings of irritability or aggression that surface during anabolic steroid detox. 

Anti-inflammatory medications are prescribed for physical discomfort, as inflammation is a symptom during anabolic steroid withdrawal, especially in those who have experienced extensive muscle use or strain while on steroids. This combination of medications is necessary to ease the transition from dependence and promote a smoother, more stable recovery.

How Long Do Anabolic Steroids Stay in Your System? 

Anabolic steroids stay in your system for 3 weeks to 3 months, with detection times varying depending on the type, dosage, frequency of use, and testing method. For example, oral steroids like Anavar are detectable in urine for up to 3 weeks, while injectable steroids such as testosterone enanthate remain detectable for up to 3 months. 

Short-acting steroids clear from the body faster, but long-acting ones linger, especially in fat tissue, leading to extended detection times in certain tests.

The body metabolizes steroids at different rates depending on the individual’s metabolic rate and other factors like hydration, age, and body fat percentage. Blood tests detect steroids for a shorter period, 1–2 days for short-acting steroids, while hair tests identify steroid use for up to 90 days or longer, reflecting long-term exposure, according to a report by the World Anti-Doping Agency, titled “Frequently Asked Questions (FAQs) on blood steroid Markers in the Steroidal Module of the Athlete Biological Passport (ABP).”

Are Anabolic Steroids Illegal? 

Yes, anabolic steroids are illegal to possess or distribute without a valid prescription in the United States. Classified as Schedule III controlled substances under the Anabolic Steroid Control Act of 1990 and its amendments, these drugs are strictly regulated due to their potential for abuse and significant health risks. Anabolic steroids are prescribed only for specific medical conditions, such as delayed puberty or muscle-wasting diseases, and any non-medical use is prohibited.

Obtaining steroids without a prescription is illegal and results in severe legal consequences, including fines and prison time. The Drug Enforcement Administration (DEA) enforces strict penalties on the lawful possession, sale, or distribution of anabolic steroids. 

Purchasing steroids online or from unauthorized sources also carries risks, as many products are counterfeit or contaminated, heightening health hazards. Although legal with a prescription, anabolic steroids are challenging to obtain for non-therapeutic purposes, making the illicit use of these substances both legally and medically risky.

Can Athletes Get Addicted to Anabolic Steroids? 

Yes, athletes can get addicted to anabolic steroids. Although anabolic steroids do not produce the same immediate “high” as other drugs, they lead to psychological dependence due to their effects on muscle growth and physical performance. Athletes continue using steroids to maintain increased muscle mass, strength, and competitiveness, developing an obsessive-compulsive drive to keep improving physical appearance and performance. 

This dependency is frequently reinforced by body image issues and performance pressures, which lead users to rely on the drug long-term. Anecdotal evidence suggests the widespread usage of anabolic steroids among athletes (20-90%), particularly at the professional and elite amateur levels, according to a study by Berning JM et al. 2004 titled “Anabolic steroid usage in athletics: facts, fiction, and public relations.”

Prolonged steroid use alters brain function and leads to addictive behaviors, including cravings and withdrawal symptoms when trying to quit. Studies from the National Institute on Drug Abuse (NIDA) titled “Anabolic Steroids and Other Appearance and Performance Enhancing Drugs (APEDs)” suggest that individuals who misuse anabolic steroids develop tolerance, requiring higher doses to achieve the same effects, a hallmark of addiction. Withdrawal symptoms, such as mood swings, depression, and fatigue, further complicate the cessation process, making it challenging for athletes to quit without structured treatment or support.

Can Anabolic Steroid Increase the Risk of Addiction to Other Steroids? 

Yes, anabolic steroids can increase the risk of addiction to other steroids and related substances. Once individuals develop a tolerance to anabolic steroids, they begin seeking additional substances to maintain the effects, such as muscle growth and strength enhancement. This leads to using higher doses or adding new steroids, intensifying the cycle of dependence. The psychological drive to sustain enhanced physical appearance or performance fuels experimentation with a variety of steroids, resulting in polysubstance use.

According to a study by Kaufman MJ et al. 2015, titled “Brain and cognition abnormalities in long-term anabolic-androgenic steroid users indicate that long-term steroid use can alter brain chemistry, affecting regions associated with reward and motivation—making users more susceptible to addictive behaviors and cravings. 

This progression leads to using other performance-enhancing drugs or stimulants to offset the side effects of steroid use or enhance performance further. This pattern, seen in competitive sports environments, underscores how initial steroid misuse escalates into broader substance dependencies.