Anabolic/Androgenic steroids are synthetic substances related to the male sex hormones. They promote growth of skeletal muscles, which is the anabolic effect, and the development of male sexual characteristics, the androgenic effects, and also have other effects. These substances are used by doctors to treat conditions that occur when the body produces abnormally low amounts of testosterone, such as delayed puberty and some type of impotence. They are also used to treat the body in wasting diseases, such as AIDS and other diseases which create this phenomenon. Steroids are legally available in the United States only by prescription. Steroid abusers obtain drugs which have been made in clandestine laboratories, which are often of poor quality and control standards, drugs which are smuggled in from other countries or diverted illegally from US pharmacies.
Anabolic steroid abuse is increasing among adolescents, most rapidly among females. In 1999, monitoring the future study produced by the National Institute of Drug Abuse indicated a 50% increase among 8th and 10th graders of anabolic steroid use and 38% increase among 12th graders. The use is still relatively small, being about 3% of the population. It is believed that there is more widespread abuse among athletes and sports competitors at all levels, although few studies are available to provide exact estimates of prevalence. In most cases, the abuser is motivated by the desire to build muscles and improve sports performance. Some individuals are motivated by erroneous perceptions of their own body, that is, mistaken belief that they look underweight or puny, and others by a desire to prevent recurrent physical or sexual attacks that they have experienced.
Anabolic steroids can be taken orally as tablets or capsules. Trade names often are Anderol, Oxanderon, Winstrol, and others, or by injection into muscles, with drugs such as Depo-Testosterone. Other ways to take in anabolic steroids are by ointment preparations rubbed into the skin and by skin patches. Doses taken by abusers can be up to 100 times more than the dose used to treat medical conditions.
In combination, a practice called stacking, abusers frequently take two or more anabolic steroids together, mixing oral and/or injectable types, sometimes adding drugs such as stimulants or painkillers. The rationale for stacking is a belief which has not been tested by science that the different drugs interact to produce a greater effect in muscle size than can be obtained by simply increasing the dose of a single drug.
Another widely used practice is called pyramiding. At the beginning of the cycle, the person starts with a low dose of the stacked substance and gradually increases the dosage for six to twelve weeks. In the second half of the cycle, the doses are slowly decreased to zero. This is sometimes followed by a second cycle during which the person continues to train without drugs. Abusers believe that pyramiding allows the body time to adjust to the high dose, and the drug free cycle allows time for the body's hormonal system to recuperate. As with stacking, the perceived benefit of pyramiding has not been substantiated scientifically.
Health consequences associated with anabolic steroid abuse in boys and men include: reduced sperm production, shrinking of the testicles, impotence, difficulty or pain in urinating, baldness and irreversible breast enlargement. In girls and women the development of more masculine characteristics such as a decrease in body fat and breast size, deepening of the voice, excessive growth of body hair and loss of scalp hair are common occurrences. In adolescents of both sexes premature termination of the adolescent growth spurt can occur so that for the rest of their lives abusers remain shorter than they would have been without the drug. In males and females of all ages, abusers risk potential fatal liver cysts and liver cancer, blood clotting, cholesterol changes and hypertension. Each of which can promote heart attack and stroke. In addition, acne tends to worsen among users. Although not all scientists agree, some interpret available evidence to show that anabolic steroid abuse particularly in high dosage promotes aggression that can manifest itself in fighting, physical and sexual abuse, armed robbery and property crimes such as burglary and vandalism. This is sometimes been referred to as "roid rage".
Upon stopping anabolic steroids some abusers experiences symptoms of depression, fatigue, restlessness, loss of appetite, insomnia, reduced sex drive, headache, muscle and joint pain and an intense desire to take more anabolic steroids. In people who inject anabolic steroids, infections resulting from the use of shared needles or non-sterile equipment include HIV, AIDS, Hepatitis B and C, and infective endocarditis, a potentially fatal inflammation of the heart. Bacterial infections can develop at the injection site causing pain and abscess.