Steroid Addiction: Signs, Symptoms, Effects and Treatment

What Are the Side Effects of Anabolic Steroid Use?

Males and females experience very different side effects when using anabolic steroids. Typically, men develop “feminized traits” and females become more masculine.

If you notice these changes in your loved one, he or she may be abusing anabolic steroids:

Side Effects of Steroid Use In Females:

• Deeper voice.
• Male-pattern baldness.
• Facial and body hair growth.
• Enlargement of clitoris.
• Breast atrophy.
• Alterations in menstrual cycle.⁵

Side Effects of Steroid Use In Males:

• Baldness.
• Breast development.
• Infertility.
• Shrunken testicles.⁵

Gender-neutral side effects of steroid use include:

• Acne.
• Oily skin.
• Fluid retention/swelling.
• Yellowing of skin and whites of eyes.
• Infection where steroids are injected.⁵

Long-Term Effects of Anabolic Steroid Dependency

Prolonged anabolic steroid use can result in a number of effects on the mind and body, some of which are life-threatening. Those who use anabolic steroids for a long time may stop producing testosterone on their own, ⁵ and those who begin using steroids in adolescence may experience stunted growth.¹

Below are the long-term effects of anabolic steroid dependency.

• Heart attacks.
• High blood pressure.
• Enlarged heart muscle.
• Liver cancer.
• HIV.
• Hepatitis.
• Peliosis hepatis (cysts form in the liver and fill with blood).
• Endocarditis (infection of the heart lining).
• Unhealthy changes in cholesterol.⁵
• Aggression.
• Irritability.
• Mania.
• Delusions.
• Violent behavior.
• Co-occurring alcohol use disorder.
• Depressive symptoms.^{5, 6, 7}

Are Anabolic Steroids Addictive?

Contrary to what some people may think, anabolic steroids can be addictive. However, since they don’t cause a “high” or a “buzz,” they are not addictive in exactly the same way many other drugs are. Still, many people who use them become psychologically and physically addicted.

Psychological Addiction

Many users who become psychologically addicted suffer from “muscle dysmorphia,” a behavioral condition in which the user’s view of himself or herself is distorted.

Women with muscle dysmorphia are lean and muscular but believe they are fat, while men with this condition believe they look weak and tiny even if they are big and muscular. ⁴

Physical Addiction

The phenomenon of a physical dependence is well-documented for many types of steroids, both of the glucocorticoid and anabolic variety. People whose systems have adapted to the presence of steroid support may experience crisis or withdrawal when steroid use abruptly stops.

In the case of the anabolic-androgenic steroids, withdrawal symptoms include: ^{13, 14}

• Fatigue.
• Depression.
• Decreased libido.
• Decreased muscle size.
• Decreased strength.
• Anorexia.
• Headaches.
• Muscle and joint pain.
• Steroid cravings.

Signs of Steroid Addiction

An addiction to anabolic steroids must consist of problematic and maladaptive use and severe impairment in the user’s life.⁹ The main difference between anabolic steroids and other substances is that steroids are not intoxicating. They don’t produce euphoria or a rush that is the signature of other drugs. The reward, instead, is muscle growth or an improvement in appearance.

The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), which is used to diagnose substance use disorders and mental disorders, has yet to provide criteria for steroid addiction. But researchers have adjusted the current DSM-5 criteria for substance addiction to address steroid abuse disorder.

Below is the adjusted criteria for steroid dependence.⁸ If you or a loved one is experiencing at least 3 of these signs or symptoms, then an addiction to steroids is very likely.

• Tolerance: you need more steroids to achieve your desired appearance and cannot maintain the same level of muscle mass with the same dose.
• Withdrawal symptoms including depressive mood, fatigue, insomnia, reduced appetite and loss of libido.
• Using steroids to alleviate or prevent withdrawal symptoms.
• Consistently decreasing the duration of steroid “off periods” or removing them altogether.
• Inability to decrease or quit using steroids due to anxiety caused by decreasing muscle size.
• Spending a substantial amount of time getting and using steroids, as well as doing muscle-related things such as lifting and planning a diet.
• Abandoning pleasurable hobbies in favor of muscle-related activities and steroid use.
• Continuing to use steroids despite mental or physical health problems such as sexual dysfunction, shrunken testicles, heart problems, acne, breast enlargement, hypertension, aggression and mood swings.

Try talking to your loved one in a kind and caring tone. Tell them that you are concerned for his or her health, and suggest steroid addiction treatment.

Getting Treatment and Starting Recovery

If you’re concerned about your addiction to steroids, treatment is recommended to help you quit using and regain control of your life. You may be anxious about muscle loss if you stop using steroids, which may be preventing you from quitting. But the immediate benefits of steroid use do not outweigh the dangerous and sometimes irreversible long-term effects.

Treatment for Steroid Addiction

Different kinds of recovery programs are designed to meet a variety of people’s needs. Below are the various treatment options:

• Dual diagnosis: Refers to substance addiction and any co-occurring mental health condition. Many steroid users suffer from muscle dysmorphia and/or depression. Finding a treatment facility that specializes in dual diagnosis will help to prevent relapse and address underlying issues.
• Inpatient recovery: You can live at the facility, away from your using environment, in order to focus on your recovery.
• Outpatient recovery: You can live at home while receiving treatment a few times week at your convenience. This isn’t recommended for someone who has a severe addiction or feels like they don’t have the willpower to avoid gyms or steroid-using friends.
• Group therapy: A certified mental health professional facilitates a group therapy session in which people share their steroid experiences, how they got started and what drove them to continue using.
• Individual therapy: You meet individually with a therapist to address underlying mental health problems, reasons for using and how you can cope with triggers in the future.

Medications for Steroid Addiciton

• Many rehab facilities will prescribe antidepressants such as selective serotonin reuptake inhibitors or clomipramine to treat the depression associated with steroid withdrawal. ¹⁰ These antidepressants may also help treat the muscle dysmorphia that is common in steroid users. ¹⁰
• Anti-inflammatory medication: Another common withdrawal symptom is muscle and joint paint, which can be uncomfortable. Many doctors will prescribe non-steroidal anti-inflammatory medication to treat these symptoms. ¹¹
• Endocrine treatment: Hypogonadism, a condition in which the body doesn’t produce enough sex hormone, is common in individuals addicted to steroids.¹² Treatment may include human chorionic gonadotropin, which increases the production of testosterone, in addition to clomiphene and tamoxifen.
• Sexual dysfunction: If the user is experiencing sexual dysfunction, a doctor may prescribe phosphodiesterase inhibitors, such as Viagra, to improve sexual functioning. ¹¹