Currently, there are more than 100 different types of anabolic steroids that have been developed, and each requires a prescription to be used legally in the United States.1
Anabolic steroids can be taken orally, injected intramuscularly, or rubbed on the skin when in the form of gels or creams.2 These drugs are often used in patterns called cycling, which involves taking multiple doses of steroids over a specific period of time, stopping for a period, and starting again. Users also frequently combine several different types of steroids in a process known as stacking.3 By doing this, users believe that the different steroids will interact to produce an effect on muscle size that is greater than the effects of using each drug individually.4
Another mode of steroid use is "pyramiding." This is a process in which users slowly escalate steroid use (increasing the number of drugs used at one time and/or the dose and frequency of one or more steroids) reaching a peak amount at mid-cycle and gradually tapering the dose toward the end of the cycle.5
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Extent of Use
Results from the 2003 Monitoring the Future Study, which surveys students in eighth, tenth, and twelfth grades, show that 2.5% of eighth graders, 3.0% of tenth graders, and 3.5% of twelfth graders reported using steroids at least once in their lifetimes.6
Percent of Students Reporting Steroid Use, 2003
Regarding the ease by which one can obtain steroids, 21.7% of eighth graders, 30.6% of tenth graders, and 40.7% of twelfth graders surveyed in 2003 reported that steroids were "fairly easy" or "very easy" to obtain. Fifty-five percent of twelfth graders surveyed in 2003 reported that using steroids was a "great risk."7
The Centers for Disease Control and Prevention (CDC) also conducts a survey of high school students throughout the United States, the Youth Risk Behavior Surveillance System (YRBSS) 6.1% of all high school students surveyed by CDC in 2003 reported lifetime use of steroid pills/shots without a doctor's prescription. 7.1% of ninth graders, 6.1% of tenth graders, 5.6% of eleventh graders, and 4.9% of twelfth graders reported lifetime illegal use of steroids.8
During 2003, 1.8% of young adults (ages 19-28) reported using steroids at least once during their lifetimes, 0.5% reported past year steroid use, and 0.2% reported past month steroid use.9
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Health Effects
Anabolic steroid abuse has been associated with a wide range of adverse side effects ranging from some that are physically unattractive, such as acne and breast development in men, to others that are life threatening. Most of the effects are reversible if the abuser stops taking the drug, but some can be permanent. In addition to the physical effects, anabolic steroids can also cause increased irritability and aggression.10
Some of the health consequences that can occur in both males and females include liver cancer, heart attacks, and elevated cholesterol levels.11 In addition to this, steroid use among adolescents may prematurely stop the lengthening of bones resulting in stunted growth.12
People who inject steroids also run the risk of contracting or transmitting hepatitis or HIV.13 Some steroid abusers experience withdrawal symptoms when they stop taking the drug. These withdrawal symptoms include mood swings, fatigue, restlessness, loss of appetite, insomnia, reduced sex drive, and depression. This depression can lead to suicide attempts, and if left untreated, can persist for a year or more after the abuser stops taking the drugs.14
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Production & Trafficking
Illicit anabolic steroids are often sold at gyms, competitions, and through mail operations after being smuggled into this country.15
The most common source for obtaining steroids for illegal use is smuggling them into the U.S. from other countries such as Mexico and European countries. These countries do not require a prescription for the purchase of steroids, making it easier to smuggle them.16
In addition to this, steroids are also illegally diverted from U.S. pharmacies or synthesized in clandestine laboratories.17
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Legislation
Concerns over a growing illicit market and prevalence of abuse combined with the possibility of harmful long-term effects of steroid use led Congress to place anabolic steroids into Schedule III of the Controlled Substances Act (CSA) in 1991.18 It is therefore illegal to possess or sell anabolic steroids without a valid prescription. Some States have also implemented additional fines and penalties for illegal use of anabolic steroids.19
The International Olympic Committee, National Collegiate Athletic Association and many professional sports leagues (including the Major League Baseball, National Basketball Association, National Football League, and National Hockey League), have banned the use of steroids by athletes due to their potentially dangerous side effects and because they give the user an unfair advantage.20
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Street Terms21
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Other Links
Anabolic Steroids: Hidden Dangers
This fact sheet provides information on the dangerous medical health effects of illegal steroid use and how to help a friend if they are abusing steroids.
Athletes and Drugs: Competing Against Substance Abuse Webcast
Provides information about the health risks and research-based programs that are available to help prevent steroid abuse.
Athletes Training & Learning to Avoid Steroids (ATLAS)
ATLAS is designed to teach male athletes how to improve their performance and strength through proper nutrition and training rather than with drugs.
Coach's Playbook Against Drugs
This document is designed to help coaches keep their teams drug free.
SteroidAbuse.Org
This NIDA site provides information about steroids.
Steroid Abuse in Today's Society
This guide will help you understand why steroids are being abused, and how you can educate athletes and others about the dangers of these drugs.
Steroids and Young People
This fact sheet provides an overview of recent data related to steroid use among youth.
Tips for Teens: The Truth About Steroids
This brochure provides teens with information about the dangers of steroid abuse.
Winning at Any Cost: Doping in Olympic Sports (PDF)
This report recommends a series of steps to eliminate doping in the Olympics.
World Anti-Doping Agency (WADA)
The mission of WADA is to promote and coordinate at international level the fight against doping in sport in all forms.
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Sources
1 National Institute on Drug Abuse, Research Report: Anabolic Steroid Abuse, April 2000
2 National Institute on Drug Abuse, Research Report: Anabolic Steroid Abuse, April 2000
3 National Institute on Drug Abuse, Infofax: Steroids (Anabolic-Androgenic), 1999
4 National Institute on Drug Abuse, Research Report: Anabolic Steroid Abuse, April 2000
5 Drug Enforcement Administration, Drugs of Abuse, 1996
6 National Institute on Drug Abuse and University of Michigan, Monitoring the Future 2003 Data from In-School Surveys of 8th-, 10th-, and 12th- Grade Students, December 2003.
7 Ibid.
8 Centers for Disease Control and Prevention, Youth Risk Behavior Surveillance—United States, 2003, May 2004
9 National Institute on Drug Abuse and University of Michigan, Monitoring the Future National Survey Results on Drug Use, 1975–2003, Volume II: College Students & Adults Ages 19–45 (PDF), 2004
10 National Institute on Drug Abuse, Research Report: Anabolic Steroid Abuse, April 2000
11 National Institute on Drug Abuse, Research Report: Anabolic Steroid Abuse, April 2000
12 Drug Enforcement Administration, Drugs of Abuse, 1996
13 National Institute on Drug Abuse, Infofax: Steroids (Anabolic-Androgenic), 1999
14 National Institute on Drug Abuse, Research Report: Anabolic Steroid Abuse, April 2000
15 Drug Enforcement Administration Web site, Drug Descriptions: Steroids
16 Drug Enforcement Administration, Anabolic Steroids: A Dangerous and Illegal Way To Seek Athletic Dominance and Better Appearance (PDF), March 2004
17 National Institute on Drug Abuse, Research Report: Anabolic Steroid Abuse, April 2000
18 Drug Enforcement Administration, Drugs of Abuse, 1996
19 Drug Enforcement Administration, Steroid Abuse by School Age Children: A Guide for Parents and School Officials (PDF), March 2004
20 Ibid.
21 Office of National Drug Control Policy, Drug Policy Information Clearinghouse, Street Terms: Drugs and the Drug Trade
Steroid section
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