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Most people that take them are trying to "bulk up" or, trying to pack on mass

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Drug abusers of steroids take 10 to 100 times more than would be prescribed by a physician.

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In 2013 2.1% of students admitted to using them

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Drug abusers of steroids take 10 to 100 times more than would be prescribed by a physician.

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Steroids replicate sex hormones

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Drug abusers of steroids take 10 to 100 times more than would be prescribed by a physician.

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An average cycle will cost $300-$500 but people that are advanced in steroids can spend around $800

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If you are about going with anabolic steroids to enhance body performance and get in the shape you want than planning carefully your budget has to be one of your priorities. Gathering information about steroids use, stacks, side effects cycles and post cycle therapy is tremendous for any bodybuilder. But you can do nothing if your wallet doesn't support the expenses required for running a steroids cycle. Since most of chemical users don't stop to first steroid cycle, and go further with more advanced stacks, you have to take this in consideration and plan a long term outgoings. That's why before getting involved in steroids use most of bodybuilders try to find out what is the medium price for each steroid and what are the main factors which influence the cost. Such an attitude is quite beneficial, since it helps potential steroid users do not get ripped off.

Like any other product in this world, the price is formed based on demand and supply. During the last years, the demand for anabolic steroids has been increased significantly. But since the supply is quite high, the price for anabolic steroids remains quite affordable. By simply typing in on the internet bar search "steroids sale" you got dozens of online stores who sell steroids at very good rates. And if you have enough patience and do not stop your attention on first page and go further, than you can come across on steroids stores with very attractive price. Additionally, you get some great bonuses too.

Another factor that influence the price is the type of steroid you gonna choose to use. Such anabolics like Testosterone-ethanate or Dianabol are the cheapest steroids. These are the basic steroids every bodybuilder begin steroid cycling with, thus the demand is very high. But since the supply is also high, the price for them is quite low. Testosterone enanthate is perfect both for cutting or bulking, and can used for other purposes like improving body strength and endurance. It is the base of every steroid cycle, and depending on steroids it is mixed with, are achieved different goals. Dianabol, or in short Dbol is more used for bulking, but also help to preserve strength.

On the other hand, if you are an intermediate or even and advanced steroid user than more probably you have heard about the effectiveness of such anabolics like Anavar or Primobolan. They are great cutting compounds,which provides with poor but high quality muscle mass gains. The supply for these gears are low, while the demand is high. That's why you will not find cheap Anavar or Primobolan in the market. Planning a steroid cycle including one of these steroids has to be done carefully, since you will spend much money on it. And this is because Anavar or Primobolan have to be used in longer duration cycles, 8 weeks minimum with daily administration.

The steroid brand name is another aspect which make an anabolic steroid expensive or cheaper one. Human grade, underground grade or veterinary steroids are mains sources to buy steroids from. Human grade labs produce under tight control of authorities, thus this category of drugs are more expensive than others two. The price is higher since these are high quality compounds, properly dosed, with no contamination. There is no risk to get an infection while using them. The main drawback is that steroids from this category are quite mild, and do not fit you if you want to get massive muscle mass gains. More powerful steroids can be found in underground market.

Undergrounds labs steroids are less expensive, at half rates from HG steroids price, and comes in a bigger variety. They are cheaper, but some of them carry many risks. They can be underdosed, infected or even in worst cases contain an another gear that those labeled on it. But choosing wisely from the wide range of manufacturers, looking for people reviews on them and asking for other more experienced bodybuilders opinions can help you to stop on the best UG manufacturer which produce qualitative gears.

Veterinary steroids like Equipoise (Boldenone-Undecylenate), or Fina (Trenbolone Acetate) are competitive priced anabolics which are usually used for cutting purpose, especially before competitions. They are quickly assimilated, giving great results in short amounts of time.

Men and women steroids needs are different. Men need to take anabolics in higher doses, while women can go with small doses for great results. So, an expensive steroid can not be a good choice for a men with limited budget. Meantime, women who uses it in much lower doses can easily afford it. Hence, take this in consideration next time you plan your steroid cycle.

Do not forget about post cycle therapy, make it an inseparable part of your steroid cycle plan. It is as important as cycle itself, since during it you will help your body to get to normal stage with minimal muscle mass losses.

An average price for a steroid cycle, with PCT drugs included, range between 300$-500$. Of course, this is just an orientative price, since the more experience you have with steroids, the more powerful anabolics you will need to achieve greater results. Thus, an advanced steroid cycle may cost you even 800$. The main idea, is that you can not achieve maximum results with little money. Be ready for this, and delay this goal for better times if you have financial troubles at the moment.

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How Much Do Steroids Cost - WhatSteroids

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How much do steroids cost If you are about going with anabolic steroids to enhance body performance and get in the shape you want than planning carefully your budget has to be one of your priorities. Gathering information about steroids use, stacks, side effects cycles and post cycle therapy is tremendous for any bodybuilder.

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One way people get helped from withdrawing from steroids is supportive therapy. Another way medication that will restore the hormones to a normal state.

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Ordering Publications

Call 1-877-643-2644 or:

APA Style MLA Style AMA Style

NIDA. (2018, February 21). Steroids and Other Appearance and Performance Enhancing Drugs (APEDs). Retrieved from https://www.drugabuse.gov/publications/research-reports/steroids-other-appearance-performance-enhancing-drugs-apeds

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Appearance and performance enhancing drugs (APEDs) are most often used by males to improve appearance by building muscle mass or to enhance athletic performance. Although they may directly and indirectly have effects on a user's mood, they do not produce a euphoric high, which makes APEDs distinct from other drugs such as cocaine, heroin, and marijuana.

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Jaundice (yellowing of the skin)

Swelling of feet or ankles

Aching joints

Bad breath

Mood swings

Nervousness

Trembling

Liver damage

Stunted growth

In Men: Nervousness, Development of breasts, Impotence, shrinking of testicles

In Women: Growth of facial hair, Deepened voice, Breast reduction, enlarged clitoris

enlarged heart, high blood pressure, and changes in blood cholesterol, all of which increase the risk of stroke and heart attack, even in young people

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Steroid Drug Abuse Signs and Symptoms | Gateway Treatment Centers

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Steroids can be very addictive and cause negative health issues, learn the signs and symptoms of steroid use.

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People often use them as capsules, tablets, injections or a gel

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Pumpers
Gym Candy
Arnolds
Stackers
Balls and Bulls
A’s
Weight Trainers
roids
gear
juice

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The drugs are legally made in laboratories and are used in medicines but are smuggled, stolen, or made in homemade labs

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Generic and trade names: oxymotholone (Anadrol®), methandrostenolone (Dianobol®), stanozolol (Winstrol®), nandrolone decanoate (Deca-Durabolin®), testosterone cypionate (Depo-Testosterone®), boldenone undecylenate (Equipoise®) and others
Street names: the juice, the white stuff, roids

What are they?

Many kinds of steroids occur naturally in various hormones and vitamins. Drugs known as "anabolic steroids" are made in laboratories and have the same chemical structure as the steroids found in the male sex hormone, testosterone. The musclebuilding (anabolic) and masculinizing (androgenic) effects of these drugs make them appealing to athletes and bodybuilders.

Anabolic steroids have few medical uses. Their primary use is to promote weight gain and muscle development in farm animals. They are rarely prescribed to humans; however, they are sometimes used to treat delayed puberty, some types of impotence, and wasting of the body caused by AIDS and other diseases.

Steroidal "supplements," such as dehydroepiandrosterone (DHEA), are converted into testosterone or a similar compound in the body. Although little research has been done on steroidal supplements, if taken in large quantities, they likely produce the same effects, and the same side-effects, as anabolic steroids. DHEA is not available in Canada, but is sold in health food stores and on the Internet in the United States.

Where do steroids come from?

Anabolic steroids manufactured by pharmaceutical companies are available legally only by prescription. Most steroids used by athletes are smuggled, stolen or made in clandestine laboratories. Veterinary drugs are often used.

Although trafficking these drugs is illegal, the penalities imposed tend to be minor. Possession of steroids is legal.

What do steroids look like, and how are they used?

Anabolic steroids come in the form of tablets, capsules, a solution for injection and a cream or gel to rub into the skin. Weightlifters and bodybuilders who use steroids often take doses that are up to 100 times greater than those used to treat medical conditions.

Regimented methods of taking steroids are believed to enhance the effects of these drugs and lessen harm to the body. However, there is no scientific evidence to back up these claims. Such methods include the following:

Cycling: a period of taking and then not taking the drugs in the belief that the drug-free cycle allows the body to recover normal hormone levels

Pyramiding: taking doses in cycles of six to 12 weeks, starting with a low dose, then slowly increasing it, and then decreasing the amount to zero, believing this allows the body time to adjust to the high doses

Stacking: taking two or more types of steroids, mixing oral and injectable forms, believing the different drugs interact to have greater effect.

Who uses steroids?

Most non-medical use of steroids is by athletes who believe that these drugs will help them to win, and by bodybuilders and young men who think they will look better with bigger muscles.

People who use steroids to improve athletic performance and build muscles are mostly men; however, the highest increase in use is among young women. U.S. studies have also noted a disturbing increase in use among adolescents concerned about body image. Some people take steroids because they have a disorted body image where they believe their muscles are small or that they have too much body fat, even when they are lean and muscular.

Steroid use has also been found among people with a history of abuse or assault who wish to build muscles in order to protect themselves better. Steroid use is banned by the International Olympic Committee and many other amateur and professional sports organizations. But because drug testing is costly, tests of professional athletes are generally "random," and are often preceded by a warning. Regular mandatory testing is standard only at the international level of competition.

Successful prevention of steroid abuse focuses on teaching people about how to refuse drugs and about other ways to build muscle bulk and strength.

How do steroids make you feel?

Steroids can produce a variety of psychological effects ranging from euphoria to hostility. Some people who take steroids say the drugs make them feel powerful and energetic. However, steroids are also known to increase irritability, anxiety and aggression and cause mood swings, manic symptoms and paranoia, particularly when taken in high doses.

Variations in how people respond to steroids may be due in part to individual differences, or depend on which type of steroid was taken. Scientific understanding of the effects of non-medical anabolic steroid use is limited.

High doses, especially when taken orally, causenausea, vomiting and gastric irritation. Other effects include fluid retention and trembling.

Are steroids dangerous?

Yes. Taking high doses of steroids increases risk of

enlargement and abnormalities of the heart, blood clots, high blood pressure, heart attack and stroke. Steroid-related heart failure has occurred in athletes younger than 30.

aggression and violence ("roid rage"), negative personality change, mania and depression, which may lead to suicide. Depression may persist for a year after drug use is stopped.

hepatitis, liver enlargement and liver cancer

reduced fertility in both women and men

tendon ruptures, cessation of growth in adolescents

hepatitis or HIV if steroids are injected using shared needles, and infections if steroids are injected with dirty needles.

Are steroids addictive?

Yes, they can be.

Addiction to steroids differs from many other drugs in that tolerance to the effects does not develop. However, some people who abuse steroids meet criteria for drug dependence in that they

continue to take steroids, even when they experience negative physical or emotional effects

spend large amounts of time and money obtaining the drugs

experience withdrawal symptoms such as mood swings, fatigue, restlessness, depression, loss of appetite, insomnia, reduced sex drive and the desire to take more steroids.

What are the long-term effects of taking steroids?

Some of the effects of steroids disappear when drug use is stopped, but others are permanent. The effects of long-term use include:

acne, cysts, oily hair and skin, and thinning scalp hair in both sexes

feminization in men, including permanent breast development

testicle shrinking, difficulty or pain urinating and increased risk of prostate cancer in men

masculinization in women, including breast size and body fat reduction, coarsening of the skin, enlargement of the clitoris, deepening of the voice, excessive growth of body hair, loss of scalp hair and changes or cessation of the menstrual cycle; with long-term use, some of these effects may be permanent

in children or adolescents, the high levels of testosterone stop bone growth, preventing them from ever growing to full height

aggression and violence; personality changes revert when drug use is stopped.

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Generic and trade names: oxymotholone (Anadrol®), methandrostenolone (Dianobol®), stanozolol (Winstrol®), nandrolone decanoate (Deca-Durabolin®), testosterone cypionate (Depo-Testosterone®), boldenone undecylenate (Equipoise®) and others Street names: the juice, the white stuff, roids What are they? Many kinds of steroids occur naturally in various hormones and vitamins.

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Steroids (anabolic steroids) are a synthetic variation of the male hormone testosterone.

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Highlights

Anabolic-androgenic steroids are the best-studied class of appearance and performance enhancing drugs (APEDs). APEDs are used to improve appearance by building muscle mass or to enhance athletic performance.

Although anabolic steroids and other APEDs may directly and indirectly have effects on a person's mood, they do not typically produce a euphoric high. However, people who use these substances may develop a substance use disorder, defined as continued use despite adverse consequences.

Anabolic steroids can cause severe, long-lasting, and in some cases, irreversible damage. They can lead to early heart attacks, strokes, liver tumors, kidney failure, and psychiatric problems. In addition, stopping steroid use can cause depression, often leading to resumption of use.

What are anabolic steroids and other appearance and performance enhancing drugs (APEDs)?

Anabolic-androgenic steroids, often shortened to "anabolic steroids," "steroids," or "androgens," are the most widely misused APED. These are synthetic substances similar to the male sex hormone testosterone. They promote the growth of skeletal muscle (anabolic effects) and the development of male sexual characteristics (androgenic effects) in both males and females.

Note that in the context of this report, anabolic steroids refer only to the non-prescribed use (misuse) of testosterone and testosterone-like substances by athletes and non-athlete bodybuilders. This research report will not cover image enhancers, such as dermal fillers, Botox, or the skin tanner, melanotan.

Non-steroidal anabolics, include insulin, insulin-like growth hormone (IGF), and human growth hormone (HGH)-substances that are produced by the human body and are prescribed for legitimate medical uses but also sometimes misused for performance enhancement.

Ergo/thermogenics are compounds used to decrease body fat or to promote leanness versus muscle mass in endurance athletes. The three main categories of ergo/thermogenics are:

Xanthines: compounds that increase attention and wakefulness and suppress appetite. Examples are caffeine, the asthma drug theophylline, and theobromine-a substance found in chocolate, coffee, and tea.

Sympathomimetics: drugs that are similar in structure and action to epinephrine and norepinephrine-natural chemicals in the body that increase heart rate, constrict blood vessels, and raise blood pressure. An example is ephedrine, which is derived from the ephedra plant. Ephedrine/ephedra used to be included in dietary supplements that promoted weight loss, increased energy, and enhanced athletic performance. In 2004, the FDA banned the U.S. sale of dietary supplements containing ephedrine/ephedra due to various possible health risks including cardiovascular and nervous system effects.

Thyroid hormones: substances that regulate metabolism by altering the function of the thyroid. Cytomel is an example.

Nutritional/dietary supplements are substances purchased legally from nutritional stores or via the internet that are often taken in combination with other APEDs. Creatine, which boosts exercise capacity, is one common example.

What is the scope of anabolic steroid use in the United States?

All data refer to the United States population.
It is difficult to estimate the prevalence of steroid misuse in the United States because many national surveys that ask about drug use do not include questions about steroids. However, data on steroid misuse among young students are available from the NIDA-supported Monitoring the Future Survey.

How many young students use steroids?

In 2022, an estimated 0.8% of 8th graders, 0.5% of 10th graders, and 1.3% of 12th graders reported misusing steroids in the past 12 months. Source: 2022 Monitoring the Future Survey.

Why are anabolic steroids misused?

Anabolic steroids increase lean muscle mass when used in conjunction with weight training. The aim, for non-athlete weightlifters, is typically improvement of appearance. Steroid use is often associated with a form of male body dysmorphic disorder called muscle dysmorphia, a preoccupation with the perceived inadequate size of their muscles.

As a result, some users report taking anabolic steroids to increase confidence and because they feel that they are at a point where they can no longer get bigger through weight training alone. Most users report that anabolic steroids help them achieve their ideal body.

Increasing muscle mass may also promote strength, which can improve performance in certain types of sports. More benefit is seen for strength-dependent sports (weightlifting, shot-put throwing, football) than for sports that require speed, agility, flexibility, and/or endurance.

Anabolic steroid users report using an average of about 11 APEDs per year. They are also more likely than non-steroid users to take supplements such as protein powders and creatine; estrogen blockers; ergo/thermogenics, such as caffeine or ephedrine; medications for erectile dysfunction; and other hormones such as insulin, thyroid hormones, and human growth hormone.

How are anabolic steroids used?

Commonly Misused Steroids

Oral Steroids
Injectable Steroids

Deca-Durabolin (nandrolone decanoate)

Durabolin (nandrolone phenpropionate)

Depo-Testosterone (testosterone cypionate)

Agovirin (testosterone propionate)

Retandrol (testosterone phenylpropionate)

Equipoise (boldenone undecylenate)

Some anabolic steroids are taken orally, others are injected intramuscularly, and still others are provided in gels or creams that are applied to the skin. Many users start with the oral form and then progress to injectable forms, since the latter causes less liver damage. However, oral steroids clear more rapidly from the body, often making this the preferred route for users concerned with drug testing. Doses taken by people misusing these substances can be 10 to 100 times higher than the doses used to treat medical conditions.

Cycling, stacking, pyramiding, and plateauing

Another common mode of steroid misuse is referred to as "pyramiding," which typically involves taking them in a cycle of six to 12 weeks, tapering gradually rather than starting and finishing a cycle abruptly. At the beginning of a cycle, the person starts with low doses of the drugs being stacked and then slowly increases the doses. In the second half of the cycle, the doses are slowly decreased to zero. This is sometimes followed by a second cycle in which the person continues to train but without drugs. Steroid users believe that pyramiding allows the body time to adjust to the high doses, and the drug-free cycle allows the body's hormonal system time to recuperate.

A technique called "plateauing" may also be used, whereby steroids are staggered, overlapped, or substituted with another type of steroid to avoid developing tolerance. As with stacking, the effects of pyramiding, cycling, and plateauing have not been substantiated scientifically.

What are the side effects of anabolic steroid misuse?

A variety of side effects can occur when anabolic steroids are misused, ranging from mild effects to ones that are harmful or even life-threatening. Most are reversible if the user stops taking the drugs. However, others may be permanent or semi-permanent.

Cardiovascular system

high blood pressure

blood clots

heart attacks

stroke

artery damage

Hormonal system - Men

decreased sperm production

enlarged breasts

shrinking of the testicles

male-pattern baldness

testicular cancer

Hormonal system - Women

voice deepening

decreased breast size

coarse skin

excessive body hair growth

male-pattern baldness

Infection

Liver

Musculoskeletal system

short stature (if taken by adolescents)

tendon injury

Psychiatric effects

Skin

severe acne and cysts

oily scalp and skin

abscess at injection site

jaundice

Cardiovascular System

Steroid use has been associated with high blood pressure; decreased function of the heart's ventricles; and cardiovascular diseases such as heart attacks, artery damage, and strokes, even in athletes younger than 30. Steroids contribute to the development of cardiovascular disease partly by increasing the level of low-density lipoprotein (LDL) and decreasing the level of high-density lipoprotein (HDL). High LDL and low HDL levels increase the risk of atherosclerosis, a condition in which fatty substances are deposited inside arteries and disrupt blood flow. If blood is prevented from reaching the heart or brain, the result can be a heart attack or stroke, respectively. Steroids also increase the risk that blood clots will form in blood vessels, potentially disrupting blood flow and damaging the heart muscle, so that it does not pump blood effectively.

Hormonal System

Steroid use disrupts the normal production of hormones in the body. Changes that can be reversed include decreased sperm production, decreased function of the testes (hypogonadism) that leads to low testosterone levels, and shrinking of the testicles (testicular atrophy). Irreversible changes include male-pattern baldness and breast development (gynecomastia) in men. Anabolic steroids may also act upon the hormone system to increase the risk of testicular cancer, especially when steroids are used in combination with insulin-like growth factor.

In females, anabolic steroids cause masculinization. Specifically, breast size and body fat decrease, the skin becomes coarse, and the voice deepens. Women may experience excessive growth of body hair but lose scalp hair. With continued administration of steroids, some of these effects become irreversible. It is commonly believed that anabolic steroids will produce irreversible enlargement of the clitoris in females, although there are no studies on this.

Infections

Liver

Musculoskeletal System

Evidence suggests that weightlifters who misuse anabolic steroids have stiffer tendons, which could lead to an increased risk for tendon injury.

Skin

Anabolic steroids can also produce jaundice, or yellowing of the skin or eyes, as a result of damage to the liver.

How does anabolic steroid misuse affect behavior?

Aggression

Case reports and small studies indicate that anabolic steroids increase irritability and aggression, although findings may be confounded by personality traits that are overrepresented in steroid users (i.e., antisocial, borderline, and histrionic personality disorder) and use of other drugs. People who misuse anabolic steroids report more anger than nonusers, as well as more fights, verbal aggression, and violence toward their significant others, sometimes called "roid rage." One study suggests that the mood and behavioral effects seen during anabolic-androgenic steroid misuse may result from secondary hormonal changes.

Psychiatric Disorders

Other Drug Use

Research also indicates that some users might turn to other drugs to alleviate some of the negative effects of anabolic steroids. For example, a study of 227 men admitted in 1999 to a private treatment center for addiction to heroin or other opioids found that 9.3 percent had previously misused anabolic steroids. Of these, most reported using opioids to counteract insomnia, irritability, depression, and withdrawal from anabolic steroids.

What are the risks of anabolic steroid use in teens?

How do anabolic steroids work in the brain?

Research with human cells demonstrates that anabolic steroids also interact with certain types of GABA A receptors, which could mediate the increased anxiety reported by steroid users. In addition, animal studies show that anabolic steroids increase serotonin levels in brain regions involved in mood and dopamine levels in reward-related brain regions. Chronic use of anabolic steroids has also been shown to cause dysfunction of these reward pathways in animals. Specifically, rats given twice daily nandrolone injections for four weeks showed loss of sweet preference (a sign of reward dysfunction) that was accompanied by reductions of dopamine, serotonin, and noradrenaline in the nucleus accumbens, a reward-related brain region.

Are anabolic steroids addictive?

An undetermined percentage of steroid users may develop a steroid use disorder. Substance use disorders are defined by continued use despite adverse consequences; for steroid users, these may include physical or psychological problems such as breast growth (in men), sexual dysfunction, high blood pressure, excessive fats in the blood, heart disease, mood swings, severe irritability, or aggressiveness. Anabolic steroid users also may give up other important activities for fear that they will miss workouts, violate their dietary restrictions, or be prevented from using steroids. Steroid users also typically spend large amounts of time and money obtaining the drugs, and they may try to reduce or stop anabolic steroid use without success-possibly due to depression, anxiety about losing muscle mass, or and other unpleasant effects of withdrawal.

How are anabolic steroids tested in athletes?

Although non-athlete weightlifters account for the bulk of anabolic steroid misuse, occasional steroid use by professional and Olympic athletes to improve performance or cheat in competition ("doping") has done the most to raise awareness of steroid misuse. The World Anti-Doping Agency (WADA) was founded in 1999 to consistently apply anti-doping policies across sports organizations and governments around the world. Non-compliant organizations can face sanctions such as event cancellation, loss of WADA funding, or ineligibility to host events.

Sports with the greatest numbers of anti-doping rules violations in 2015.

Refinements in drug testing have improved the ability to detect anti-doping violations, resulting in increased numbers of reported violations over recent years. For example, the discovery of long-term steroid metabolites has lengthened the drug detection window, making it more difficult for athletes to pass drug tests by simply discontinuing steroid use just prior to an event. In addition, more sensitive technologies have allowed detection of lower metabolite thresholds.

Drug Testing and Nutritional Supplements

Athletes taking over-the-counter nutritional supplements may believe that such products are safe. However, nutritional supplements are not subjected to the same pre-approval requirements and quality tests as FDA-approved medications. For example, some supplements advertised to promote weight loss have been found to contain banned stimulants such as ephedrine or clenbuterol. Other research shows that supplements sometimes contain prohormones or anabolic steroids. In a study looking at 634 nutritional supplements from 13 different countries, 15 percent included some type of prohormone not listed on the label. Another study showed that some non-labeled prohibited substances could be detected by drug tests up to 144 hours later.

Nutritional supplements sometimes contain banned substances that are not indicated in their labels. The FDA notes that consumers should be wary if a product meets any of these criteria:

products claiming to be alternatives to FDA-approved drugs or to have effects similar to prescription drugs

products claiming to be a legal alternative to anabolic steroids

products that are marketed primarily in a foreign language or those that are marketed through mass e-mails

sexual enhancement products promising rapid effects such as working in minutes to hours, or long-lasting effects such as 24 hours to 72 hours

products that provide warnings about testing positive in performance enhancement drug tests

According to WADA's codes, athletes are responsible for any prohibited substance found in their samples, regardless of whether ingestion was intentional or unintentional. However, sanctions may be reduced or avoided if the athlete can demonstrate that the substance was ingested through no significant fault or negligence on his/her part, or in some circumstances where the athlete did not intend to enhance performance.

What can be done to prevent steroid misuse?

Research suggests that high school athletes are less likely to use steroids if their peers and parents disapprove, indicating that peers and parents can be strong partners in prevention efforts.

However, research shows that simply teaching students about steroids' adverse effects does not convince adolescents that they will be adversely affected, nor does such instruction discourage young people from taking steroids in the future. Presenting both the risks and benefits of anabolic steroid use is more effective in convincing adolescents about steroids' negative effects, apparently because the students find a balanced approach more credible.

Research also indicates that some adolescents misuse steroids as part of a pattern of high-risk behaviors such as drinking and driving, carrying a gun, driving a motorcycle without a helmet, and using other illicit drugs. This suggests that a prevention program should focus on comprehensive high-risk behavior screening and counseling among teens who use anabolic steroids.

NIDA-Funded Prevention Research Helps Reduce Steroid Misuse

A more sophisticated approach has shown promise for preventing steroid misuse among players on high school sports teams. The Adolescents Training and Learning to Avoid Steroids (ATLAS) program is showing high school football players that they do not need steroids to build powerful muscles and improve athletic performance. By educating student athletes about the harmful effects of anabolic steroids and providing nutrition and weight-training alternatives to steroid use, the ATLAS program has increased football players' healthy behaviors and reduced their intentions to misuse steroids. In the program, coaches and team leaders teach the harmful effects of anabolic steroids and other illicit drugs on immediate sports performance and discuss how to refuse offers of drugs.

Studies show that one year after completion of the program, compared with a control group, ATLAS-trained football student athletes in 15 high schools had:

less use of anabolic steroids and less intention to misuse them in the future

less misuse of alcohol, amphetamines, and narcotics

less misuse of "athletic enhancing" supplements

less likelihood of engaging in hazardous behaviors such as drinking and driving

better knowledge about anabolic steroid, alcohol, and marijuana effects; better knowledge of alternatives to steroid misuse; greater confidence in athletic abilities; and improved nutritional behaviors

What treatments are effective for anabolic steroid misuse?

Current views recommend that treatment for steroid use address the underlying causes of the steroid use. This can include:

psychological therapies (and possibly medications) for muscle dysmorphia

endocrine therapies to restore function in those suffering from hypogonadism and to alleviate symptoms of depression

antidepressants for those whose depression does not respond to endocrine therapies

pharmacological and psychosocial treatments for patients who are also dependent on opioids, which appear to also be effective in alleviating signs of anabolic steroid dependence

Find More Resources on Anabolic Steroids and Other Appearance and Performance Enhancing Drugs

1. Kanayama G, Pope HG. History and epidemiology of anabolic androgens in athletes and non-athletes. Mol Cell Endocrinol. March 2017. doi:10.1016/j.mce.2017.02.039

2. Rashid H, Ormerod S, Day E. Anabolic androgenic steroids: what the psychiatrist needs to know. Adv Psychiatr Treat. 2007;13(3):203-211.

3. Lipsett MB, Korenman SG. Androgen Metabolism. JAMA. 1964;190(8):757-762. doi:10.1001/jama.1964.03070210063011

4. Shahidi NT. A review of the chemistry, biological action, and clinical applications of anabolic-androgenic steroids. Clin Ther. 2001;23(9):1355-1390.

5. Testosterone Information. https://www.fda.gov/drugs/drugsafety/
postmarketdrugsafetyinformationforpatientsandproviders/ucm161874.htm. Published March 3, 2015. Accessed May 26, 2017.

6. Rao PK, Boulet SL, Mehta A, et al. Trends in Testosterone Replacement Therapy Use from 2003 to 2013 among Reproductive-Age Men in the United States. J Urol. 2017;197(4):1121-1126. doi:10.1016/j.juro.2016.10.063.

7. Brennan R, Wells JSG, Van Hout MC. The injecting use of image and performance-enhancing drugs (IPED) in the general population: a systematic review. Health Soc Care Community. January 2016. doi:10.1111/hsc.12326.

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134. Brennan BP, Kanayama G, Pope HG. Performance-enhancing drugs on the web: a growing public-health issue. Am J Addict Am Acad Psychiatr Alcohol Addict. 2013;22(2):158-161. doi:10.1111/j.1521-0391.2013.00311.x.

135. Kanayama G, Brower KJ, Wood RI, Hudson JI, Pope HG. Treatment of anabolic-androgenic steroid dependence: Emerging evidence and its implications. Drug Alcohol Depend. 2010;109(1-3):6-13. doi:10.1016/j.drugalcdep.2010.01.011

NIDA. 2021, December 21. Fentanyl . Retrieved from https://nida.nih.gov/research-topics/fentanyl

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What are anabolic steroids and other appearance and performance enhancing drugs (APEDs)?

Anabolic-androgenic steroids, often shortened to "anabolic steroids," "steroids," or "androgens," are the most widely misused APED. These are synthetic substances similar to the male sex hormone testosterone. They promote the growth of skeletal muscle (anabolic effects) and the development of male sexual characteristics (androgenic effects) in both males and females.

Note that in the context of this report, anabolic steroids refer only to the non-prescribed use (misuse) of testosterone and testosterone-like substances by athletes and non-athlete bodybuilders. This research report will not cover image enhancers, such as dermal fillers, Botox, or the skin tanner, melanotan.

Non-steroidal anabolics, include insulin, insulin-like growth hormone (IGF), and human growth hormone (HGH)-substances that are produced by the human body and are prescribed for legitimate medical uses but also sometimes misused for performance enhancement.

Ergo/thermogenics are compounds used to decrease body fat or to promote leanness versus muscle mass in endurance athletes. The three main categories of ergo/thermogenics are:

Xanthines: compounds that increase attention and wakefulness and suppress appetite. Examples are caffeine, the asthma drug theophylline, and theobromine-a substance found in chocolate, coffee, and tea.

Sympathomimetics: drugs that are similar in structure and action to epinephrine and norepinephrine-natural chemicals in the body that increase heart rate, constrict blood vessels, and raise blood pressure. An example is ephedrine, which is derived from the ephedra plant. Ephedrine/ephedra used to be included in dietary supplements that promoted weight loss, increased energy, and enhanced athletic performance. In 2004, the FDA banned the U.S. sale of dietary supplements containing ephedrine/ephedra due to various possible health risks including cardiovascular and nervous system effects.

Thyroid hormones: substances that regulate metabolism by altering the function of the thyroid. Cytomel is an example.

Nutritional/dietary supplements are substances purchased legally from nutritional stores or via the internet that are often taken in combination with other APEDs. Creatine, which boosts exercise capacity, is one common example.

What is the scope of anabolic steroid use in the United States?

All data refer to the United States population.
It is difficult to estimate the prevalence of steroid misuse in the United States because many national surveys that ask about drug use do not include questions about steroids. However, data on steroid misuse among young students are available from the NIDA-supported Monitoring the Future Survey.

How many young students use steroids?

In 2022, an estimated 0.8% of 8th graders, 0.5% of 10th graders, and 1.3% of 12th graders reported misusing steroids in the past 12 months. Source: 2022 Monitoring the Future Survey.

Why are anabolic steroids misused?

Anabolic steroids increase lean muscle mass when used in conjunction with weight training. The aim, for non-athlete weightlifters, is typically improvement of appearance. Steroid use is often associated with a form of male body dysmorphic disorder called muscle dysmorphia, a preoccupation with the perceived inadequate size of their muscles.

As a result, some users report taking anabolic steroids to increase confidence and because they feel that they are at a point where they can no longer get bigger through weight training alone. Most users report that anabolic steroids help them achieve their ideal body.

Increasing muscle mass may also promote strength, which can improve performance in certain types of sports. More benefit is seen for strength-dependent sports (weightlifting, shot-put throwing, football) than for sports that require speed, agility, flexibility, and/or endurance.

Anabolic steroid users report using an average of about 11 APEDs per year. They are also more likely than non-steroid users to take supplements such as protein powders and creatine; estrogen blockers; ergo/thermogenics, such as caffeine or ephedrine; medications for erectile dysfunction; and other hormones such as insulin, thyroid hormones, and human growth hormone.

How are anabolic steroids used?

Commonly Misused Steroids

Oral Steroids

Anadrol (oxymetholone)

Anavar (oxandrolone)

Dianabol (methandienone )

Winstrol (stanozolol)

Restandol (testosterone undecanoate)

Injectable Steroids

Deca-Durabolin (nandrolone decanoate)

Durabolin (nandrolone phenpropionate)

Depo-Testosterone (testosterone cypionate)

Agovirin (testosterone propionate)

Retandrol (testosterone phenylpropionate)

Equipoise (boldenone undecylenate)

Some anabolic steroids are taken orally, others are injected intramuscularly, and still others are provided in gels or creams that are applied to the skin. Many users start with the oral form and then progress to injectable forms, since the latter causes less liver damage. However, oral steroids clear more rapidly from the body, often making this the preferred route for users concerned with drug testing. Doses taken by people misusing these substances can be 10 to 100 times higher than the doses used to treat medical conditions.

Cycling, stacking, pyramiding, and plateauing

Another common mode of steroid misuse is referred to as "pyramiding," which typically involves taking them in a cycle of six to 12 weeks, tapering gradually rather than starting and finishing a cycle abruptly. At the beginning of a cycle, the person starts with low doses of the drugs being stacked and then slowly increases the doses. In the second half of the cycle, the doses are slowly decreased to zero. This is sometimes followed by a second cycle in which the person continues to train but without drugs. Steroid users believe that pyramiding allows the body time to adjust to the high doses, and the drug-free cycle allows the body's hormonal system time to recuperate.

A technique called "plateauing" may also be used, whereby steroids are staggered, overlapped, or substituted with another type of steroid to avoid developing tolerance. As with stacking, the effects of pyramiding, cycling, and plateauing have not been substantiated scientifically.

What are the side effects of anabolic steroid misuse?

A variety of side effects can occur when anabolic steroids are misused, ranging from mild effects to ones that are harmful or even life-threatening. Most are reversible if the user stops taking the drugs. However, others may be permanent or semi-permanent.

Cardiovascular System

Steroid use has been associated with high blood pressure; decreased function of the heart's ventricles; and cardiovascular diseases such as heart attacks, artery damage, and strokes, even in athletes younger than 30. Steroids contribute to the development of cardiovascular disease partly by increasing the level of low-density lipoprotein (LDL) and decreasing the level of high-density lipoprotein (HDL). High LDL and low HDL levels increase the risk of atherosclerosis, a condition in which fatty substances are deposited inside arteries and disrupt blood flow. If blood is prevented from reaching the heart or brain, the result can be a heart attack or stroke, respectively. Steroids also increase the risk that blood clots will form in blood vessels, potentially disrupting blood flow and damaging the heart muscle, so that it does not pump blood effectively.

Hormonal System

Steroid use disrupts the normal production of hormones in the body. Changes that can be reversed include decreased sperm production, decreased function of the testes (hypogonadism) that leads to low testosterone levels, and shrinking of the testicles (testicular atrophy). Irreversible changes include male-pattern baldness and breast development (gynecomastia) in men. Anabolic steroids may also act upon the hormone system to increase the risk of testicular cancer, especially when steroids are used in combination with insulin-like growth factor.

In females, anabolic steroids cause masculinization. Specifically, breast size and body fat decrease, the skin becomes coarse, and the voice deepens. Women may experience excessive growth of body hair but lose scalp hair. With continued administration of steroids, some of these effects become irreversible. It is commonly believed that anabolic steroids will produce irreversible enlargement of the clitoris in females, although there are no studies on this.

Infections

Liver

Musculoskeletal System

Evidence suggests that weightlifters who misuse anabolic steroids have stiffer tendons, which could lead to an increased risk for tendon injury.

Skin

Anabolic steroids can also produce jaundice, or yellowing of the skin or eyes, as a result of damage to the liver.

How does anabolic steroid misuse affect behavior?

Aggression

Case reports and small studies indicate that anabolic steroids increase irritability and aggression, although findings may be confounded by personality traits that are overrepresented in steroid users (i.e., antisocial, borderline, and histrionic personality disorder) and use of other drugs. People who misuse anabolic steroids report more anger than nonusers, as well as more fights, verbal aggression, and violence toward their significant others, sometimes called "roid rage." One study suggests that the mood and behavioral effects seen during anabolic-androgenic steroid misuse may result from secondary hormonal changes.

Psychiatric Disorders

Other Drug Use

Research also indicates that some users might turn to other drugs to alleviate some of the negative effects of anabolic steroids. For example, a study of 227 men admitted in 1999 to a private treatment center for addiction to heroin or other opioids found that 9.3 percent had previously misused anabolic steroids. Of these, most reported using opioids to counteract insomnia, irritability, depression, and withdrawal from anabolic steroids.

What are the risks of anabolic steroid use in teens?

How do anabolic steroids work in the brain?

Research with human cells demonstrates that anabolic steroids also interact with certain types of GABA A receptors, which could mediate the increased anxiety reported by steroid users. In addition, animal studies show that anabolic steroids increase serotonin levels in brain regions involved in mood and dopamine levels in reward-related brain regions. Chronic use of anabolic steroids has also been shown to cause dysfunction of these reward pathways in animals. Specifically, rats given twice daily nandrolone injections for four weeks showed loss of sweet preference (a sign of reward dysfunction) that was accompanied by reductions of dopamine, serotonin, and noradrenaline in the nucleus accumbens, a reward-related brain region.

Are anabolic steroids addictive?

An undetermined percentage of steroid users may develop a steroid use disorder. Substance use disorders are defined by continued use despite adverse consequences; for steroid users, these may include physical or psychological problems such as breast growth (in men), sexual dysfunction, high blood pressure, excessive fats in the blood, heart disease, mood swings, severe irritability, or aggressiveness. Anabolic steroid users also may give up other important activities for fear that they will miss workouts, violate their dietary restrictions, or be prevented from using steroids. Steroid users also typically spend large amounts of time and money obtaining the drugs, and they may try to reduce or stop anabolic steroid use without success-possibly due to depression, anxiety about losing muscle mass, or and other unpleasant effects of withdrawal.

How are anabolic steroids tested in athletes?

Although non-athlete weightlifters account for the bulk of anabolic steroid misuse, occasional steroid use by professional and Olympic athletes to improve performance or cheat in competition ("doping") has done the most to raise awareness of steroid misuse. The World Anti-Doping Agency (WADA) was founded in 1999 to consistently apply anti-doping policies across sports organizations and governments around the world. Non-compliant organizations can face sanctions such as event cancellation, loss of WADA funding, or ineligibility to host events.

Sports with the greatest numbers of anti-doping rules violations in 2015.

Refinements in drug testing have improved the ability to detect anti-doping violations, resulting in increased numbers of reported violations over recent years. For example, the discovery of long-term steroid metabolites has lengthened the drug detection window, making it more difficult for athletes to pass drug tests by simply discontinuing steroid use just prior to an event. In addition, more sensitive technologies have allowed detection of lower metabolite thresholds.

Drug Testing and Nutritional Supplements

Athletes taking over-the-counter nutritional supplements may believe that such products are safe. However, nutritional supplements are not subjected to the same pre-approval requirements and quality tests as FDA-approved medications. For example, some supplements advertised to promote weight loss have been found to contain banned stimulants such as ephedrine or clenbuterol. Other research shows that supplements sometimes contain prohormones or anabolic steroids. In a study looking at 634 nutritional supplements from 13 different countries, 15 percent included some type of prohormone not listed on the label. Another study showed that some non-labeled prohibited substances could be detected by drug tests up to 144 hours later.

Nutritional supplements sometimes contain banned substances that are not indicated in their labels. The FDA notes that consumers should be wary if a product meets any of these criteria:

products claiming to be alternatives to FDA-approved drugs or to have effects similar to prescription drugs

products claiming to be a legal alternative to anabolic steroids

products that are marketed primarily in a foreign language or those that are marketed through mass e-mails

sexual enhancement products promising rapid effects such as working in minutes to hours, or long-lasting effects such as 24 hours to 72 hours

products that provide warnings about testing positive in performance enhancement drug tests

According to WADA's codes, athletes are responsible for any prohibited substance found in their samples, regardless of whether ingestion was intentional or unintentional. However, sanctions may be reduced or avoided if the athlete can demonstrate that the substance was ingested through no significant fault or negligence on his/her part, or in some circumstances where the athlete did not intend to enhance performance.

What can be done to prevent steroid misuse?

Research suggests that high school athletes are less likely to use steroids if their peers and parents disapprove, indicating that peers and parents can be strong partners in prevention efforts.

However, research shows that simply teaching students about steroids' adverse effects does not convince adolescents that they will be adversely affected, nor does such instruction discourage young people from taking steroids in the future. Presenting both the risks and benefits of anabolic steroid use is more effective in convincing adolescents about steroids' negative effects, apparently because the students find a balanced approach more credible.

Research also indicates that some adolescents misuse steroids as part of a pattern of high-risk behaviors such as drinking and driving, carrying a gun, driving a motorcycle without a helmet, and using other illicit drugs. This suggests that a prevention program should focus on comprehensive high-risk behavior screening and counseling among teens who use anabolic steroids.

NIDA-Funded Prevention Research Helps Reduce Steroid Misuse

A more sophisticated approach has shown promise for preventing steroid misuse among players on high school sports teams. The Adolescents Training and Learning to Avoid Steroids (ATLAS) program is showing high school football players that they do not need steroids to build powerful muscles and improve athletic performance. By educating student athletes about the harmful effects of anabolic steroids and providing nutrition and weight-training alternatives to steroid use, the ATLAS program has increased football players' healthy behaviors and reduced their intentions to misuse steroids. In the program, coaches and team leaders teach the harmful effects of anabolic steroids and other illicit drugs on immediate sports performance and discuss how to refuse offers of drugs.

Studies show that one year after completion of the program, compared with a control group, ATLAS-trained football student athletes in 15 high schools had:

less use of anabolic steroids and less intention to misuse them in the future

less misuse of alcohol, amphetamines, and narcotics

less misuse of "athletic enhancing" supplements

less likelihood of engaging in hazardous behaviors such as drinking and driving

better knowledge about anabolic steroid, alcohol, and marijuana effects; better knowledge of alternatives to steroid misuse; greater confidence in athletic abilities; and improved nutritional behaviors

What treatments are effective for anabolic steroid misuse?

Current views recommend that treatment for steroid use address the underlying causes of the steroid use. This can include:

psychological therapies (and possibly medications) for muscle dysmorphia

endocrine therapies to restore function in those suffering from hypogonadism and to alleviate symptoms of depression

antidepressants for those whose depression does not respond to endocrine therapies

pharmacological and psychosocial treatments for patients who are also dependent on opioids, which appear to also be effective in alleviating signs of anabolic steroid dependence

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Anabolic Steroids and Other Appearance and Performance Enhancing Drugs (APEDs) | National Institute on Drug Abuse

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Anabolic steroids are synthetic variations of the male sex hormone testosterone. The proper term for these compounds is anabolic-androgenic steroids.