Anabolic steroids are defined as substances capable of reproducing the effects of testosterone, a hormone responsible for the aesthetic and behavioral characteristics of male sex.

The phenomenon of steroid abuse is characterized by the use of higher than therapeutic doses for non-medical purposes, with negative consequences for health. This is a fairly common phenomenon in the United States in adolescent groups, to a lesser extent in our areas. The link with the sports environment is typical, but not the only one. The steroid provider may be in contact with the “gym” even secondarily, for the training necessary to make the steroids work, but without any real interest in racing.

The categories of underwriters and potential steroid abusers are substantially three:

a) those who want to enhance athletic performance

b) who wants to shape his body to be aesthetically attractive or suitable for artistic professions

c) who wants to enhance the aggressive performances for work or social success. This category also includes cases in which aggressive behaviors, in reality antisocial, however, become positive connotations within their group (eg gang, student youth circles).

During use, the most frequent psychic effects include excitatory (manic) and psychotic symptoms, while the interruption of use develops depressive syndromes of varying intensity, which involve suicidal risk.

The effects are often biphasic, that is, the effect during use is followed by the effect opposite to the suspension of use. Thus, for example, the energies increase during use but are reduced to suspension, and at the same time sexual desire.

Sometimes the effects on the aesthetic and sexual sphere are paradoxical. For example, one can have breast development in humans. These effects derive in part from the exhaustion of the spontaneous production of testosterone, when the organism has become accustomed to receiving it in massive doses from the outside. When the steroid is discontinued, the person has a “blocked” testosterone production system. In addition, some steroids partly produce “mixed”, virilizing or feminizing effects depending on the organ on which they act.

Some of the side effects during use are as follows:

  • – increase in arterial pressure, water retention with tissue swelling
  • – increase in muscle mass
  • -development of the breast (gynecomastia) in men or its reduction in women
  • -epatopatia
  • – increase in prostate size
  • – volume reduction of the testicles
  • – increase in clitoral size
  • – skin rashes
  • – baldness, loss of hair; hirsutism in women
  • -change of the tone of the voice (more “deep”)

The toxic effects can be aggravated by the simultaneous use of other anabolic drugs or by “brick” substances, that is, constituents of the muscle that go to form new tissue under the stimulus of the steroid, like some mixtures of amino acids.

Growth hormone (GH) is for example used as an anabolic. Its effects are particularly negative for the induction of an increase in the size of the heart, not associated with a parallel vascularization. While in parallel the territory to be irrigated increases with the increase of the muscular masses, and the required pump strength increases due to the increase of the pressure, the capacities of the heart are reduced. The development of the articular extremities, which gives a more “massive” appearance, associated with the increase of the muscular masses, makes articular movement difficult.

Steroid dependence should be considered a toxic to medium-long term effect of steroids, which develops from a brain action, and, unlike other toxic effects, is not spontaneously reversible.

Recurrent behavior in steroid use despite toxic effects must be distinguished in:

– research of the desirable effects of steroids with risk acceptance for life and health, including psychic. These cases constitute a mental disorder comparable to anorexia nervosa, in which the control of the physical form is pursued through the forcing of the same in the direction of the increase of the muscular mass. The subject’s interest is focused on the perception of physical form as satisfying, often beyond limited objective results and real acquired deformities for the disharmonic development of some muscle groups, and the functional limitations imposed by the anatomic imbalance between muscle and osteo-apparatus -articular. To indicate this condition we can use the diagnostic scheme of “dismorfophobia”, as well as that of anorexia nervosa. Steroids become problematic substances as they are, for anorexic subjects, anorectics, diuretics and laxatives.

– research into the state of excitement induced by steroids. This eventuality configures a dependence on Steorides. Anabolic steroids are substances of abuse that become such through an initial phase of instrumental use. In fact, classical drugs are mostly used to produce euphoria and pleasure, and they induce dependence through this type of bond. In some cases, as in morphine addiction, the initial reason for use was to control pain, but the action of the substance on the brain produces a link that then continues independently, and constitutes addiction. Other substances are initially used for a pleasant purpose without being identified by themselves as “the end”, but because of their action on the brain they also induce dependence.

As in other addictions, the doses used and the duration of use are crucial factors for addiction, which on average requires a year of regular use. Medical use, which involves contained doses, and can simply compensate for deficiencies, is not associated with a significant risk of abuse. The gratification component associated with hyperstimulation would be a crucial factor in making the relationship with steroids relatively “autonomous” relative to its initial motive. The doubt about the effective equivalence of steroid dependence to other addictions is given by the delay with which steroids produce their effects, while the other drugs owe to the speed of their effect the ability to bind the absorber to itself.

In any case, steroid abuse tends to become a polyammuso, in which the initial part pending the arrival of the steroid effect can be carried out by more classic substances such as alcohol, cocaine. It is not uncommon for the unpleasant component of steroid excitation or withdrawal depression to be managed by the use of the same substances. In general, the scheme follows that of the abuse of stimulants: it starts with a predominantly stimulating effect to end up in a picture of depressive abuse, when the stimulation has become unpleasant and the prevailing anxiety and depressive symptoms.

The most difficult aspect to understand in steroid dependence is to distinguish the psychology of initial use, aimed at developing muscle masses and sexual performance, and what happens later, that is, addiction, which becomes an independent problem.

In intervention programs on steroid dependence, the increased knowledge of adverse effects does not change the risk of relapse. What is surprising is not so much this result, as if ever the fact that someone thought that the drug addicts could change their behavior driven by the fear of negative consequences of drug use.