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The use of performance enhancing drugs (PED) in sports, doping, has been practiced for over a hundred years. Early cases of drug use to enhance athletic performance were admitted to without consequence to athletes or coaches. Among the most popular PEDs are anabolic steroids, human growth hormone, erythropoietin, beta-blockers, stimulants and diuretics. The anabolic steroid testosterone was first synthesized in Germany in 1935. Most anabolic steroid users are male non-athletes aiming to improve their appearance by building muscle and use of steroids is strongly tied to a male body image disorder called muscle dysmorphia. In 1969, the International Olympic Committee initiated drug tests for athletes at the Olympic Games. As levels of illicit traffic in steroids increased, congress passed the Anabolic Steroid Act of 1990. This Act identified anabolic steroids as a separate drug class and categorized over two dozen drugs as controlled substances.1-3
The Use and Abuse of Anabolic Steroids
Anabolic steroids are synthetic variations of the male sex hormone testosterone. The proper term for these compounds is anabolic-androgenic steroids. "Anabolic" refers to muscle building, and "androgenic" refers to increased male sex characteristics. Some common names for anabolic steroids are Gear, Juice, Roids, and Stackers. Health care providers can prescribe steroids to treat various medical conditions, including delayed puberty. But some athletes and bodybuilders misuse these drugs to boost performance or improve their physical appearance. Athletes may have stimulants in their body for one of three main reasons: inadvertent consumption in a propriety medicine; deliberate consumption for misuse as a recreational drug and deliberate consumption to enhance performance. People who misuse anabolic steroids usually take them orally, inject them into muscles, or apply them to the skin as a gel or cream. These doses may be 10 to 100 times higher than doses prescribed to treat medical conditions.
Misuse of anabolic steroids might lead to negative mental effects, such as:
Anabolic steroid misuse might lead to serious, even permanent, health problems such as:
Several other effects are gender- and age-specific:
Some of these physical changes, such as shrinking sex organs in men, can add to mental side effects such as mood disorders.
Anabolic Steroid Use Disorder
Anabolic steroids work differently from other drugs of abuse; they do not have the same short-term effects on the brain. The most important difference is that steroids do not directly activate the reward system to cause a “high”; they also do not trigger rapid increases in the brain chemical dopamine, which reinforces most other types of drug taking behavior. Even though anabolic steroids do not cause the same high as other drugs, they can lead to a substance use disorder. A substance use disorder occurs when a person continues to misuse steroids, even though there are serious consequences for doing so. The most severe form of a substance use disorder is addiction. People might continue to misuse steroids despite physical problems, high costs to buy the drugs, and negative effects on their relationships. These behaviors reflect steroids' addictive potential. Research has further found that some steroid users turn to other drugs, such as opioids, to reduce sleep problems and irritability caused by steroids.4,5
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