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Anabolic steroid abuse and dependence.

Kirk J Brower1

  • 1Department of Psychiatry and Addiction Research Center, The University of Michigan, Ann Arbor 48108, USA. kbrower@umich.edu

Current Psychiatry Reports
|September 17, 2002
PubMed
Summary

Anabolic-androgenic steroids (AAS) can lead to dependence, particularly in individuals misusing high doses for physique enhancement. Therapeutic AAS use does not appear to cause dependence, but non-medical use presents risks and treatment considerations.

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Area of Science:

  • Endocrinology
  • Psychiatry
  • Sports Medicine

Background:

  • Anabolic-androgenic steroids (AAS) are prescribed for androgen deficiency and AIDS-associated wasting.
  • Therapeutic AAS use is not linked to abuse or dependence in medical literature.
  • Non-medical AAS use, especially supraphysiologic doses in weight training, is associated with dependence.

Purpose of the Study:

  • To review the adverse consequences of AAS use.
  • To propose a model for AAS dependence development.
  • To compare AAS use disorders with other substance use disorders for treatment implications.

Main Methods:

  • Literature review of AAS therapeutic use and abuse.
  • Analysis of reported cases of AAS dependence in athletes.
  • Development of a dual-component model (myoactive and psychoactive effects) for AAS dependence.
  • Review of assessment methods including physical, mental status, and laboratory tests.

Main Results:

  • No evidence links therapeutic AAS use to dependence.
  • 165 cases of AAS dependence reported in weightlifters and bodybuilders using high doses and combinations of substances.
  • A proposed model suggests both physical and psychological effects contribute to AAS dependence.
  • Assessment and comparison with other substance use disorders reveal similarities and differences.

Conclusions:

  • AAS dependence is primarily associated with non-medical, high-dose administration in athletic contexts.
  • Understanding the dual nature of AAS effects is crucial for dependence models.
  • Assessment and treatment strategies for AAS use disorders should consider parallels with other substance use disorders.

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