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Prescription, Nonprescription and Orphan Drugs01:02

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Illicit anabolic-androgenic steroid use.

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Anabolic-androgenic steroids (AAS) abuse has long-term medical risks, including cardiovascular toxicity. AAS use can also lead to mood changes and dependence, posing a growing public health concern.

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Area of Science:

  • Endocrinology
  • Toxicology
  • Psychiatry

Background:

  • Anabolic-androgenic steroids (AAS) are synthetic derivatives of testosterone.
  • Illicit AAS use surged in the 1980s, primarily among men, for performance or appearance enhancement.
  • Medical and behavioral effects of AAS abuse are still being understood.

Purpose of the Study:

  • To review the evolving medical and behavioral effects of illicit anabolic-androgenic steroid (AAS) use.
  • To highlight the cardiovascular toxicity and psychiatric side effects associated with AAS abuse.
  • To examine the co-ingestion of other drugs and the potential for AAS dependence.

Main Methods:

  • Literature review of medical and behavioral effects of AAS.
  • Analysis of survey data on AAS prevalence and co-ingestion.
  • Examination of potential biological mechanisms for AAS-opioid interaction.

Main Results:

  • Supraphysiologic AAS doses cause significant long-term adverse medical effects, particularly cardiovascular toxicity.
  • Behavioral effects include mood disturbances (mania, depression) and aggression, though idiosyncratic.
  • AAS users show increased risk for co-ingestion of other drugs, notably opioids, and may develop dependence.

Conclusions:

  • Illicit AAS use presents substantial medical and psychiatric risks, including cardiovascular damage and mood disorders.
  • The association between AAS and opioid use may have a shared biological basis.
  • AAS dependence is a potential public health issue requiring further research.