For references to the studies discussed in this info sheet, see the reference list.
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What are steroids?
Steroids or, more precisely, androgenic anabolic steroids, are a class of drugs similar to the male hormone testosterone. These drugs have muscle-building (anabolic), masculinizing (androgenic) and mind-altering (psychoactive) effects.
Steroids are manufactured by pharmaceutical companies. The drugs are also produced in uncontrolled laboratories. Typically, steroids come in pill or liquid form and are swallowed or injected.
Why do we use steroids?
Steroids were first developed in the 1930s to treat a male growth problem that affected physical development and sexual functioning. Today they are still prescribed for certain health conditions. Steroids are also used for non-medical reasons. Some bodybuilders use steroids to increase their muscle mass and strength, and some athletes use the drugs believing they will improve their physical performance. Some people use steroids because they want to improve their appearance by becoming bigger. And others use the drugs to feel confident and energetic. But like any drug, steroids can be harmful.
Many people choose not to use steroids or to use the drugs in moderation, because being less in control of their behaviour increases the likelihood of over-reacting when relating with others. Using steroids may help us feel more confident about our appearance, but repeatedly using the drugs to address difficulties with body satisfaction may lead to harms to our health and relationships.
What happens when we use steroids?
When swallowed, steroids are absorbed into the bloodstream through the small intestine and stomach. When the route is injection, the drug is commonly injected into muscle mass where it is absorbed into the bloodstream.
Steroids function in different ways. The primary way is by promoting the production of proteins. This results in an increase in muscle. In more than moderate doses, steroids also affect how we think and behave. The effects can be different for different people. Instead of feeling energetic and happy, some of us may feel irritated. Factors that can influence how steroids will affect us include our
past experiences with the drug,
present mood and surroundings, and
mental and physical health condition.
Impact on well-being
When we think about steroids, it is important to keep in mind that there can be health benefits. For instance, steroids have positive effects for people suffering from hormone deficiency and diseases that result in loss of muscle mass. But buying non-prescription steroids is always risky because the drugs are distributed in uncontrolled conditions and the diversion of veterinary steroids is common. The substance a person picks up at a gym may look legitimate but could be diluted or mixed with toxic material.
Steroid use can also affect our social lives. While using steroids may help us feel strong and assured about our appearance, using more than moderate amounts may lead to feeling irritable and agitated, potentially affecting our relationships. And while using steroids to develop a muscular body may make us feel more attractive, frequent use may lead to sexual difficulties.
Steroid use can lead to acne. And frequent use of more than moderate amounts may result in temporary aggressive behaviour (research suggests some people may be more vulnerable to this negative effect than others). Regular use of more than moderate amounts is also linked to heart and liver disease.
When is using steroids a problem?
Using steroids is a problem when it negatively affects our life or the lives of others. Many of us may think this refers only to people who regularly use large amounts, but even a single occasion of use can lead to a problem. For instance, if we share needles, we are at risk of infection. What’s important to recognize is the potential for adverse consequences of use in any context and over time.
Steroid use, especially regular use, by young people has particular risks. Like other psychoactive drugs, steroids may interfere with normal brain development. Early use can also interfere with developing a positive perception of body image and have a negative impact on well-being.
While most people who use steroids do not become dependent on the drug, those who use steroids frequently over a period of time may begin to feel like they need the drug to function and feel normal.
The reasons people use steroids influence their risk of developing problems. For instance, if a person uses steroids to experiment, only occasional use may follow. But when a person uses steroids to cope with a long-term problem such as negative body image, then more long-lasting and intense use may follow.
People who develop a dependence on steroids may experience signs of withdrawal, including depression, fatigue, sleep difficulties, lack of appetite, and muscle and joint pain.
Mixing steroids with other substances
People sometimes mix steroids with other substances without realizing there is the potential for harmful consequences. The following are some common combinations and possible results.
Alcohol and other depressants
Both steroids and alcohol are processed by the liver and can independently lead to liver damage. Using them at the same time can increase the risk of negative impacts on the liver.
These are substances such as cocaine that increase our heart rate. Using steroids with stimulants may increase the stress on our cardiovascular system and put us at risk for experiencing heart disease.
When prescription or over-the-counter medications are used with steroids, there is the potential for side effects or for the medicinal benefits to cancel out. Taking time to read medication labels or consulting with a healthcare professional can reduce these risks.
How to make healthier choices about steroids
Some of the risks of using steroids are related to how we use them. For instance, injecting the drug (or any drug) can lead to infection and transmission of disease if we share needles. Some other useful guidelines to follow are: not too much, not too often and only in safe contexts.
Are steroids legal?
Steroids are controlled substances in Canada. The drugs are legal by prescription only and for veterinary use. It is illegal to produce, sell, import or export the drugs. Under current laws, offenders may receive a fine, a prison term and a criminal record that could affect their future employment, travel plans and educational opportunities. Steroids are banned by most professional and amateur sports governing bodies.
What to do if you or someone you know wants to explore change
To better understand how substances play a role in your life, visit the You and Substance Use Workbook. This website also features detailed information on substance use and mental health.
You can also find information on a wide variety of substance use issues on the Canadian Institute for Substance Use Research, website: cisur.ca.
For information on treatment options and resources throughout BC, call the Alcohol and Drug Information and Referral Service at 1-800-663-1441. In Greater Vancouver, call 604-660-9382.
About the author
The Canadian Institute for Substance Use Research, formerly CARBC, is a member of the BC Partners for Mental Health and Substance Use Information. The institute is dedicated to the study of substance use in support of community-wide efforts aimed at providing all people with access to healthier lives, whether using substances or not. For more, visit www.cisur.ca.