How to avoid anabolic steroid abuse

Anabolic steroids are synthetic, or human-made, 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.

How to avoid anabolic steroid abuse

Health care providers can prescribe steroids to treat hormonal issues, such as delayed puberty. Steroids can also treat diseases that cause muscle loss, such as cancer and AIDS. But some athletes and bodybuilders misuse these drugs in an attempt to boost performance or improve their physical appearance.

The majority of people who misuse steroids are male weightlifters in their 20s or 30s. Anabolic steroid misuse is much less common in women. It is difficult to measure steroid misuse in the United States because many national surveys do not measure it. However, use among teens is generally minimal. The 2016 NIDA-funded Monitoring the Future study has shown that past-year misuse of steroids has declined among 8th and 10th graders in recent years, while holding steady for 12th graders.

How do people misuse anabolic steroids?

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.

Commons patterns for misusing steroids include:

  • cycling—taking multiple doses for a period of time, stopping for a time, and then restarting
  • stacking—combining two or more different steroids and mixing oral and/or injectable types
  • pyramiding—slowly increasing the dose or frequency of steroid misuse, reaching a peak amount, and then gradually tapering off to zero
  • plateauing—alternating, overlapping, or substituting with another steroid to avoid developing a tolerance

There is no scientific evidence that any of these practices reduce the harmful medical consequences of these drugs.

How do anabolic steroids affect the brain?

How to avoid anabolic steroid abuse

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.

Misuse of anabolic steroids might lead to negative mental effects, such as:

  • paranoid (extreme, unreasonable) jealousy
  • extreme irritability and aggression (“roid rage”)
  • delusions—false beliefs or ideas
  • impaired judgment
  • mania

What are other health effects of anabolic steroids?

Anabolic Steroids and Infectious Diseases

People who inject steroids increase their risk of contracting or transmitting HIV/AIDS or hepatitis.

Read more about this connection by visiting:

Aside from mental effects, steroid use commonly causes severe acne. It also causes the body to swell, especially in the hands and feet.

Long-Term Effects

Anabolic steroid misuse might lead to serious, even permanent, health problems such as:

  • kidney problems or failure
  • liver damage and tumors
  • enlarged heart, high blood pressure, and changes in blood cholesterol, all of which increase the risk of stroke and heart attack, even in young people
  • increased risk of blood clots

Several other effects are gender- and age-specific:

  • In men:
    • shrinking testicles
    • decreased sperm count
    • baldness
    • development of breasts
    • increased risk for prostate cancer
    • growth of facial hair or excess body hair
    • decreased breast size
    • male-pattern baldness
    • changes in or stop in the menstrual cycle
    • enlarged clitoris
    • deepened voice
    • stunted growth (when high hormone levels from steroids signal to the body to stop bone growth too early)
    • stunted height (if teens use steroids before their growth spurt)

    Some of these physical changes, such as shrinking sex organs in men, can add to mental side effects such as mood disorders.

    Are anabolic steroids addictive?

    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.

    People who misuse steroids might experience withdrawal symptoms when they stop use, including:

    • fatigue
    • restlessness
    • loss of appetite
    • sleep problems
    • decreased sex drive
    • steroid cravings

    One of the more serious withdrawal symptoms is depression, which can sometimes lead to suicide attempts.

    How can people get treatment for anabolic steroid addiction?

    Some people seeking treatment for anabolic steroid addiction have found a combination of behavioral therapy and medications to be helpful.

    In certain cases of addiction, patients have taken medicines to help treat symptoms of withdrawal. For example, health care providers have prescribed antidepressants to treat depression and pain medicines for headaches and muscle and joint pain. Other medicines have been used to help restore the patient’s hormonal system.

    An undetermined percentage of steroid users may develop a steroid use disorder. Substance use disorders are defined by continued use despite adverse consequences; for steroid users, these may include physical or psychological problems such as breast growth (in men), sexual dysfunction, high blood pressure, excessive fats in the blood, heart disease, mood swings, severe irritability, or aggressiveness. Anabolic steroid users also may give up other important activities for fear that they will miss workouts, violate their dietary restrictions, or be prevented from using steroids. Steroid users also typically spend large amounts of time and money obtaining the drugs, and they may try to reduce or stop anabolic steroid use without success—possibly due to depression, anxiety about losing muscle mass, or and other unpleasant effects of withdrawal. 110

    Withdrawal from steroids occurs when an individual develops dependence. A review of the research suggests that about 32 percent of people who misuse anabolic steroids become dependent. 23 Symptoms of dependence can include tolerance, which is needing to take more steroids to achieve the same effects. Another indicator of dependence is withdrawal once anabolic steroid use stops. 110 Withdrawal symptoms can include fatigue, restlessness, loss of appetite, insomnia, reduced sex drive, and steroid cravings. 111 The most dangerous of the withdrawal symptoms is depression, because it sometimes leads to suicide attempts. 112

    How to avoid anabolic steroid abuse


    Anabolic steroids are medications related to testosterone (male sex hormone) that are made in labs. Doctors use anabolic steroids to treat hormone problems in men, delayed puberty, and muscle loss from some diseases.

    Bodybuilders and athletes might misuse anabolic steroids in attempts to build muscles and improve athletic performance, often taking doses much higher than would be prescribed for a medical condition. Using them this way, without a prescription from a doctor, is not legal—or safe—and can have long-term consequences.

    Anabolic steroids are only one type of steroid. Other types of steroids include cortisol, estrogen, and progesterone. These are different chemicals and do not have the same effects.

    How Anabolic Steroids Are Misused

    When people take steroids without a doctor’s prescription or in ways other than as prescribed, it is called misuse.

    Some people who misuse steroids take pills; others use needles to inject steroids into their muscles or apply them to the skin as a gel or cream.

    What happens to your brain when you misuse anabolic steroids?

    Anabolic steroids affect a part of the brain called the limbic system, which controls mood. They don’t cause a “high” like some other drugs, but can cause harmful effects.

    Long-term steroid misuse can lead to aggressive behavior and extreme mood swings. This is sometimes referred to as “roid rage.” It can also lead to feeling paranoid (like someone or something is out to get you), jealous, delusional (believing in something that is not true), and invincible (like nothing can hurt you).

    What happens to your body when you misuse anabolic steroids?

    Short-Term Effects

    People who misuse anabolic steroids can experience many effects, some of which are serious:

    • oily skin and acne
    • water retention
    • yellowing of the skin
    • muscle building
    • possible improved athletic performance
    • infection

    Long-Term Effects

    • stunted growth (in teens)
    • stunted height (if teens use steroids before their growth spurt)
    • high blood pressure
    • changes in blood cholesterol (increases in “bad” cholesterol or LDL, decreases in “good” cholesterol or HDL)
    • enlarged heart
    • heart attack or stroke (even in young people)
    • liver disease, including cancer
    • kidney problems or failure


    • breast growth and shrinking of testicles
    • low sperm count/infertility
    • baldness
    • increased risk for prostate cancer


    • voice deepening
    • growth of facial hair
    • male-pattern baldness
    • changes in or end of menstrual cycle/getting your period
    • enlargement of clitoris

    In addition, people who misuse steroids by injecting them risk getting HIV or hepatitis (a liver disease) if they share needles. Read more about the link between viral infections and drug use.

    Some people who misuse steroids believe they can avoid unwanted side effects or increase the drugs’ effects by using them in specific ways, sometimes called cycling, stacking, or pyramiding. There is no scientific evidence that any of these approaches reduces the harmful effects of misusing these drugs.

    Can you overdose or die if you misuse anabolic steroids?

    Yes. Although it is rare, there are a few ways steroid misuse can cause death.

    • Heart attacks and strokes. Steroid misuse can lead to a condition called atherosclerosis, where fat builds up inside arteries and makes it hard for blood to flow. When blood flow to the heart is blocked, a heart attack can occur. If blood flow to the brain is blocked, a stroke can occur.
    • HIV. People who inject anabolic steroids using needles might share dirty drug injection equipment that can spread serious viral infections such as HIV/AIDS or hepatitis (a liver disease).
    • Depression. Steroid misuse can lead to depression, especially during withdrawal. In rare cases, this can contribute to destructive behaviors, including suicide.
    • Cancer. There is some scientific evidence that repeated misuse of anabolic steroids can contribute to the development of liver and prostate cancer.

    Mixing steroids with other drugs, including alcohol, can be especially dangerous.

    Are anabolic steroids addictive?

    They can be. Addiction to steroids is different than addiction to other drugs, such as cocaine or heroin. People who misuse steroids don’t experience a “high” from the drug. However, they can experience withdrawal symptoms if they stop using them.

    People who do become addicted keep using steroids despite bad effects on their bodies and lives. Also, people who misuse steroids typically spend a large amount of time and money obtaining the drugs, another sign they could be addicted.

    When they stop using steroids, people can experience uncomfortable symptoms, including:

    • feeling depressed
    • having mood swings
    • feeling tired or restless
    • losing their appetite
    • being unable to sleep (insomnia)
    • having a strong desire to take more steroids

    Depression can be very dangerous, because it sometimes leads people to think of or attempt suicide (killing themselves). Some symptoms of depression that are linked with anabolic steroid withdrawal have lasted for a year or more after the person stops misusing the drugs.

    What should I do if someone I know needs help?

    If you, or a friend, are in crisis and need to speak with someone now:

    • Call the National Suicide Prevention Lifeline at 1-800-273-TALK (they don’t just talk about suicide—they cover a lot of issues and will help put you in touch with someone close by)

    If you want to help a friend, you can:

    • Share resources from this site, including this page.
    • Point your friend to NIDA’s Step by Step Guide for Teens and Young Adults.
    • Encourage your friend to speak with a trusted adult.

    If a friend is using drugs, you might have to step away from the friendship for a while. It is important to protect your own mental health and not put yourself in situations where drugs are being used.

    For more information on how to help a friend or loved one, visit our Have a Drug Problem, Need Help? page.

    NORTH TEXAS (CBSDFW.COM) – The U.S. Attorney’s Office for the Northern District of Texas has filed federal charges against what it calls “one of the world’s largest” alleged anabolic steroid producers.

    Chuen Fat Yip, 68, a citizen of the People’s Republic of China, was charged in September 2018 with five drug crimes, including conspiracy to possess with intent to distribute anabolic steroids, conspiracy to possess with intent to distribute fentanyl precursor, conspiracy to import anabolic steroids, and manufacturing anabolic steroids and fentanyl precursor with the knowledge that they will be unlawfully imported, The U.S. Attorney’s Office explained in a news release Wednesday, Dec. 15.

    The indictment against Yip and two coconspirators was unsealed on March 11, 2021.

    On Nov. 18, 2021, the U.S. Attorney’s Office obtained a seizure warrant for more than 49.1 bitcoin – currently worth approximately $2.3 million – from a crypto wallet that traced back to Yip.

    How to avoid anabolic steroid abuse

    Chuen Fat Yip (credit: U.S. Attorney’s Office)

    “We cannot allow foreign nationals to flood the United States with dangerous drugs,” said U.S. Attorney Chad Meacham. “This defendant allegedly made millions manufacturing and distributing anabolic steroids and fentanyl precursors to American customers. The Justice Department will pursue drug defendants to the furthest reaches of the globe if that’s what it takes to stem the tide of the drug epidemic.”

    “Transnational criminal organizations seek to threaten our health and safety by importing dangerous drugs and chemicals, such as fentanyl. DEA’s mission to seek justice must be worldwide when combatting this threat,” said DEA Special Agent in Charge, Eduardo A. Chávez. “The YC Group allegedly utilized global logistics for personal gain while profiting from those individuals vulnerable to the dangers of drug abuse. Mr. Yip’s alleged criminal activities have caught up with him and DEA Fort Worth will use every tool, every law enforcement partner, and every community resource to ensure he and his conspirators are held accountable.”

    According to court documents, Yip – who is believed to reside in Wuhan City, Hubei Provence, PRC – allegedly owned and operated the Yuancheng (YC) Group, a chemical manufacturing company responsible for producing and distributing approximately $280 million worth of anabolic steroids, including $55 million worth of anabolic steroids shipped to the United States over a five-year period.

    The YC Group allegedly advertised the sale of illegal controlled substances at trade shows and on a variety of websites, including,, and

    In October 2015, Yip allegedly attended a trade show in the United States, bringing his company vice president and a sales manager with him. His underlings allegedly met with customers and negotiated transactions involving more than 100 kilograms.

    During those meetings, they acknowledged the U.S. Drug Enforcement Administration’s efforts to stem the flow of anabolic steroids and outlined steps the customers needed to avoid detection.

    Following production of the steroids and other controlled substances, the YC Group allegedly shipped the contraband out of Shanghai or Hong Kong to locations around the globe, including 84 foreign counties and all 50 U.S. states.

    They shipped parcels weighing less than 50 kilograms via commercial air carries, including the U.S. Postal Service, and used cargo vessels to transport shipments weighing more than 50 kilograms. Shipments were typically disguised in packaging intended to resemble other products, such as food.

    On one occasion, the YC Group allegedly agreed to ship approximately 24 kilograms of 4-ANPP, a precursor for fentanyl, from the PRC to the United States.

    The conspirators also allegedly agreed that the precursor would then be smuggled from the United States to Mexico, where it would be combined with other chemicals to produce fentanyl, then smuggled back into the United States, where it would be distributed to dealers and end-users.