An undetermined percentage of steroid abusers may become addicted to the drugs, as evidenced by their continued abuse despite physical problems and negative effects on social relations. Also, steroid abusers typically spend large amounts of time and money obtaining the drugs, which is another indication that they may be addicted. Individuals who abuse steroids can experience withdrawal symptoms when they stop taking steroids, such as mood swings, fatigue, restlessness, loss of appetite, insomnia, reduced sex drive, and steroid cravings. The most dangerous of the withdrawal symptoms is depression, because it sometimes leads to suicide attempts. If left untreated, some depressive symptoms associated with anabolic steroid withdrawal have been known to persist for a year or more after the abuser stops taking the drugs.
What can be done to prevent steroid abuse?
Most prevention efforts in the United States today focus on athletes involved with the Olympics and professional sports; few school districts test for abuse of illicit drugs. It has been estimated that close to 9 percent of secondary schools conduct some sort of drug testing program, presumably focused on athletes, and that less than 4 percent of the Nation's high schools test their athletes for steroids. Studies are currently under way to determine whether such testing reduces drug abuse.
Research on steroid educational programs has shown that simply teaching students about steroids' adverse effects does not convince adolescents that they can be adversely affected. Nor does such instruction discourage young people from taking steroids in the future. Presenting both the risks and benefits of anabolic steroid use is more effective in convincing adolescents about steroids' negative effects, apparently because the students find a balanced approach more credible, according to the researchers.
NIDA-funded prevention research helps reduce steroid abuse.
Amore sophisticated approach has shown promise for preventing steroid abuse among players on high school sports teams. The Adolescents Training and Learning to Avoid Steroids (ATLAS) program is showing high school football players that they do not need steroids to build powerful muscles and improve athletic performance. By educating student athletes about the harmful effects of anabolic steroids and providing nutrition and weight-training alternatives to steroid use, the ATLAS program has increased football players' healthy behaviors and reduced their intentions to abuse steroids. In the program, coaches and team leaders teach the harmful effects of anabolic steroids and other illicit drugs on immediate sports performance, and discuss how to refuse offers of drugs.
Studies show that 1 year after completion of the program, compared with a control group, ATLAS-trained students in 15 high schools had:
- Half the incidence of new abuse of anabolic steroids and less intention to abuse them in the future;
- Less abuse of alcohol, marijuana, amphetamines, and narcotics;
- Less abuse of "athletic enhancing" supplements;
- Less likelihood of engaging in hazardous substance abuse behaviors such as drinking and driving;
- Increased protection against steroid and other substance abuse. Namely, less interest in trying steroids, less desire to abuse them, better knowledge of alternatives to steroid abuse, improved body image, and increased knowledge of diet supplements.
The Athletes Targeting Healthy Exercise and Nutrition Alternatives (ATHENA) program was patterned after the ATLAS program, but designed for adolescent girls on sports teams. Early testing of girls enrolled in the ATHENA program showed significant decreases in risky behaviors. While preseason risk behaviors were similar among controls and ATHENA participants, the control athletes were three times more likely to begin using diet pills and almost twice as likely to begin abuse of other body-shaping substances, including amphetamines, anabolic steroids, and muscle-building supplements during the sports season. The use of diet pills increased among control subjects, while use fell to approximately half of the preseason levels among ATHENA participants. In addition, ATHENA team members were less likely to be sexually active, more likely to wear seatbelts, less likely to ride in a car with a driver who had been drinking, and they experienced fewer injuries during the sports season.
Both Congress and the Substance Abuse and Mental Health Services Administration have endorsed ATLAS and ATHENA as model prevention programs. These Oregon Health & Science University programs have been awarded the 2006 annual Sports Illustrated magazine's first-ever "Champion Award."
What treatments are effective for anabolic steroid abuse?
Few studies of treatments for anabolic steroid abuse have been conducted. Current knowledge is based largely on the experiences of a small number of physicians who have worked with patients undergoing steroid withdrawal. The physicians have found that supportive therapy is sufficient in some cases. Patients are educated about what they may experience during withdrawal and are evaluated for suicidal thoughts. If symptoms are severe or prolonged, medications or hospitalization may be needed.
Some medications that have been used for treating steroid withdrawal restore the hormonal system after its disruption by steroid abuse. Other medications target specific withdrawal symptomsfor example, antidepressants to treat depression and analgesics for headaches and muscle and joint pains.
Some patients require assistance beyond pharmacological treatment of withdrawal symptoms and are treated with behavioral therapies.