0

20

40

60

80%

1998 1999 2000 2001 2002 2003 2004 2005

12th-Graders’ Perceived Harmfulness of Steroid Use

What are

anabolic steroids?

nabolic steroids” is the

familiar name for synthetic

substances related to the

male sex hormones (e.g., testosterone). They promote the growth

of skeletal muscle (anabolic

effects) and the development 

of male sexual characteristics

(androgenic effects) in both males

and females. The term “anabolic

steroids” will be used throughout this report because of its

familiarity, although the proper

term for these compounds is

“anabolic-androgenic steroids.”

Anabolic steroids were developed in the late 1930s primarily

to treat hypogonadism, a condition in which the testes do not

produce sufficient testosterone

for normal growth, development,

and sexual functioning. The 

primary medical uses of these

compounds are to treat delayed

puberty, some types of impotence, and wasting of the body

caused by HIV infection or other

diseases.

During the 1930s, scientists

discovered that anabolic steroids

could facilitate the growth of

skeletal muscle in laboratory 

animals, which led to abuse of

f

r

o

m

t

h

e

dir

e

c

t

o

r

Persistent reports of anabolic

steroid abuse by professional athletes,

many of whom are regarded as role

models by young people, highlight the

fact that we are now facing a very

damaging message in our society—

that bigger is better, and being the

best is more important than how you

get there. 

Abuse of anabolic steroids differs

from the abuse of other illicit substances because the initial abuse of

anabolic steroids is not driven by the

immediate euphoria that accompanies

most drugs of abuse, such as cocaine,

heroin, and marijuana, but by the

desire of abusers to change their

appearance and performance, 

characteristics of great importance 

to adolescents. The effects of steroids

can boost confidence and strength,

leading abusers to overlook the potential serious and long-term damage

that these substances can cause. 

While anabolic steroids can

enhance certain types of performance

or appearance, they are dangerous

drugs, and when used inappropriately

they can cause a host of severe, 

long-lasting, and in some cases, 

irreversible negative health consequences. Anabolic steroids can lead

to early heart attacks, strokes, liver

tumors, kidney failure, and serious

psychiatric problems. In addition,

because steroids are often injected,

users who share needles or use nonsterile techniques when they inject

steroids are at risk for contracting

dangerous infections, such as

HIV/AIDS and hepatitis B and C.

I hope that students, parents,

teachers, coaches, and others will

take advantage of the information

about anabolic steroids found on 

the NIDA Web site (www.steroidabuse.gov) and join us in our 

prevention and education efforts.

Participating in sports offers many

benefits, but young people and adults

should not take unnecessary health

risks in an effort to win.

Nora D.Volkow, M.D.

Director

National Institute on Drug Abuse

ResearchReport NATIONAL INSTITUTE ON DRUG ABUSE

SERIES

“

A

68.1%

62.1%

57.9% 58.9% 57.1% 55.0% 55.7% 56.8%

U.S. Department of Health and Human Services • National Institutes of Health

Source: 2005 Monitoring the Future Survey.
the compounds first by bodybuilders and weightlifters and

then by athletes in other sports.

Steroid abuse has become so

widespread in athletics that it 

can affect the outcome of sports

contests.

Illicit steroids are often sold at

gyms, competitions, and through

mail order operations after being

smuggled into this country. Most

illegal steroids in the United States

are smuggled from countries that

do not require a prescription for

the purchase of steroids. Steroids

are also illegally diverted from

U.S. pharmacies or synthesized in

clandestine laboratories.

What are steroidal

supplements?

I

n the United States, supplements such as tetrahydrogestrinone (THG) and

androstenedione (street name

“Andro”) previously could be

purchased legally without a 

prescription through many 

commercial sources, including

health food stores. Steroidal 

supplements can be converted

into testosterone or a similar

compound in the body. Less is

known about the side effects of

steroidal supplements, but if

large quantities of these compounds substantially increase

testosterone levels in the body,

then they also are likely to produce the same side effects as

anabolic steroids themselves. The

purchase of these supplements,

with the notable exception of

dehydroepiandrosterone (DHEA),

became illegal after the passage

in 2004 of amendments to the

Controlled Substances Act.

What is the scope

of steroid use in

the United States?

T

he 2005 Monitoring the

Future study, a NIDA-funded

survey of drug use among

adolescents in middle and high

schools across the United States,

reported that past year use of

steroids decreased significantly

among 8th- and 10th-graders

since peak use in 2000. Among

12th-graders, there was a different trend—from 2000 to 2004,

past year steroid use increased,

but in 2005 there was a significant decrease, from 2.5 percent

to 1.5 percent. 

Steroid abuse affects individuals of various ages. However, it

is difficult to estimate the true

prevalence of steroid abuse in

the United States because many

data sources that measure drug

abuse do not include steroids.

Scientific evidence indicates that

anabolic steroid abuse among

athletes may range between one

and six percent. 

Why do people

abuse anabolic

steroids?

One of the main reasons

people give for abusing

steroids is to improve their

athletic performance. Among 

athletes, steroid abuse has been

estimated to be less that 6 percent according to surveys, but

anecdotal information suggests

more widespread abuse.

Although testing procedures are

now in place to deter steroid

abuse among professional and

Olympic athletes, new designer

drugs constantly become available that can escape detection

and put athletes willing to cheat

one step ahead of testing efforts. 

This dynamic, however, may 

be about to shift if the saving 

of urine and blood samples 

for retesting at a future date

becomes the standard. The high

probability of eventual detection

of the newer designer steroids,

once the technology becomes

Commonly Abused Steroids

2NIDA RESEARCH REPORT SERIES

Oral Steroids

■ Anadrol

(oxymetholone)

■ Oxandrin

(oxandrolone)

■ Dianabol

(methandrostenolone)

■ Winstrol

(stanozolol)

Injectable Steroids

■ Deca-Durabolin

(nandrolone decanoate)

■ Durabolin

(nandrolone phenpropionate)

■ Depo-Testosterone

(testosterone cypionate)

■ Equipoise

(boldenone undecylenate)

■ Tetrahydrogestrinone (THG)
available, plus the fear of

retroactive sanctions, should give

athletes pause.

Another reason people give

for taking steroids is to increase

their muscle size or to reduce

their body fat. This group

includes people suffering from

the behavioral syndrome called

muscle dysmorphia, which causes

them to have a distorted image

of their bodies. Men with muscle

dysmorphia think that they look

small and weak, even if they are

large and muscular. Similarly,

women with this condition think

that they look fat and flabby,

even though they are actually

lean and muscular.

Some people who abuse

steroids to boost muscle size

have experienced physical or

sexual abuse. In one series of

interviews with male weightlifters, 25 percent who abused

steroids reported memories of

childhood physical or sexual

abuse. Similarly, female weightlifters who had been raped were

found to be twice as likely to

report use of anabolic steroids 

or another purported musclebuilding drug, compared with

those who had not been raped.

Moreover, almost all of those

who had been raped reported

that they markedly increased

their bodybuilding activities 

after the attack. They believed

that being bigger and stronger

would discourage further attacks

because men would find them

either intimidating or unattractive.

Finally, some adolescents

abuse steroids as part of a pattern

of high-risk behaviors. These

adolescents also take risks such

as drinking and driving, carrying

a gun, driving a motorcycle without a helmet, and abusing other

illicit drugs. Conditions such as

muscle dysmorphia, a history of

physical or sexual abuse, or a

history of engaging in high-risk

behaviors have all been associated with an increased risk of initiating or continuing steroid abuse. 

How are anabolic

steroids abused?

S

ome anabolic steroids are

taken orally, others are

injected intramuscularly, 

and still others are provided in

gels or creams that are applied to

the skin. Doses taken by abusers

can be 10 to 100 times higher

than the doses used for medical

conditions. 

Cycling, stacking, and

pyramiding 

Steroids are often abused in 

patterns called “cycling,” which

involve taking multiple doses of

steroids over a specific period 

of time, stopping for a period,

and starting again. Users also frequently combine several different

types of steroids in a process

known as “stacking.” Steroid

abusers typically “stack” the

drugs, meaning that they take

two or more different anabolic

steroids, mixing oral and/or

injectable types, and sometimes

even including compounds that

are designed for veterinary use.

Abusers think that the different

steroids interact to produce an

effect on muscle size that is

greater than the effects of each

drug individually, a theory that

has not been tested scientifically.

Another mode of steroid abuse

is referred to as “pyramiding.”

This is a process in which users

slowly escalate steroid abuse

(increasing the number of steroids or the dose and frequency

of one or more steroids used at

one time), reaching a peak

amount at mid-cycle and gradually tapering the dose toward the

end of the cycle. Often, steroid

abusers pyramid their doses in

cycles of 6 to 12 weeks. At the

beginning of a cycle, the person

starts with low doses of the

drugs being stacked and then

slowly increases the doses. In 

the second half of the cycle, the

doses are slowly decreased to

zero. This is sometimes followed

by a second cycle in which the

person continues to train but

without drugs. Abusers believe

that pyramiding allows the body

time to adjust to the high doses,

NIDA RESEARCH REPORT SERIES3

0.0

0.5

1.0

1.5

2.0

2.5

3.0

3.5%

8th Grade 10th Grade 12th Grade

Annual Prevalence of Steroid Use Among Males 

Grades 8, 10, 12

Source: 2005 Monitoring the Future Survey.
and the drug-free cycle allows

the body’s hormonal system time

to recuperate. As with stacking,

the perceived benefits of pyramiding and cycling have not

been substantiated scientifically.

What are

the health 

consequences of

steroid abuse? 

Anabolic steroid abuse has

been associated with a

wide range of adverse side

effects ranging from some that

are physically unattractive, such

as acne and breast development

in men, to others that are life

threatening, such as heart attacks

and liver cancer. Most are reversible if the abuser stops taking

the drugs, but some are permanent, such as voice deepening in

females.

Most data on the long-term

effects of anabolic steroids in

humans come from case reports

rather than formal epidemiological studies. From the case

reports, the incidence of lifethreatening effects appears to be

low, but serious adverse effects

may be underrecognized or

underreported, especially since

they may occur many years later.

Data from animal studies seem 

to support this possibility. One

study found that exposing male

mice for one-fifth of their lifespan to steroid doses comparable

to those taken by human athletes

caused a high frequency of early

deaths. 

Hormonal system

Steroid abuse disrupts the normal

production of hormones in the

body, causing both reversible and

irreversible changes. Changes that

can be reversed include reduced

sperm production and shrinking

of the testicles (testicular atrophy).

Irreversible changes include

male-pattern baldness and breast

development (gynecomastia) 

in men. In one study of male

bodybuilders, more than half 

had testicular atrophy and/or

gynecomastia. 

In the female body, anabolic

steroids cause masculinization.

Breast size and body fat decrease,

the skin becomes coarse, the 

clitoris enlarges, and the voice

deepens. Women may experience

excessive growth of body hair

but lose scalp hair. With continued administration of steroids,

some of these effects become

irreversible.

Musculoskeletal system

Rising levels of testosterone and

other sex hormones normally

trigger the growth spurt that

occurs during puberty and adolescence and provide the signals

to stop growth as well. When a

child or adolescent takes anabolic

steroids, the resulting artificially

high sex hormone levels can 

prematurely signal the bones to

stop growing.

Cardiovascular system

Steroid abuse has been associated

with cardiovascular diseases

(CVD), including heart attacks

and strokes, even in athletes

younger than 30. Steroids contribute to the development of

CVD, partly by changing the 

levels of lipoproteins that carry

cholesterol in the blood. Steroids,

particularly oral steroids, increase

the level of low-density lipoprotein (LDL) and decrease the

level of high-density lipoprotein

(HDL). High LDL and low HDL

levels increase the risk of atherosclerosis, a condition in which

fatty substances are deposited

inside arteries and disrupt blood

flow. If blood is prevented from

reaching the heart, the result 

can be a heart attack. If blood 

is prevented from reaching the

brain, the result can be a stroke.

Steroids also increase the risk

that blood clots will form in

blood vessels, potentially disrupting blood flow and damaging the

heart muscle so that it does not

pump blood effectively.

4NIDA RESEARCH REPORT SERIES

Annual Prevalence of Use of Steroids 

8th-Graders, 10th-Graders, and 12th-Graders

0.0

0.5

1.0

1.5

2.0

2.5% 8th

10th

12th

2000 2001 2002 2003 2004 2005

Source: 2005 Monitoring the Future Survey.
Liver

Steroid abuse has been associated

with liver tumors and a rare 

condition called peliosis hepatis,

in which blood-filled cysts form

in the liver. Both the tumors and

the cysts can rupture, causing

internal bleeding.

Skin

Steroid abuse can cause acne,

cysts, and oily hair and skin.

Infections

Many abusers who inject anabolic steroids may use nonsterile

injection techniques or share

contaminated needles with other

abusers. In addition, some

steroid preparations are manufactured illegally under nonsterile

conditions. These factors put

abusers at risk for acquiring lifethreatening viral infections, such

as HIV and hepatitis B and C.

Abusers also can develop endocarditis, a bacterial infection that

causes a potentially fatal inflammation of the inner lining of 

the heart. Bacterial infections

also can cause pain and abscess

formation at injection sites.

What effects do

anabolic steroids

have on behavior? 

C

ase reports and small studies

indicate that anabolic

steroids, when used in high

doses, increase irritability and

aggression. Some steroid abusers

report that they have committed

aggressive acts, such as physical

fighting or armed robbery, theft,

vandalism, or burglary. Abusers

who have committed aggressive

acts or property crimes generally

report that they engage in these

behaviors more often when they

take steroids than when they 

are drug free. A recent study

suggests that the mood and

behavioral effects seen during

anabolic-androgenic steroid

abuse may result from secondary

hormonal changes. 

Scientists have attempted to

test the association between 

anabolic steroids and aggression

by administering high steroid

doses or placebo for days or

weeks to human volunteers and

then asking the people to report

on their behavioral symptoms.

To date, four such studies have

been conducted. In three, high

steroid doses did produce greater

feelings of irritability and aggression than did placebo, although

the effects appear to be highly

variable across individuals. In

one study, the drugs did not

have that effect. One possible

explanation, according to the

researchers, is that some but 

not all anabolic steroids increase

irritability and aggression. 

Recent animal studies show 

an increase in aggression after

steroid administration. 

In a few controlled studies,

aggression or adverse, overt

behaviors resulting from the

administration of anabolic steroid

use have been reported by a

minority of volunteers. 

In summary, the extent to

which steroid abuse contributes

to violence and behavioral disorders is unknown. As with the

health complications of steroid

abuse, the prevalence of extreme

cases of violence and behavioral

NIDA RESEARCH REPORT SERIES5

Hormonal system

■ men

• infertility

• breast development

• shrinking of the testicles

• male-pattern baldness

■ women

• enlargement of 

the clitoris

• excessive growth 

of body hair

• male-pattern baldness

Musculoskeletal system

■ short stature (if taken

by adolescents)

■ tendon rupture

Cardiovascular system

■ increases in LDL; 

decreases in HDL

■ high blood pressure

■ heart attacks

■ enlargement of the heart’s 

left ventricle

Liver

■ cancer

■ peliosis hepatis

■ tumors

Skin

■ severe acne and cysts

■ oily scalp

■ jaundice

■ fluid retention

Infection

■ HIV/AIDS

■ hepatitis

Psychiatric effects

■ rage, aggression

■ mania

■ delusions

Possible Health

Consequences of 

Anabolic Steroid Abuse
disorders seems to be low, but 

it may be underreported or

underrecognized.

Research also indicates that

some users might turn to other

drugs to alleviate some of the

negative effects of anabolic

steroids. For example, a study 

of 227 men admitted in 1999 to 

a private treatment center for

addiction to heroin or other 

opioids found that 9.3 percent

had abused anabolic steroids

before trying any other illicit

drug. Of these 9.3 percent, 86

percent first used opioids to

counteract insomnia and irritability resulting from anabolic

steroids.

Are anabolic

steroids addictive?

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;

6NIDA RESEARCH REPORT SERIES
■ 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?

F

ew 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 symptoms—for 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.

Where can I get

further scientific

information about

steroid abuse? 

T

o learn more about anabolic

steroids and other drugs of

abuse, contact the National

Clearinghouse for Alcohol and

Drug Information (NCADI) at

800-729-6686. Information 

specialists are available to help

you locate information and

resources. 

Fact sheets, including

InfoFacts, on the health effects of

anabolic steroids, other drugs of

abuse, and other drug topics are

available on the NIDA Web site

(www.drugabuse.gov), and can

be ordered free of charge in

English and Spanish from NCADI

at www.health.org.

NIDA RESEARCH REPORT SERIES7

Access information 

on the Internet

• What’s new on the NIDA Web site

• Information on drugs of abuse

• Publications and communications

(including NIDA NOTES)

• Calendar of events

• Links to NIDA organizational units

• Funding information (including program

announcements and deadlines)

• International activities

• Links to related Web sites 

(access to Web sites of many other

organizations in the field)

NIDA Web Sites

www.drugabuse.gov

www.steroidabuse.gov

www.clubdrugs.gov

www.hiv.drugabuse.gov

www.inhalant.drugabuse.gov

NCADI

Web Site: www.health.org

Phone No.: 800-729-6686
References

Bahrke MS, Yesalis CE, Wright JE. Psychological and

behavioral effects of endogenous testosterone and

anabolic-androgenic steroids: an update. Sports Med

22(6):367–390, 1996.

Berning JM, Adams KJ, Stamford BA. Anabolic steroid

usage in athletics: facts, fiction, and public relations.

J Strength Conditioning Res 18(4):908–917,

2004.

Blue JG, Lombardo JA. Steroids and steroid-like compounds. Clin Sports Med 18(3):667–689, 1999.

Bronson FH, Matherne CM. Exposure to anabolicandrogenic steroids shortens life span of male mice.

Med Sci Sports Exerc 29(5):615–619, 1997. 

Brower KJ. Withdrawal from anabolic steroids. Curr Ther

Endocrinol Metab 6:338–343, 1997.

Daly RC, et al. Neuroendocrine and behavioral effects 

of high-dose anabolic steroid administration in male

normal volunteers. Psychoneuroendocrinology

28(3):317–331, 2003.

Elliot D, Goldberg L. Intervention and prevention of

steroid use in adolescents. Am J Sports Med

24(6):S46–S47, 1996.

Goldberg L, et al. Anabolic steroid education and 

adolescents: Do scare tactics work? Pediatrics

87(3):283–286, 1991.

Goldberg L, et al. Effects of a multidimensional anabolic

steroid prevention intervention: The Adolescents

Training and Learning to Avoid Steroids (ATLAS)

Program. JAMA 276(19):1555–1562, 1996.

Goldberg L, et al. The ATLAS program: Preventing drug

use and promoting health behaviors. Arch Pediatr

Adolesc Med 154(4):332–338, 2000.

Gottfredson GD, et al. The national study of delinquency

prevention in schools. Ellicott City, MD: Gottfredson

Associates, Inc., 2000.

Green et al. NCAA study of substance use and abuse

habits of college student-athletes. Clin J Sport Med

11(1):51–56, 2001. 

Gruber AJ, Pope HG Jr. Compulsive weight lifting and

anabolic drug abuse among women rape victims.

Compr Psychiatry 40(4):273–277, 1999.

Gruber AJ, Pope HG Jr. Psychiatric and medical effects 

of anabolic-androgenic steroid use in women.

Psychother Psychosom 69:19–26, 2000.

Hoberman JM, Yesalis CE. The history of synthetic 

testosterone. Sci Am 272(2):76–81, 1995.

Leder BZ, et al. Oral androstenedione administration and

serum testosterone concentrations in young men.

JAMA 283(6):779–782, 2000.

The Medical Letter on Drugs and Therapeutics. Creatine

and androstenedione—two “dietary supplements.”

40(1039):105–106. New Rochelle, NY: The

Medical Letter, Inc., 1998. 

Middleman AB, et al. High-risk behaviors among high

school students in Massachusetts who use anabolic

steroids. Pediatrics 96(2):268–272, 1995.

Pope HG Jr, Kouri EM, Hudson MD. Effects of 

supraphysiologic doses of testosterone on mood 

and aggression in normal men: a randomized 

controlled trial. Arch Gen Psychiatry

57(2):133–140, 2000.

Porcerelli JH, Sandler BA. Anabolic-androgenic steroid

abuse and psychopathology. Psychiatr Clin North Am

21(4):829–833, 1998. 

Rich JD, Dickinson BP, Flanigan TP, Valone SE. Abscess

related to anabolic-androgenic steroid injection. 

Med Sci Sports Exerc 31(2):207–209, 1999.

Stilger VG, Yesalis CE. Anabolic-androgenic steroid use

among high school football players. J Community

Health 24(2):131–145, 1999.

Su T-P, et al. Neuropsychiatric effects of anabolic 

steroids in male normal volunteers. JAMA

269(21):2760–2764, 1993.

Sullivan ML, Martinez CM, Gennis P, Gallagher, EJ. 

The cardiac toxicity of anabolic steroids. Prog

Cardiovasc Dis 41(1):1–15, 1998.

Verroken M. Hormones and Sport. Ethical aspects 

and the prevalence of hormone abuse in sport. 

J Endocrinol 170(1):49–54, 2001.

Yesalis CE. Anabolic steroids in sports and exercise, 2nd

edition. Champaign, IL: Human Kinetics. 2000.

Yesalis CE. Androstenedione. Sport dietary supplements

update, 2000, E-SportMed.com.

Yesalis CE. Trends in anabolic-androgenic steroid use

among adolescents. Arch Pediatr Adolesc Med

151(12):1197–1206.

Yesalis CE, Kennedy NJ, Kopstein AN, Bahrke MS.

Anabolic-androgenic steroid use in the United States.

JAMA 270(10):1217–1221, 1993.

Zorpette G. Andro angst. Sci Am 279(6):22–26, 1998.

8NIDA RESEARCH REPORT SERIES

Glossary

Addiction: A chronic, relapsing disease, characterized by compulsive drug seeking and abuse and

by long-lasting chemical changes in the brain.

Anabolic effects: Drug-induced growth or 

thickening of the body’s nonreproductive tract 

tissues—including skeletal muscle, bones, the 

larynx, and vocal cords—and a decrease in 

body fat.

Analgesics: A group of medications that reduce

pain.

Androgenic effects: A drug’s effects upon 

the growth of the male reproductive tract and 

the development of male secondary sexual 

characteristics.

Antidepressants: A group of medications used

in treating depressive disorders.

Cardiovascular system: The heart and blood

vessels.

Hormone: A chemical substance formed in glands

in the body and carried by the blood to organs

and tissues, where it influences function, structure,

and behavior.

Musculoskeletal system: The muscles, bones,

tendons, and ligaments.

Placebo: An inactive substance (pill, liquid, etc.),

which is administered to a comparison group, as 

if it were therapy, but which has no therapeutic

value other than to serve as a negative control.

Sex hormones: Hormones that are found in

higher quantities in one sex than in the other.

Male sex hormones are the androgens, which

include testosterone; and the female sex 

hormones are the estrogens and progesterone.

Withdrawal: Symptoms that occur after chronic

use of an addictive drug is reduced or stopped.

NIH Publication Number 06-3721

Printed July 2001, Revised August 2006.

Feel free to reprint this publication.