Background info on Anabolic-Androgenic Steroids
The debate over Anabolic-Androgenic Steroids continues: Do these drugs pose a health threat or not?
Lipophilic hormones are derived from cholesterol that includes the natural male hormone, testosterone, together with numerous synthetic testosterone derivatives, they are called anabolic-androgenic steroids (AAS). By ingesting doses greater than normally found in the body of these hormones, in combination with intensive weight training and appropriate nutrition, AAS users can gain considerable muscle mass, often well beyond the limits possible by natural means. Elite athletes have used AAS to improve performance for decades. However, today most AAS users are not competitive athletes, but simply individuals who want to look leaner and more muscular. This much larger but less obvious population of illicit AAS users started to emerge in the 1980s, partly because of the introduction of increasingly more advanced underground guides on how to self-administer AAS.
It is also likely that Western cultural developments contributed to the increased prevalence of use of AAS. Media images have been increasingly focusing on male muscularity in the past few decades. When Arnold Schwarzenegger went winning Mr Olympia during the 1970’s, the steroids he used were not banned in sports in general. Today illicit AAS use has grown into a common form of substance abuse throughout the United States, British Commonwealth countries, the Scandinavian countries, and others.
Epidemiologic studies indicate a lifetime prevalence of AAS use of at least 3% in young men, meaning that some tens of millions of individuals worldwide have used these drugs. AAS use in women is uncommon, since they are less likely to want to become very muscular. Also the masculinizing effects of AAS should be taken into account, such as beard growth, deepening of the voice, and masculinized sexual characteristics.
AAS users generally self-administer their drugs for blocks of time, called "cycles". These cycles typically last 8–16 weeks, separated by drug-free intervals lasting months or years. Planned cycles of increasing and decreasing AAS doses, called "pyramiding", helps users to avoid plateauing, minimize withdrawal symptoms at the end of a cycle, and conserve drug supplies. Perhaps the most important rationale for cycles, however, is the fact that exogenous AAS administration suppresses the hypothalamic-pituitary-testicular (HPT) axis, leading to decreased endogenous testosterone production in men. If a man uses AAS in cycles, rather than continuously, then the HPT axis can rebound during the drug-free intervals between cycles, restoring normal endogenous testosterone production.
Many users complete only a few cycles of AAS in their careers, with a cumulative lifetime exposure of less than a full year. Such users hardly report any adverse medical or psychological effects from AAS. But some users progress from cycles of AAS into a pattern of nearly unbroken use, which could continue despite noted adverse medical, psychological, and social effects. This syndrome of AAS dependence has been recognized for more than 20 years, and appears to be common and possibly increasing in prevalence.
A growing literature of human and animal studies indicates that AAS dependence is a valid diagnostic entity, often associated with conduct disorder and other forms of substance abuse. As increasing numbers of AAS users are growing old enough to have established a dependence pattern, the prevalence of AAS dependence may be rising. Since the criterias for dependence were designed primarily for acutely intoxicating drugs, and are not optimally suited for cumulatively acting drugs such as AAS, the diagnosis of AAS dependence requires some modest adaptations of standard diagnostic criteria for substance dependence.
AAS dependence might be the only major form of worldwide substance dependence that remains largely unexplored, and it remains unclear why some AAS users progress from more mild initial use to more harmful AAS dependence. The observed overlap between AAS and opioids, in both men and animals could hold a key to this explanation. Since individuals with dependence likely account for the great majority of the public health problems associated with AAS, including the cardiovascular, neuroendocrine, and psychiatric complications of long-term AAS exposure, understanding the nature and etiology of AAS dependence is a matter of growing public health importance. With an improved understanding of AAS dependence, appropriate treatment could be developed and better identifying those at risk.
The written statements are supported by recent scientific research and documented statements by Arnold Schwarzenegger on his previous use of anabolic steroids.
- A full documentary film on steroids will be posted this weekend here at Ad Astra!