Steroid Addiction: Signs and Side Effects of Steroid Abuse

Steroid is a general term that can refer to different substances. There are corticosteroids, which are in over-the-counter cortisone cream and prescription steroids, such as Prednisone. When we’re talking about substance use and addiction, we’re referring to anabolic-androgenic steroids, which are commonly used to build muscle and boost physical performance.

Anabolic steroids are prescription medications, and you may be familiar with brand names such as Sustanon, Anavar and Masteron, as well as generic testosterone cypionate. However, when used for nonmedical reasons, these substances can lead to dangerous health effects and compulsive use patterns. Common street names for anabolic steroids and similar drugs include roids, gear and juice, and these products may be counterfeit or contaminated, which can lead to increased risks.

Learn how using steroids can become compulsive, the potential health risks and potential signs of steroid addiction. Since this guide focuses on the signs and effects of steroid addiction, it doesn’t cover rehab or treatment options.

For many people, steroid addiction starts with wanting to get stronger or change their appearance. These substances make it easier to build muscle, and the positive results can reinforce continued use, leading to dependence.

Steroids are generally used on a cyclical basis. During an “on” period, the person takes steroids for a course of several weeks and may take more than one steroid, which is called steroid stacking. This allows the body to increase muscle mass and strength quickly. It can also make the person feel powerful, energetic and euphoric, which reinforces use.

During the “off” period, testosterone levels decrease quickly. This can lead to a decrease in energy and mood and make strength training more difficult. The contrast in mood, appearance and training capacity leads people to chase the next high.

Over time, steroid tolerance can develop, meaning the person needs higher doses or multiple medications to get the same effect. Body image and steroids are often closely related, and the pressure to look a certain way or be a certain size can drive compulsive steroid use. Body dysmorphic disorder and other co-occurring mental health conditions can complicate the anabolic steroid use cycle.

If you’re using steroids for nonmedical purposes, such as appearance or performance, or you’re using them without a prescription or in higher doses than prescribed, it’s referred to as anabolic steroid misuse or abuse. Performance-enhancing drug misuse isn’t the same as addiction, but it can still lead to it. Misuse is more common in men, adolescents, athletes and bodybuilders.

Compulsive steroid use, formally diagnosed as steroid use disorder, is defined as ongoing misuse with impaired control. Steroid addiction generally includes strong cravings when the person stops taking them and continued use despite clear harm, such as heart problems or infertility. Other signs that misuse has developed into addiction are having rigid routines around steroid use, hiding vials or pills and buying from illegal sources.

Steroid dependence often looks different from other substances, such as alcohol or opioids. Anabolic-androgenic steroids contain hormones that suppress the body’s natural hypothalamic-pituitary-gonadal (HPG) axis, which is responsible for natural testosterone production. Basically, your body stops producing its own testosterone because it’s getting it from steroids.

When someone stops using steroids, testosterone levels drop dramatically, often below the natural baseline. This can lead to physical symptoms, such as fatigue, depressed mood, brain fog and low libido.

While these aren’t technically withdrawal symptoms, they present the same way and immediately stop when the person starts using steroids again. This creates a strong reinforcement loop that can drive compulsive use.

Steroid dependence can also be psychological. Someone who’s using anabolic steroids to build muscle and achieve aesthetic goals is likely to get reinforcement from their appearance and performance. When they move to an off cycle and the body goes back to a more normal state, it can trigger feelings of anxiety and shame, especially if the person has body image concerns or body dysmorphic disorder.

The signs of steroid addiction can include physical, emotional and behavioral changes. Physically, someone may be putting on muscle rapidly and appear very lean, such as when prominent veins are visible. This may be accompanied by very strict training schedules or dieting rules.

Mood swings are a common steroid cycle abuse sign as someone goes through the highs and lows of the on/off cycle. Other emotional signs include irritability and aggression, commonly referred to as “roid rage.”

Anabolic steroid addiction symptoms also include dangerous behaviors, such as steroid stacking, escalating doses, buying steroids illegally and using unsafe injection practices. Someone who’s struggling with steroid abuse may also have longer and longer on cycles or experience repeated failed attempts to stop using steroids.

When someone stops using steroids, the resulting hormone disruption can cause uncomfortable physical symptoms and depression, known as the anabolic steroid crash. Depression after steroids is common because the person isn’t getting the positive reinforcement from their leaner appearance and increased strength and performance. This can lead to negative body image, insecurity and anxiety.

Hormone-related steroid withdrawal symptoms include:

• Fatigue
• Difficulty sleeping or sleeping too much
• Depressed mood
• Irritability
• Anxiety
• Decreased physical performance
• Lack of motivation
• Low libido

In some cases, the low mood associated with withdrawal can lead to depression after steroid use. If you’re having difficulty getting through daily tasks or you have thoughts about hurting yourself, it’s critical to reach out for help.

Steroid misuse can lead to negative health effects, such as:

• Increased risk of cardiovascular disease
• Potential injury to the liver
• Breast growth and shrinking testicles in men
• Infertility
• Severe acne
• Thinning hair and baldness
• Increased risk of infection from dangerous injection practices

In women, the hormonal effects are slightly different, and common symptoms include changes to the menstrual cycle, a deeper voice and increased facial and body hair.

Steroid side effects can also include mood and cognitive changes, such as increased irritability and aggression, feeling anxious or restless and having depressive episodes when stopping steroid use.

One of the primary risk factors for steroid addiction is the presence of mental health issues, specifically body dysmorphic disorder, anxiety and depression. Other mental health conditions, such as ADHD, may also play a role in impulsivity, which can drive substance use. Those who have a history of other substance use may also be at an increased risk of developing a dependence on steroids.

Gym culture and pressure to perform in competitive sports are risk factors for steroid addiction. Many people start using steroids as a temporary way to build muscle or boost performance, not realizing how quickly misuse can become compulsive. In some sports and gyms, steroid use is normalized and medications are easy to get, which can lead to increased peer pressure.

Diagnosing steroid addiction involves assessing behavior and use patterns over time. Clinicians look at factors such as how long someone has been using steroids, how often they cycle and whether they’re engaging in any risky behaviors, such as sharing needles.

A steroid misuse assessment may include detailed questions about how often you use steroids, what steroids you’re using, the doses and where you’re getting the medications. High-risk behaviors, such as escalating doses and steroid stacking, are strong indicators for an anabolic steroid use disorder diagnosis.

Labs and physical exams can be especially helpful in understanding how steroid use is affecting the body. This can include blood pressure reading, hormone disruption evaluation testing and performance-enhancing drug screening.

The clinician will take all this information and combine it with behavioral and mental health assessments to determine if a substance use disorder diagnosis is appropriate based on the individual’s patterns.

What begins as a way to help you reach your goals can quickly evolve into dependence and addiction. If you or someone you love is taking higher doses of steroids, using dangerous injection practices or experiencing side effects, it’s time to reach out for help.

Help.org offers a free, confidential treatment finder that can help you find a program that fits your needs and preferences. Whether you’re looking for help for steroid addiction locally or you want to find a rehab that can also help with body image issues, performance pressures and mental health concerns, we offer a place to start.