Review Article

Abuse of Supraphysiologic Doses of Anabolic Steroids

Authors: Ryan C. W. Hall, MD, Richard C. W. Hall, MD

Abstract

The following article is a literature review of supraphysiologic doses of anabolic-androgenic steroids (AAS). This article contains a brief review of the history of AAS, the chemistry of the varying forms of AAS, and proposed mechanisms of action. The article then focuses on how AAS are used in an illicit manner by the general population. Terms such as “stacking” and “pyramiding” are discussed. The article concludes by looking at the major detrimental side effects, such as liver damage and cardiovascular changes, which physicians may encounter when treating AAS abusers.


Key Points


* Anabolic steroid abuse has become a major problem in the United States, with more than 1 million individuals abusing these drugs.


* Specific pharmacology that permits the production of “designer” molecules has produced a vast underground market for these illicit substances.


* The metabolism of these classes specifically affects their side effect profiles and physiologic effects.


* Stacking occurs when abusers choose medications of different classes to neutralize or enhance certain desired effects.


* The majority of abusers begin use by age 16 years and obtain their drugs on the black market, with physicians supplying a significant number of these abusers.


* The abuse of these compounds is often associated with the abuse of other substances.


* All, when taken in supraphysiologic doses, can produce significant mental changes including irritability, aggressivity, euphoria, grandiose beliefs, hyperactivity, and reckless and dangerous behavior.

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