Other relevant but less highly-rated factors included increased confidence, decreased fat, improved mood and attraction of sexual partners. AAS' psychotropic effects have been posited as a means whereby AAS dependence might occur [ 47 ]; however, virtually all users in our sample The literature suggests that NMAAS use is rarely, in a statistical sense, motivated by sports participation.
Our data showed this as well; Only 6. At the most common level of organized sports, high school athletics, A minority 4. Complementary to the positive reinforcement motivations endorsed, when asked about aversive factors motivating continued use i. Notably, Most of these changes, such as age-related decreases in a desire for increased muscle, strength, and sexual attraction and increased interest in fat reduction appear to reflect expected shifts in focus based on development.
Improving mood, appearance, endurance, power lifting and amateur bodybuilding were not correlated with age. Estimates for suggested that 2. This study addresses a slightly different question: What is the average age of initiation and the prevalence of adolescent NMAAS use onset among adults who are currently using AAS? The average user had used AAS, from onset to the present, for 5. Most Users averaged Most maintained a fairly standard training regimen and few 0.
For a large majority Fried food was largely "always" or "frequently" limited More than one-quarter Most had administered AAS for a total of 5 of the preceding 12 months; The average year included 4 to 6 months of use; however several The modal longest on-cycle period was 12 weeks. Cycles were altered to increase Finances 3. An additional 1. Reusing of needles was rare 0.
To a lesser extent, the ability to maintain a stable blood level was somewhat important, while ease of use, how the AAS made the individual feel, and the inability to obtain injectable AAS were of lesser importance. NMAAS is largely an adult phenomenon; the median user was twenty-nine years old, agreeing with earlier reports [ 25 , 32 ].
Users were typically unmarried Caucasians in their 20s and 30s who initiated NMAAS use after reaching the age of majority. They were not active in organized sports. They were highly educated, gainfully employed, white collar workers earning an above average income; such high levels of functioning in terms of education, income, and employment are consistent findings [ 9 , 25 ] and are inconsistent with the popular view of substance abusers.
In total, our findings belie the images of AAS users as mostly risk-taking teenagers, cheating athletes, and a group akin to traditional drug abusers. One possible limitation is our use of the Internet and the potential bias toward a higher-functioning group.
However, the similarities of this sample with others employing different methodologies [ 25 , 32 , 53 ] minimizes this concern. Because the Internet is now a primary source for both purchasing AAS [ 31 ] and NMAAS information [ 32 ], a wide range of users are likely familiar and comfortable with its use.
Further, the use of the Internet controlled for potential geographical variation in NMAAS prevalence and related behaviors [ 53 , 57 , 58 ]. Finally, the Internet facilitated access to a large sample — the largest, to our knowledge, ever collected. NMAAS use was rarely associated with athletics; most users did not compete in sports of any kind. In fact, relatively few had participated in high school sport and few reported using AAS at that time in their life. Interestingly, NMAAS was also reported in unexpected professional sports, such as rodeo, dance and tennis.
Bias must also be considered as a possible cause for low prevalence of athletes in our sample. Competitive athletes may be less likely to volunteer to participate and provide such sensitive information.
Conversely, as noted previously, the observed consistency between our findings and those from smaller datasets [ 59 ] suggests we have tapped the same population and we would expect that with the Internet serving as the primary source of AAS trade, athletes should be represented. The largest yet least visible group of NMAAS users is recreational weightlifters with more varied reasons for use than competitive athletics [ 51 , 60 ]; " Injectable AAS were most popular and preferred, due largely to decreased liver toxicity as compared to oral agents.
Contrary to traditional notions that injection reflects escalation in drug use, intra-muscular IM injection of AAS avoids several of the more serious potential side effects of NMAAS and may be a less risky approach. Despite having reduced hepatotoxicity, intramuscular injection is not without potential complications; a small minority reported injection-site infection. Still, unlike other groups of illicit drug users [ 63 - 65 ], sharing of needles and multi-use vials, and reuse of needles were almost non-existent.
The use of separate needles to draw and inject oil-based products was the standard approach. Accordingly, viral hepatitis and HIV infection were not reported by anyone in our sample.
Amateur sports, bodybuilding and power lifting were rarely cited as motivators. Consistent with this, few acknowledged a fear of losing athletic abilities if they ceased AAS use. Negative reinforcement avoidance motivation was not as important as positive reinforcement anticipated gains in NMAAS; positive effects were endorsed more frequently and highly than were concerns about avoiding negative effects upon cessation.
Overall, cessation of AAS use was not a concern for many users. Although low self-esteem certainly may motivate some AAS users, it was not a primary motivator. In fact, loss of respect was the least endorsed fear. The most parsimonious explanation seems to be that NMAAS respondents, like most people, have an idea of how they wish to appear and, as a goal-directed group, adopted a structured NMAAS regimen, along with diet, exercise and other supportive components to attain a desired physique or outcome.
NMAAS appeared to be more associated with an image of the ideal attractive body structure and ability as large, muscular and powerful, a view that is consistent with Western ideals, and not with an aversion towards being small.
Positive changes in strength and muscularity were more highly endorsed than were avoidance of loss of these characteristics. This is a subtle but important distinction; it suggests a desire to enhance one's physique, even when it leads to use of NMAAS, as motivation, as opposed to body dissatisfaction as psychopathology which leads to AAS use [ 67 ].
It is clear, however, that we did not measure satisfaction or dissatisfaction with current physique on our sample. Nonetheless, it has been noted that " Hence, in goal-oriented NMAAS users, the desire for an improved physique may not reflect dissatisfaction with one's current physique but part of a strategy aimed at self-improvement and achieving their goals. Interestingly, even though increases in body esteem associated with NMAAS allegedly remitted after cessation of use [ 70 ], becoming less attractive upon cessation did not concern this group.
The top three motivators among this sample replicated those in two Australian surveys [i. Wright and colleagues [ 62 ] also found increased muscle mass as the primary motivating factor. The use of AAS for fitness-related and cosmetic purposes is widely reported [ 7 , 8 , 24 , 47 , 71 - 74 ] and NMAAS use has been discussed as a form of appearance enhancement similar to plastic surgery [ 75 ].
Our data adds to a literature that suggests that users may consider NMAAS use as a means to enhance normal functioning, which is a growing trend in our society [ 76 ]. The minor differences that did appear primarily were associated with typical age-related biological changes e. In any case, although statistically significant, the magnitude of these age-related changes was less than might be expected. It has been suggested [ 77 ] that many AAS users experience a "high" from use, although others [ 78 ] found such reports to be rare.
Reports of age of onset in the literature vary; our results agree with some reports [ 21 ] but not others [ 79 ]. It appears, however, that the typical adult male American using AAS initiated NMAAS in his mid-twenties [see also [ 24 , 25 ]], within 5 years of beginning weight training.
This does not minimize concerns about adolescent NMAAS; significant numbers of adolescents are experimenting with AAS although surveys suggest that many more experiment with and use other drugs. But adolescent onset of use was rare among ongoing adult users, suggesting a discontinuity between adult NMAAS and adolescent experimentation. Of course, the best data to explore this issue would come from true longitudinal studies as opposed to retrospective reports of onset.
Nonetheless, given the potential negative effects of adolescent use, research efforts should focus on exploring adolescents' patterns of and motivations for NMAAS to more fully inform identification of those at risk and efforts to prevent use. Ultimately, in the absence of longitudinal studies [ 80 ], it is impossible to make definitive statements about the relationship between patterns of initiation and long-term use. It is noteworthy that the prevalence of adult onset we observed differs from the pattern of initiation seen in other drugs [e.
However, research has shown clear distinction between AAS users and those using other generally illicit drugs [ 82 ]. The overall fitness and lifestyle context in which NMAAS is embedded is likely inconsistent with widespread use; as Korkia [ 58 ] noted, few " AAS were used about six months per year, broken up into 3 month periods, reflecting common cycling practices employed to allow the body to return to homeostasis.
Periods of use were largely planned in great detail and the necessary drugs were most often in hand ahead of time. Ancillary drugs — drugs used to prevent or treat AAS related side effects or make AAS more effective — were relatively commonplace. The use of peptides i. Insulin, familiar to many only as a medication used in the treatment of diabetes, is a very anabolic compound that shuttles needed nutrients to muscles, produces growth factors when combined with HGH in the liver and combats insulin resistance produced by HGH.
This data raises two interesting points. First, NMAAS involves more forethought and organization than other illicit drug use; it is less impulsive and more considered. The planned cycling, healthy diet, ancillary drugs, blood work, and mitigation of harm via route of administration suggest a strategic approach meant to maximize benefits and minimize harm. Second, pre-planning required users to obtain most of their planned cycle prior to beginning.
Hence, unlike other illicit drugs procured by end-users in single or short-term use quantities, AAS users are likely to have substantial amounts of AAS on hand for long-term personal use. To achieve supraphysiological levels of steroid hormones, many respondents used up to 12 methandrostenolone tablets 5 mg each per day, with a few using over 20 tablets. This reasonably necessitates an initial possession of 1, tablets or more for personal use consistent with anecdotal observations of AAS purchasing patterns; [ 84 ].
Such quantities, in the case of single-use illicit drugs, would suggest intent to distribute; in NMAAS they are more likely an on-hand quantity for personal use. Dietary supplements are sold in health food stores, over the internet, and through mail order. People may believe that these supplements will produce the same desired effects as steroids, but at the same time avoid the medical consequences associated with using steroids.
This belief is dangerous. Supplements may also have the same medical consequences as steroids. This guide will help you understand why steroids are being abused, and how you can educate athletes and others about the dangers of these drugs. This guide will also discuss the dangerous medical effects of illegal use of steroids on health.
The short-term adverse physical effects of anabolic steroid abuse are fairly well known. However, the long-term adverse physical effects of anabolic steroid abuse have not been studied, and as such, are not known. In addition, abuse of anabolic steroids may result in harmful side-effects as well as serious injury and death. The abuser in most cases is unaware of these hidden dangers.
By working together we can greatly reduce the abuse of anabolic steroids and steroid related products.
It is important to recognize this problem and take preventive measures to protect athletes and other users. Anabolic steroids are synthetically produced variants of the naturally occurring male hormone testosterone. Both males and females have testosterone produced in their bodies: males in the testes, and females in the ovaries and other tissues.
The full name for this class of drugs is androgenic promoting masculine characteristics anabolic tissue building steroids the class of drugs. The common street slang names for anabolic steroids include arnolds, gym candy, pumpers, roids, stackers, weight trainers, and juice. The two major effects of testosterone are an androgenic effect and an anabolic effect. The term androgenic refers to the physical changes experienced by a male during puberty, in the course of development to manhood.
Androgenic effects would be similarly experienced in a female. This property is responsible for the majority of the side effects of steroid use. The term anabolic refers to promoting of anabolism, the actual building of tissues, mainly muscle, accomplished by the promotion of protein synthesis. Also, individuals in occupations requiring enhanced physical strength body guards, construction workers, and law enforcement officers are known to take these drugs.
Steroids are purported to increase lean body mass, strength and aggressiveness. Steroids are also believed to reduce recovery time between workouts, which makes it possible to train harder and thereby further improve strength and endurance. Some people who are not athletes also take steroids to increase their endurance, muscle size and strength, and reduce body fat which they believe improves personal appearance.
Doctors may prescribe steroids to patients for legitimate medical purposes such as loss of function of testicles, breast cancer, low red blood cell count, delayed puberty and debilitated states resulting from surgery or sickness. Veterinarians administer steroids to animals e. They are also used in veterinary practice to treat anemia and counteract tissue breakdown during illness and trauma. For purposes of illegal use there are several sources; the most common illegal source is from smuggling steroids into the United States from other countries such as Mexico and European countries.
Smuggling from these areas is easier because a prescription is not required for the purchase of steroids. Less often steroids found in the illicit market are diverted from legitimate sources e. Anabolic steroids dispensed for legitimate medical purposes are administered several ways including intramuscular or subcutaneous injection, by mouth, pellet implantation under the skin and by application to the skin e. These same routes are used for purposes of abusing steroids, with injection and oral administration being the most common.
People abusing steroids may take anywhere from 1 to upwards of a times normal therapeutic doses of anabolic steroids. This often includes taking two or more steroids concurrently, a practice called "stacking. This practice is called "cycling.
Search form. Home News Young steroid users at increased risk of heart disease Young steroid users at increased risk of heart disease. Date Published: 26 Feb Contact person: Marion Downey.
Phone: Email: m. A health care professional can prescribe steroids off-label, meaning for conditions other than those that are FDA-approved. But children, particularly teens, are getting access to steroids and taking them for reasons far outside of their intended use. Some may be dealing with unscrupulous clinics or street dealers on the black market. Unfortunately, a number of vendors sell anabolic steroids online without a prescription. Individuals should also be aware that some dietary supplements advertised for body building may unlawfully include steroids or steroid-like substances, and the ingredient statement on the label may not include that information.
A: FDA is taking a number of steps to discourage these practices. Action has been taken against illegal online distributors who sell steroids without valid prescriptions, but an ongoing problem is that you can take one site down and another pops up.
In such cases, individuals may have no idea what they are taking, what the appropriate dose should be, or what levels of control and safety went into the manufacturing process. These facts make the risks of taking anabolic steroids bought without a prescription even greater than they otherwise would be.
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