Psychological and physical impact of anabolic-androgenic steroid dependence

Pharmacotherapy. 2012 Oct;32(10):910-9. doi: 10.1002/j.1875-9114.2012.01123.


Study objective: To contrast the characteristics of two groups of anabolic-androgenic steroid (AAS) users-those with versus those without AAS dependence.

Design: Subanalysis of data from the Anabolic 500, a cross-sectional survey.

Participants: One hundred twelve male AAS-dependent users and 367 AAS-nondependent users who completed an online survey between February 19 and June 30, 2009.

Measurements and main results: Respondents were recruited from the Internet discussion boards of 38 fitness, bodybuilding, weightlifting, and steroid Web sites. The respondents provided online informed consent and completed the Anabolic 500, a 99-item Web-based survey. Self-reported data included demographics, exercise patterns, use of AAS and other performance-enhancing agents, adverse effects of AAS use, behavior consistent with Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision (DSM-IV-TR) criteria for AAS dependence, history of illicit drug and alcohol use, history of sexual or physical abuse, and psychiatric conditions diagnosed according to the DSM-IV-TR. Behavior consistent with AAS dependence was identified in 23.4% of the survey participants. These AAS-dependent users were more excessive in their AAS use (e.g., higher doses, higher quantity of agents, longer duration of use), more likely to report a history of illicit heroin use in the last 12 months (5.4% vs 1.9%, p=0.049), and more likely to report a diagnosis of an anxiety disorder (16.1 vs 8.4%, p=0.020) or major depressive disorder (15.2% vs 7.4%, p=0.012) than AAS-nondependent users.

Conclusion: Data from the Anabolic 500 survey showed that almost one quarter of AAS users were dependent on these drugs. These AAS-dependent users had a higher rate of heroin use as well as anxiety and major depressive disorders compared with AAS-nondependent users. These findings can help clinicians and researchers better understand and address the potential illicit drug use and psychiatric comorbidities that may be present among AAS-dependent users.

Publication types

  • Comparative Study

MeSH terms

  • Adolescent
  • Adult
  • Anabolic Agents / administration & dosage
  • Anabolic Agents / adverse effects*
  • Androgens / administration & dosage
  • Androgens / adverse effects*
  • Anxiety Disorders / complications
  • Cohort Studies
  • Cross-Sectional Studies
  • Depressive Disorder, Major / complications
  • Diagnostic and Statistical Manual of Mental Disorders
  • Dose-Response Relationship, Drug
  • Health Surveys
  • Heroin / administration & dosage
  • Humans
  • Internet
  • Male
  • Middle Aged
  • Performance-Enhancing Substances / administration & dosage
  • Performance-Enhancing Substances / adverse effects
  • Steroids / administration & dosage
  • Steroids / adverse effects*
  • Substance-Related Disorders / complications
  • Substance-Related Disorders / physiopathology*
  • Substance-Related Disorders / psychology*
  • Young Adult


  • Anabolic Agents
  • Androgens
  • Performance-Enhancing Substances
  • Steroids
  • Heroin