Anabolic-androgenic steroid use in the United States

JAMA. 1993 Sep 8;270(10):1217-21.


Objective: To estimate the size of the anabolic-androgenic steroid (AAS) user population in the United States, to examine characteristics of AAS users, and to explore the association between AAS use and the use of other illicit drugs as well as self-reported aggressive behaviors.

Design: A cross-sectional study using data from the 1991 National Household Survey on Drug Abuse.

Study population: The survey covered the population aged 12 years and older living in households in the United States. The results of the survey were based on personal interviews combined with self-administered questionnaires from 32,594 respondents. These respondents were randomly selected by means of a stratified multistage area sample of the household population.

Results: Estimates based on data from the National Household Survey on Drug Abuse indicated that there are more than 1 million current or former AAS users in this country, with more than half of the lifetime user population being 26 years of age or older. More than 300,000 individuals used AAS in the past year. Males had higher levels of AAS use during their lifetime than females (0.9% and 0.1%, respectively; P < .01). The median age of first use of AAS for the study population was 18 years; for 12- to 17-year-olds, the median age of initiation was 15 years. Among 12- to 34-year-olds, AAS use was significantly and positively associated with the use of other illicit drugs (P < .05), cigarettes (12- to 17-year-olds only; P < .01), and alcohol (P < .01). Furthermore, AAS use is highly correlated with self-reported aggressive behavior (P < .01) and crimes against property (P < .01).

Conclusions: These results indicate that AAS use impacts a large number of men and women from various racial and age groups across the nation. While causal inferences cannot be made regarding the associations between AAS use and use of other drugs as well as antisocial behavior, these findings should enhance our ability to profile the typical AAS user.

MeSH terms

  • Adolescent
  • Adult
  • Aggression / drug effects
  • Anabolic Agents* / adverse effects
  • Behavior / drug effects
  • Cross-Sectional Studies
  • Female
  • Humans
  • Illicit Drugs* / adverse effects
  • Male
  • Population Surveillance
  • Substance-Related Disorders / epidemiology*
  • Substance-Related Disorders / physiopathology
  • Testosterone Congeners / adverse effects
  • United States / epidemiology


  • Anabolic Agents
  • Illicit Drugs
  • Testosterone Congeners