Anabolic steroids have legitimate medical uses, but they’re also widely misused. Peer-reviewed estimates suggest that 3 to 4 million Americans have used anabolic steroids, most often to build muscle or improve athletic performance. About 30% of people who misuse them develop a dependence syndrome. If you’re misusing steroids, you’re not alone, and help is available.
This page explains what anabolic steroids are, how to recognize misuse, the possible side effects and withdrawal risks and which treatment options can help. If you’re ready to talk through your situation, the National Rehab Hotline at 866-210-1303 can connect you with free, confidential information and referrals.
If you or someone you know is in immediate danger, call 911. Steroid withdrawal can cause severe depression. If you’re having thoughts of suicide or self-harm, call or text the 988 Suicide & Crisis Lifeline anytime. The National Rehab Hotline at 866-210-1303 is a non-emergency line for information, support and referrals.
What Are Anabolic Steroids?
Anabolic steroids are synthetic versions of testosterone, the primary male sex hormone. Under the Controlled Substances Act, they’re Schedule III drugs, which means they require a prescription to obtain legally. They also have legitimate medical uses, including treating low testosterone or delayed puberty and helping people with certain cancers or AIDS rebuild muscle lost to illness.
You may also have heard of corticosteroids, but they’re different. Corticosteroids mimic the hormone cortisol and are prescribed to reduce inflammation and calm an overactive immune system. They’re prescribed more often and don’t carry the same dependence risk as anabolic steroids.
How Are Anabolic Steroids Misused?
Most misuse centers on appearance and performance. People may take steroids alongside weight training to build lean muscle faster or gain more muscle than training alone would allow. Others use them to look more muscular or gain strength and a competitive edge in sports.
Steroids are also frequently taken in patterns meant to maximize results or dodge detection. “Cycling” means taking them for a set period, stopping, then starting again. “Stacking” means combining multiple steroid types at once. “Pyramiding” means ramping the dose up and then tapering back down. None of these patterns has been shown to reduce the health risks, and doses in misuse can run far above any medically prescribed amount.
According to NIDA, steroid misuse also overlaps with other drug use. In one study, 25% of men entering treatment for opioid use disorder reported prior anabolic steroid use.
Signs of Steroid Misuse
Because steroids are often used privately, misuse can be hard to spot. Physical and behavioral signs may include:
Physical signs.
- Rapid muscle gain or dramatic changes in physique
- Severe acne, especially on the back and shoulders
- Hair loss or, in women, increased body and facial hair
- Breast development and testicle shrinkage in men
- A deepening voice and menstrual changes in women
- Swelling, high blood pressure or yellowing skin, which may be a warning sign of liver problems
Behavioral signs.
- Heightened aggression or irritability, sometimes called “roid rage”
- Mood swings or depression when not using steroids
- Preoccupation with body image, diet and training
- Secrecy around supplements, injectable vials or needles
- Continued use despite clear physical or relationship consequences
Recognizing these signs of misuse early can make it easier to step in with support.
The Dangers of Anabolic Steroids
Whether prescribed or obtained illegally, anabolic steroids carry real risks. Because they’re synthetic versions of a male sex hormone, some effects differ between men and women. Side effects can range from cosmetic changes to life-threatening health problems, including:
- Acne and male-pattern baldness
- Breast growth, low sperm count or infertility and testicle shrinkage in men
- Menstrual changes, a deepening voice and increased body and facial hair in women
- Aggressiveness and mood disturbances
- High blood pressure, heart attack and other cardiac problems
- Liver disease and kidney damage
Some of these effects reverse when use stops. Others, including the voice deepening and increased facial and body hair women may experience, can be permanent. Injecting steroids adds a separate set of risks, since sharing needles can transmit HIV and hepatitis B and C.
Steroid Dependence and Withdrawal
People who develop steroid dependence may continue using despite the harm. Stopping can also be difficult physically and emotionally.
Dependence develops as the body adjusts to high levels of external testosterone and reduces its own production. When someone stops using steroids, it can take time for the body’s hormone levels to recover.
Common withdrawal symptoms include:
- Extreme fatigue and weakness
- Sleep problems and difficulty concentrating
- Loss of appetite and weight loss
- Lower sex drive
- Joint or muscle pain
- Anxiety and depression
Depression can become severe during withdrawal and, in some people, lead to thoughts of suicide. If that happens, call or text 988 right away. Because of this risk, tapering off and quitting are safest with medical support.
Steroid Addiction Treatment Options
Treatment should be tailored to the person and may include several forms of support:
- Medically supervised detox to manage withdrawal safely
- Behavioral therapy to address the thoughts and habits driving steroid use
- Group therapy and peer support
- Medications, such as antidepressants or pain relievers, to ease specific symptoms
For many people, addressing body image concerns and co-occurring mental health conditions is also an important part of lasting recovery. Muscle dysmorphia — a persistent belief that your body is too small or insufficiently muscular, regardless of how you actually look — is common among people who misuse steroids, and treating it directly makes stopping far more sustainable.
When to Call the Steroid Hotline
The National Rehab Hotline is available to anyone who needs non-emergency help with anabolic steroid misuse. Call 866-210-1303 for information, guidance and referrals to treatment programs nationwide. You can call if you’re using steroids without a prescription, trying to taper off or supporting someone who is. The service is free, confidential and available 24/7.
Frequently Asked Questions
- Are Anabolic Steroids Addictive? Yes. While they don’t cause a euphoric high like many drugs, about 30% of people who misuse anabolic steroids develop dependence. They may continue using despite harm and find it difficult to stop.
- What Are the Signs Someone Is Misusing Steroids? Signs may include rapid muscle gain, severe acne, mood swings or aggression and secrecy around vials or needles. Other signs include breast growth in men or a deepening voice in women.
- Is Steroid Withdrawal Dangerous? Most withdrawal symptoms are uncomfortable rather than dangerous, but depression can become severe and, in some cases, lead to thoughts of suicide. Tapering with medical support is safest. If you’re in crisis, call or text 988.
- Are the Side Effects of Steroids Permanent? It depends. Many effects, such as acne and changes in mood, ease after use stops. Others can be lasting — in women, a deepened voice and increased facial and body hair often don’t reverse, and effects on fertility can take a long time to recover.
- Can You Get Addicted to Corticosteroids? Corticosteroids, such as prednisone, are different from anabolic steroids and don’t carry the same dependence risk. However, they shouldn’t be stopped abruptly without medical guidance.
- What Happens When I Call the Hotline? You’ll receive information, guidance and referrals to treatment options. The National Rehab Hotline is a free, confidential non-emergency line. Call 866-210-1303 anytime.
- Is the Hotline Free and Confidential? Yes. The National Rehab Hotline is free, confidential and available 24/7. You don’t have to share more than you’re comfortable with to be pointed toward the right help.
Get Help for Steroid Addiction
If anabolic steroids have become difficult to stop, reaching out is a strong first step. The National Rehab Hotline can connect you with information and treatment referrals. Call 866-210-1303 for free, confidential support 24/7, 365 days a year.