Hidden steroid use among people with substance abuse disorder

Unmasking Steroid Use: Why Doctors Aren't Asking and What You Need to Know

Elliot Brynn in Health & Wellness August 2025 • 4 min read.

"Are anabolic steroids slipping under the radar in substance abuse treatment? A new study reveals a concerning gap in patient screening and highlights the hidden risks."

Anabolic-androgenic steroids (AAS), synthetic versions of the male hormone testosterone, are known for their muscle-building (anabolic) and male characteristic-enhancing (androgenic) effects. While sometimes prescribed for specific medical conditions, their misuse is a growing concern, particularly among those struggling with substance use disorders (SUD).

AAS misuse carries significant health risks, ranging from cardiovascular and liver problems to psychological effects like aggression and mood swings. What's particularly troubling is that many individuals misusing AAS also struggle with other substance dependencies, creating a complex web of challenges for treatment and recovery.

A recent study sheds light on a concerning gap in how healthcare professionals address AAS misuse among patients in SUD treatment. The research reveals that AAS use is often overlooked, highlighting the need for increased awareness, better screening practices, and integrated treatment approaches.

The Hidden World of Steroid Use in Substance Abuse Recovery

Hidden steroid use among people with substance abuse disorder

A study published in the Journal Brasileiro de Psiquiatria explored the prevalence of AAS use among patients undergoing treatment for substance use disorders. Researchers interviewed ten participants (eight men and two women) receiving treatment for SUD, using scales like ASSIST-WHO and MINI-SUD, alongside semi-structured interviews.

The findings revealed a significant issue:

High Rate of AAS Use: Seven out of the ten participants reported using AAS within the past year.
Lack of Screening: None of the participants had been previously questioned about their AAS use by mental health professionals.
Motivations for Use: Common reasons included low self-esteem, desire for weight loss, and wanting to improve physical appearance.
Adverse Effects and Withdrawal: Participants reported side effects like voice changes, hair growth, acne, and psychological issues. Withdrawal symptoms included muscle loss, weight gain, and depression.

These findings underscore a critical gap in current SUD treatment approaches. The fact that AAS use was not identified or addressed highlights a potential blind spot for healthcare providers.

Why This Matters: The Overlooked Dangers of AAS Misuse

The study's authors suggest that overlooking AAS misuse can complicate SUD treatment. Individuals may turn to escalating doses of other substances to compensate for the adverse effects of AAS or to manage withdrawal symptoms. The combination of AAS and other substances can also exacerbate mental health issues and increase the risk of relapse.

Increased awareness and proactive screening are crucial first steps. Mental health professionals need to be better equipped to identify AAS misuse and address the underlying issues that drive it, such as body image concerns, eating disorders, and low self-esteem.

By integrating AAS screening and treatment into existing SUD programs, healthcare providers can offer more comprehensive care, prevent relapses, and protect patients from the harmful effects of AAS misuse.

About this Article -

This article was crafted using a human-AI hybrid and collaborative approach. AI assisted our team with initial drafting, research insights, identifying key questions, and image generation. Our human editors guided topic selection, defined the angle, structured the content, ensured factual accuracy and relevance, refined the tone, and conducted thorough editing to deliver helpful, high-quality information.See our About page for more information.

This article is based on research published under:

DOI-LINK: 10.1590/0047-2085000000160, Alternate LINK

Title: Use Of Androgenic Anabolic Steroids By Patients Under Treatment For Substance Use Disorder: Case Series

Subject: Psychiatry and Mental health

Journal: Jornal Brasileiro de Psiquiatria

Publisher: FapUNIFESP (SciELO)

Authors: Julio Mario Xerfan Do Amaral, Marcelo Santos Cruz

Published: 2017-06-01

Everything You Need To Know

What exactly are anabolic-androgenic steroids (AAS), and why is their misuse a growing concern?

Anabolic-androgenic steroids, or AAS, are synthetic forms of testosterone, a male hormone. They're misused for muscle-building and to enhance male characteristics. While doctors sometimes prescribe them for specific medical issues, the main concern is the increasing misuse, especially by those with substance use disorders. This can lead to serious health problems.

What did the study reveal about the prevalence of anabolic steroid use and screening practices in substance use disorder treatment?

The study revealed a high rate of AAS use among individuals in substance use disorder treatment; seven out of ten participants reported using AAS in the past year. Shockingly, none of these participants had been asked about their AAS use by mental health professionals, highlighting a significant oversight in screening practices.

What are the primary motivations behind Anabolic-androgenic steroids use, and what adverse effects and withdrawal symptoms were reported?

Individuals reported using Anabolic-androgenic steroids due to low self-esteem, a desire for weight loss, and to improve their physical appearance. The adverse effects included voice changes, hair growth, acne, and psychological issues. Withdrawal symptoms consisted of muscle loss, weight gain, and depression. These motivations and effects show the complex relationship between AAS use and mental health.

How does overlooking anabolic-androgenic steroids misuse complicate substance use disorder treatment and recovery?

Overlooking Anabolic-androgenic steroids misuse in substance use disorder treatment can lead to individuals increasing the doses of other substances to compensate for the adverse effects of AAS or manage withdrawal symptoms. This combination can worsen mental health issues and increase the risk of relapse, complicating the recovery process.

What steps can healthcare professionals take to improve screening and treatment for anabolic-androgenic steroids misuse in substance use disorder patients?

Healthcare professionals can improve screening by incorporating specific questions about Anabolic-androgenic steroids use during patient assessments. Utilizing tools like the ASSIST-WHO and MINI-SUD scales can help identify AAS misuse. Integrated treatment approaches should address both substance use disorders and AAS misuse concurrently, providing comprehensive care that considers the interplay between these issues.