Past Anabolic-Androgenic Steroid Use Among Men Admitted for Substance Abuse Treatment: An Underrecognized Problem? [CME]
J Clin Psychiatry 2003;64(2):156-160
© Copyright 2014 Physicians Postgraduate Press, Inc.
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Background: Recent reports suggest that
anabolic-androgenic steroids (AAS) may cause mood disorders or
dependence syndromes and may help to introduce some individuals
to opioid abuse. At present, however, little is known about prior
AAS use among men entering inpatient substance abuse treatment.
Method: We assessed lifetime AAS use in 223 male
substance abusers admitted to a substance abuse treatment unit
primarily for treatment of alcohol, cocaine, and opioid
dependence. Subjects reporting definite or possible AAS use were
then asked to participate in a detailed semistructured interview
that covered demographics, drug use history, and symptoms
experienced during AAS use and withdrawal, and whether AAS use
had helped introduce the subject to other classes of drugs.
Results: Twenty-nine men (13%) reported prior
AAS use, but this history was documented on physicians' admission
evaluations in only 4 cases. Among 88 men listing opioids as
their drug of choice, 22 (25%) acknowledged AAS use, versus only
7 (5%) of the other 135 men (p < .001). Twenty-four (83%) of
the 29 AAS users were interviewed in detail. Seven (29%) of the
men interviewed, all with opioid dependence, reported that they
first learned about opioids from friends at the gym and
subsequently first obtained opioids from the same person who had
sold them AAS. Eighteen (75%) of the men interviewed reported
that AAS were the first drugs that they had ever
self-administered by injection, 4 (17%) reported severe
aggressiveness or violence during AAS use, 1 (4%) attempted
suicide during AAS withdrawal, and 5 (21%) described a history of
Conclusion: Prior AAS use appears to be common
but underrecognized among men entering inpatient substance abuse
treatment, especially those with opioid dependence. AAS use may
serve as a "gateway" to opioid abuse in some cases and
may also cause morbidity in its own right.