Study links steroid abuse to key biological, psychological characteristics

A study by researchers at Harvard-affiliated McLean Hospital sheds new light on anabolic steroid users, augmenting previous research suggesting that users can become dependent on the drugs and showing for the first time that those who do become dependent tend to share certain biological and psychological characteristics.

The findings could help in understanding who is most likely to become dependent on anabolic steroids as well as aid in efforts to both prevent and treat steroid dependence.

“The thing that is remarkable about steroid dependence is that it afflicts hundreds of thousands of people, yet it remains the only major form of substance dependence that is almost completely unexplored,” said Harrison G. Pope Jr., lead author of a paper published in the journal Drug and Alcohol Dependence, currently available online. Pope is co-director of McLean’s Biological Psychiatry Laboratory and a professor of psychiatry at Harvard Medical School.

In the study, Pope and his co-authors, Gen Kanayama and James I. Hudson, both from the Biological Psychiatry Laboratory at McLean, evaluated 134 male weight-lifters, including 72 who had never used steroids, 42 who had used steroids but had not developed dependence, and 20 with steroid dependence. Of the total who had used steroids, 30 percent had developed dependence.

The participants were evaluated in the course of a larger study assessing childhood and adolescent risk factors for steroid use. The new study is the first to obtain detailed psychiatric and demographic information about men with steroid dependence and then to compare them with other groups.

Pope noted that anabolic steroids do cause actual biological dependence, pointing out that animal studies have shown that hamsters will continue to self-administer testosterone even to the point of death. Human users also exhibit classic criteria for addiction, even though the drugs do not produce a “high” as is the case with opiates, alcohol, or other addictive substances, he said.

“Anabolic steroids clearly do cause an actual biological dependence syndrome, and men who develop dependence on them often have considerable difficulty getting off the drugs, just like people with other forms of drug dependence,” Pope said.

The study found that the men who had used steroids but did not develop dependence on them were almost indistinguishable from the men who had never used steroids in terms of the variables being compared. These included such things as childhood family structure, anti-social behavior, education, whether they had ever been married, psychological history, and use of other drugs or alcohol.

However, the study found that men with steroid dependence were more likely to have grown up in a single-parent home and to have a first-degree relative with an alcohol or substance use disorder. They were also less likely to have graduated from college.

In addition, the steroid-dependent men showed a much higher degree of “conduct disorder” in adolescence — things such as running away from home or getting into trouble for such offenses as stealing or breaking and entering.

The steroid-dependent men were also more likely to report a history of abuse of opiates or cocaine, both before and after they started using steroids, the study found.

“Is there some common underlying biological vulnerability that causes them to have conduct disorder, opiate dependence, and steroid dependence?” Pope asked.

Further studies on the subject could help identify those who are at risk for developing a steroid dependency, he said. “You could at least make some intervention, to prevent it or treat it,” he said.

Pope said he hopes the study will spur more research into the secret world of steroid users, given that steroid dependence is such a prevalent problem.

“There is a dearth of research,” he said. “Steroids are probably the most secret of all illicit drugs. As a result, few scientific investigators are able to study the world of steroid users.”