Steroids: Not Just for Athletes

Anyone who follows the news probably has a picture of the typical steroid user: an elite athlete — a home-run hitter, say — trying to get an edge on the competition, or a high-school or college kid who wants desperately to get into the pros.

But while those cases make headlines, the stereotype turns out to be largely off base, according to a new study published online in the Journal of the International Society of Sports Nutrition. In a web-based survey of nearly 2,000 self-prescribed steroid users (the stuff has legitimate medical uses as well, such as correcting hormone imbalances), it turns out that the typical user isn't a competitive athlete at all. He (and it's pretty much always "he") is a highly educated professional, about 30 years old, who doesn't participate in organized sports at all — and never has. He uses steroids to build muscle, increase strength and look good. And he does it, not as an easy, stand-alone shortcut to body modification, but as a supplement to a carefully planned regimen of diet and exercise. In short, says one internist: "They're gym rats."

A majority of steroid users say they'd be willing to consult with doctors about their steroid use — in principle. In practice most didn't actually reveal their habit to their physicians. The reason: they don't believe doctors know a lot about the drugs, and they suspect that physicians, like the general public, have an exaggerated idea about how dangerous steroids really are. The users themselves tend to be aware of side effects like liver damage, high blood pressure and behavioral changes. That's why most users inject the steroids instead of taking them by mouth, in order to better control blood levels and lessen the risk of liver toxicity. A majority of habitual users also get blood work at least once a year, probably to make sure the drugs aren't throwing hormone levels too far out of balance.

The authors make it clear that they don't approve of the non-medical use of steroids — but do believe that reducing the potential harm they can cause is never going to be possible if nobody understand who the users really are.