Steroids are a category of drugs that seem to fall into a gray area in the minds of some recovering addicts. They can be addicting but are not considered intoxicating in the same way that most drugs of abuse are. They don’t act directly on the brain’s reward center or trigger massive short-term floods of dopamine. People don’t use them to party or to get an instantaneous euphoric rush like with stimulants or opiates. Steroids are used to improve athletic performance, build muscle mass, increase strength, and to make people feel better about how they look physically. As addicts, in active addiction, we pummel our bodies with toxins and the effects are usually very visible. We become emaciated and lose muscle tone. We might have sores from picking at our skin and scars from injection sites. Dental problems are common. There could be long term internal damage. When we get clean and start recovery, there’s often a big shift to wanting to take care of ourselves. A lot of people decide to get healthy and start exercising and going to the gym. Steroids have a certain appeal, especially to addicts. They’re an easy way to get fast results. Because steroids aren’t necessarily intoxicating and addictive in the same way as other drugs, taking them may not seem like a big deal. Taking them may not seem like a relapse.

There are many different kinds of steroids. Some, like corticosteroids, are used legitimately and legally to treat a variety of health issues. Most of these are inflammatory conditions caused by arthritis, asthma, eczema, and tumors. They work like the natural hormone Cortisol.

Anabolic steroids are synthetic versions of testosterone. They are used to help patients gain weight after serious illness or injury and to treat some kinds of anemia and cancer. They are also the kind of steroids that people abuse. As synthetic derivatives of a natural hormone, anabolic steroids may seem like more of a supplement than a drug. The problem is that they don’t just build muscle and increase strength.

Testosterone affects the kidneys, the liver, and the endocrine and cardiovascular systems. High levels of testosterone, augmented by anabolic steroids, can have devastating effects on the body over time. It can cause kidney failure and liver damage, sometimes tumors. Increased levels of cholesterol cause high blood pressure and blood clots. These can lead to heart attacks and strokes. There are gender specific side effects that occur as a result of imbalanced hormones. Men experience shrinking testicles, decreased sperm count, and breast development. Women may also experience male-pattern baldness, deepening of the voice and facial hair growth. Teen users may have stunted growth. Most users experience severe acne on the face, back, or arms. Steroid abuse does affect the brain too. Chemical imbalances cause mood swings, irritability, and aggression; also known as “roid rage”. People often feel fatigued during withdrawal and can experience severe depression, paranoia, and have suicidal thoughts. Adverse psychological effects are much more likely in steroid users who are predisposed to those conditions.

These days, there are all kinds of performance enhancing drugs. They don’t all act on the body in the same way but they come with the same kinds of risks. Problems with the heart and other organs. There’s a greater risk for injury because users may not feel strain and pain on joints, ligaments, and muscles that they would normally feel. Like other drugs of abuse, the effects of these drugs wear off with cessation of use, users experience withdrawal, and an addictive cycle can begin. Steroids don’t act rapidly on the brain’s dopamine in the reward system but with heavy use over time, it will start to have an effect. The addictive nature of performance enhancing drugs is shown mainly through the fact that people will continue to use them despite negative consequences.

Different sources over the years cite different statistics of whether the use of performance enhancing drugs is increasing or decreasing but the margin of change was usually relatively low. There was consistent information that, by far, the most common users are physically active males in their 20’s and 30’s.

One study that I found showed that almost 80% of the participants were “not athletes or competitive bodybuilders, but just regular guys taking them for cosmetic reasons.”

I saw the same debate here, in the case with doping and competitive athletes that exists with the subject of another blog I recently wrote: Adderall among students and professionals. There’s such a prevalence of athletes in most sports using some kind of performance enhancing drugs that if you’re not using them, you can’t be competitive. With bodybuilding, there is a limit to how big your muscles can get naturally. To get to a certain size, at some point you will have to take some kind of steroid or growth hormone.

As someone who works out almost every day, honestly, I can see the appeal of using steroids. Even with a lot of hard work in the gym, my results aren’t always where I’d like them to be. I’ve been hitting the weights hard and doing cardio for months now since getting clean. There’s been muscle gain but I can’t seem to burn the fat that I really want to get rid of. Some of my friends in recovery are using steroids or have used them and it’s easy to get envious of how these drugs have made them look.

What I’m not envious of is the large patches of acne one of my friends developed on his back and arms. Another friend was telling me that after he stopped, it was giving him mood swings and affecting his libido. Most of the muscle he had gained went away and he never felt like going to the gym anymore. He said that he wasn’t going to do them again and realized he would have to keep to a regimen of steroids, either steady or cycling on and off, in order to keep the same level of muscle mass and tone.

As an addict, I’m always tempted by the quick, easy way to do anything. My disease makes me impulsive and compulsive to the extreme. But in recovery, I don’t want to abuse and damage my body anymore. I have enough issues with anxiety, depression, and insecurity as it is and really don’t want to make them worse with performance enhancing drugs. While I would very much like to look a certain way and steroids would definitely help me get there, the outward appearance doesn’t seem worth what they would do to me mentally and eventually, physically.

One of the cornerstones of recovery is coming to a place of acceptance with the world, other people, and most importantly, one’s self. If I’m going to stay clean, I need to be ok with myself as I am. There’s always room to improve but the pursuit of perfection is futile and will only lead me to disappointment and frustration. If I really want to be in better shape without a lot of negative consequences and without putting my recovery in danger I just have to work harder in the gym. No drugs, no shortcuts. And if I still don’t get the results that I want, I have to accept that things won’t always work out exactly how I want them to and doing my best is enough.

I don’t know if steroids are a relapse. A few of my friends who used them are still clean from everything else and the others did relapse. I can’t say whether the steroids had anything to do with it or not. When I asked people in the recovery community that I respect, some said steroids were a relapse, others said they weren’t. For me personally, I would feel guilty doing them and wouldn’t want to tell most people. The fact that I would feel like I would have to hide what I was doing is more important than the technicalities of the word “relapse”. If I’m being dishonest about how I’m living my life, I’m not living in recovery. I can’t make that decision for anyone else, I can only make it for me. A good way to answer the question of “is this a relapse?” might be to ask yourself another question: Would I tell my parents, my sponsor, or whoever paid for my treatment about this?