Anabolic Androgenic Steroids: Is “The Cycle” Addictive?

Anabolic androgenic steroids (AAS) are synthetic versions of testosterone, and like naturally produced testosterone, they can increase male sex characteristics and help build muscle. They are prescribed for low testosterone, delayed puberty and muscle loss from severe illness, among other things. But AAS are also used regularly – particularly among gay, bisexual and queer men – without a prescription to gain muscle and improve physical appearance.

The health impact of use varies from injection-site infection to sexual dysfunction and high blood pressure, and many people who use AAS have developed creative ways to mitigate risk. Today’s episode will introduce AAS as performance enhancing drugs and provide harm reduction strategies that clinicians can employ to mitigate risks associated with their use. Related content:

Kutscher E, Arshed A, Greene RE, Kladney M. Exploring Anabolic Androgenic Steroid Use Among Cisgender Gay, Bisexual, and Queer Men. JAMA Netw Open. 2024 May 1;7(5):e2411088. doi: 10.1001/jamanetworkopen.2024.11088.
Kutscher E, Arshed A, Greene R, Kladney M. Exploring Anabolic-Androgenic Steroids Use Among Cisgender Gay, Bisexual, and Queer Men. Drug and Alcohol Dependence. 2025 Feb 1;267:112112.
Kutscher E, Arshed A, Greene RE, Kladney M. Harm Reduction Techniques among Cisgender Gay, Bisexual, and Queer Men Using Anabolic Androgenic Steroids: A Qualitative Study. Harm Reduction Journal. 2024;21:196. doi.org/10.1186/s12954-024-01121-8.
Kutscher E, Silverman E, Bachi K. Anabolic Androgenic Steroids: Emerging Use Disorder, Mechanisms of Action, and Clinical Considerations for Pharmacotherapy. Focus (Am Psychiatr Publ). 2026 Spring;24(2):168-178. doi: 10.1176/appi.focus.20250045.
Clinical decision tool for providers and patients: https://aas-87py.onrender.com/#/providers/
CEI Line: 1-866-637-2342
https://ceitraining.org/

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