Steroid use has seen a significant increase across Australia in recent years, prompting concerns among researchers and healthcare professionals. Despite this rise, the country's health sector currently lacks standardized clinical guidelines for safe steroid cessation and recovery. Individuals attempting to discontinue steroid use, such as powerlifter George Napper, report challenges in accessing formal medical support and often face perceived stigma from healthcare providers, leading many to seek advice from unverified online sources.
Trends in Anabolic Androgenic Steroid Use
Anabolic androgenic steroids (AAS) are synthetic drugs designed to mimic the male hormone testosterone. While medically prescribed for conditions such as hormone issues, they are also used non-medically to enhance strength and muscle mass. Non-medical use of these substances is illegal in Australia.
Research from the University of Queensland, including contributions from Tim Piatkowski, indicates a substantial increase in non-medical steroid use nationwide. Australian drug data from 2022-23 shows an almost 40% rise in individuals reporting lifetime steroid use between 2015-16 and 2022-23. Border detections of steroids also increased by 64% in 2020-21 compared to the previous year.
Personal Experience with Cessation
Powerlifter George Napper experienced a heart attack attributed to high-dose steroid use, resulting in hospitalization. Weeks after his discharge, Napper participated in a powerlifting tournament. Subsequently, he undertook a year-long process to discontinue steroid use. Napper reported a reliance on peer support, noting a perceived lack of formal clinical guidance for steroid cessation compared to support available for users of other substances.
Napper had previously used steroids in his twenties and resumed use approximately 15 years later following a diagnosis of low testosterone, a condition potentially linked to his earlier steroid use. He reportedly increased his dosages and utilized a "blast and cruise" method, which involves alternating between high and low doses without extended breaks. During this period, he experienced side effects such as respiratory difficulty and sleep disruption.
Napper reported encountering judgmental responses from some medical professionals when seeking blood work to monitor health markers and other assistance for steroid-related health concerns. This experience, he stated, hindered open discussions with healthcare providers. Two years after his heart attack, Napper reports successfully discontinuing steroid use and experiencing improved health. He advocates for increased public information and medical understanding regarding steroid use and its potential consequences.
Usage Patterns and Health Impacts
Common patterns of steroid use include "cycling," where doses are taken for a period followed by a break, and "blast and cruise," which involves shifts between high and low doses without a full cessation period.
Side effects associated with steroid use can include:
- Water retention
- Increased aggression
- Baldness
- Severe acne
- Changes in sex drive
Men may experience gynecomastia (breast development) and infertility, sometimes permanently. Women may develop increased hair growth and a deepened voice. Long-term use is associated with more severe health impacts, including cardiovascular issues, impaired liver and kidney function, and mental health conditions. While AAS do not typically cause physical dependence, psychological addiction, often linked to perceived benefits in physique and confidence, has been reported.
Challenges in Clinical Support and Information Access
According to Tim Piatkowski, Australia lacks standardized clinical guidelines for safe steroid cessation and recovery, creating a disparity between the rising prevalence of steroid use and the existing health sector support. Piatkowski suggests that the stigma surrounding steroid use often deters individuals from engaging in transparent discussions with doctors.
Consequently, many steroid users seek advice on cessation or management strategies through online forums and social media platforms. This reliance on non-clinical sources can expose users to inconsistent, inaccurate, or potentially harmful information, with some advice prioritizing short-term outcomes over long-term health.
Steroid withdrawal symptoms can include severe fatigue, muscle and bone density loss, and depression, with suicidal ideation being a significant risk. "Post cycle therapy" (PCT), which involves the use of other substances, including certain breast cancer medications, to support recovery after a steroid cycle, is commonly discussed in online communities. While some observational studies suggest PCT might aid in restoring natural hormone production and alleviating withdrawal symptoms, it is not a clinically approved or standardized medical treatment.
Call for Enhanced Health Sector Response
Piatkowski emphasizes the need for the Australian health sector to develop a robust evidence base for steroid cessation and recovery. This includes efforts to disseminate accurate information, potentially through collaboration with online communities and influencers.