Why are steroids illegal? The ever-changing legal status of anabolic steroids fluctuates, at times they are widely accepted and used by the public for aesthetic enhancement, while at other periods they are deemed inappropriate.
Currently, anabolic steroids are prohibited in numerous nations (1), rendering them inaccessible through legitimate medical channels for the purpose of body sculpting.
Yet, there are countries like Mexico and Thailand where legal frameworks allow the population to utilize anabolic steroids without repercussion.
There was a time when anabolic steroids were entirely legal for purchase, even in jurisdictions that have since criminalized their use and placed them under the regulatory watch of the FDA.
To paint a historical example, Arnold Schwarzenegger once openly discussed how he obtained his steroid regimen prescribed by his doctor; products such as Dianabol or Deca Durabolin were commonplace in enhancing his bodybuilding progress.
Nevertheless, with the advancement of medical research and numerous trials, the adverse effects of anabolic steroids are now better understood (2).
This increased awareness has resulted in the FDA’s prohibition of several anabolic-androgenic steroids, categorizing them as schedule III controlled substances.
Therefore, possession or distribution of anabolic steroids can result in severe penalties, including significant fines or imprisonment, in accordance with local regulations.
Ironically, even in the United States and other countries where anabolic steroids are illegal for general use, doctors still prescribe certain steroids for medical conditions including weight loss due to illness, bone thinning, and testosterone deficiency.
Medications like Anavar (Oxandrolone), Deca Durabolin (Nandrolone), and Testosterone continue to have FDA approval for treatments, regarded as safe under doctor supervision for those with valid medical needs.
This indicates the medical consensus that the therapeutic benefits for patients requiring anabolic steroids can outweigh potential risks under proper medical care, a distinction not extended to non-medical use by the general populace.
Why Are Steroids Illegal?
The illegality of anabolic steroids primarily stems from their significant side effects, which are deemed too severe for public use.
What presents as a contradiction is that while certain steroids are sanctioned by the FDA for medical purposes (3), others are not, with preferences given to the compounds showing lesser side effects. However, in the eyes of the law, all anabolic steroids are treated equally, regardless of their varying toxicities.
What are the Side Effects Associated With Steroids?
Anabolic steroids are linked to both minor and serious side effects. Common lesser problems that bodybuilders face include hair loss, development of breast tissue in men, and acne vulgaris.
Yet, the more alarming concerns, undoubtedly contributing to their prohibition, involve considerable risks to heart and liver health, along with disruptions to the HPTA (hypothalamic-pituitary-testicular axis), as reported in our treated patients.
Heart Disease
Medical assessments reveal an elevated risk of heart attack among steroid users, with augmented testosterone levels perturbing cholesterol balance, specifically raising LDL (low-density lipoprotein) while lowering HDL (high-density lipoprotein) levels.
Patients have found certain interventions, such as fish oil supplementation, engaging in regular cardiovascular activities, and avoiding particularly cardiotoxic steroids, to mitigate increases in blood pressure.
Liver Failure
Elevations in liver enzymes, ALT (alanine aminotransferase) and AST (aspartate aminotransferase), are frequently noted in steroid users, principally with the use of oral steroids (c-17 alpha alkylated compounds) that pose dual challenges to the liver on both entry and exit, unlike their injectable counterparts.
While some argue in favor of the liver’s resilience, acknowledge that the correct supplements can lower liver enzyme levels, and suggest avoiding extremely toxic steroids, the counterpoint remains: oral steroid misuse is likely to culminate in long-term liver deterioration.
TUDCA (tauroursodeoxycholic acid) has emerged as a supplement with significant liver-restoring properties, as seen in clinical trials (4, 5), and is thus commonly used by our patients to potentially lower the risk of developing conditions like peliosis hepatis.
Despite the liver’s inherent resilience and the potential benefits of certain supplements, chronic abuse of oral steroids can lead to long-term damage to this critical organ.
Virilization
For female patients, virilization, or the development of male characteristics, stands out as one of the most distressing side effects of anabolic steroid use.
Aside from being psychologically damaging, leading to reduced confidence and self-esteem, certain aspects of virilization can have lasting effects (6), such as changes to the voice box resulting in a deeper voice or clitoral enlargement.Some contend that specific anabolic steroids, like Anavar (Oxandrolone) and Anadrol (Oxymetholone), present a low risk of masculinization effects according to clinical studies. With prudent doses, these substances are frequently associated with negligible adverse reactions.
Should Steroids Be Illegal?
The debate on the legality of anabolic steroids is framed by both benefits and drawbacks.
On one hand, outlawing these substances can limit their accessibility, which may, in turn, reduce the number of incidents related to steroid misuse.
On the other hand, the prohibition of steroids leads to the rise of makeshift and unregulated labs, posing risks associated with unsanitary conditions and potential product contamination. In contrast, licensed laboratories adhere to stringent standards, ensuring the purity and safety of their products.
If steroids were legitimate, they would be produced under the strict oversight of qualified scientists in medical-grade facilities, effectively eliminating the risk of contaminated products that are currently seen from illicit sources.
If milder anabolic steroids were legal and managed responsibly under medical supervision, following set dosing guidelines, it could arguably be safer than the current situation of widespread use sourced from unregulated labs.
Nonetheless, legalizing steroids for cosmetic purposes could result in an escalation of abuse. In the United States, there’s already a significant problem with steroids abuse among the youth, with an estimated 375,000 high school boys and 175,000 high school girls misusing steroids. Some individuals have been reported to consume doses that are 10-100 times higher than what is medically recommended. The addictive nature of steroids is not often discussed but constitutes a major challenge for medical professionals trying to wean patients off these substances when their brains have adapted to the dramatic increases in dopamine experienced during cycles.
Conclusion
The perception of the risks associated with anabolic steroids can be underplayed by users and overstated by non-users, due to respective biases and lack of knowledge.
Regardless of the global legal status of steroids, it’s evident they pose the risk of dangerous side effects and carry addictive properties. These issues were not wholly recognized during the period when steroids were legally available.
Ongoing research supports the view that long-term steroid use can reduce lifespan, a finding corroborated by anecdotal evidence, which underscores that steroids should only be used when medically necessary.
REFERENCES
(1) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3436118/
(2) https://pubmed.ncbi.nlm.nih.gov/20153798/
(4) https://pubmed.ncbi.nlm.nih.gov/8254052/
(5) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5297843/
(6) https://www.sciencedirect.com/science/article/pii/S0955395920302164
Dr. Grant Fourie, a specialist in male hormones, is based in Cape Town, South Africa. He provides comprehensive treatments for conditions related to low testosterone, such as erectile dysfunction, fatigue, and mood changes. His methods include hormone replacement therapy and other modern treatment options.
Contact me via email or phone to book personal appointment in my clinic: The Village Square, Cape Town - South Africa