Why Are Anabolic Steroids Illegal?
Disclaimer: The following article is for educational purposes only and NOT to promote the use of illegal steroids. If you have any questions or concerns, Dr. Touliatos is currently available for consultations.
The legality of anabolic steroids is seemingly constantly changing, being deemed acceptable for one generation, with the masses using them for cosmetic purposes — yet unacceptable in the next.
Today, anabolic steroids are illegal in many countries (1) and thus cannot be directly purchased from legitimate pharmacies to aid bodybuilding endeavours.
However, some exceptions to this rule exist, such as Mexico and Thailand, where the general population are legally permitted to use anabolic steroids.
Anabolic steroids however were once 100% legal to obtain, even in countries where they are now outlawed and banned by the FDA.
However, several years later and after numerous clinical trials, anabolic steroids’ side effects are now better established (2).
Consequently, this has led to an FDA ban of many anabolic-androgenic steroids, with them being classed as schedule III controlled substances.
Thus, any person caught in possession or selling anabolic steroids can be issued with a hefty fine or/and prison time (determined by the local laws).
Ironically, in America and other countries (where anabolic steroids are now illegal), doctors continue to prescribe certain anabolic steroids for various conditions; including cachexia, osteoporosis and hypogonadism.
Anavar (Oxandrolone), Deca Durabolin (Nandrolone) and Testosterone are just a few examples of anabolic steroids that remain FDA-approved in medicine and are deemed safe for patients to take; should they have a medical need for such drugs.
Thus, a judgment has been made that if a person has a medical need for an anabolic steroid, the benefits of that drug outweigh the risks (when under medical supervision). But the general public is forbidden from taking the same substances.
Why Are Anabolic Steroids Illegal?
Ultimately, anabolic steroids are illegal because their side effects are deemed to be excessively harsh; and thus are considered unnecessary for the public to use.
What is inconsistent with medicine and the law is that certain steroids are FDA-approved in medicine (3), whilst other steroids are not. As one can imagine, the milder compounds with less side effects are FDA-approved and prescribed, whereas the more toxic steroids are not.
However, with regard to the law, all anabolic steroids are treated the same, despite them having varying levels of toxicity.
What are the Side Effects Associated With Steroids?
We have seen anabolic steroids cause mild and harsh side effects. Some mild reactions common in bodybuilders we treat include hair loss, gynecomastia and acne vulgaris.
However, anabolic steroids are almost certainly prohibited due to high levels of cardiotoxicity and hepatotoxicity; in conjunction with damage to the HPTA (hypothalamic-pituitary-testicular axis). These are the three most prominent side effects our patients experience.
In our patient’s blood work (who use anabolic steroids), an increased risk of myocardial infarction is a reality, with higher testosterone levels causing negative fluctuations in cholesterol; specifically LDL (low-density lipoprotein) increasing and HDL (high-density lipoprotein) decreasing.
We have seen certain measures help combat excessive rises in systolic and diastolic blood pressure, such as supplementing with fish oil, performing regular cardiovascular exercise and avoiding excessively cardiotoxic steroids.
We often see ALT (alanine aminotransferase) and AST (aspartate aminotransferase) enzymes notably rise from taking anabolic steroids; particularly when taking c-17 alpha alkylated compounds, better known as oral steroids.
This is because oral steroids pass through the liver upon entry and exit, whereas injectable steroids only stress the liver upon the latter.
Some could argue that the liver is a resilient organ, effective supplementation can lower AST/ALT enzymes and overly hepatotoxic steroids can be avoided.
TUDCA (tauroursodeoxycholic acid) is a supplement with potent liver rejuvenating properties, according to various clinical trials (4, 5). Consequently, many of our patients take TUDCA to reduce their risk of developing risk peliosis hepatis.
Although the liver is typically a resilient organ and certain supplementation can help, abusing oral steroids is likely to cause deterioration of this organ long term.
One of the most unpleasant side effects of anabolic steroids that we observe among women is virilization, or masculinization.
Although this is not inherently dangerous, it can have a profound negative effect on a woman’s mental well-being; with decreased confidence and self-esteem.
Some virilization side effects also may persist long-term (6), including modifications to the larynx, causing a deepened voice or clitoromegaly (clitoral enlargement).
Some may argue that certain anabolic steroids such as Anavar (Oxandrolone) and Anadrol (Oxymetholone) have a low incidence of virilization in clinical research; and when cautious dosages are utilized, they often produce minimal side effects.
Should Steroids Be Illegal?
There are several pros and cons to anabolic steroids being illegal.
Firstly, banning anabolic steroids makes them less readily available to purchase, which naturally will decrease the amount of steroid-induced casualties.
However, making steroids illegal also encourages underground lab ‘cooking’, which presents new dangers in terms of hygiene and contamination. Also, there is a lack of regulation, in comparison to a licensed pharmaceutical lab used to formulate the compounds.
Consequently, the products can be tainted, making them dangerous to the public. This wouldn’t be the case if steroids were legal, as they’d be more widely manufactured by scientists in certified medical facilities. And such companies would be liable if any product were to be tainted.
It is reasonable to assume that if certain mild anabolic steroids were legal, and people took them responsibly (following the appropriate dosing protocols) under a doctor’s supervision, it could be less dangerous than masses of steroid users taking them from underground labs.
However, if the general population was given the green light to pick up anabolic steroids from their doctor for cosmetic use, there would be more cases of steroid abuse. This is already an issue in American society, with 375,000 young men and 175,000 young women in high school thought to be abusing steroids (7). We have treated individuals that have taken as much as 10-100x the recommended therapeutic dosage. The addictiveness of anabolic steroids is seldom spoken about, yet remains one of the biggest problems today for our doctors. It is always a challenge getting patients off anabolic steroids long-term when their brains have become accustomed to exceptional surges in dopamine on-cycle.
Those who take anabolic steroids may downplay the dangers, due to bias.
And those who don’t take steroids may exaggerate the dangers, due to ignorance.
Regardless of whether steroids should be legal or not worldwide, we know they have the potential to cause dangerous side effects and are addictive. Both of these were not fully understood when they were previously legal.
Research and our own anecdotal observations confirm that steroids also have the power to reduce a person’s lifespan when taken long-term (8) and thus should be avoided unless there is a medical need for their use.
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