References

Anabolic Reference Guide (6th Edition) 1991. Mile High Publishing. Goldon, Co.
Body blow. (1995, March 19). Nursing Times, 91 (13), 14-15.
Catlin, D., Wright, J., Pope, H., & Liggett, M. (1993, August).
Assessing the threat of anabolic steroids. The Physician and Sportsmedicine. 21(8),
37-45.
Corbin, C.B., Feyner-Melk, S.A., Phelp, C. & Lewis, L. (1994).
Anabolic steroids: A study of high school athletes. Pediatric Exercise Science. 6, 149-158.
Council on Scientific Affairs. (1992, December 12). Medical and non-medical uses
of anabolic-androgenic steroids. JAMA. 264(22), 2923-2927.
Cowart, V.S. (1992, March). Dietary supplements: Alternatives to anabolic steroids?
The Physician and Sportsmedicine. 20(3). 189-196, 198.
Inaba, D.S. & Coher, W.E. (1993)
Uppers. Downers, All arounders. (2nd Ed.) CNS Productions Oregon
Luetkemeier, M.J., Bainbridge, C.N., Walker, J., Brown, D.B. & Eisenman, P.A.,
(1995, January/February). Anabolic-androgenic steroids: Prevalence, knowledge,
& attitudes in junior and senior high school students. Journal of Helath Education.
20(1). 4-9.
Lukas, S. (1994). Steroids. Hillside, NJ: Enslow Press.
Maropis, C. & Yesalis, C.E. (1994, October). Intramuscular abscess: Anoither
anabolic steroid danger. The Physician and Sportsmedicine. 122(10), 105-108.
Rogak, L.A. (1992). Steroids. Mineapolis: Lerner Publications.
Strong medicine. (1993, October 27). Nursing Times. 189(43), 50-52.
Talmadge, K.S. (1991). Focus on steroids. Frederick, MD: Twenty-First
Century Books.
Talor, W.N. (1982). Anabolic Steroids and the athlete. Jefferson, NC: McFarland.
Thein, L.A., Thein, J.M. & Landry, G.L. (1995, May). Ergogenic aids. Physical therapy.
75(5), 426-438.
Wright, J.E. (1990). Anabolic steroids: Altered states. Carmel, Ind: Benchmark Press.
Yesalis, C.E. (Ed). (1993). Anabolic steroids in sport and exercise.
Champaign, IL: Human Kinetics Publishers.

14
This booklet is designed for people
using anabolic steroids. It is about
harm reduction – a health
promotion strategy recognizing
that despite the risks, people
use drugs – including steroids. contents
We do not promote the use Steroids: An Overview 1
of steroids and emphasize
that the only sure way Legal Aspects 2
to avoid all potential
hazards is not to take
Types of Steroids 3
steroids at all.

Harm reduction Adverse Effects 4

promotes optimal
health despite Injecting 5
drug use.

Safe Needle Use 6

Cycling, Stacking,
and Pyramiding 7

Medical Care and Follow Up 8

Addiction 11

HIV/Hepatitis 12

Numbers to Call 13
Your
Yourssel f!
elf!
If you must share, clean
Always use a the needle and syringe
latex condom. with bleach after each use.

Free Testing
You can get tested for HIV and hepatitis B hepatitis C at your family
doctor, Family Planning Clinic, STD Clinic, or anonymous testing is
available at the Needle Exchange.

Numbers to Call for Further Information

CRHA 571-9190
Communicable Disease Control
Safeworks Needle Exchange
8th & 8th Health Centre
912 - 8th Avenue S.W.
Saturday to Wednesday 5pm - 10pm Phone: 781-1200
CUPS Health Centre
128 - 7th Avenue S.E.
Monday to Thursday 10am - 6pm Phone: 221-8786
Friday 10am - 4pm Saturday 11am - 3pm
A mobile van can arrange needle drop-off and pick up
Sun, Mon, Tues, Thurs 8pm - 1am Van pager: 232-3838
Friday 5pm - 1am
Distress Centre/Drug Centre 266-1605
Alberta Alcohol and Drug Abuse Commission (AADAC)
1177 - 11 Avenue S.W. 297-3071
Canadian Mental Health Association
Suicide Services
Weekdays 9am - 4pm 297-1744
After Hours 266-1605 13
Community Resource Team 299-9699
 Protecct
t
Never share needles,
syringes or vials.

HIV and Hepatitis

HIV is the virus that causes AIDS. Hepatitis is an inflammation
There is no cure for AIDS – it is of the liver caused by a virus.
a fatal disease. It causes jaundice (yellow skin)
and can progress to permanent
HIV is spread by:
liver damage or cancer and may
• blood
be fatal.
• semen
• vaginal secretions Hepatitis b is spread by:
• blood
HIV gets into
• semen
the body by:
• vaginal secretions
~ sharing needles and syringes
~ sexual intercourse Hepatitis B gets
~ a mother can give into the body by:
it to her unborn child • sharing needles and syringes
• sexual intercourse
People who are infected usually
• a mother can give
appear healthy, but from the
it to her unborn child
moment of transmission the person
can infect other people. Hepatitis C is spread by:
• blood

Hepatitis c gets
into the body by:
12 • sharing needles and syringes
• sharing vials
Steroids:
An Overview
Androgenic anabolic steroids are synthetic
derivatives of the male sex hormone
testosterone. Anabolic refers to tissue
building and Androgenic refers to
masculininzing effects. Anabolic and
Androgenic effects cannot be separated,
but the ideal steroid would have high
anabolic effects and low androgenic effects.

Steroids build tissue by holding onto nitrogen

therefore increasing protein synthesis and
preventing tissue breakdown associated
with weight training.

Everyone responds differently to steroids

depending on age, weight, genetics, diet,
training and present conditioning.
Once steroid use is stopped there is a loss
of strength and size.

Prolonged steroid use results in a decrease of

the body’s own testosterone production.

1
 Legal Aspects

Steroids can be prescribed by

a physician for medical reasons.
Steroids are legal when taken as
prescribed. Androgenic anabolic
steroids are restricted drugs
according to the Food and Drug Act
(Schedule G in the Criminal Code,
Section 48, Subsection 1).

This means that if the drug is not

prescribed by a physician it is illegal
to possess the drug. A conviction for
trafficking or possessing a restricted
drug could result in imprisonment
from 18 months to 10 years.
Steroids are banned in sports.

2
Addiction
involves
two basic things:
1 Drug seeking behaviour – taking
large amounts of time finding, buying
and then using steroids.
2 Dependence – loss of the ability to
stop using the drugs. The body becomes
used to the drug and needs it to function. Signs that
you may be
addicted:
Symptoms of steroid
withdrawal include: • using more than you
cravings, fatigue, depression, restlessness, originally intended
decreased appetite (anorexia), insomnia, • loosing control
headaches and decreased interest in sex. over the amount
being used
Steroids users often experience euphoria
• preoccupied with
and a sense of well being. Steroids also
steroid use
have a very strong psychological addiction
component. Steroid users experience • continuing to use
despite the risks
increased muscle mass and performance.
These effects are lost when steroids are • developing a
stopped, and may cause serious self-esteem tolerance – needing
a higher dose to get
problems.
the same results
Steroid users will need to find other ways • using steroids to
to feel good about themselves other than avoid withdrawal
their appearance. symptoms

• noticing that steroids

Generally, steroids take a while to produce
disrupt normal daily
an effect, so it takes longer to develop an activities
addiction.

Detox from steroids may require gradual

tapering and intensive psychiatric support
11
to decrease withdrawal symptoms and
prevent relapse.
 sleep
…provides Performance
the body with energy by enhancement
allowing muscles to recover requires all
and giving the brain and body of the following:
rest. Sleep provides time for
muscle cells to repair damage good night’s sleep
from training.

The recommended amount of good nutrition

sleep is eight hours per night,
and could be more if training physical training
is intense.
proper training technique

proper mental preparation

10
 of Ster oi dss
TTypes
Steroids are available in three forms:
Oil Based
INJECTION
• Absorbs slowly so there is
a lower concentration in the
bloodstream at any given
time, resulting in less liver
damage.
• Often used in animals by vets
so easier to get.
• Increased risk of infection and
tissue damage with injections.
• If it is counterfeit or from a
vet, the steroid is often made
under non-sterile conditions,
which could mean it has
bacteria in it increasing the
risk of infection.
• Thick solution, so injections
can be painful.
Pills
• Taken by mouth, these tend
to be more dangerous as
they are broken down and
processed by body organs
before reaching the muscle.
• Pills must be taken daily.
• Greater tendency for
side effects.
• Excreted faster in urine.
Water Based
INJECTION
• Injections will be everyday
or every other day.
• Less discomfort when injected
as solution is not thick.
• Less available than
oil-based or pills.
3

Adverse Effects
Steroids impact every cell in the body
– not just muscle cells. Side effects
will vary depending on the route of
administration, specific drugs taken,
dosage, frequency of use, age, sex,
and health of the user.
All steroid users may
experience physical
effects such as:
• acne
• jaundice
• upset stomach
• decreased HDL (good cholesterol)
and increased LDL (bad cholesterol)
• increased tendency to blood clots
• increased blood pressure
• liver, kidney and heart damage
• swelling of extremities
• mental/emotional mood swings
• aggressive behaviour
• irritability
• mania
• anxiety
• darkening of skin
• behaviour changes
• schizophrenic paranoia
• “roid rage” – unable to control
behaviour – may be violent
• aggressive sexual behaviour
4
The receptor cells on each muscle
can only respond to a certain
amount of steroid. Using more
steroids will not increase the benefit
of the steroid but will result in more
side effects.
Men who use steroids may
also experience:
• early balding
• breast enlargement
• increased facial and body hair
• decreased sex drive
• testicular atrophy (shrinkage)
• decreased sperm cells (infertility)
• difficulty urinating
• enlarged prostate
Young boys who use
steroids experience the same side
effects as men and also:
• growth retardation
(stunted growth)
• painful sexual orgasms
☛ Younger boys are more prone
to side effects or toxic effects due
to smaller body size
Females who use steroids
may experience:
• lower voice
• breast shrinkage
• facial hair
• increased body hair
• clitoral enlargement
• change in body shape
• balding
• menstrual irregularities
• weight gain
☛ These masculinizing effects are
usually permanent with women
Maintaining
Your Health
Muscles need fuel and energy to
maximize the affects of the steroids
on muscle mass and strength.
Follow Canada’s Food Guide
for an adequate diet.

Milk Meat &

Grain Vegetables Products Alternatives
& Fruit Choose leaner
Products Choose lower-
Choose dark meats, poultry
Choose whole fat milk
green and and fish, as
grain and products
enriched
orange well as dried
more often.
products vegetables peas, beans
and orange and lentils
more often.
fruit more more often.
often.
9
 Medical Care
and Follow Up
Steroids cause changes in your health,
so it is very important to get regular
health checks.

Get a physical examination including

baseline bloodwork before you start
using steroids. Have this repeated
2-3 weeks into your cycle regimen You should not
for comparison. use steroids if
you have:
Bloodwork should include: • diabetes
CBC – complete blood count • breast cancer
LFT’s – liver function tests • diseases of blood vessels,
Cholesterol – including HDL (good) kidney, liver or heart
and LDL (bad) • prostate problems
Glucose level
You should not
Physical examination must include
use steroids if
blood pressure and pulse, a prostate
you are taking:
exam, and an evaluation of your
• acetaminophen (tylenol)
mood state to assess aggression and
• antabuse
tendency toward violence.
• Texan (naltrexone)
• anticonvulsants (i.e. Dilantin)
• Depakene (valproic acid)
• phenothiazine

8
 When individuals stop using steroids,
most experience depression
that sometimes leads to suicide.
Injecting
Injection of steroids presents
health complications – especially
nerve damage, infection or
hematoma (bruising).
Injection Equipment
• Use a 2 or 3 cc syringe
with a 21 gauge, 11/2 inch
or 23 gauge, 11/4 inch needle.
• The needle must be long
enough to reach the muscle.
Steroids injected into
subcutaneous (fat) tissue
absorb very slowly.
Main Sites for Injection
• Thigh muscle (outer mid
1/ of muscle).
3
• Upper outer 1/4 of buttock
(to avoid sciatic nerve).
• Maximum amount per site
is 2cc; inject into another site
if more is desired.
• Vary your injection sites to
decrease local side effects.
How to Inject
• Use a Z-tracking technique
to decrease tissue irritation.
• After drawing up, change
to a clean needle.
• Swab the site.
• Pull skin to the side over the
site prior to injection.
• Push needle into the muscle.
• Let go of the skin.
• Draw back slightly on
plunger to ensure you are
not in a vein (change sites
if you drawback blood).
• Inject steroid slowly.
• Withdraw needle.
• Dispose of needle safely.
Never inject a steroid
into a vein or artery.
5
 Safe Needle Use
Never share your
injecting equipment.

If you must share equipment,

ing
clean it with bleach. Reus es
l
• rinse the needle and syringe with need ns
k e
wea ,
water m
the
ing
• fill syringe with bleach, caus le
ib
wait 30 seconds and poss age
ea k
br e.
discard bleach – repeat th e sit
in
• rinse again with clean water
Bleach may not kill the
Hepatitis C virus so a clean
needle each time is
recommended.

Intra muscular abscesses are caused by:

• reusing needles and syringes
• sharing contaminated needles,
vials or ampules
If you get an abcess you will notice swelling, pain
and redness where • apply warm compress for 20
you injected. minutes – three times per day
• see a doctor to get antibiotics
Side effects of intramuscular injections:
• pain, change of skin pigmentation,
bleeding, cellulitis, sterile or septic
abscess, tissue necrosis, gangrene,
nerve injury

Sterile abscess
A persistent and painful encapsulation nodule could be
caused by the steroid not being absorbed
properly at the site.
6
Cycling, Stacking and Pyramiding
Cycling Pyramiding is the process
Cycling makes steroids more of starting the cycle at a small
effective and safer. Steroid users dose and gradually increasing
need to take breaks while using the dosage so that by mid
because it takes time cycle you are at the maximum.
to change the body’s chemistry. Steroids are then gradually
There is a plateau phase after a tapered to return to the low
month to six weeks where there dose by the end of the cycle.
are no weight or strength changes.
There is a break of four to six
weeks needed before cycling again.
Be sure to see a doctor for
bloodwork and a physical exam
before starting a cycle and again
ns:
half-way through. Recommendatio
Stacking is taking more than
Take the lowest dose possible.
one type of steroid at the same
time to get the right balance.
Use only six to eight week cycles
Steroid users believe this minimizes
and allow at least ten weeks
side effects and maximizes
between cycles to minimize side
effectiveness. There is no scientific
effects.
evidence that shows that stacking
is necessary to get anabolic effects More is not better.
because the androgen receptors on
the muscle cells are well saturated Use only steroids that have been
at lower dosages. The excess on the market for a while. Don’t
steroids taken are not beneficial try new steroids.
and may increase the side 7
effects experienced.