The vast majority of people who misuse steroids are male non-athlete weightlifters in their 20s or 30s.1,22 Contrary to popular belief, only about 22 percent of anabolic steroid users started as teenagers.23 Anabolic steroid use is less common among females, since fewer women desire extreme muscularity and the masculinizing effects of steroids.22
Males who are more likely to use steroids tend to have poor self-esteem, higher rates of depression, more suicide attempts, poor knowledge and attitudes about health, greater participation in sports emphasizing weight and shape, greater parental concern about weight, and higher rates of eating disorders and substance use.24 Steroid misuse is associated with muscle dysmorphia, a behavioral disorder in which men think that they look small and weak, even if they are large and muscular (see “Why are anabolic steroids misused?”).25
Some people who misuse steroids have experienced physical or sexual abuse. In a study of 506 male users and 771 male nonusers of anabolic steroids, users were significantly more likely than nonusers to report being sexually abused in the past.26 Similarly, female weightlifters who had been raped were found to be twice as likely to report use of anabolic steroids or another purported muscle-building drug, compared with those who had not been raped. Moreover, almost all females who had been raped reported that they markedly increased their bodybuilding activities after the attack. They believed that being bigger and stronger would discourage further attacks because men would find them either intimidating or unattractive.27
It is difficult to estimate the true prevalence of steroid misuse in the United States because many surveys that ask about illicit drug use do not include questions about steroids. However, the annual Monitoring the Future study, a NIDA-funded survey of drug use and attitudes in middle and high school students across the United States, shows that past-year use of steroids has generally declined among 8th and 10th graders, after peaking in 2000. Past-year steroid use among 12th graders increased from 2011 to 2015, although use significantly declined from 2015 to 2016. The 2017 rate of use among 12th graders holds relatively steady.