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Steroid Withdrawal

Articles


ARTICLE SUMMARY: Medically supervised detox can help you counteract the disruptive effects of steroids on your brain and body. This article reviews the best practices in effective detox treatment and give you some insider information about the process. Then, we invite your questions in the comments section at the end. 


ESTIMATE READING TIME: 10 minutes.


TABLE OF CONTENTS


Regardless of whether you use steroids for a legitimate medical reasons, or illegally, withdrawal symptoms are inevitable after long term use. 


What Is Steroid Withdrawal?

Legitimately prescribed drugs such as steroids can have addictive properties. In addition steroids can cause physical dependence. When discontinued, they produce severe physical and psychological discomfort. So, what is withdrawal?

Withdrawal symptoms are all the physical and psychological signs that follow after you stop taking steroids. For example, depression and suicidal thoughts are commonly reported. In order to quit steroid safely, it is highly advised that you seek medical supervision or undergo a medically supervised steroid detox. This way, symptoms can be addressed as they occur.


After you stops using steroids, you may become depressed, or have suicidal thoughts.


The Brain on Steroids

Using steroids changes the way your brain and body work. However, anabolic steroids produce different effects on the mind and body than other drugs. Steroids do not stimulate the release of dopamine in the brain the same way as other drugs do. The “high” is not the main reason people (ab)use steroids. So, how do steroids work?

As artificial versions of testosterone, steroids produce multiple effects on the mood and behavior. Studies have shown that the use of steroids might provoke aggression at some people. This is because steroids greatly influence the hormonal balance in a person’s body. Hormones regulate our emotions. So, when testosterone and estrogen levels become uneven, people may act irritated and angry. And when hormonal balance gets disrupted, users feel like they are riding an “emotional roller-coaster.”

According to some medical studies, mood and behavioral effects detected during steroid abuse are usually the result of hormonal changes.

Testosterone production is controlled by a group of nerve cells at the base of the brain, called the “hypothalamus”. The hypothalamus is in charge of several functions such as: appetite control, regulation of blood pressure, moods, and reproductive ability. What steroid use actually do is a change in the communication between the hypothalamus and the body. This action might disrupt the usual hormonal balance and function.

Long-Term Effects

In the male population, steroids interfere with normal testosterone production. They act directly on the testicles and cause them to shrink which may result in a lower sperm count. Another consequence of steroid use is irreversible loss of scalp hair. Women who abuse steroids may experience period irregularities, loss of scalp hair, growth of body and facial hair, and voice changes.

The long term use of steroids may cause severe body damage including:

  • enlarged heart
  • heart attack
  • increased blood cholesterol
  • increased blood pressure
  • kidney and liver damage
  • strokes

NOTE: To avoid the listed dangers it’s best to quit steroids under medical supervision. For more reading, this NIDA Research Report on Anabolic Steroids lists more harms and negative effects of use and abuse of steroids.

Dependence or Addiction?

Drug dependence and addiction are different conditions. Dependence is present when a person develops tolerance to a substance, or when people experiences withdrawal symptoms after they stop taking the drug abruptly. A chemically dependent person might display physical changes around chronic usage, tolerance levels, and even withdrawal symptoms…however, the main difference is this:

Someone addicted to steroids CANNOT STAY STOPPED. They may go through withdrawal, but the craving to use more steroids returns and the person “relapses.”

Addiction refers to obsessive and compulsive behaviors. Medically, the term addiction is translated as a chronic relapsing brain disease.  In traditional diagnoses, “addiction” is generally referred to behavioral and personality changes due to drug abuse, while “dependence” is viewed more as a physical adaptation on the presence of a specific drug. Both conditions are most successfully addressed by medical professionals in a safe and drug free environment of detox clinics.


Addiction and dependence are two different conditions. Not everyone who becomes dependent on anabolic steroids is addicted to them.


Main Symptoms

After discontinued, steroids produce severe withdrawal symptoms. The main goal of detox is to manage these symptoms and prevent physical harm. Steroid detoxification should, therefore, be medically supervised in a detox facility.

When coming down off steroids people usually experience both, physical and psychological symptoms. Physical withdrawal symptoms include:

  • anxiety
  • decreased sex drive
  • depression
  • diarrhoea
  • fatigue
  • fever
  • headaches
  • insomnia
  • joint pain
  • lack of appetite
  • lethargy
  • low blood pressure
  • mood swings
  • muscle aches
  • nausea
  • restlessness
  • trouble concentrating
  • vomiting
  • weakness

Psychological or emotional withdrawal symptoms include:

  • anger
  • mood swings
  • insomnia
  • restlessness
  • depression
  • suicidal thoughts

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Withdrawal Timeline

24 – 48 hours after steroid discontinuation withdrawal symptoms begin to show. During this period you can expect to feel quite irritated and nervous. You shouldn’t be surprised if headaches occur along with nausea. The overall start of steroid withdrawal is marked by a state of anxiety and strong need to reach for steroids. But you should not surrender to these sensations. Your body is naturally manifesting his discomfort due to the lack of steroids in the system. Endure, you will get better.

3 – 5 days after steroid discontinuation you’ll start to feel an overall decrease in energy followed by an alertness. During this period depression and anxiety start to intensify. At times such as these, it’s best to look for an assistance from the nurses and/or your doctor at the clinic. You might be prescribed with some medications that will help you relieve tension and anxiety. Psychological and emotional support from friends and loved ones during this phase is critical.

6 – 7 days after steroid discontinuation symptoms mark their peak. The peak is characterized by abdominal pains, nausea and weight loss. If symptoms escalate, depressive thoughts and struggle with insomnia might occur.

2 weeks after steroid discontinuation your condition should begin to stabilize and symptoms to subside. However, minor withdrawal symptoms may linger but they should be less intense in comparison to the previous week. Withdrawal symptoms should fade out completely after a month of steroid discontinuation.

Safety Guidelines

The body stops producing testosterone at its normal levels during steroid use and has a difficult time adjusting to the lack of this hormone in the system. This is what makes steroid use so “addicting”.  Sometimes, it seems easier to go back to steroid use than to deal with the complications and pain during withdrawal.

Still, coming off steroids with the least possible side effects and discomfort is possible. Here we suggest some tips for coming off steroids safely.

TIP #1: Plan your withdrawal carefully. It’s not recommended that you decide to stop “cold turkey” steroids because your body may experience a shock. The intense decrease in energy and mass may cause severe health risks. Instead, ask about tapering guidelines that are supervised by a prescribing doctor.

TIP #2: Reduce steroids slowly. Talk to your doctor and conduct a tapering schedule that will allow you to decrease your daily doses gradually. The tapering plan is made in accordance with the strength of steroids you are taking, the amount you were using and your general mental and physical health.

TIP #3: Make sure your hormones are balanced. Run some tests to check your hormonal status.

TIP #4: The food you eat matters a great deal when you discontinue steroids. You’re eating regime should consist of food that has less fat and calories. Try to replace sugar and meat with a lot of fresh fruit and vegetables. This will keep your body hydrated and help you during detox.

TIP #5: Decrease the intensity of your exercises and sport regimens. Your body is not prepared to maintain the same level of training during steroid detox.

Tapering Steroids

Tapering is the practice of slow drug reduction over a longer period of time. This is a safer method of drug discontinuation than “cold turkey”. This step by step journey aims to give your body a chance to slowly adjust to having fewer levels of steroids in the system before you completely quit. In order for this method to show successful results, regular monitoring during tapering is strongly advised. This will keep you and your doctor updated and will prevent you from relapse.

Q: So how is tapering steroids actually done?
A: The dosage decrease and the dynamic depends on the type of steroid you use.

Oral steroids are tapered in the course of 3-6 weeks. During this period, you and your doctor shout stay in active communication twice a week. Oral steroids are usually reduced by 10mg every 3 days until you reach a dose of 10mg a day. Once you get to use 10mg a day, it is advised to reduce by 5mg every 5 days before you completely quit.

Intravenous steroid are tapered in the course at least 6 weeks. During this period you should continue to take IV methylprednisolone 2mg/kg/day for 5 days. Then you should switch to oral prednisolone 1mg/kg/day for 3 days, and reduce 60mg prednisolone daily. As you taper intravenous steroids make sure you keep regular communication with your doctor at least twice a week during taper.

Prednisolone doses should be reduced by 10mg every 7 days until you get to use 10mg a day. Once you reach this level, prednisolone is reduced by 5mg every 7 days before complete cessation.

Going Cold Turkey Off Steroids

Going cold turkey off steroids is not recommended due to severe and harmful side effects of withdrawal. An abrupt cessation off steroids is accompanied by severe depression and suicidal thoughts.

According to medical studies and research from the National Institute on Drug Abuse (NIDA) some steroid abusers start using other drugs such as heroin or Oxycontin to ease the negative effects of withdrawal from steroids. Self-medicating steroid withdrawal only sinks you deeper into the cycle of addiction.


The painful truth is that steroids are effective short term, but at a high price.


Medical Detox

Many people fear detox outcomes only because they are not familiar with the detox protocol. So how does this process really look like and what does it include? The treatment plan needs to address steroid abuse and the abuse of other substances (if there are any).

The first stage of detox  requires assessment. During initial consultation, doctors and counselors will run some tests and screening to get a clearer picture of your overall health condition. This initial stage of a medically guided steroid detox is called “evaluation”.

During this assessment, staff take into consideration the person’s muscle development. In order for the procedure to be successful, doctors should be familiar with body-building style, the way the person was using steroids and for how long. The usual tests done at this stage include:

  1.  Assessment of medical and psychological status
  2.  Blood tests
  3.  Risk assessment for withdrawal severity
  4. Screening for co-occurring disorders (if present)

The second stage is the actual procedure of detoxification called “stabilization”. This stage often includes

  • Medications to ease withdrawal symptoms. Doctors usually prescribe two types of medications during a steroid withdrawal: one to restore normal hormonal balance, and other for regulating pain and depression.
  • Diet and nutrition plan.
  • Introducing people to the process of treatment and recovery.
  • Including friends and family when appropriate for emotional support.

The third and the last stage of your steroid detox journey includes a safe transition into treatment. This step involves a preparation for further work to address possible addiction. so, if you are addicted to steroids, longer term treatment and aftercare can help. Addiction treatment programs aim to address the mental and emotional reasons behind drug use.

Steroid Addiction Treatment

After a tapered detox under medical care, treatment centers help foster a lasting recovery with several therapies. The main types of addiction treatment include modalities such as:

  1.  Counseling to determine and neutralize triggers that provoke steroid cravings.
  2.  Group therapy to share, learn and discuss experiences with other people who struggle the same problems.
  3.  Holistic treatments to ease muscle pain and anxieties.
  4.  Integrated diagnosis and treatment for co-occurring mental health and mood disorders.
  5.  Skill-building therapies that teach anger management, relaxation and conflict resolution.
  6.  Therapies to address negative thinking and beliefs associated with addictive behaviors.

Recovery is about more than just cleaning your body from the presence of steroids. Treatment centers provide a comprehensive approach that addresses all the aspects of addiction (physical, mental, emotional and spiritual). Highly trained staff are great at helping you find the right combination of treatments to continue working on the underlying issues behind your steroid addiction. In many cases, people who abuse steroids usually deal with co-occuring disorders, or low self-esteem issues that led them to drug abuse in the first place.

Residential treatment centers provide individual counseling and behavioral therapies which provide training and education on establishing control over your thoughts and behavior. During your sessions with a licensed psychiatrist you’ll have the chance to improve your self-esteem and self-image. There is a beautiful life on the other side of steroid addiction waiting for you. You simply have to do your part. If you are afraid, know that it is quite normal, but you can move forward anyway.

Fear of Withdrawal

Now that you know you want to get free from steroids, don’t be afraid to ask for help. Going through steroid withdrawal can be intense and you might feel fear as you think about it. If this is the case, understand that the staff in detox centers are understanding, and professionally trained at helping people get through steroid withdrawal symptoms with much less pain and frustration than doing it alone at home. They also have medication that they can give you to ease the symptoms.

The primary benefit of seeking professional assistance from a licensed detox clinic for steroid detox is having round the clock supervision and care. Doctors, nurses and other professionals can administer prescription medication to help you treat any adverse withdrawal symptoms that may occur. Medical professionals can also help you easily deal with the psychological triggers. Mood changes and behaviors are addressed as part of a structured treatment plan. Professionally assisted steroid detox greatly reduces the risk of relapse.

Your Questions

Do you have questions about withdrawing from anabolic steroids? Please leave your questions or comments in the section below. We do our best to respond to all real-life questions personally and promptly.

Reference Sources: Drug Abuse: Mind Over Matter: Anabolic Steroids
Drug Abuse: Anabolic Steroid Abuse
Substance Abuse Treatment Advisory: Anabolic Steroids
Drug Abuse: What treatments are effective for anabolic steroid abuse?
U.S. Department of Justice: A Guide for Understanding Steroids and Related Substances

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