Dual diagnosis, also known as a co-occurring disorder, occurs when a person experiences both a substance use disorder and a mental health condition at the same time. These conditions often influence one another, making symptoms more difficult to manage and increasing the risk of relapse if only one condition is treated.

Understanding how co-occurring disorders develop, how they are diagnosed, and how integrated treatment addresses both conditions can help individuals and families make informed decisions about recovery and long-term mental wellness.

What Is Dual Diagnosis? 

Dual diagnosis refers to the presence of both a substance use disorder and a mental health disorder. These conditions often develop together and can affect one another in ways that make recovery more challenging.

Either condition can develop first. Some people experience mental health conditions such as depression, anxiety, bipolar disorder, or post-traumatic stress disorder before developing a substance use disorder. Others develop mental health symptoms alongside or after prolonged alcohol or drug use. 

In some cases, individuals use alcohol or drugs to manage difficult emotions or psychiatric symptoms, a behavior often referred to as self-medication. While substances may provide temporary relief, they frequently worsen mental health symptoms over time and increase the risk of addiction.

Because addiction and mental illness can share similar symptoms, understanding the relationship between the two conditions is an important part of the diagnostic process.

How Common Are Co-Occurring Disorders?  

Co-occurring disorders are more common than many people realize. According to the Substance Abuse and Mental Health Services Administration (SAMHSA), approximately 21.2 million adults in the United States experienced both a mental health condition and a substance use disorder in 2024.

Research consistently shows that people with mental health disorders are more likely to develop substance use disorders than the general population. Likewise, individuals with substance use disorders have a higher risk of experiencing conditions such as depression, anxiety, bipolar disorder, and post-traumatic stress disorder.

The presence of both conditions can make recovery more challenging. Individuals with co-occurring disorders often experience more severe symptoms, higher rates of relapse, and greater difficulty maintaining long-term stability when only one condition is treated.

Despite the prevalence of dual diagnosis, many people do not receive treatment that addresses both conditions at the same time. Integrated treatment approaches help to make sure that substance use and mental health concerns are treated together, supporting better long-term recovery outcomes.

Understanding how common co-occurring disorders are can help reduce stigma and encourage individuals to seek comprehensive care when both mental health and substance use challenges are present.

Common Signs and Symptoms of Dual Diagnosis 

The signs and symptoms of dual diagnosis can vary depending on the specific mental health condition, the substance being used, and the severity of each disorder. Because addiction and mental illness often occur together, symptoms can overlap and intensify one another, making it difficult to determine where one condition ends and the other begins.

Common mental health conditions associated with co-occurring disorders include depression, anxiety disorders, bipolar disorder, post-traumatic stress disorder (PTSD), attention-deficit/hyperactivity disorder (ADHD), and schizophrenia.

Mental health symptoms may include:

• Persistent sadness, hopelessness, or emotional distress
• Excessive worry, anxiety, or panic
• Mood swings or emotional instability
• Difficulty concentrating or making decisions
• Changes in sleep patterns or energy levels
• Social withdrawal or loss of interest in activities

At the same time, individuals may experience signs of a substance use disorder, such as:

• Strong cravings for alcohol or drugs
• Difficulty controlling substance use
• Increased tolerance or withdrawal symptoms
• Neglecting responsibilities at work, school, or home
• Continuing to use despite negative consequences
• Repeated unsuccessful attempts to cut back or stop

When both conditions are present, symptoms often become more severe and persistent. Mental health challenges may contribute to substance use as a way to cope with distress, while alcohol or drug use can worsen existing psychiatric symptoms and interfere with recovery.

Because symptoms often overlap, identifying a co-occurring disorder can be challenging without a comprehensive evaluation. 

How Dual Diagnosis Is Diagnosed 

Diagnosing a co-occurring disorder requires a comprehensive evaluation of both substance use and mental health symptoms. Because addiction and mental illness can produce similar symptoms, identifying the relationship between the two conditions is often an important part of the assessment process.

Diagnosis typically begins with screening for concerns related to both substance use and mental health. If a co-occurring disorder is suspected, healthcare providers conduct a more detailed assessment that may include a review of substance use history, mental health history, medical background, current symptoms, and previous treatment experiences.

A dual diagnosis is established when both a substance use disorder and a mental health disorder can be identified as separate conditions, rather than one condition being solely caused by the other.  Determining this can be challenging because alcohol and drug use may contribute to symptoms such as anxiety, depression, mood changes, or sleep disturbances. At the same time, untreated mental health conditions can increase the likelihood of substance use as a coping mechanism.

For some individuals, a period of sobriety may help clarify whether certain symptoms persist after alcohol or drug use has stopped. However, because waiting for complete symptom clarity is not always possible, treatment providers often begin addressing both conditions when a co-occurring disorder is suspected.

Accurate diagnosis is an ongoing process. As recovery progresses and additional information becomes available, treatment providers can continue refining diagnoses and adjusting treatment plans to support an individual’s evolving needs.

Treatment for Co-Occurring Disorders 

Effective treatment for co-occurring disorders addresses both the substance use disorder and the mental health condition at the same time. Integrated treatment combines addiction and mental health services into a coordinated plan that addresses the full range of an individual’s needs. Treating only one condition while ignoring the other can leave important symptoms unresolved and increase the risk of relapse. 

Individual Therapy and Counseling

Individual therapy helps people understand the relationship between their mental health symptoms and substance use. Treatment may focus on identifying triggers, developing healthier coping strategies, improving emotional regulation, and addressing underlying issues that contribute to both conditions.

Evidence-based approaches such as Cognitive Behavioral Therapy (CBT), Dialectical Behavior Therapy (DBT), and Motivational Interviewing (MI) are commonly used to support recovery and long-term symptom management.

Medication Management

For some individuals, medication may play an important role in treatment. Psychiatric medications can help manage symptoms associated with conditions such as depression, anxiety, bipolar disorder, or other mental health disorders while individuals work on recovery from substance use.

Medication decisions should be made in collaboration with qualified healthcare providers and monitored as part of an overall treatment plan.

Levels of Care

Treatment for co-occurring disorders can be provided in a variety of settings depending on symptom severity, recovery progress, and the level of support needed. Care may include medical detox, residential treatment, partial hospitalization programs (PHP), intensive outpatient programs (IOP), outpatient treatment, and ongoing recovery support.

Because recovery needs can change over time, treatment plans are often adjusted as symptoms improve or additional support becomes necessary. The goal is to provide the appropriate level of care while helping individuals build long-term stability in both recovery and mental health.

Relapse Prevention and Ongoing Support

Recovery from co-occurring disorders is an ongoing process that extends beyond the completion of a treatment program. Continued support through therapy, support groups, aftercare services, medication management, and recovery planning can help individuals maintain progress and respond effectively to future challenges.

Long-term recovery is often strengthened when both mental health and substance use concerns continue to be monitored and addressed throughout the recovery journey.

Dual Diagnosis Treatment at The Ridge Ohio 

People with co-occurring disorders require treatment that addresses both substance use and mental health concerns. At The Ridge Ohio, treatment plans are designed to address the unique challenges associated with dual diagnosis while supporting long-term recovery and emotional wellness.

Our team works with individuals experiencing substance use disorders alongside conditions such as depression, anxiety, bipolar disorder, post-traumatic stress disorder (PTSD), and other mental health challenges. Treatment may include medical detox, residential treatment, individual therapy, group counseling, medication management, relapse prevention planning, and ongoing recovery support based on each person’s needs.

Recovery from co-occurring disorders is possible with the right support and a treatment plan that addresses both conditions together. If you or a loved one is struggling with addiction and mental health symptoms, learning more about our dual diagnosis treatment program can help you understand your treatment options and begin the recovery process.

Prescription painkillers are necessary for people in unbearable pain after an injury or a major medical procedure, but they have a deadly dark side that has more people seeking drug detox programs by the day. Opioid painkillers are extremely easy to become addicted to and introduce people to a life-destroying habit. Every American needs to know the risks these drugs carry and how to avoid getting hooked.

Prescription drugs are more prevalent now than ever. Enough pills were prescribed in 2010 to keep every adult in the country fully medicated 24 hours a day for an entire month. The number of prescriptions for opioid painkillers has nearly tripled from 70 million in 1991 to 210 million in 2011. Unless Americans happened to experience three times more pain that year than they did twenty years earlier, something is wrong with the frequency of these prescriptions. And the statistics for deaths by overdose back that up, too: deaths from prescription drug overdoses more than quadrupled from 4,030 in 1999 to 16,651 in 2010.

Although these drugs have medical legitimacy, it’s essential to remember that they’re still opioids. The euphoric, painless sensation they cause is very easy to get addicted to. The brain will shut down the natural production of pleasure-causing chemicals in response to the unnaturally large amounts the drug causes the brain to release, forcing a person to seek more of the drug. When a person runs out of legally obtained pills, they’ll likely try to buy them through less-than-legitimate means, which can run up to $100 per pill. Many then switch to the much cheaper and much more potent heroin. People in this situation often never would have willingly tried heroin and never thought they’d end up struggling with addiction, especially since the pill that got them hooked wasn’t an illicit substance, but medication recommended by their doctor. With this kind of risk present for literally anyone prescribed an opioid painkiller, education and preparation are key!

So, how can you avoid having you or a loved one fall into addiction if you need a painkiller because of a medical condition? The best bet is to communicate your concerns with your doctor. See if there are any non-addictive, non-opioid methods of dealing with pain. If not, make sure you and your doctor agree on a limited amount of refills and a safe schedule for taking the pills. Consider having a trusted family member make sure that the drugs are only taken at the correct times in the correct dosages. These precautions are especially important since addiction usually begins when people can get their prescription refilled many more times than necessary and start taking the pills for the euphoric high rather than pain relief. If you see anyone starting to abuse painkillers in this way, act immediately and look for an inpatient drug rehab center. Don’t wait for their addiction to get worse.

A less direct action, but no less important, is to be an advocate in your community for safe, effective opioid control. By raising awareness, you’ll force doctors and pharmacists filling prescriptions to be more accountable for their actions, and gain public support for more treatment options for prescription opioid addicts.

Prescription painkiller overdose is one of the leading causes of death in America right now, affecting millions of lives.

According to the Centers for Disease Control:

• In 2012, health care providers wrote 259 million prescriptions for opioid pain medication, enough for every adult in the United States to have a bottle of pills.
• Opioid prescriptions per capita increased 7.3% from 2007 to 2012, with opioid prescribing rates increasing more for family practice, general practice, and internal medicine compared with other specialties.
• From 1999 to 2014, more than 165,000 persons died from overdose related to opioid pain medication in the United States.
• In 2013, on the basis of DSM-IV diagnosis criteria, an estimated 1.9 million persons abused or were dependent on prescription opioid pain medication.

There is no question that prescription opioids are being abused by many who claim to have a pain disorder. These addicted individuals visit several doctors for the same conditions in order to obtain multiple prescriptions. They fake illness or injury to get drugs. They falsify prescriptions and buy painkillers from the black market. They manipulate the system in order to get the drugs they are addicted to. In fact, nearly 30% of patients prescribed opiates had no recorded pain diagnosis, according to the CDC.

Lives are being ruined and lost because of prescription opiates. In order to combat this epidemic, several laws and practices have recently been put into place. There are now stricter regulations for doctors who prescribe controlled substance, more comprehensive reporting required by pharmacists who fill the prescriptions, and more data collected on patients who are taking the medications. However, because of the increased security surrounding prescription painkillers, many who legitimately need pain medication for severe and chronic pain are sometimes unable to get the medications they need. The question remains, to what extent are we as a country willing to negatively impact pain patients in order to stop painkiller abusers and addicts?

CDC Recommendations For Opioid Prescription

The CDC published its guidelines for prescribing opioids in 2016, in an effort to help doctors, pharmacists, and even insurance companies aid in curbing unnecessary opioid prescribing and abuse and addiction. However, the CDC’s publication is simply a guide and is not mandatory, but because of some overzealous following of these suggestions, and fear of the growing opioid epidemic, some pain patients find it difficult and even impossible to get the pain relief they require. Below are some examples of the struggle pain patients face trying to get the medication they legitimately need to manage pain, according to a study published in Science Direct.

• Twenty-six states have passed laws that impose mandatory limits on the prescribing or dispensing of opioids for acute pain from surgery or an injury.
• Some pharmacies have placed restrictions on opioid prescriptions they will fill, limiting numbers of pills dispensed as well as denying prescriptions with dosages stronger than the CDC’s dosing guide.
• More than half of the pain patients surveyed (56 percent) reported disruptions in care or outright abandonment by their physicians.
• Some physicians are being red flagged for overprescribing, some even losing their licenses or facing criminal charges for overprescribing. Some physicians are now leery to prescribe at higher levels, even when necessary, in order to avoid scrutiny from the DEA or state medical boards.
• The state of Oregon is considering a proposal that would end coverage for opioids for many chronic pain patients on Medicaid. The original proposal would have forced pain patients to taper off their dose of painkillers in 12 months. Since its original consideration, last August, officials in Oregon have scaled back their proposal, to taper patients to 0 “when appropriate” based on the individual’s needs.

See the CDC guidelines here.

Pain Patient Statistics

According to the CDC report:

• The 1999–2002 National Health and Nutrition Examination Survey estimated that 14.6% of adults have current widespread or localized pain lasting at least 3 months.
• Based on a survey conducted during 2001–2003, the overall prevalence of common, predominantly musculoskeletal pain conditions (e.g., arthritis, rheumatism, chronic back or neck problems, and frequent severe headaches) was estimated at 43% among adults in the United States.
• Most recently, an analysis of data from the 2012 National Health Interview Study showed that 11.2% of adults report having daily pain.
• On the basis of data available from health systems, researchers estimate that 9.6–11.5 million adults, or approximately 3%–4% of the adult U.S. population, were prescribed long-term opioid therapy in 2005.

Reinterpreting The Guidelines

Some people wonder if the changes in prescription regulations are even helping. The rate of prescribing opioids has dropped every year since 2011, and still, opioid overdose deaths have continued to skyrocket during that same time frame.

Risks associated with denying prescription painkillers to pain patients include a loss of productivity, inability to function, medical decline, and increased risk of suicide. Individuals are losing their livelihoods and even their lives because they are unable to deal with chronic pain day after day.

The American Medical Association has recently pushed back against the misapplication of the CDC’s guidelines. At its meeting last November, the AMA adopted a series of resolutions describing its stance.

“Our AMA affirms that some patients with acute or chronic pain can benefit from taking opioids at greater dosages than recommended by the CDC Guidelines for Prescribing Opioids for chronic pain and that such care may be medically necessary and appropriate.

Our AMA advocates against the misapplication of the CDC Guidelines for Prescribing Opioids by pharmacists, health insurers, pharmacy benefit managers, legislatures, and governmental and private regulatory bodies in ways that prevent or limit access to opioid analgesia.

Our AMA advocates that no entity should use MME thresholds as anything more than guidance, and physicians should not be subject to professional discipline, loss of board certification, loss of clinical privileges, criminal prosecution, civil liability, or other penalties or practice limitations solely for prescribing opioids at a quantitative level above the MME thresholds found in the CDC Guidelines for Prescribing Opioids.”

Finding The Balance

So, what should be done? Prescription painkillers are addicting, and even when used as prescribed at first, can cause dependence and eventually addiction and drug-seeking behavior. First of all, we need to create better awareness of the dangers of any type of drug use. Doctors should try alternative forms of treatment whenever possible, and for those who require prescription opioids, they should be prescribed with care. Patients should be monitored closely for dependence and signs of abuse while on the medication, and patients should be screened for addiction prior to going on the medications.

On the other hand, physicians should be trusted enough to know which patients need more pain relief and should be allowed to prescribe based on the individual’s needs. Finding the balance between necessary pain relief and drug-seeking behavior is difficult, but if medical facilities take the CDC’s recommendations as just that and not requirements, we will provide more options for patients who desperately need this pain relief.

If you’re addicted to painkillers, you might need a detox program that can be monitored through residential or outpatient treatment facilities. Contact us now for more details.

When people talk about the dangers of certain substances, they often are referring to how addictive these substances are. This is not necessarily the same thing, because a substance can be extremely dangerous and have a high potential for overdose without causing much dependence. Other substances are more addicting, yet their risk for sudden overdose is low. However, these substances are dangerous in their own way because they cause serious health risks if used over a long period of time.

Regardless of which substance is involved, evidence-based addiction treatment follows the same continuum — assessment, medical detox where needed, residential or step-down care, and aftercare matched to severity.

Understanding The Matrix Of Harm In Addiction

Researcher David Nutt and his colleagues studied the most harmful drugs in the world and came up with a list of the top five. Nutt and his team developed a “matrix of harm” that helped them assess and classify substances based on the risk of each drug.

Nutt explains in the study, which was published in The Lancet, “Drug misuse and abuse are major health problems. Harmful drugs are regulated according to classification systems that purport to relate to the harms and risks of each drug. However, the methodology and processes underlying classification systems are generally neither specified nor transparent, which reduces confidence in their accuracy and undermines health education messages. We developed and explored the feasibility of the use of a nine-category matrix of harm…to assess the harms of a range of illicit drugs in an evidence-based fashion. Our methodology offers a systematic framework and process that could be used by national and international regulatory bodies to assess the harm of current and future drugs of abuse.”

Top 5 Most Addictive Substances

The following are the five most addictive substances, according to researchers.

1) Heroin And Opiates

1. Heroin and Opiates. The number one addictive substance on Nutt’s list is heroin an opioid street drug. Included in this category would be other opioids, including prescription painkillers, which work on the brain in the same manner as heroin. This group of drugs received a score of 3 out of 3, putting it at the top of the addictive substance list.

Heroin increases the levels of dopamine in the brain, causing a feeling of euphoria and making the user instantly crave more. Opioids, in general, have caused a huge disruption in America in the last decade, as more and more people are becoming hooked on prescription painkillers or their more dangerous replacement, heroin.  It is estimated that nearly 25% of all people who try heroin at least one time will become addicted.

According to the National Survey on Drug Use and Health (NSDUH), in 2016 about 948,000 Americans reported using heroin in the past year, a number that has been on the rise since 2007. This trend appears to be driven largely by young adults aged 18–25 among whom there have been the greatest increases. The number of people using heroin for the first time is high, with 170,000 people starting heroin use in 2016, nearly double the number of people in 2006 (90,000). In contrast, heroin use has been declining among teens aged 12–17. Past-year heroin use among the nation’s 8th, 10th, and 12th graders is at its lowest levels since 1991, at less than 1 percent in each grade level.

According to the National Institute on Drug Abuse, those who are addicted to heroin and stop using the drug abruptly may have severe withdrawal. Withdrawal symptoms—which can begin as early as a few hours after the drug was last taken—include:

• restlessness
• severe muscle and bone pain
• sleep problems
• diarrhea and vomiting
• cold flashes with goose bumps (“cold turkey”)
• uncontrollable leg movements (“kicking the habit”)
• severe heroin cravings

2) Cocaine

Cocaine. Second on Nutt and his team’s list of most addictive substances is another common illicit drug, cocaine. This drug is a stimulant that interferes with the dopamine receptors in the brain, causing dopamine levels to increase and cause a feeling of euphoria. Cocaine also causes increased energy, rapid heart rate, and increased blood pressure. It has an extremely fast impact on the brain and a short half-life, which causes the user to seek more as soon as the high wears off.

It is estimated that 21% of people who try cocaine will become dependent on it at some time in their life. According to the National Survey on Drug Use and Health (NSDUH), cocaine use has remained relatively stable since 2009. In 2014, there were an estimated 1.5 million current (past-month) cocaine users aged 12 or older (0.6 percent of the population). Adults aged 18 to 25 years have a higher rate of current cocaine use than any other age group, with 1.4 percent of young adults reporting past-month cocaine use.

According to the National Institute on Drug Abuse withdrawal from cocaine causes:

• depression
• fatigue
• increased appetite
• unpleasant dreams
• slowed thinking
• insomnia
• agitation
• extreme cravings for the drug

3) Nicotine

Nicotine. It might come as a surprise to some, but nicotine was the number three addictive substance on Nutt’s list. As nicotine is smoked, it is delivered to the brain rapidly, mimicking receptors in the brain and causing an increase in dopamine similar to cocaine.

According to the National Survey on Drug Use and Health (NSDUH), fewer Americans are smoking today. In 2013, an estimated 55.8 million Americans aged 12 or older, or 21.3 percent of the population, were current cigarette smokers. This reflects a continual but slow downward trend from 2002 when the rate was 26 percent.

However, those who are addicted to nicotine find it extremely difficult to quit, even when faced with serious health concerns. In fact, tobacco use is the leading preventable cause of disease, disability, and death in the United States, with 16 million people suffering from a serious illness that is caused by smoking. More than two-thirds of Americans who tried smoking reported becoming dependent during their life.

According to the World Health Organization:

• Tobacco kills up to half of its users.
• Tobacco kills more than 7 million people each year. More than 6 million of those deaths are the result of direct tobacco use while around 890 000 are the result of non-smokers being exposed to second-hand smoke.
• Around 80% of the world’s 1.1 billion smokers live in low- and middle-income countries.

It is difficult to quit using nicotine. According to smokefree.gov, symptoms of quitting smoking include:

• cravings for cigarettes
• feeling down or sad
• insomnia
• irritability
• trouble thinking clearly and concentrating
• feeling restless and jumpy
• slower heart rate
• weight gain

4) Barbiturates (“downers”).

Next, on Nutt’s most addictive substance list are barbiturates or downers. These are medications that work on the individual by shutting down signals in certain regions of the brain. These medications are used to treat anxiety disorders and insomnia and can lead to addiction very easily.

Today in America, barbiturates have largely been replaced by benzodiazepines, which act in much the same way, and are also addicting. According to National Survey on Drug Use and Health (NSDUH), 12.5% of adults in the U.S. used benzodiazepines, which extrapolates to about 30.5 million persons. However, only 2.1% of U.S. adults misused them (at least once), and only 0.2% met the criteria for benzodiazepine use disorders. Among benzodiazepine users, 17.1% misused them, and fewer than 2% had benzodiazepine use disorders.

Barbiturates and benzodiazepines are dangerous to withdraw from, and the individual should be monitored when quitting these medications. Withdrawal symptoms include:

• irritability
• sleeplessness
• seizures
• tremors
• hallucinations
• fever
• sweating
• delirium
• cardiovascular collapse
• severe anxiety
• hypotension
• mood disorders
• death

5) Alcohol.

Finally, one of the most commonly used legal addictive substances in America is on Nutt’s list. Alcohol is consumed by millions of people throughout the world, some even citing health benefits to moderate drinking. Not all agree, however. Alcohol depresses the central nervous system, causing the brain to release dopamine and endorphins. Those who consume alcohol on a regular basis develop a tolerance to it, which requires them to drink more and more in order to feel the same effects. During this time, dependence settles in for many and can lead to a lifetime of addiction.

Dangerous Addiction Statistics

According to the 2015 National Survey on Drug Use and Health (NSDUH):

• 86.4 percent of people ages 18 or older reported that they drank alcohol at some point in their lifetime; 70.1 percent reported that they drank in the past year; 56.0 percent reported that they drank in the past month.
• In 2015, 26.9 percent of people ages 18 or older reported that they engaged in binge drinking in the past month; 7.0 percent reported that they engaged in heavy alcohol use in the past month.
• 15.1 million adults ages 18 and older had and alcohol use disorder (AUD). This includes 9.8 million men and 5.3 million.
• About 6.7 percent of adults who had AUD in the past year received treatment. This includes 7.4 percent of males and 5.4 percent of females with AUD in this age group.
• An estimated 88,000 people die from alcohol-related causes annually, making alcohol the third leading preventable cause of death in the United States.
• In 2014, alcohol-impaired driving fatalities accounted for 9,967 deaths (31 percent of overall driving fatalities).

Alcohol withdrawal is dangerous and should not be attempted alone. Symptoms include:

• agitation
• anxiety
• headaches
• shaking
• nausea and vomiting
• disorientation
• seizures
• insomnia
• high blood pressure
• hallucinations
• delirium tremens
• death

All of these substances are dangerous if overused or abused. Some, such as prescription medications, can provide benefits if used with caution. However, it is important that we work to educate our communities about the dangers of these very addictive substances so that we can work to prevent abuse and dependence and provide treatment to those who are struggling with addiction.

The Ridge offers an inpatient rehab facility along with detox programs to help people struggling with addiction.

We hear about steroids all the time. But what are steroids? Steroids are hormones, substances produced by glands (or organs) that regulate bodily functions and behavior. It is important to understand that there are several types. Steroid hormones in general include:

• Corticosteroids, including most synthetic steroid drugs, with natural product classes the glucocorticoids (which regulate many aspects of metabolism and immune function) and the mineralocorticoids (which help maintain blood volume and control renal excretion of electrolytes) and,
• Anabolic steroids (also known as androgenic steroids), natural and synthetic, interact with androgen receptors to increase muscle and bone synthesis.

What are Steroid Hormones?

In popular use, the term “steroids” often refers to anabolic or anabolic-androgenic steroids (AAS). Anabolic steroids may be synthetic, or human-made, and are variations of the male sex hormone testosterone. The proper term for these compounds is anabolic-androgenic steroids [AAS]. “Anabolic” refers to muscle building, and “androgenic” refers to increased male sex characteristics. Some common names for anabolic steroids are Gear, Juice, Roids, and Stackers.

Our focus today is on the anabolic version, or anabolic-androgenic steroids [AAS].  These are used to build muscle mass to enhance athletic performance. (If your 65-year-old grandmother is on “steroids” they are most likely not anabolic but corticosteroids which are frequently used for such conditions as asthma, bad allergy reactions [e.g., poison ivy]) or some auto-immune diseases. The most frequently prescribed anabolic steroid is testosterone.

Are There Legitimate Reasons To Take Steroids?

There are legitimate medical indications for AAS to be prescribed to patients. The most common indication is to prescribe testosterone for patients that are deficient in testosterone, which includes hormone replacement for transgender men.  Testosterone is frequently used off-label in men with sexual dysfunction due to low testosterone associated with aging [Low-T]. [Testosterone is not recommended for low testosterone status due to aging due to potential risk for cardiovascular events and stroke.] AAS are prescription only medications. They are sometimes taken without medical guidance to increase muscle mass and improve athletic performance. AAS are recognized to enhance athletic performance by improving endurance and strength, by reducing post-exertion pain and enhancing recovery time. If used in medication that can be legally prescribed there are steroids not approved by the FDA for medical use including androlone and dromostanolone. These are frequently used by bodybuilders, power athletes, and weightlifters for the desired effect on muscle building and shaping. This style of use can cause serious side effects including addiction.

How Are Steroids Administered?

Anabolic steroids including testosterone can be administered as oral pills, injections, creams or topical gels, and skin patches. While testosterone is an FDA approved medication that can be legally prescribed there are steroids not approved by the FDA for medical use including androlone and dromostanolone. These are frequently used by bodybuilders, power athletes, and weightlifters for the desired effect on muscle building and shaping.

What Are the Common Adverse Effects Of Steroids?

Some of the adverse effects of anabolic steroids include but are not limited to hypertension, coronary disease, abnormal cholesterol and lipid profiles, mouth irritation, hot flashes, tendon rupture, muscle pain, emotional disorders including severe mood swings and aggressiveness, violence, suicidal thoughts, insomnia, skin rashes, and acne.

In some instances, individuals that use anabolic-androgenic steroids [AAS] develop an addiction which refers to the continued desire or craving to use a drug despite knowing about or experiencing serious adverse consequences.

Are Steroids Addictive?

The individual most prone to developing an addiction to anabolic steroid use is the athlete and there is evidence that some people who misuse them go on to develop an addiction. Though not generally considered to be intoxicating drugs, anabolic-androgenic steroids may produce potentially reinforcing psychoactive effects such as increased self-confidence and aggressiveness.

Some of the behavioral, social, and emotional symptoms of note include severe, frequently aggressive mood swings, withdrawal from friends and/or family, paranoid thoughts, excessive desire to workout and depression. There is no scientific evidence to support the concept of “Roid Rage” as a behavioral condition that can develop when people use increasing amounts of steroids over an extended period. As the term indicates, people may display unusual and excessive displays of aggression.

Treatment & Recovery For Steroids

Symptoms from anabolic-androgenic steroids withdrawal include mood swings, serious depression, fatigue and excessive sleeping, cravings for steroids, insomnia, loss of sex drive, and loss of appetite.

The first step to recover from addiction to anabolic-androgenic steroids [AAS] is detoxification off the steroids. Medications to stabilize mood swings in a safe environment (like an inpatient rehab center) is generally recommended although not always necessary. Treatment for anabolic-androgenic steroid addiction includes a safe and support environment with Cognitive Behavioral Therapy [CBT], one on one counseling, lectures and education, referral to self-help groups for ongoing support and physician managed medications to treat the psychiatric symptoms frequently seen. Athletes or competitors who abuse steroids may have to make lifestyle adjustments in order to maintain recovery. But as with other addictions, the first step with anabolic steroid addiction is to have the courage to reach out for help.

Sources:

https://en.wikipedia.org/wiki/Corticosteroid

https://en.wikipedia.org/wiki/Glucocorticoid

https://en.wikipedia.org/wiki/Mineralocorticoid

https://en.wikipedia.org/wiki/Anabolic_steroid