Emerging Trends in Drugs, Addictions, and Health (Dec 2025)
Steroid and illicit drug abuse in the health and fitness community: A systematic review of evidence
Abstract
Background and aims: Anabolic androgenic steroids (AAS) have become a significant concern within the health and fitness community, particularly among athletes seeking enhanced performance. This systematic review investigates the prevalence, motivation, physiological and psychological effects, and risks of AAS use while identifying gaps in knowledge surrounding these substances. Methods: A systematic search of PubMed, Google Scholar, Scopus, and Web of Science was conducted for studies published between 2014 and 2024. Inclusion criteria focused on research exploring athletes’ experiences with AAS, specifically side effects and usage patterns. Data extraction followed a standardized template, and study quality was assessed using the Joanna Briggs Institute (JBI) and Critical Appraisal Skills Programme (CASP) tools. Findings: From 13,387 identified records, 56 studies met the inclusion criteria. AAS use was prevalent across various regions and demographics, with rates ranging from 6.4 % to 29.3 % globally among gym participants, depending on the population and setting. In Saudi Arabia, the prevalence was notably high at 29.3 %, reflecting unique regional factors. Motivations for AAS use consistently included enhancing physical performance, improving body image, and achieving a competitive edge. Awareness of AAS-related risks was alarmingly low across all regions, with only 38.1 % of users recognizing health concerns such as hypertension and hair loss. Misuse was universally associated with severe physical and physiological complications, including cardiovascular issues, and psychological disorders like depression and aggression. Conclusions: AAS misuse is a complex issue driven by performance goals and societal pressures. Targeted educational interventions are urgently needed to enhance awareness of the associated risks and legal implications. Future research should prioritize strategies to mitigate misuse and foster healthier practices within fitness communities.
