Anabolic–Androgenic Steroids as a Gateway to Opioid Dependence

Abstract
Athletes who abuse anabolic–androgenic steroids may go on to abuse opioid agonist–antagonists such as nalbuphine1-3 or even classic opioids such as heroin.2,3 We studied this phenomenon among patients treated at Sunrise House, a private inpatient facility for substance-dependence treatment in northern New Jersey. Among 227 men admitted for dependence on heroin or other opioids in 1999, we found that 21 (9.3 percent) had a history of anabolic–androgenic steroid use. In contrast, among 197 men admitted for opioid dependence in 1990, only 1 (0.5 percent) reported prior use of anabolic–androgenic steroids (P<0.001 by two-tailed Fisher's exact test).

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