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Alcohol and Drug Abuse

What can allostasis tell us about anabolic-androgenic steroid addiction?

December 17, 2011

Hildebrandt T, Yehuda R, Alfano L.
Dev Psychopathol. 2011 Aug;23(3):907-19.

Anabolic-androgenic steroids (AASs) are synthetic hormones used by individuals who want to look better or perform better in athletics and at the gym. Their use raises an interesting paradox in which drug use is associated with a number of health benefits, but also the possibility of negative health consequences. Existing models of AAS addiction follow the traditional framework of drug abuse and dependence, which suggest that harmful use occurs as a result of the drug’s ability to hijack the motivation-reward system. However, AASs, unlike typical drugs of abuse, are not used for acute intoxication effects or euphoria. Rather, AASs are used to affect the body through changes to the musculoskeletal system and the hypothalamic-pituitary-gonadal axis as opposed to stimulating the reward system. We offer an allostatic model of AAS addiction to resolve this inconsistency between traditional drug addiction and AAS addiction. This allostatic framework provides a way to (a) incorporate exercise into AAS misuse, (b) identify where AAS use transitions from recreational use into a drug problem, and (c) describe individual differences in vulnerability or resilience to AASs. Implications for this model of AAS addiction are discussed.

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‹ A new article on suicide in the military › Treatment of suicide attempters with bipolar disorder: a randomized clinical trial comparing lithium and valproate in the prevention of suicidal behavior

Editorials

  • The role of the h-index in academic medicine
  • A timeless commitment: Reflections on the Hippocratic Oath
  • Abraham Flexner history: Celebrated medical educator – improved physician training, yet also left a not well-known legacy  
  • Suicide medical malpractice: A conceptual perspective

Research Papers

  • COVID-19 mortality in Europe and the ’Iron Curtain’ between East and West
  • Examination of depressive signs and symptoms among 803 University students in seven Universities and Colleges. Hungary, Romania, Serbia.
  • Examination of spirituality and the dimensions of spirituality among 803 students in seven different Universities. Hungary, Romania and Serbia.
  • Examination of depressive signs and symptoms among 932 students in eight different secondary schools in Hungary

Research News

  • Blood alcohol concentration and suicide mortality in Finland
  • Suicide risk in older adults: clinical responsibilities and medico-legal considerations
  • Conceptualizing a combat veteran’s suicide death through the stress-diathesis model
  • No evidence of a causal link between glucagon-like peptide-1 receptor agonists and suicidal behavior

Latest News

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Interviews with eminent psychiatrists

  • 2026 Interview with Professor Zoltan Rihmer
  • 2026 Interview with Doctor María Dolores Braquehais Conesa
  • 2026 Interview with Professor Shih-Ku Lin
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Ten Years Ago

  • Suicide malpractice
  • Testosterone levels and future suicide attempts in women with bipolar disorder
  • Bipolar disorder, testosterone administration, and homicide
  • The cosyntropin stimulation test in military veterans with or without posttraumatic stress disorder

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