Epidemiology

The global lifetime prevalence rate of anabolic-androgenic steroid (AAS) use is 3.3%.[3]​ The lifetime prevalence rate of AAS use in general populations varies, but is found to be higher in the US, parts of Europe (e.g., Scandinavia), and the Middle East, and lower in parts of Asia (e.g., China, Korea, and Japan) and Africa.[4]​​ AASs are the most abused category of banned drugs in Olympic athletes.[5]

Determining the prevalence of use of AAS by standard questionnaires is unreliable, especially in elite athletes, as there is a high likelihood of false answers.[1]​ The use of randomized response techniques results in higher and more accurate estimations of socially undesirable behaviors, and studies using this technique indicate that 20% to 60% of elite athletes report past-year use of some type of performance-enhancing drug, although further information on the specific type of drug is not available.[1]

Use is prevalent among bodybuilders, weightlifters, and elite power lifters with rates between 33% to 80%.[6]​ It is estimated that over 20% of US college athletes have used AASs.[7]​ Use is primarily a problem among male athletes.[1]

National Institute on Drug Abuse 2022 data show that for three grades in US secondary schools (8th, 10th, and 12th, combined [ages 13, 15, and 17 years, respectively]), the lifetime prevalence of use of steroids was 1.3%, and both annual and past 30-day prevalence levels were <1.0%​.[8]​ The overall prevalence of AAS use seems to be declining among adolescents after a peak in the early 2000s.[6]

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