Mixing Prednisone (Steroids) and Alcohol

What Are Steroids?

Anabolic-androgenic steroids belong to a class of drugs known as appearance- and performance-enhancing drugs (APEDs).¹ These drugs may be referred to as anabolic steroids, androgens, steroids, roids, or juice.^1,2 They mimic the effects of testosterone, which is a male sex hormone, so they can stimulate muscle growth and male sexual characteristics.¹ They can also lead to feelings of well-being and greater bone strength.¹

Steroids are sometimes used medically to treat low testosterone, delayed puberty, and muscle loss associated with various conditions.¹ Other types of APEDs include human growth hormone (HGH), insulin-like growth hormone (IGH), and ergo/thermogenics such as xanthines, sympathomimetics, and thyroid hormones.¹

Corticosteroids are another type of steroids, but they aren’t like anabolic steroids and are used only as prescription medications.^3,4 This type of medication works to reduce inflammation in the body. It is often used to treat disorders of the immune system, arthritis, asthma, or skin conditions.^3,4 They work by mimicking hormones created by your adrenal glands, reducing inflammation and the activity of your immune system.^3,4

Anabolic steroids can be abused to enhance appearance by gaining muscle and decreasing body fat for aesthetic purposes, or to improve performance in competitive sports such as weightlifting and football.^1,5,6 When steroids are abused, they are taken at much higher doses than those used medically.⁵ They can be taken as oral pills, injections into muscles, or gels or creams that are absorbed into the skin.^2,5,6

Patterns of Steroid Abuse

Steroid abuse can occur in various patterns:^1,2,6,7

• Cycling is when steroids are used for a certain length of time, then stopped for a while, and restarted.
• Stacking is when more than one type of steroid is used, often combining steroids that are taken orally and injected.
• Pyramiding is when steroids are taken in a cycle lasting 6-12 weeks. The drugs are gradually increased for the first half and then gradually decreased for the second half, followed by a period where no steroids are used.
• Plateauing is when the dosage and/or the types of steroid are staggered, overlapped or substituted, so the person avoids becoming tolerant of a single type of steroid.

Are Steroids Addictive?

APEDs such as steroids are addictive, and it is possible to develop a substance use disorder after using them.^1,2,5,6 Studies suggest that approximately 32% of people who misuse anabolic steroids develop a dependence on them.¹

Unlike other substances of abuse, steroids generally do not cause a high or feelings of euphoria.^1,2 Yet people who are addicted to steroids may continue to use them even after experiencing negative physical or mental health side effects. They may prioritize workouts over other activities, devote significant amounts of time and money to steroids, and struggle to cut down or stop using without success. They may also experience tolerance and symptoms of withdrawal when trying to stop.^1,2,6

Side Effects of Steroid Abuse

A range of side effects are associated with steroid use and misuse. They can be mild or escalate to severe and life-threatening.^1,2 Abusing steroids can have serious health risks, some of which can be permanent.⁵ Side effects and health risks of steroid misuse can include:^1,2,5,6,8

• Cardiovascular issues, including blood clots, damage to arteries, enlarged heart, high blood pressure, high cholesterol, and increased risk of heart attack and stroke.
• Decreased functioning of the immune system, making you more likely to get sick.
• Hormonal issues for men including decreased testicle size, infertility, male-pattern baldness, reduced sperm production, and increased risk for testicular and prostate cancer.
• Increased risk of contracting hepatitis or HIV/AIDS and damage to the veins if shared needles are used to inject steroids.
• Kidney problems, which can cause swelling of the hands and feet, possible kidney failure, and an increased risk of developing kidney cancer.
• Liver problems such as jaundice, tumors, liver damage, the development of blood-filled cysts throughout the liver (peliosis hepatitis), and increased risk of liver cancer.
• Musculoskeletal issues including stunted growth (if steroids are used by adolescents) or increased risk of injury to tendons and ligaments.
• Psychiatric issues such as aggressive behavior, anxiety, depression, impaired judgment, irritability, mania, mood swings, hallucinations, and/or delusions.
• Skin problems including severe acne or cysts, increased oil production on the scalp or skin, and the possibility of developing abscesses at injection sites.

Can You Drink Alcohol While Taking Steroids?

Use of anabolic steroids is associated with a higher risk of alcohol and illicit drug use, and, in general, those dependent on anabolic steroids may have a greater risk of substance abuse during their lifetime.⁹ If you are unable to stop drinking while taking steroids that are prescribed, you may be demonstrating a loss of control over alcohol use, which is a symptom of alcohol use disorder (AUD).¹⁰ It may be helpful to better understand the signs of alcohol use which can lead to an AUD.

Some signs indicating that someone may be struggling with alcoholism include:^10,11,12,13

• Alcohol use interferes with completing responsibilities at home, school, or work.
• Continuing to drink after it has created or worsened problems within relationships.
• Developing a tolerance (the need to consume significantly more alcohol to get the same effects).
• Experiencing withdrawal symptoms if you cut back significantly or try to stop drinking altogether.
• Inability to stop drinking, even after it has caused or worsened physical or mental health problems.
• Spending a lot of time getting, drinking, or recovering from the effects of alcohol.
• Trying unsuccessfully to cut back or stop drinking.

An AUD can only be diagnosed only by a health professional, so if you feel you or a loved one may be struggling with alcohol abuse, you may want to speak to your doctor or a mental health professional to be formally assessed for an AUD.^11,13

Steroid and Alcohol Withdrawal

When you take a substance like alcohol regularly, your body becomes used to its presence. Eventually, you require it to function normally.¹⁴ This is known as physical dependence, and individuals who’ve become dependent on a substance may experience symptoms of withdrawal when you stop taking it.¹⁴

Excessive drinking for women is the consumption of 4 or more drinks in a 2-hour period or having at least 8 drinks a week.¹⁵ For men, it is having 5 or more drinks in a 2-hour period, or at least 15 drinks weekly.¹⁵ If you drink excessively, you may be at higher risk of developing an alcohol use disorder.¹⁵

Experiencing withdrawal symptoms is one of the signs of an alcohol use disorder.¹⁰ These symptoms can range from mild to severe and life-threatening. Because of this, undergoing detox from alcohol under medical supervision can provide a more comfortable and safe experience while ridding your body of alcohol’s toxins.^17-16 Some mild symptoms of alcohol withdrawal include anxiety, depression, fatigue, lack of appetite and mood swings.^{10,11,12,13,16} More serious symptoms may include hallucinations, seizures, tremors or delirium tremens (rare).^{10,11,12,13,16}

Symptoms of Steroid Withdrawal

Steroid misuse may also cause withdrawal symptoms when you stop taking them.^1,2,5 Some symptoms of withdrawal from anabolic steroids include:^1,2,5,6,8

• Anxiety.
• Depression that can be severe and lead to suicidal thoughts and attempts.
• Exhaustion.
• Impaired focus and concentration.
• Lack of appetite.
• Loss of strength.
• Restlessness.
• Trouble sleeping.

Treatment for Steroid Abuse and Alcoholism

Like other substance use disorders, alcoholism is not a curable condition, but it can be treated effectively with behavioral therapies, medications, mutual support groups and ongoing aftercare support.¹³ Detox from alcohol should be done only in a medically supervised environment so that staff can monitor your condition and provide medication and treatment to manage your symptoms.¹⁷ For steroids, withdrawal symptoms can be eased by slowly tapering the dose.

During alcohol detox, medications may be administered to ease symptoms of withdrawal. For alcohol, long-acting benzodiazepines such as Valium (diazepam) or Librium (chlordiazepoxide) can be used in slowly tapering doses to manage withdrawal symptoms effectively and reduce the risk of dangerous complications.¹⁷

After you have completed detox, effective treatment will address the underlying factors that have contributed to addiction. One such factor may be muscle dysmorphia, a male body image disorder, which may play a role in steroid use.^1,2,13 Behavioral therapy and medications can help you learn coping skills, develop healthy habits, improve communication skills, avoid relapse and high-risk situations, manage symptoms of depression if present, improve muscle dysmorphia, build a support group, and resist cravings.^1,13

Research has shown that treatment for alcohol use disorder can be extremely effective. Around 1 in 3 people who receive treatment for alcohol use disorder display no symptoms after a year, and a significant number report major reductions in drinking and alcohol-related consequences.¹³

Seek Treatment for Addiction

If you or a loved one is struggling with substance abuse and want to learn more about your treatment options, American Addiction Centers (AAC) can help. AAC is a nationwide provider of addiction treatment centers and believes everyone should have access to the highest quality care when it comes to recovery from drugs and/or alcohol.

Our facilities offer evidence-based therapies and approaches to addiction treatment while providing unique medical capabilities to ensure you or your loved one has the best chance at a successful recovery. Call our admissions navigators at any time of day to discuss treatment, learn more about what your insurance covers and how to take the first step toward a life free of drugs and alcohol.

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