07. Harm Reduction / Safer Use Guidelines

Harm reduction is a concept among healthcare workers that seeks to reduce the negative health consequences of drug abuse. The principles of harm reduction call for an acceptance of the fact that, good or bad, illicit drugs exist in today’s society. Instead of ignoring drug users, harm reduction practitioners actively work with them to promote safer use strategies and decrease the health damage of drug abuse. The effort of harm reduction is always helping, not judging, the individual. Although previously focused exclusively on narcotic drugs of abuse, harm reduction principles can (and should) also be developed for steroid users, a group that rarely has the benefit of full physician oversight in its drug programs. In an effort to further this goal, ANABOLICS has outlined the following principles of steroid harm reduction. If followed, these principles should measurably reduce the negative health impact of steroid use, making it a safer (although not completely safe) practice.

Principles of Anabolic Steroid Harm Reduction

1. Avoid Counterfeit and Underground Steroids. Anabolic steroids produced by illicit manufacturers are often of low quality, and may present additional health risks to the user beyond what are presented by the steroids themselves. Even if they contain actual steroids in properly labeled doses, underground drugs may contain toxic heavy metals, use dirty raw materials, or even carry bacterial, viral, and other forms of contamination. Pharmaceutical drug purity is assured to the public only by an extremely costly, tedious, and methodical process of quality assurance and government oversight. There is little financial and even logistical incentive for most underground drug makers to produce their drugs at such high levels of purity. Counterfeit and underground drugs are not considered equal substitutes for real pharmaceutical products, and should be avoided.

2. Avoid Toxic Oral Steroids. Aside from Andriol esters like cypionate, enanthate, and Sustanon tend to have the lowest negative impact on health when taken in muscle building and performance-enhancing doses. Testosterone drugs provide a hormone identical to that already produced in the body, presenting the same spectrum of physical and physiological effects. In addition to being one of the most efficient muscle-builders available, testosterone (nandrolone decanoate), Durabolin. Cycling helps reduce the risk of developing long-term fertility and hormonal issues, which are sometimes caused by the uninterrupted use of steroids for many months or years. Cycling also lets your general markers of health (such as cholesterol levels, hematocrit, and blood pressure) return to their normal state periodically, reducing the impact temporary changes may have over time. Those individuals who use anabolic/androgenic steroids for long periods of time without interruption run a greater risk that these negative changes in health markers will result in long-term health issues.

7. Use Reasonable Dosages. High doses of steroids are not necessary to achieve significant muscle growth, especially if moderate physique or performance enhancement is desired. A dosage limit of 400 mg per week on injectables is advised. In the case of testosterone cypionate, 400 mg per week equates to at least 4 to 5 times the level of hormone naturally produced in a healthy male body. This level of use will produce dramatic muscle gain if combined with proper training and diet. In fact, during the 1970s and 80s the dosage range of 200-400 mg per week was considered “standard” for the bodybuilding use of testosterone, nandrolone, boldenone, or methenolone. There is actually little real need for extreme doses of 750-1,000 mg or more of steroid per week, or to supplement an injectable base with additional orals. High doses may produce a faster rate of gain, but are generally not cost effective for the extra muscle they provide. Additionally, high doses of steroids greatly increase cardiovascular strain and the incidence of other side effects.

8. Avoid Aromatase Inhibitors. Aromatase-inhibiting drugs counter estrogenic side effects by preventing the production of estrogen in the body. While an effective practice, they also deprive the body of a hormone that is important to cardiovascular health. In particular, estrogen supports the production of good (HDL) cholesterol, which means that aromatase inhibitors may inadvertently increase the cardiovascular strain of a steroid cycle. If estrogenic side effects are apparent and a reduction or elimination of the offending steroid(s) is not considered an option, the SERM (Selective Estrogen Receptor Modulator) drug Nolvadex could be used instead. This drug offers partial estrogenic action in the liver, which may allow it to counter estrogenic side effects without the same negative shift in cholesterol.

9. Get Regular Blood Tests. Comprehensive blood testing including an examination of hormones, cholesterol, blood cell concentrations, and enzymes is the most useful tool for assessing the negative health impact of steroid use. Changes in cholesterol, for example, can help quantify for the user what effect a particular drug regimen is having on their cardiovascular health. The individual then has the opportunity to better assess long-term risk if this cycle is to be repeated. At a minimum, blood testing should be conducted before a cycle is initiated, 3 to 4 weeks into a cycle, and a couple of months after a cycle. This allows for 1) a baseline for later comparison; 2) a snapshot of the on-cycle health impact; and 3) an opportunity to assess if natural homeostasis has been restored post-cycle.

10. Use Proper Injection Procedures. Careful attention to correct injection procedures can help eliminate some of the complications associated with nonmedical steroid use. Steroids are given via deep intramuscular injections. The most common site of application is the upper outer quadrant of the gluteus muscle, although the drugs are also commonly injected to the upper outer thigh and shoulder. Site injections (in smaller muscle groups like the biceps, triceps, or calf muscles) for cosmetic purposes are discouraged, as they are technically more difficult to navigate and more prone to complications. Comfortable injection volumes should also be used, generally no more than 3 mL per application. Each injection site should be rotated so that the same muscle is not injected more than once every two weeks. A general focus should be made on cleanliness, including the use of alcohol pads on the vials and skin before injection, and the proper disposal of all needles and empty vials/ampules after use.

11. Sterilize. Though never advised, should the choice be made to use an injectable steroid of underground origin, an effort should be made to sterilize the solution before use. This will reduce the likelihood of illness or infection due to microorganism.

12. Watch Your Diet. Anabolic/androgenic steroids can allow an individual significantly more latitude with their diet than normal. The caloric demand typically increases due to the effects of these drugs on muscle mass and metabolism, allowing more calories to be consumed each day without adding fat mass. It is important not to let this latitude affect your health in a negative way. Remember, the use of steroids at physique- and performance enhancing doses is expected to cause an unfavorable shift in cholesterol levels and other cardiovascular health markers, favoring a higher risk of cardiovascular disease. Simultaneously feeding your body greater amounts of saturated fats, cholesterol, and simple carbohydrates can make the impact of these drugs even worse. Diets low in saturated fats, cholesterol, and simple sugars are recommended, and are known to reduce cardiovascular disease risk. Note, however, that diet alone is not effective at countering the negative cardiovascular effects of steroid use, but dietary restrictions can reduce these risks.

13. Always Consider Reward AND Risk. It can be easy to ignore the potential health impact of steroid use when the positive benefits are so rapid and the negative consequences so remote. At the end of the day, however, it is very important to remember that the use of steroids in doses sufficient to support short term muscle gain are virtually always going to have some negative impact on your body. Your cholesterol will shift in an unfavorable direction, your blood pressure may go up a little bit, and you may ever so slightly thicken the ventricles in your heart. Your hormones are out of balance when you take steroids, which will invariably cause other things to go out of balance. Steroid use is rarely dangerous over a short term period. These hormonal drugs are acutely very safe. As use continues over the years, however, these short-term periods accumulate, and total on-cycle time may become very long. Always remember to consider the risks as well as the rewards of each cycle. Choosing your drug program carefully and keeping the negative effects of steroid use in check over the short term is the best way to reduce long term risks.


Wlliam Llewellyn (2011) - Anabolics

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