he incidence and prevalence of anabolic steroid abuse, especially by adolescents, carries with it significant social as well as health-risk concerns.There are a number of questions regarding this misuse that need to beaddressed. Do results from well-controlled studies support the efficacy ofanabolic steroids in increasing muscle mass and augmenting performance?What information is available on the health consequences of misuse of anabolicsteroids at suprapharmacological doses over extended periods of time?Do steroids have the potential for development of tolerance and dependence, and do they meet the criteria for abuse potential as defined in strict pharmacologicalterms? Are adolescents at particular risk? These are among thequestions that prompted the National Institute on Drug Abuse to undertakethis review on anabolic steroid abuse in an effort to understand the extentand scope of the problem and to identify research priorities in this area.The contents of this monograph encompass a wide range of topics beginningwith the important question of whether anabolic steroids possess abusepotential and whether they play a role in the abuse of other substances.There follows an historical overview of the discovery and development ofanabolic steroids, a critical evaluation of the performance-enhancing effectsof anabolic steroids, and an ethnographic study of anabolic steroid abuse inNew York City. Next is a summary of the epidemiological evidence on theincidence and prevalence of steroid use. To better understand the healthconsequences of abuse, the normal endocrine physiology and pharmacology, as well as molecular and receptor mechanisms underlying the actions ofanabolic steroids, are presented, followed by an appraisal of the health risksassociated with abuse. Since adolescents are of special concern, a detailedaccount of the endocrinological effects of anabolic steroids in this specialpopulation is included. Finally, this review is completed with a discussionof the behavioral aspects of anabolic steroid use including indications ofpsychological dependence and evidence for steroid-induced mental statuschanges and aggressive behavior.This monograph represents a "state-of-the-art" information resource concerninganabolic steroid abuse and suggests future directions for research. It is hoped that this monograph will serve to stimulate further research in this area. The monograph should be valuable to members of the scientific community who are involved in drug abuse research; to those interested in the field of anabolic steroids, including professionals in sports medicine, endocrinology, psychiatry, and education; and to government agencies with regulatoryresponsibility, drug enforcement responsibility, or both.The editors would like to express their thanks to the authors of the chaptersin this monograph and to all the participants in the technical review onwhich this monograph is based. We would especially like to thankDr. Marvin Snyder, Director, Division of Preclinical Research, for his rolein initiating and supporting this eff