Are men who inject testosterone and other anabolic steroids at risk of entering a violent “roid rage“?
Many people think so. Whenever a professional athlete commits a violent crime, it’s not long before someone suggests that steroids may have been involved. The most recent example of this is the case of Jonathan “War Machine” Koppenhaver. The steroid theory has emerged as an explanation for why he violently assaulted his girlfriend and then went on the run, e.g. here.
But the whole “roid rage” theory is flawed, according to a new study from Swedish researchers Lena Lundholm and colleagues, published today in the journal Addiction: Anabolic androgenic steroids and violent offending
Lundholm et al say that previous research has found correlations between anabolic steroid use and violent criminal behaviour, but that this doesn’t establish causation. The authors suggest that the true cause of the association might be that people who use steroids also tend to use other drugs like amphetamines and cocaine – and that this ‘polysubstance abuse’ is what’s most strongly linked to violence.
In a study of over 10,000 Swedish males, Lundholm et al found that men who had been convicted of a violent crime were much more likely to report having used anabolic steroids (although the rates were still low in absolute terms: 2.7%, vs. 0.6% in men not convicted.) However, they say, “this association was substantially attenuated and lost statistical significance after adjusting for other lifetime substance abuse.” In other words, men who’ve used steroids are not more likely to be convicted of violence after accounting for other drug use.
Our results suggest that it was not lifetime steroid use per se, but rather co-occurring polysubstance abuse that most parsimoniously explains the relatively strong association of steroid use and interpersonal violence.
However, limitations of the study include the self-report nature of the drug and steroid use data, and the fact that the study didn’t consider the timing of the use of the different drugs, and the convictions. It might be that although polysubstance use is the main risk factor for violence over the whole lifespan, men are more likely to be violent during periods of time when they are abusing anabolic steroids.
Lundholm L, Frisell T, Lichtenstein P, & Långström N (2014). Anabolic androgenic steroids and violent offending: Confounding by polysubstance abuse among 10,365 general population men. Addiction PMID: 25170826