Mental health correlates of risky anabolic-androgenic steroid use in Australian alcohol and other drug treatment services

Anabolic-androgenic steroid (AAS) use is increasing globally yet remains poorly integrated into alcohol and other drug (AOD) service models. This study aimed to examine data from AOD service clients using AAS, seeking to understand the psychosocial correlates of risky use.
We analyzed service intake data from 2022-2025, comprising adults (N = 18786) who reported prior use of AAS (N = 521; 92.7% male). Measures included demographics, primary drug of concern, mental health (depression, anxiety), impulsivity (Short UPPS-P), and substance-related risk (WHO ASSIST). A multinomial logistic regression was conducted to examine how depression, anxiety, and impulsivity traits predict levels of AAS-related risk.
Methamphetamine (49.3%) and alcohol (23.2%) were the most common primary drugs of concern. AAS risk scores ranged from 2 to 39 (M = 10.60, SD = 9.34). Regression analysis (Nagelkerke R2 = 0.53, p < .001) showed that higher depression and anxiety scores significantly predicted moderate and high AAS risk (both p < .001). Age and impulsivity traits (positive/negative urgency, lack of perseverance) also significantly predicted higher risk (all p < .001).
Higher AAS-related risk is associated with poorer mental health and impulsivity. Mental health support is needed for AAS consumers presenting to AOD services.