Episodes of Rage Seen as Tip of the Iceberg for Steroid Abuse

UPPSALA, Sweden, Nov. 6 -- Violent physical outbursts triggered by abuse of anabolic steroids, the so-called 'roid rage, may mask a more complicated criminal picture linked to the drugs.

Among a cohort of people being tested for steroid use, convictions for violent impulsive crimes against people were not different among those who tested positive or negative, according to Fia Kltz, M.D., of Uppsala University.

On the other hand, steroid abusers were twice as likely to have been convicted of weapons offenses, Dr. Kltz and colleagues reported in the Nov. 7 issue of Archives of General Psychiatry.

One possible explanation for the finding is that being "bulked up" through the use of steroids is an advantage for those routinely involved in offenses such as armed robbery or the collection of crime-related debts, Dr. Kltz and colleagues concluded.

Such crimes are not usually impulsive, contrary to the usual picture of steroid-linked crime, but the perpetrators may benefit from the well-known aggressiveness associated with the drugs, the researchers said.

The finding comes from controlled retrospective cohort study of known criminal activity among individuals tested for anabolic androgenic steroid use from Jan. 1, 1995, through Dec. 31, 2001, at Sweden's doping laboratory in the Stockholm metropolitan area.

The researchers used the country's national police database to link criminal convictions to 1,400 individuals who were referred for testing from a range of sources, including centers for substance abuse treatment, police custody, and private medical practitioners.

The study found:

• 241 of the referred individuals tested positive for steroid use.
• Among those, the relative risk of having been convicted of weapons offenses, compared with those who tested negative, was 2.09, with a 95% confidence interval from 1.58 to 2.74.
• Steroid users were also more likely to have been convicted of fraud. The relative risk was 1.51, with a 95% confidence interval from 1.20 to 1.89.
• There were no significant differences with respect to either violent crimes or crimes against property.

When the researchers excluded people who were being tested because they were involved in a voluntary drug program, the association between steroids and fraud was no longer significant, but the link to weapons offences wasn't changed.

One limitation of the study, Dr. Kltz and colleagues noted, is that by its nature it can't account for crimes that did not result in a conviction. Also, the researchers said, it's not possible to know if those who tested positive for steroids are representative of all steroids users - they might just be the ones who seek medical attention or come to the attention of the judicial system.

While the abuse of steroids has been linked with violent outbursts of "roid rage," the researchers said, the Swedish police system doesn't keep records of the nature or extent of violence in crimes against people.

As a result, the study can't show qualitative differences between the two groups, including possible "unusually vicious assaults by individuals testing positive" for steroids, Dr. Kltz and colleagues said.