High doses of anabolic steroids can make someone leaner, bigger and angrier, studies suggest. But can suddenly stopping the drugs make someone mentally ill?
A lawyer for a longtime New Jersey police officer who allegedly fired more than 100 bullets at police during a 10-hour standoff in Doylestown Township last year believes the answer is yes. He won’t be the first defense lawyer to use the so-called “dumbbell defense,” a legal strategy of blaming criminal behavior on the psychological effects of anabolic steroids.
“If I were in his shoes, I’d be reaching for this (defense), too,” said John Hoberman of the University of Texas, who has studied steroid use among athletes and law enforcement. “At this point, there is no way to confirm that anabolic steroid use or withdrawal from use is the cause of a specific violent outburst. It’s basically speculation.”
Because scientific evidence linking anabolic steroid abuse and side effects is limited — at best — mostly because the non-medical use of the drug is illegal, such a defense has worked in some court cases, but not in others.
What data is available suggest the drug can be addictive and that stopping it suddenly can trigger withdrawal symptoms, including depression, experts say. Evidence also suggests that psychiatric side effects quickly disappear after the drug is stopped.
Jeffrey Simms, the attorney who represents the New Jersey officer, Richard Klementovich, maintains that Klementovich was under intense personal and professional stress and experiencing several psychiatric conditions, including withdrawal from anabolic steroids, when he snapped last Father’s Day and barricaded himself in the Bittersweet Drive home of his estranged wife.
He recently filed notice with Bucks County Court that he will prepare a temporary insanity defense for his client’s trial scheduled for April. Klementovich is charged with six counts of attempted murder, 21 counts of aggravated assault and related charges. He’s being held in the county prison on $1 million bail.
Steroid use as a defense is tricky ground, especially in states like Pennsylvania where voluntary intoxication isn’t a legitimate defense, according to forensic psychiatrist Dr. Ryan Hall, who has published articles on anabolic steroid abuse.
If someone voluntarily takes an illegal drug — and without a prescription anabolic steroids are illegal — trying to say behaviors committed under its influence was the cause won’t fly, he said.
Where the defense might apply is when a person buys an over-the-counter product or dietary supplement that contains anabolic steroids unbeknownst to the person, Hall said.
In cases in which a defendant has both a history of mental illness and steroid addiction, the legal waters get murkier: Did the steroid use trigger a bipolar episode or visa-versa, Hall said.
Blaming anabolic steroids for criminal behavior has worked at least once. In 1986, a Maryland judge ruled that a former competitive bodybuilder could not be held criminally responsible for burglarizing six homes and setting fire to three of them. The judge ruled that “toxic” levels of anabolic steroids taken by the man during his bodybuilding career made him mentally ill.
More recently, the defense has backfired.
A former Boston cop — whose lawyer claimed anabolic steroid addiction made his client exaggerate many of his behaviors — was sentenced to 26 years in federal prison in 2008 for his part in a major police corruption and drug scandal.
The attorney for the largest drug kingpin in Vermont history also failed in his attempt to blame anabolic steroids for his client’s money laundering and cocaine distribution. His client eventually pleaded guilty in 2011 and was sentenced to 20 years in prison, according to media reports.
Doctors most often prescribe anabolic steroids to restore the body’s normal hormone balance, particularly among men with abnormally low testosterone levels.
Testosterone, the hormone that anabolic steroids mimic, has been prescribed in controlled amounts since the 1930s to treat conditions ranging from impotence to depression. No medical evidence exists that therapeutic doses of the drug result in abuse or dependence, when prescribed properly.
But problems occur when the drug is used in large doses over a short period of time or smaller doses for longer than a couple of weeks, and then abruptly stopped, experts say. What researchers believe happens is the user’s natural testosterone production center shuts down in an attempt to keep the body’s hormones balanced. But once the user stops the steroids, it can take months before the testosterone production resumes to normal.
Few small studies have examined the health risks associated with excessive or prolonged use of anabolic steroids, mostly because ethical concerns prevent scientists from giving subjects super doses to induce side effects. The results of available case studies have been largely inconclusive since side effects vary widely based on the dose amount, duration of use, if other drugs are used with the steroids and any underlying psychiatric issues the user has, experts say.
Most data has focused on the side effects associated with excessive use of anabolic steroids such as irrational behavior, anger, recklessness and depression. Lesser known are the health risks associated with abruptly stopping the drug, experts say.
A 1990 study in the “American Journal of Psychiatry” looked at withdrawal effects in eight bodybuilders using performance-enhancing drugs. All reported at least one bad reaction as a result of drug withdrawal, the most common were greater fatigue and reduced sex drive.
The National Institute on Drug Abuse cites depression as the most dangerous steroid withdrawal symptom and noted that the side effect might be experienced for 12 months or longer after steroid use has stopped. A 1999 “Annals of Clinical Psychiatry” study describes several cases showing a possible association between suicidal thoughts and stopping anabolic steroids.
Generally, psychotic symptoms associated with anabolic steroids are seen in individuals using more than 1,000 mg of testosterone weekly, according to a 2005 study co-authored by Hall, the forensic psychiatrist.
But the psychological symptoms usually resolve within a few weeks after the person stops using the drug, though they can persist for up to a month even when properly treated with anti-psychotic medications, according to Hall, also an assistant professor of psychiatry in the Department of Medical Education at the University of the Central Florida College of Medicine.
In his 2005 research paper, Hall found at least six cases of steroid-induced criminal behavior — three murders and three violent attacks. In half the cases, there was evidence of significant antisocial behavior, violence or criminal behavior before the steroid-related episode.
Hall also found that the psychiatric symptoms in all the perpetrators cleared within two weeks to two months after stopping steroids, and all the subjects retained specific memory of the acts and their “delusional” thinking at the time the crime was committed.
Hall says there is evidence that anabolic steroid abusers are at a higher risk of violent death because of their impulsiveness, aggressive behavior or depression.
Charles Yesalis is a nationally recognized expert on steroid abuse and professor emeritus at Penn State University in health policy and administration exercise and sports medicine
He believes steroid withdrawal could contribute to depression in some people. In studies, he found weightlifters who stopped using the drug became depressed when their ability to lift heavy weight decreased, as well as their muscular appearance.
“Is the science really strong behind this? No it’s not,” Yesalis said. “All in all, it’s a murky defense.”
Jo Ciavaglia: 215-949-4181; email: {a href=”Mailto:%20jciavaglia@phillyBurbs.com”}jciavaglia@phillyBurbs.com; {a href=”http://www.twitter.com/jociavaglia”}Twitter: @jociavaglia
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| Richard Klementovich |
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