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Commons patterns for misusing steroids include: cycling’taking multiple doses for a period of time, stopping for a time, and then restarting stacking’combining two or more different steroids and mixing oral and/or injectable types pyramiding’slowly increasing the dose or frequency of steroid misuse, reaching a peak amount, and then gradually tapering off to zero plateauing’alternating, overlapping, or substituting with another steroid to avoid developing a tolerance. There is no scientific evidence that any of these practices reduce the harmful medical consequences of these drugs. How Anabolic Steroids Work. Anabolic steroids work differently from other drugs of abuse; they do not have the same short-term effects on the brain. The most important difference is that steroids do not directly activate the reward system to cause a ‘high’; they also do not trigger rapid increases in the brain chemical dopamine, which reinforces most other types of drug taking behavior. Misuse of anabolic steroids might lead to negative mental effects, such as: paranoid (extreme, unreasonable) jealousy, extreme irritability and aggression (‘roid rage’), delusions ‘false beliefs or ideas, impaired judgment, and mania. Aside from mental effects, steroid use commonly causes severe acne. It also causes the body to swell, especially in the hands and feet. Anabolic steroid misuse might lead to serious, even permanent, health problems such as kidney problems or failure, liver damage and tumors, enlarged heart, high blood pressure, and changes in blood cholesterol, all of which increase the risk of stroke and heart attack, even in young people, and increased risk of blood clots. 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