Abuse of performance-enhancing drugs is not limited to competitive athletes. Some people are driven by psychological motives (obsession, body shape dysphoria, need for self-esteem, etc).
Adverse effects that can be seen in an athlete abusing a performance-enhancing drug include:
(1) hyperthyroidism
(2) cardiomyopathy or heart failure
(3) acute drug-induced hepatitis
(4) unexplained cholestasis
(5) viral hepatitis (HBV, HBC)
(6) HIV
(7) gynecomastia in male or hirsutism in female
(8) unexplained venous thrombosis
(9) electrolyte abnormalities
(10) polycythemia
(11) psychiatric disorder (aggression, depression, mania, etc)
Mechanism for adverse effects:
(1) shared needles for drug injection
(2) direct toxic effects
