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Injectable Steroids on Steroids

Anabolic Steroid Anabolic steroids come in oil based formulations. All anabolic steroids have a basic cholesterol-like structure and thus do not dissolve in water. While there are some water based formulations, the majority of anabolic steroids sold in cyberspace come in oil formulations.

There are several benefits of having the formulation in oil. Once injected the active drug is slowly released over time and thus a constant level in the blood is maintained. Oil depots usually stay where they are injected and are less likely to disappear in the surrounding tissues. Intramuscular injections (IM) do not have to be performed everyday but 1-2 times a week or even longer.

When the drug has to be injected intramuscularly, this means you have to inject it into the muscles and not simply underneath the skin. The drug when injected in the muscle forms a depot. If the drug is simply injected underneath the skin, it will not only be painful but will form a large swelling and the results can be unpredictable. Further, subcutaneous injections of oily formulations can also lead to skin breakdown.

The most common sites of intramuscular injections are the buttocks, outside of the thigh or upper arm.

Buttock injections

Buttock IM injections are usually done by a colleague or a friend. If one looks at the buttock, the injections must be done on the upper and outer quadrant of the buttock. This is vital because anywhere else, and you risk injuring the major sciatic nerve. When the injection is done elsewhere, injury to the sciatic nerve can occur and remains painful for a long time. For the intramuscular injection, one should either lie down on the stomach or stand up with the body leaning forward. The buttock area should be cleansed with an alcohol wipe and in one swift motion the needle is inserted at a 90 degree angle. Never inject immediately after you have penetrated into the muscle. Always aspirate slightly on the plunger. The reason for this is to prevent accidental injection into a blood vessel. If upon aspiration you get blood in the syringe, remove the needle and go more laterally and superior (outside and upwards). One the injection is done, pull the needle and gently massage the area with the fingers. A few seconds of pressure is all that is required.

After each injection, the needle and the syringe should be disposed in a biohazard container.

Figure showing injection into the buttock muscle

Hip - Steroid Injection Site In the below figure, one can see the area of injection. If the needle is aimed lower or more inside the buttocks, you risk injury to the sciatic nerve.

Deltoid injections

Some people prefer to inject the drug in the upper arm. On the lateral aspect of the arm, one can inject into the deltoid muscle. Unlike the buttocks, the volume of drug injected is quite small, in most cases it is less than 1 ml. The injection can be done by first feeling for the shoulder bone on the side of the arm. Then one can grab the muscle and directly aim the injection into the muscle. Once the needle is inserted, always aspirate slightly to ensure that the needle is not inside a blood vessel. After injection, pull the needle out and gently massage the area for a few seconds.

For large volumes the deltoid is not a great place to inject. Further repeated injections into the arm can cause pain.

Figure showing area of injection into the upper arm.

Detroid - Steroid Injection Site

Outside of thigh

Outside the thigh is another area where one can inject anabolic steroids. This can be done in the seating position. It is vital that the injection be made on the outside on the thigh. Identify the lateral muscle, clean the area and inject at right angle. Always aspirate first before injection. If there is no blood then one can safely inject. No IM injections should be done anywhere else on the leg or thigh. There are vital nerves and large blood vessels on the inside of the thigh.

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