What Is ’Roid Energy — And Does Trump Have It?

Hey, does anyone think this Donald Trump guy’s acting a bit weird lately? What a kook, huh?

The president’s current line is that contracting coronavirus was “a blessing from God,” because it led to him (a non-doctor) essentially prescribing himself a drugs treatment, then deciding based on how fantastic he felt that it should now be rolled out for all Americans, for free, paid for by China due to everything being their fault. And he’s walking around unmasked, breathing on people, telling everyone he feels amazing and the disease that has killed 210,000 Americans is bullshit. “Normal” is a really relative term in this day and age, and all the more so where this particular chap is involved. But it’s at least a bit weird. 

We know the dude’s on steroids, though, so is this a side-effect? Or is he just continuing an unbroken run of acting like a turd? The thing is, he’s a pretty difficult guy to spot erratic behavior in. Erratic behavior is kind of his stock in trade: It’s like looking for a shithead needle in a haystack made of asshole. How do you identify unusual behavior in an unhinged yahoo? It’s tricky! But let’s try!

Is Trump behaving particularly oddly, really?

No more than normal. He’s ticking all his usual boxes — giving himself credit for something other people did; disregarding basic safety advice; blaming other countries for everything; and throwing in words he thinks make him sound clever, like “logistics.” He’s refusing to take part in a proposed “virtual debate,” claiming it would be a waste of his time. He could fairly be described as acting like a bit of a dickhead, but, again, no more than usual.

What medication is Trump actually on?

Trump was given an experimental antibody treatment developed by pharmaceutical giant Regeneron. The 8-gram dose, referred to as an “antibody cocktail” or REGN-COV2, isn’t yet FDA approved, but there are promising signs — the results of a 275-person trial conducted in September suggests it significantly reduces viral levels and improves symptoms, working most effectively in patients whose bodies hadn’t yet begun developing antibodies on their own.

(Trump was able to be given an unapproved drug on the “compassionate use” basis — the same thing that lets experimental techniques be tried out on seriously ill children. This decision has been questioned, as it’s generally a last resort. Possible side effects of REGN-COV2 are as yet unknown. Harvard public health expert Jeremy Faust told AFP it suggested that either the doctors treating Trump didn’t understand the processes involved in using unapproved drugs or their judgements were overruled, saying, “People will see this and they’ll think that this is the treatment you should have, and if you don’t give it to other people who have coronavirus that we’re denying them special treatment. In reality that’s not the case. We shouldn’t be treating the president as a guinea pig.” Regeneron has asked the FDA for emergency approval.)

According to Trump’s physician, Sean Conley, he was also given dexamethasone.

Right. So what the fuck is that, then?

Dexamethasone is a commonly-prescribed steroid.

Whoa, whoa, whoa. Steroids? Surely getting buff is the least of his concerns right now. Nobody’s going, “You know what my real problem with that guy is? His physique.”

Different kind of steroids. There are, broadly, two types of steroids. They are both synthetic versions of the hormones produced by your adrenal glands, but the way they bind to hormone receptors is different. Anabolic steroids bind to the androgen receptors, while corticosteroids bind to glucocorticoid receptors. That’s not super important right now though.

Anabolic steroids are the ones used to increase muscle mass. Charlie Sheen took a bunch before filming Major League. Arnold Schwarzenegger was a fan in his younger days. Jose Canseco and Mark McGwire couldn’t get enough of them. A-Rod? A-Fan! While anabolic steroids are sometimes legitimately prescribed, like for hypogonadism or delayed-onset puberty, they’re much more commonly misused in the pursuit of swoleness.

Corticosteroids are prescribed medicines. They function as anti-inflammatories, making them very useful for treating inflammation-based conditions like asthma, eczema, sciatica and Crohn’s disease. Conditions caused by the body’s autoimmune system overreacting, like rheumatoid arthritis, lupus and multiple sclerosis, also benefit from corticosteroids as they reduce autoimmune activity.

Dexamethasone, along with fellow corticosteroid hydrocortisone, has been used effectively to treat people with severe or critical COVID-19 (using it to treat less-sick patients or those with better immune responses is dangerous, according to the WHO). They don’t “cure” patients of COVID, but make hyperactive immune responses — where the body pretty much ends up attacking itself in an overreaction to the virus’ presence — less likely. Willfully slowing the immune system down obviously isn’t something you do casually, whatever anyone might claim:

That said, it’s quite commonly prescribed — a million or so times a year in the U.S. 

But steroids make you angry, right?

They can. Anabolic steroids are particularly associated with “’roid rage.” Anabolic steroid users frequently find themselves uncontrollably angry, often taking it out on those closest to them. It’s a catchy name but a life-destroying thing, often implicated in domestic abuse, murders and murder-suicides. Other psychological side effects can include paranoia, mania, hallucinations and delusions, while physical ones can include shrunken testicles, reduced sperm count, infertility, baldness, acne and stomach pain. Anabolic steroid use also places you at a higher risk of prostate cancer and can lead to heart attacks and blood clots. It’s bad stuff.

However, again, Trump isn’t on anabolic steroids. He’s not going to whip off his shirt, challenge Mike Pence to a fight then go and book a sick tribal. He’s on dexamethasone, a corticosteroid. These aren’t without their own side effects — 28 percent of people prescribed corticosteroids experience mild to moderate adverse psychiatric effects, according to the Mayo Clinic, and a 2013 paper in the Journal of Pharmacology and Pharmacotherapeutics lists “catatonia, decreased concentration, agitation, insomnia and abnormal behaviors” among the effects corticosteroids can have on the central nervous system. Dexamethasone has also been associated with confusion, disorientation, indigestion and “steroid euphoria.” 

Hold the phone. Steroid euphoria??

This is the name given to the sense of intense well-being that can come with treatment. A combination of alleviated symptoms, glee from having alleviated symptoms and simply feeling kinda high as shit, it’s a common side effect of treatment. However, according to the British Journal of Clinical Pharmacology, this feeling of well-being is “inappropriate” and doesn’t correlate with any actual improvement in health. In extreme circumstances, it can lead to actual psychosis. 

So when Trump tweeted that he hadn’t felt as good in 20 years…

He was probably high as an airplane’s balls, yes. He is, in all likelihood, headed for a bit of a comedown, a crash accompanied by depression and/or diarrhea. 2020 can’t have many more surprises in the bank, but the president shitting his pants and crying would be quite, quite something.

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Mike Rampton

Mike Rampton is a freelance writer who lives in London. He enjoys making aggressively difficult puns, drinking on trains and pretending to be smarter than he is. He would like to own a boat one day but accepts that he probably won't.