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As Lexico says, 'on steroids' is

Biochemistry
used to suggest a highly exaggerated, enhanced, or accelerated version of something.

However, steroids are just a kind of chemical substance. How can a chemical substance be related to the idea of exaggeration or enhancement?

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    Amphetamine and cocaine are 'just kinds of chemical substances' yet they lead to types of exaggerated behaviour, which have led to their metaphoric use. In fact a number of drugs are used to describe behaviour.
    – Michael Harvey
    Commented Aug 24, 2022 at 17:28
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    When Ben Johnson ran 100 m in 9.79 seconds, that was track and field on steroids ;-).
    – Peter - Reinstate Monica
    Commented Aug 26, 2022 at 12:49

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When something is referred to as "on X" where X is a chemical substance, it refers to the usual effects of X in people. Anabolic steroids can be used to enhance muscle mass and achieve an exaggeratedly muscular physique. Something that is "on steroids" follows the usual pattern of a person "on steroids", which is to become a bigger, exaggerated, enhanced version of the original. The construction is commonplace for different chemical substances - to describe something as "on acid" describes its surreal, "trippy" qualities, while describing it as "on speed" implies its energetic, frenetic nature.

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  • I know someone who is a body-builder, who enters (and wins) 'body beautiful' competitions. It has been an open secret among those who know him that he uses (or abuses) anabolic steroids and other substances. He seems to live on protein powder. Aged 41, he has had three heart attacks and one stroke in the last three years. I don't expect him to make 50.
    – Michael Harvey
    Commented Aug 24, 2022 at 19:36
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    @MichaelHarvey real beauty comes within.… Maybe these competitions should come a fit medical certificate and a robust echocardiogram test result.
    – Mari-Lou A
    Commented Aug 25, 2022 at 7:28
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    @MichaelHarvey At the risk of going off-topic, I want to clarify that protein powders and steroids are NOT the same things. The adverse effects your friend experienced probably stem from steroid usage and not protein powder. Disclaimer: I am not a doctor. Consult your physician before taking either of them.
    – starikcetin
    Commented Aug 26, 2022 at 14:52
  • I know they are not the same things. High use of protein powder, as opposed to eating a decent balanced diet is an unhealthy lifestyle choice, like abusing steroids is.
    – Michael Harvey
    Commented Aug 26, 2022 at 14:56
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    I've recently started hearing "on meth" to describe doing something dangerously stupid and crazy (even when actual methamphetamines are not involved). "On coke/cocaine/crack" seems to be about equivalent to "on speed". Not sure I've heard any other "on [drug]" phrase used in this manner, though it is frequently used in the more literal sense of actually being under the influence of said drug.
    – Darrel Hoffman
    Commented Aug 26, 2022 at 17:26
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This usage came about specifically because of anabolic steroids:

anabolic steroid
noun
: any of a group of usually synthetic hormones that are derivatives of testosterone, are used medically especially to promote tissue growth, and are sometimes abused by athletes to increase the size and strength of their muscles and improve endurance
definition from m-w.com

Before (anabolic) steroids were regulated and eventually banned by the various sports' governing bodies, some athletes would take them to achieve muscle-building results in weeks or months that they normally either could not reach at all or would have reached only after years of effort. Becoming unnaturally large, unnaturally fast became the signature effect of steroids.

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    There's been enough steroid scandals for us to know that (some) athletes didn't stop taking them after they were regulated :P
    – mbrig
    Commented Aug 25, 2022 at 3:56
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Anabolic steroids increase muscle growth. For an athlete, taking steroids makes them faster and stronger. Obviously this is cheating in competitive sports, and is why professiona athletes are so rigourously tested. So "on steroids" means "enhanced", essentially. Because that's what they were / are used for. There's still a big steroid scene around some gyms, where certain members will sell it if you know who to ask.

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