The media attention that steroids have received in recent months
is good news and bad news for Minnesota parents. The good news
is that the general public is much more aware of the dangers
steroids pose to our youth. The bad news is that the revelation
of steroid use in professional sports creates an implied
legitimacy in the eyes of many young athletes.
Think about it: your teenager looks at these professional
athletes and sees a celebrity, who seems to be in great physical
shape, is performing superbly at his or her sport, and is making
millions of dollars. Ironically, media stories about steroids
may paint an appealing picture of the drug for aspiring young
athletes—our sons and daughters.
Risks of abuse
Steroids are hormones that the body uses to cause physiological
activity, such as growth or metabolism. Performance-enhancing
steroids, sometimes referred to as anabolic or androgenic
steroids, are synthetic versions of the male hormone
testosterone. Synthetic derivatives of natural steroids have
many valid medical applications, such as treating asthma, skin
disorders, impotence, osteoporosis, breast cancer, and
inflammation. When taken under a doctor's supervision and in
prescribed doses, steroids are not typically harmful. However,
individuals using steroids for their performance- enhancing
qualities are taking doses 10 to 100 times higher than would
ever be prescribed.
It is through sustained use at these high doses that long-term
health consequences can occur. Some of the long-term health
risks are heart disease, high blood pressure, liver or kidney
tumors and even cancer, adverse psychiatric effects, and
infection (HIV or hepatitis) from sharing needles.
Putting it in perspective
Steroid use by high school students has been on the rise since
the early 1990s. The Youth Risk Behavior Surveillance, conducted
by the Centers for Disease Control and Prevention (CDC) in 2003,
found that 6.1 percent of high school students (grades 9–12)
nationwide had used steroids without a prescription one or more
times in their lifetime. With 17.1 million students enrolled in
high school, that is over 1 million kids in the U.S.
experimenting with steroids.
When we think of steroids and high school students, we probably
think of football players and wrestlers. What the CDC study
shows is that the highest groups for steroid use are Hispanic
males, at 7.8 percent, and ninth-grade females, at 7.3 percent.
Bodybuilding athletes may be the obvious users, but more
adolescents are turning to steroids as a means of dealing with
their own body image issues. Comparing steroid use with other
teenage risk behaviors, the CDC survey found that:
* Motor vehicle crashes remain the No. 1 cause of death among
adolescents.
* 74.9 percent of high school students had had at least one
alcoholic drink during their lifetime, and 28.3 percent showed
episodic heavy drinking.
* 58.4 percent of high school students had ever tried cigarette
smoking, and 3.1 percent smoked more than ten cigarettes a
day.
* 34.3 percent of high school students had had sexual
intercourse during the three months preceding the survey, and
4.2 percent had ever been pregnant or gotten someone
pregnant.
* 8.5 percent of high school students had attempted suicide at
least once in the 12 months preceding the survey, and 6.1
percent of high school students had carried a gun on at least
one of the 30 days preceding the survey.
Legal aspects
Much like the current visibility provided by the media
attention to steroids in baseball, the attention on steroids was
highlighted by the stripping of Ben Johnson's Olympic gold medal
during the 1988 Olympic Games. This was one contributing factor
to heightened interest by Congress and the subsequent passage of
the Anti- Drug Abuse Act of 1988, which categorized the sale or
possession of anabolic steroids as a felony. The publisher's
sale of this reprint does not constitute or imply any
endorsement or sponsorship of any project, service, company or
organization.
Following the BALCO (Bay Area Laboratory Co-operative)
investigation, which involved a controversial sports nutrition
center in Burlingame, Calif., that allegedly provided anabolic
steroids and other banned performance-enhancing drugs to
athletes, Congress once again turned its attention to steroids.
The Anabolic Steroid Control Act of 2004 increased the list of
banned substances and included steroid "precursors." Precursors
are not steroids outside of the body; however, they can be
metabolized into steroids once they are introduced into the
body.
Warning signs
So, how do you tell if your teenager is using steroids? While
there are a number of signs to watch for, parents sometimes
overlook the most obvious one: rapid muscle growth. It is not
uncommon for a user to gain 20 to 30 pounds of lean muscle mass
in one month's time while abusing steroids. Other visible signs
of steroid abuse are acne, which can become severe and show up
in unlikely areas such as the back or chest; jaundice; and hair
loss. In addition, females may experience deepening of the
voice, growth of facial and body hair, and reduction in breast
size, while breast growth (gynecomastia) occurs in males.
Changes in behavior also can be an indicator of steroid use.
Your child may exhibit a new-found fixation with working out and
with body image. Side affects include increased aggressiveness
and sexual desire from higher testosterone levels, as well as
euphoria, confusion, sleeping disorders, pathological anxiety,
paranoia, and hallucinations. Users who become dependent on the
drug may experience symptoms of withdrawal after cessation that
include aggressive and violent behavior, mental depression with
suicidal behavior, mood changes, and, in some cases, acute
psychosis.
Talk to your child
If you are not sure that your child is using steroids and you
just want to talk to him or her about the drug, remember to keep
it simple. Discussing the long-term health risks, such as cancer
and heart disease, will mean little to teenagers, who can't
imagine becoming older than 30. Teenagers live in the here and
now, so the aspects of steroid use that will get their attention
are the superficial effects. Even with a great physique, it's
tough to look attractive when you are a female growing facial
hair or have severe acne.
When talking to your child about steroids, be prepared to
discuss other matters that might cause a child to be tempted to
take the drug. Be ready to discuss the pressures your child may
be dealing with in competitive sports or in self-esteem and body
image issues. It is important to stress, in words and in your
own behavior, positive alternatives that encourage a healthy
lifestyle.
Intervention
Intervention can help to prevent abuse and to end abuse once it
has become a problem. There are two basic types of intervention:
active intervention, which deals with individuals who have a
substance abuse problem; and proactive intervention, which
prevents abuse.
The only science-based education programs that have been proven
to prevent steroid use are ATLAS (Athletes Training & Learning
to Avoid Steroids) and ATHENA (Athletes Targeting Healthy
Exercise & Nutrition Alternatives). ATLAS is targeted at
preventing steroid use by male high school athletes; ATHENA
deters body-shaping drug use and disordered eating among
adolescent females. Both programs use good nutritional behaviors
and proper exercise technique as alternatives to these risky
behaviors. ATLAS has been recognized by SAMHSA (Substance Abuse
and Mental Health Services Administration) as a "model program"
and by the U.S. Department of Education's Safe and Drug-Free
Schools as an "exemplary program." In addition, both ATLAS and
ATHENA are the only preferred programs mentioned in the Anabolic
Steroid Control Act of 2004. According to Oregon Health and
Science University's Linn Goldberg, M.D., principal investigator
of ATLAS, "Young developing bodies are likely more sensitive to
the adverse health effects of steroids, some of which can be
irreversible, such as the stunting of height in males and voice
and body-facial hair changes in females."
As parents, encourage your child's school to investigate these
programs. If your child is already using steroids, an active
intervention is designed to motivate an individual to accept
help. If unable to act upon an active intervention,
professionals are available to assist you.
The most important aspect of intervention is the recurring
theme, "We see you are struggling, we love you, we are concerned
for you, and help is available today." When parents discover
that their children are using steroids, they have two options:
do nothing or get involved. Denying or ignoring the problem of
steroids will not make it go away. When it comes to children and
steroids, the only real option is to get involved and stay
involved.
John "Chip" Dempsey is vice president of Addiction Intervention
Resources, a national addiction consulting practice
headquartered in St. Paul with offices located throughout the
country. Find out more at http://www.addiction
intervention.com/
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