Structure and Functions (Magill’s Medical Guide, Sixth Edition)
Steroids are a group of organic compounds that are distinguished by a unique molecular arrangement of seventeen carbon atoms situated in four adjacent rings. This set of four rings is referred to as the steroid nucleus and is common to all steroid compounds. Three of these rings are hexagonal six-carbon rings arranged in a bent-line fashion to form what is called a phenanthrene group. The fourth group or ring contains only five carbon atoms. Steroids vary with the nature of the attached groups, the position of a given attached group, or some alteration to the configuration of the steroid nucleus. Small chemical differences in the structure of steroids can reflect very great differences in specific biological effects. Steroids are included in the lipid category of biological molecules because they are nonpolar and insoluble in water.
Any steroid that contains a hydroxyl group (-OH) is called a sterol. This term comes from a Greek word meaning “solid”; sterols were so named because they were among the earliest compounds that were found to be solid at room temperature. Once chemical structures were determined, then other compounds with similar structures were given the name steroid, which means “sterol-like.” The suffix “-oid” comes from the Greek and means “similar to.”
Chemists have isolated hundreds of different steroids from plants and animals; additionally, thousands have been made by...
(The entire section is 1158 words.)
Uses and Complications (Magill’s Medical Guide, Sixth Edition)
When cortisone was initially discovered, it was labeled a “wonder drug” and was thought to possess widespread effectiveness in many areas of medicine. Although these expectations have not been realized, a variety of steroids are found to be effective in medical practice and treatment. Steroids are commonly prescribed to serve as replacements for those persons whose bodies are unable to produce specific steroid hormones in adequate quantities. Steroids are effective as anti-inflammatory agents, reducing inflammatory reactions in a variety of body tissues. They are also prescribed for patients who have undergone an organ transplantation or have highly sensitive allergies because they inhibit the responsiveness of the immune system.
The primary therapeutic use of androgens is for testicular deficiency in which the induction and maintenance of male secondary sex characteristics are desired. In these cases, supplemental doses of androgens are given to stimulate and enhance the development of sexual and accessory sex characteristics. Androgens are effective also in the therapy of some anemias when persons have reduced levels of red blood cells. Androgens are used to treat osteoporosis, which is a decrease in bone or skeletal mass. Androgens are given to women in the treatment of breast cancer and are effective about 20 percent of the time. They are used to treat the abnormal growth of endometrial tissue in the peritoneal...
(The entire section is 1061 words.)
Perspective and Prospects (Magill’s Medical Guide, Sixth Edition)
The use of steroids as therapeutic agents began in the early 1930’s. At that time, Philip Showalter Hench, who was working in the Mayo Clinic, noticed that the symptoms of arthritic women were alleviated when they became pregnant. He suggested that increased secretions from the adrenal cortex might be the responsible agents. Later, clinical trials were conducted to test the role of corticosteroids in treating acute arthritis. With the use of adequate dosages, the clinical response was impressive. The 1950 Nobel Prize in Physiology or Medicine was awarded to Hench and his coworkers for their finding that cortisone was effective in treating arthritis.
Pharmaceutical firms have manufactured numerous steroid derivatives, all of which have different effectiveness levels as glucocorticoids, mineralocorticoids, or sex steroids. Organic chemists synthesize analogues of adrenal steroids in order to create compounds that produce heightened biological effects with a minimum or lack of side effects. As a consequence, hundreds of different steroids are available. Most of these are characterized according to their biological effectiveness, such as their ability to reduce inflammation or to inhibit the immune system. When determining a course of treatment, a physician chooses a particular steroid that enhances the effects that are desired and has minimal effects in related areas. Some pharmaceutical derivatives of adrenal...
(The entire section is 628 words.)
For Further Information: (Magill’s Medical Guide, Sixth Edition)
Craig, Charles R., and Robert E. Stitzel, eds. Modern Pharmacology with Clinical Applications. 6th ed. Philadelphia: Lippincott, 2004. This college-level pharmacology text contains easy-to-comprehend sections on steroids, including their chemistry, synthesis, physiological activity, and pharmacological activity.
Guyton, Arthur C., and John E. Hall. Human Physiology and Mechanisms of Disease. 6th ed. Philadelphia: W. B. Saunders, 1997. Guyton is a nationally recognized authority on medical physiology, having written and edited numerous college-level and medical school textbooks on the subject. His writing style is flowing and understandable to the nonmedical specialist and student.
Henry, Helen L., and Anthony W. Norman, eds. Encyclopedia of Hormones. 3 vols. San Diego, Calif.: Academic Press, 2003. A comprehensive overview of the role of hormones, the major physiological systems in which they operate, and the biological consequences of an excess or deficiency of a particular hormone.
Kronenberg, Henry M., et al., eds. Williams Textbook of Endocrinology. 11th ed. Philadelphia: Saunders/Elsevier, 2008. Comprehensive information regarding endocrine diseases, pathophysiology, diagnoses, treatment, and prognoses.
Montgomery, Rex, et al. Biochemistry: A Case-Oriented Approach. 6th ed. St. Louis, Mo.: Mosby Year Book, 1996. Surveys the field of biochemistry,...
(The entire section is 307 words.)
Steroids (Encyclopedia of Drugs and Addictive Substances)
- What Is It Made Of?
- Steroid Chronology
- Are There Any Medical Reasons for Taking This Substance?
- Effects on the Body
- Treatment for Habitual Users
- The Law
What Kind of Drug Is It?
Steroids are drugs that mimic the actions of testosterone (tess-TOS-tuhr-own), a found in greater quantities in males than in females. Testosterone is responsible for male traits and the male sex drive. Steroids are syntheticMade in a laboratory. versions of the testosterone that is produced by the body. Steroids help build muscle mass and strength.
Steroids are referred to medically as anabolic-androgenic steroids. The term anabolic describes the characteristics of the drugs that build muscle. The term androgenic refers to the way the substances heighten masculine traits. Most doctors use the acronym "AAS" to describe these steroids. This abbreviation helps avoid confusion with a different class of steroids, the corticosteroids. These other steroids are used widely to treat a variety of medical conditions, including internal swelling and inflammation; asthma (AZ-muh), a lung and breathing disorder; bronchitis, an illness that affects the bronchial tubes in the lungs; and allergic reactions. Unless otherwise noted, use of the term "steroids" in this entry refers to anabolic-androgenic steroids.
Anabolic-Androgenic Steroids (AAS)
Such steroids have some limited medical use. More commonly, though, they are abused in high doses to increase lean muscle mass and strength. Chemists have created more than 100 varieties of anabolic-androgenic steroids that are available legally by prescription only. New designer steroids, which are just slightly altered versions of existing prescription steroids, hit the regularly. Designer steroids are made in a laboratory and designed to pass through urine tests undetected.
In 1991, health concerns brewed over the abuse of steroids. As a result, steroids were placed on the list of Schedule III drugs under the U.S. Controlled Substances Act. Since then it has been illegal to possess or sell prescription steroids in the United States. While some illegal drug makers work hard to create synthetic male hormone drugs that will not be detected in drug tests, medical researchers are busy devising more accurate tests to spot these "designer" substances.
It is true that high doses of anabolic-androgenic steroids increase muscle size and endurance in both men and women. But this does not come without dangerous costs to the health of the user. "Research has shown that the inappropriate use of anabolic steroids can have catastrophic medical, psychiatric and behavioral consequences," wrote Dr. Nora D. Volkow, director of the National Institute on Drug Abuse (NIDA), in "Consequences of the Abuse of Anabolic Steroids." Volkow added: "We are now facing a very damaging message that is becoming [widespread] in our societyhat bigger is better, and being the best is more important than how you get there."
In fact, use of high doses of anabolic-androgenic steroids by men and women has been linked to heart problems, negative sexual side effects, aggressive behavior, depression, and suicide. The way steroids are misused to build muscle leads to chemical imbalances in the body that can affect the mind and the body's . "Steroids are toxic [harmful and poisonous] substances that have to be cleaned from your body by your liver and kidneys," noted Terry Goodland in Flex magazine. Goodland added, "without regular testing by a doctor, you will have no idea how your body is dealing with the drugs until it's too late."
Research on Testosterone
The history of experimentation with testosterone, the main hormone associated with male characteristics, began in 1889. That year, French-born scientist Charles Edouard Brown-Sequard (1817894) reported that he had injected himself with a compound taken from the testicles of dogs. He said the compound made him feel stronger and more energetic. In fact, he recommended it highly as a "fountain of youth."
In the early twentieth century, scientists experimented with natural testosterone. They thought it might decrease symptoms of age-related illnesses and syndromes such as senility (suh-NILL-ihtee), a condition associated with old age that decreases a person's ability to think clearly and make decisions.
Testosterone was first isolated in a European laboratory in 1935, and synthetic versions of the hormone quickly followed. These were the first anabolic-androgenic steroids. Doctors began using the synthetic steroids to treat men who suffered from hypogonadism (high-poh-GO-nad-izm), which is the inability of the body to produce enough natural testosterone. Steroids have been prescribed by doctors for this purpose ever since.
At the end of World War II (1939945), when Allied troops liberated prisoners from the Nazi concentration camps, many of the survivors were at the brink of death from starvation. Doctors gave some of these former prisoners anabolic-androgenic steroids to help restore their muscle mass and gain their weight back quickly. Soon after, bodybuilders and athletes began taking steroids to further develop their already-fit bodies. Historians believe that the abuse of synthetic steroids began in the weight lifting and bodybuilding communities in the late 1940s and spread to some Olympic sports by the 1950s.
Effective drug tests for anabolic-androgenic steroids did not exist before the early 1970s. Steroid use was widespread during that time in Olympic sports, particularly among Eastern European
competitors. Both female and male athletes from various countries in Europe broke recordsnd roused suspicionsith their heavily muscled frames. When questioned later about their training methods, many of these young athletes said they just took the "vitamins" their trainers offered and never asked what might be in them. (Barry Bonds , the 2004 National League Most Valuable Player and record-holder for single-season home runs as of 2005, would later make the same claim when accused of abusing steroids in 2005.)
In 1975 the International Olympic Committee banned use of all anabolic-androgenic steroids and began a testing policy to keep steroid users out of the Olympics. The tests were only effective when they were done randomly. If athletes knew the test date ahead of time, they could cease steroid use beforehand. This would give them enough time to clean their systems of the drug and avoid detection. Scandal erupted at the 1988 Summer Olympic Games in Seoul, South Korea, when Canadian sprinter Ben Johnson (1961) tested positive for banned substances after winning a gold medal in the 100eter dash. Johnson had to forfeit his medal to the runner-up, American Carl Lewis (1961).
Abuse Floods Other Sports
When Johnson lost his medal, the situation helped call attention to the rampant use of steroids in almost every high-level competitive sport. According to retired professional football player Steve Courson (1955), author of False Glory: Steelers and Steroidshe Steve Courson Story, many football players of the 1980s bulked up with steroids. In fact, Courson barely survived a damaged heart after taking steroids during his playing career with the Pittsburgh Steelers.
Since then the National Football League (NFL) has set down a strict set of guidelines regarding the use of steroids and other banned substances. The league's official "Steroid Policy," posted on the NFL Players Association Web site, notes that the league specifically "prohibits the use by NFL players of anabolic/androgenic steroids." The policy further states that such "substances have no legitimate place in professional football" and that "steroids and related substances threaten to distort the results of games and League standings." Furthermore, "the League is concerned with the adverse health effects of steroid use," along with "the wrong message [that a player's use of prohibited substances sends] to young people who may be tempted to use them."
Professional wrestling was popular in the 1980s as well. Many of the stars of that sport were involved in steroid abuse, too. Anabolicandrogenic steroids were also the drugs of choice for weight lifters and bodybuilders.
Women and Steroids
Young women began using steroids not only to improve their athletic ability but also to slim down and reduce body fat quickly. According to an article titled "Girls Are Abusing Steroids Too, Experts Say," published on MSNBC.com in 2005, the rate of steroid use among teenage girls has been rising since 1991. The article notes that "overall, up to about 5 percent of high school girls and 7 percent of middle school girls admit trying anabolic steroids at least once."
Steroids are also sometimes used by women in the aftermath of traumatic, dangerous, or life-threatening attacks, such as rape or assault. The psychology behind this type of use involves the woman's desire to appear stronger, less vulnerable, and consequently less likely to be the target of a future attack.
Steroids Join List of Controlled Substances
Concerns about the long-term health issues surrounding steroids led the U.S. government in 1991 to place all prescription steroids on the Schedule III list of controlled substances. However, this did not end steroid abuse. A $500-million-year black market developed, with dealers offering "juice" or "gear" of unknown strength and purity to people of all ages. American dealers typically smuggle steroids across the border to the United States from Mexico.
Illegal underground laboratories began creating compounds such as tetrahydrogestrinone (THG) that could not be detected in urine. Interest in herbal dietary supplementsProducts including vitamins, herbal extractions, and synthetic amino acids sold for specific uses such as weight loss, muscle building, or prevention of disease., such as ephedra, creatine, and androstenedione ("andro"), skyrocketed as young athletes sought legal ways to bulk up. (Entries on creatine and ephedra are available in this encyclopedia.) Coaches and trainers contributed to the problem by urging young athletes to bulk up. However, they failed to monitor the safety of the methods used to attain that goal.
Baseball, Hot Dogs, Apple Pie, and Steroids
The twenty-first century has seen the level of anabolicandrogenic steroid abuse decrease. In September of 2003, investigators from the U.S. Drug Enforcement Administration (DEA) raided the Bay Area Laboratory Cooperative (BALCO) in San Francisco, California, and discovered that the lab had been creating steroids that could go undetected in drug tests. The agents also uncovered the names of professional athletes in several sports who had received products from BALCO through personal trainers or other suppliers.
This raid followed two highly publicized suicide deaths of aspiring baseball players: Rob Garibaldi in California, who shot himself in the fall of 2002, and Taylor Hooten in Texas, who hanged himself in the summer of 2003. Both men had abused steroids thinking that the drugs would help them make it to the major leagues. The U.S. Food and Drug Administration (FDA) declared THG illegal in 2003 and also, in early 2005, placed "andro" on the Schedule III list of controlled substances.
Steroid use made the headlines again in March of 2005, when several Major League Baseball players, executives, and the commissioner testified before Congress. One of those who testified, Jose Canseco (1964), wrote a book earlier that year called Juiced: Wild Times, Rampant 'Roids, Smash Hits, and How Baseball Got Big. In it, he states that he used steroid swhile he was with the Oak land Athletics. Canseco named other players whom he alleged used steroids too, including Mark "Big Mac" McGwire (1963. McGwire broke the single-season home run record in 1998 while with the St. Louis Cardinals. Making his own appearance before the Congressional Committee, McGwire refused to answer questions about his alleged past use of performance-enhancing products.
In the wake of the hearings, Major League Baseball's steroid policy was criticized by many as not being strict enough. Many fans, lawmakers, and sports commentators didn't believe that the fines were set high enough or the suspensions set long enough. Some even suggested that players be banned from the sport if they violated the policy more than once. The notion that "three strikes and you're out" was expressed by many who want steroids out of baseball.
Bad News for Palmeiro
In August of 2005, steroids in baseball again made the headlines when Baltimore Orioles star Rafael Palmeiro (1964) was suspended for 10 days for "violating baseball's anti-drug policy," according to Jorge Arangure Jr. of the Washington Post. Palmeiro was one of the players who had testified before Congress just a few months earlier and had strongly denied ever having used steroids. When news of his positive drug test broke, Palmeiro again denied taking steroids. As reported on ESPN.com, Palmeiro explained: "Today I am telling the truth again that I did not do this intentionally or knowingly." He added: "Why would I do this in a year when I went in front of Congress and I testified.Why would I do this during a season where I was going to get to 3,000 hits? It just makes no sense."
Opinion has begun to turn against steroid users, an attitude that is reflected in the 2004 Monitoring the Future (MTF) survey. The MTF report is an annual survey of drug use among young people in the United States. The MTF survey is conducted by the University of Michigan with funding from NIDA. The 2004 MTF study noted a general decrease in steroid use among eighth and tenth graders. According to the survey, these younger teens expressed more concern about the health issues surrounding steroids than their peers of the 1980s and 1990s.
Steroid use among seniors in high school, however, "remained stable at peak levels," according to the MTF. Researchers suggest that steroid use may be even higher among high school students than the survey shows, since some young athletes would never report their steroid useven on an anonymous survey.
What Is It Made Of?
Testosterone is a naturally occurring hormone in both men and women, but men produce more of it than women. At pubertyhe stage of growth in which a person becomes capable of sexual reproductionhe hormone is responsible for changing a boy into a man. It causes deepening of the voice, growth of facial hair, and the maturity of the reproductive organs. It also plays an important role in the growth and development of muscles. When men are finished growing, they typically produce between 35 and 50 milligrams of natural testosterone each week throughout life. The hormone is created in the testes, the male reproductive glands.
Women also produce natural testosterone but at far lower levels than men. Female maturity is influenced chiefly by estrogen, a hormone that regulates the female reproductive system.
Synthetic anabolic-androgenic steroids are very similar to natural testosterone, except for a slightly altered carbon structure. Pill forms of steroids contain an extra chain of carbon and hydrogen atoms called an alkyl group. These can be dangerous to the liver and to levels when taken at high doses. Injectable steroids contain an acidic chain of carbon and hydrogen called an ester that is slightly less toxic to the liver.
Creatine and DHEA are considered dietary supplements. As of 2005, they have not been regulated as drugs by the FDA. Creatine provides fuel to muscles during periods of high exertion. DHEA is sold as an anti-aging supplement. But because DHEA turns into androstenedione in the body, it is used as a steroid. Users of either of these supplements run health risks when they exceed the doses recommended on the labels.
How Is It Taken?
With steroids, the issue is not only how they are taken, but how much of the substance is needed to produce results. A healthy man will produce 35 to 50 milligrams of natural testosterone each week. Most steroid programs involve 300 to more than 1,000 milligrams per week in pills, creams, or injectable forms.
Steroid users have several strategies for taking the substances. Medical professionals consider all of them extremely dangerous to immediate and long-term health.
- Cycling involves taking high doses of steroids for several weeks to several months, then discontinuing use of the steroids for as many weeks or months.
- Stacking involves using two or more different steroids or combining oral and injectable steroids in the belief that the drugs will interact to produce better results.
- Pyramiding involves beginning a cycle with a lower dose of steroids, gradually increasing the dose over time to a peak level, then gradually decreasing the dose down to zero again.
Those who use injectable steroids usually administer shots into their large muscles in the buttocks. Sometimes people who inject steroids share needles or inject one another without sterilizing the needles or the injection sites. This can cause infectious diseases such as HIV (the human immunodeficiency virus), which leads to AIDS (acquired immunodeficiency syndrome), and hepatitis, which is a liver disease.
Are There Any Medical Reasons for Taking This Substance?
Anabolic-androgenic steroids are legally prescribed for men who have lower than normal levels of testosterone. They may also be used to treat patients who have developed muscle-wasting syndromes associated with cancer and AIDS. Very rarely they are used to help restore tissue in burn victims. Female patients sometimes receive these kinds of steroids for problems associated with and other issues related to the female reproductive system. In all of these cases, the dosage prescribed by physicians is far lower than the levels of steroids typically seen among illegal users.
From 2002 to 2004, the number of teenagers reporting steroid use in the MTF survey declined overall, but the statistics can be misleading. Eighth- and tenth-grade respondents reported being more concerned about the health risks surrounding steroid use than older students. Use among twelfth-graders remained steady. A breakdown of the survey results showed a dramatic decrease in use among male seniors, from about 6 percent in 2002 to 4.4 percent in 2004. At the same time, however, the reported use of steroids by female seniors was nearly six times higher in 2004 than it was in 1991. This spike in usage among twelfth-grade girls made up for the drop in usage among twelfth-grade boys.
However, evidence shows that female users are not necessarily athletes. According to the 2005 MSNBC.com article "Girls Are Abusing Steroids Too, Experts Say," the Oregon Health and Science University found that about two out of every three high school girls in the state who said they had used steroids weren't looking for an athletic advantage. Instead, they just wanted to get thin. Members of the medical and health community are continuing their efforts to identify steroid abuse and to educate those who are at high risk for potential abuse.
It's Not about Getting High
is the scientific name for a disease that affects some teenagers and adults. The condition resembles anorexia nervosa (ah-nuh-REK-see-uh ner-VOE-sah), a severe eating disorder characterized by an intense fear of gaining weight. People who have muscle dysmorphia are never satisfied with how muscular they appear. No matter how hard they train, they never feel "big enough." These individuals run a higher risk for steroid abuse because steroids build muscle rapidly.
Steroid abusers are very different from those who abuse other illegal drugs. For instance, heroin, cocaine, and marijuana users take the substances for an immediate "high," or rush of pleasurable feelings. (Entries for these three drugs are included in this encyclopedia.) Steroid users do not experience a high after taking pills or injecting the drug. They have different goals and may not notice the behavioral changes and compulsive behavior brought on by the drugs until their health is affected. In the meantime, they may spend many hundreds or thousands of dollars on illegal substances that have not been tested for strength or purity or safety.
Effects on the Body
Anabolic-androgenic steroids increase strength and lean muscle mass. However, flooding the body with any hormone at ten to twenty times greater strength than normal is dangerous. Anabolic-androgenic
steroids produce a long list of potential side effects. Some of these effects can be deadly. Others are just plain unpleasant.
Steroids Do More Than Just Build Muscles
Side effects for men abusing anabolic steroids include:
- acne and oily hair
- gynecomastia (GY-nuh-koh-MASS-tee-uh), the formation of female-type breasts on a male body, which is a permanent condition that can only be reversed with surgery
- testicular atrophy (tess-TIK-yoo-lar AH-truh-fee), the shrinking of the male testicles, which sometimes results from overdoses of testosterone or anabolic-androgenic steroids; this condition may not be reversible
- low sperm count
- disruption of the natural "growth spurt" in young users, which leads to abnormal shortness throughout life
- male-pattern baldness
- insomnia, which is difficulty falling asleep or an inability to sleep
- ruptured tendons
- increased chance of heart attack
- increased chance of liver cancer or bleeding in the liver, especially with pill forms of steroids
- bursts of aggressive behavior (called "roid rage")
- mania (a mental disorder characterized by intense anxiety, aggression, and delusions), loss of touch with reality, and delusions or false beliefs. (Note: anabolic-androgenic steroids are classified as hallucinogens, which are substances that bring on hallucinations that alter the user's perception of reality.)
- boils or infections at injection sites, as well as infections elsewhere from dirty needles
- human immunodeficiency virus (HIV) or hepatitis infections from sharing needles
- depression, sometimes leading to suicide, when steroid use is stopped
- loss of enthusiasm and sex drive when steroid use is stopped.
Side effects for women abusing steroids include:
- growth of coarse hair on the face and body
- enlargement of the clitoris (a part of the female genitals)
- deepening of voice
- male-pattern baldness
- mood swings and aggression
- loss of menstrual period (also referred to as a "menstrual cycle")
- infertility or the inability to have children.
Bulk v. Height
One of the most devastating side effects of steroid abuse occurs in the youngest users. If teens begin using steroids before they have stopped growing, the flood of hormones will alter the normal growth process. Under normal circumstances, height increases as the soft ends of the bones grow longer. However, high levels of testosterone shut down the production of new bone. The body is fooled into thinking that the user has already reached maturity. As a result, growth stops prematurely.
Reactions with Other Drugs or Substances
Any combination of anabolic-androgenic steroids and other mind-altering substances increases the risk of mental side effects and dangerously aggressive behavior. When users end a cycle of steroid use, they often find themselves sinking into depression. They may seek help from a doctor for depression without admitting to steroid use. Antidepressant medications should not be mixed with steroids. Doctors can only provide effective treatment when they have a complete medical history, including knowledge of any illegal substancesr even any dietary supplementshat the patient is taking or may have taken.
Users sometimes take other drugs to counteract some of the side effects associated with steroid use. may be used to rid the body of excess water. Human growth hormone may be taken to compensate for the effects steroids have on height. Estrogen blockers may be used to reduce breast enlargement in men. The practice of adding more and more drugs to the system can increase the risk of adverse reactions, or negative side effects, in the user.
Covering Up Steroid Use
Diuretics also have another impact on steroid usene that some athletes use to their advantage. Some sports figures use diuretics to "mask" the use of steroids. They use diuretics to speed the elimination of banned performance-enhancing substances from their bodies in an effort to increase their chances of passing mandatory drug tests. Various sporting organizations have added diuretics and other masking agents to their list of banned substances. Athletes testing positive for banned diuretics will also be suspended or disqualified from competition just like those using steroids.
Treatment for Habitual Users
Even though steroids are not classified as addictive substances, steroid users do exhibit patterns of habitual behavior. Help for steroid abusersnd education for those considering trying steroidss available through several national programs in the United States. The National Center for Drug Free Sport offers online and telephone support, newsletters, and other resources. (The Drug Free Sport Web site is located at http://www.drugfreesport.com.)
In addition, the U.S. Substance Abuse and Mental Health Services Administration (SAMHSA) has pioneered two model programs: ATLAS (Athletes Training and Learning to Avoid Steroids) for boys and ATHENA (Athletes Targeting Healthy Exercise and Nutritional Alternatives) for girls. (SAMHSA's Web site is located at http://www.oas.samhsa.gov.) These programs are designed for school coaches and health teachers to use with sports teams. Even some bodybuilding magazines, including Flex, take pride in spotlighting drug-free athletes and their successful training regimens.
Some people who use steroids for a short period of time stop on their own without help. Many more will need counseling, prescription medications, and serious lifestyle alterations to stay clear of steroid use.
Severe depression and an increased chance of suicide have been linked to steroid abuse. Other consequences may take years to develop. Steve Courson, the former Pittsburgh Steeler player who admitted to steroid use, almost lost his life to heart disease brought on by his drug abuse. He has since recovered, and he dedicates a great deal of his time to lecturing about the dangers of steroid use. Even short-term use of steroids can damage the heart, liver, kidneys, and sexual function in otherwise healthy people.
Athletes who use performance-enhancing drugs are often seen as cheaters because they have used chemicals to achieve their goals. "Real men work for what they earn," wrote Terry Goodland in Flex. "They don't look for quick fixes or magic bullets. Lasting results don't come overnight. You need patience to grow, despite what some people would like you to think. Your progress will be unpredictable and temporary as long as you lean on the crutch of drug abuse."
On March 17, 2005, former Oakland Athletics and St. Louis Cardinals star Mark McGwire testified before Congress about the
use of performance-enhancing drugs in Major League Baseball. McGwire's seventy home runs in 1998 set a new single-season record in the sport (since broken by Barry Bonds). Although he had always previously denied steroid use, he refused to "talk about the past" when asked under oath if he had used steroids. McGwire told Congress, as reported in the Philadelphia Daily News, "I cannot answer these questions without jeopardizing my family, my friends, and myself."
The press reacted sharply, challenging McGwire's records and suggesting that he should not be eligible for the Baseball Hall of Fame. On the day of the testimony, according to Howard Bryant in the Boston Herald, "the entire nation witnessed the end of Mark McGwire as an American icon."
It is against the law to possess a Schedule III controlled substance without a valid prescription. It is also against the law to sell Schedule III controlled substances or their . Penalties vary from state to state but can include high fines, probation, mandatory rehabilitation, a criminal record, andspecially with second and third offensesail time.
Chemists try to get around the law by creating steroids that cannot be detected in drug tests, or substances that can be called "dietary supplements." One anonymous "doctor" boasted to Sports Illustrated in2005:"Aguy on my stuff coul dwalk into the test with a needle in his [buttocks] and not worry." The same source said he knew of ten substances that could not be detected by urine tests.
The illegal creation of synthetic drugs that are not covered by law creates another challengehat of detecting and revealing the substances and prosecuting their creators. The bust at the Bay Area Laboratory Cooperative in 2003 led to the scheduling of THG, a substance once thought to be undetectable by tests.
As of 2005, creatine and DHEA were still legal over-the-counter dietary supplements. However, the FDA was studying the effects of DHEA overdose and considering adding it to the list of controlled substances.
For More Information
Canseco, Jose. Juiced: Wild Times, Rampant 'Roids, Smash Hits, and How Baseball Got Big. New York: Regan Books, 2005.
Carson, Judy. The Adonis Complex: The Secret Crisis of Male Body Obsession. New York: The Free Press, 2000.
Clayman, Charles B., ed. The American Medical Association Encyclopedia of Medicine. New York: Random House, 1989.
Courson, Steve. False Glory: Steelers and Steroidshe Steve Courson Story. Stamford, CT: Longmeadow Press, 1991.
Hoberman, John. Testosterone Dreams: Rejuvenation, Aphrodisia, Doping. Los Angeles: University of California Press, 2005.
Kuhn, Cynthia, Scott Swartzwelder, and Wilkie Wilson. Buzzed: The Straight Facts about the Most Used and Abused Drugs from Alcohol to Ecstasy, 2nd ed. New York: W.W. Norton, 2003.
Nelson, Rebecca, and Marie J. MacNee, eds. The Olympic Factbook: A Spectator's Guide to the Summer Games. Detroit, MI: Visible Ink Press, 1996.
Adams, Jacqueline. "The Incredible Bulk: Major League Baseball Struggles to Beat Performance-Enhancing Drugs." Science World (March 28, 2005): p. 18.
Adler, Jerry. "Toxic Strength." Newsweek (December 20, 2004): p. 44.
"Anabolic Steroid Control Act Passed." Nutraceuticals World (November, 2004): p. 8.
Bryant, Howard. "Ex-Slugger Whiffs with His Silence." Boston Herald (March 18, 2005): p. 4.
Burch, Nina. "Taylor Hooten's Parents Campaign to End Steroid Abuse." Plano Star Courier (March 6, 2004).
Carroll, Will. "The Creator." Sports Illustrated (April 25, 2005): p. 18.
Clark, Nancy. "Mirror, Mirror on the Wall Are Muscular Men the Best of All? The Hidden Turmoil of Muscle Dysmorphia." American Fitness (January-February, 2004): p. 52.
Donnellon, Sam. "Swearing Thin." Philadelphia Daily News (March 18, 2005).
Evans, Nick A. "Anabolic Steroids: Answers to the Bigger Questions." Journal of Musculoskeletal Medicine (March, 2004): p. 166.
Fainaru-Wada, Mark. "Dreams, Steroids, Death Ballplayer's Downfall." San Francisco Chronicle (December 19, 2004): p. A1.
Goodland, Terry. "Dancing with the Dark Side: So, You Think You're Ready for Your First Steroid Cycle?" Flex (April, 2004): p. 190.
Jarvi, Jeffrey F. "Stay Alert for Performance-Enhancing Substance Use." JAAPA: Journal of the American Academy of Physician Assistants (December, 2004): p. 36.
Kluger, Jeffrey. "The Steroid Detective." Time (March 1, 2004): p. 60.
McGrath, Ben. "Dr. Juice." New Yorker (March 7, 2005): p. 28.
Mirkin, Gabe. "Anabolic Steroids Come at Big Cost." Washington Times (February 27, 2005): p. C12.
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See also: Creatine; Ephedra