This article provides a brief overview of the history of the introduction of the performance enhancing drug, anabolic steroids, into American sport. Performance enhancing substances/drugs are discussed in terms of the method of use, the performance enhancing properties and effects of the substance, and the adverse effects of the substance. Particular attention is given to steroids, creatine, ephedrine, and androstenedione. Guidelines for coaches, athletic administrators and other related professionals are provided for the recognition, intervention, and prevention of steroid use, following those proposed by Johnson and Van de Loo (2002).
Keywords Androstenedione; Creatine; Dianabol; Drug Abuse; Ephedrine; Dietary Supplements; Performance Enhancing Drugs/Supplements; Pyramiding; Stacking; Steroids; Testosterone
The history of the use of performance enhancing drugs in sport as a means to improve athletic performance extends beyond a time frame that most would think possible. Athletes have been using performance enhancing substances for over 3000 years (Prokop, 1970), yet not until 1935 was testosterone isolated and determined to be a means to increase muscle tissue size (Berning, Adams, & Stamford, 2004). In 1954 Dr. John Ziegler, physician with the United States Weightlifting team, learned about the use of testosterone by Soviet athletes at the world championships. Dr. Ziegler returned to the United States and worked with a pharmaceutical company on the development of a synthetic testosterone which was released in 1958 (Goldman, Klutz, & Goldman, 1987). Athletes began trying the synthetic Dianabol without much information on the possible side effects of the substance (Berning, Adams, & Stamford, 2004), but as the increase in muscular strength of these athletes grew at exponential rates, more and more athletes began taking the drug privately. Dianabol usage was not illegal at this time, but athletes who were users kept their use private and the general public believed Dianabol usage to be limited; that these athletes had too much to lose and would not risk being caught (Berning, Adams, & Stamford, 2004).
The stripping of Ben Johnson's Olympic medal and world record at the Seoul Olympic Games in 1988 after he tested positive for anabolic steroids brought the use of steroids by elite level athletes into mainstream America (Berning, Adams, & Stamford, 2004). As a result, anti-doping measures were strengthened for the 2000 and subsequent Olympic Games. However, the subsequent revelations of ongoing performance enhancing drug use by athletes such as Olympic sprinter Marion Jones and Tour de France winner Lance Armstrong, who were never detected as drug users through ordinary sport-related testing, have created concerns that the use of performance enhancing drugs could be much more widespread than indicated by official test results (Dimeo & Taylor, 2013), and that official testing agencies may never be able to keep up with new means of artificially enhancing performance and ways to mask the use of banned drugs . This brief overview of the history of how performance enhancing drugs infiltrated International and American sport provides the necessary background to discuss and explore the prevalence, use, and types of substances that are currently used by adolescent athletes in the United States.
“It is easy for coaches and athletic administrators to say, ‘That does not happen here’ when it comes to a discussion on student athlete performance enhancing drug supplement use. The increased availability of these products on the Internet, by mail order, or from nutritional supplement retailers and illegal vendors, allows student athletes access to a wide variety of performance enhancing drugs and supplements that are highly marketed in fitness and strength training magazines with promises, endorsed by faulty research claims, of extraordinary weight loss, explosive power, or tremendous strength gains. Athletes consume these substances in addition to their normal diet because of the belief that these products will live up to the claims. Unfortunately, supplements are not regulated by the Food and Drug Administration (FDA) and, therefore, may include undisclosed ingredients have negative side effects, may be harmful when combined with other substances, or are impure and may be potentially unsafe or harmful to the consumer” (“Nutritional Supplements, ¶ 1).
Use of Performance Enhancing Drugs by Adolescents
The focus of this article is the adolescent use of performance enhancing drugs/substances. In a survey conducted by the Blue Cross Blue Shield Association's Healthy Competition Foundation, 1002 adults and 785 youths between the ages of 10-17 years were surveyed to assess the prevalence of performance enhancing substance use and knowledge about the potential harmful effects of these substances. The survey revealed that one in five American youths know someone who is using a performance enhancing drug and approximately 96% of American youth are aware that there are potential health hazards of using (Alcoholism & Drug Abuse Weekly, 2001). However, only 70% of the youth and 50% of the adults surveyed could specifically identify the potential effects of performance enhancing drug/substance use (Alcoholism & Drug Abuse Weekly, 2001). The Healthy Competition Foundation study also found that the top performance enhancing substances being used by youth were creatine followed by anabolic steroids (Alcoholism & Drug Abuse Weekly, 2001). Another study conducted by the Community Anti-Drug Coalitions of America (CADCA) in 2003 revealed that 1 in 30 student athletes was using a performance enhancing substance or steroids with 2.1 percent of 12th graders and 1.4 percent of 8th graders reporting steroid use in the previous year (Alcoholism & Drug Abuse Weekly, 2004).
A 2011 survey by Lorang and colleagues found that although the rate of use of anabolic steroids by high school students is low (1.4%), rates of use were high among males, recreational drug users, and those participating in school sports. In addition, many students believed that steroid use improved athletic performance (49%) and/or appearance (38%). Research conducted by Buckley and his colleagues (1988) indicated that of high school anabolic steroid users, approximately 65% were student athletes, suggesting the need to educate student athletes about the risks involved with steroid use and the need for future research to monitor changes in steroid use. Adolescent student athletes who have reported using steroids cite the desire to improve their athletic performance with the highest rates of use in football, wrestling, and track and field (Bahrke et al., 2000). Hodge, Hargreaves, Gerrard, and Lonsdale (2013) found that moral disengagement was a predictor of the use of performance-enhancing drugs among elite athletes.
Anabolic steroids are comprised of synthetic testosterone and mimic some aspects of the androgenic effects and most of the anabolic effects that natural testosterone has on the male body (Johnson & Van de Loo, 2002). The androgenic effects of testosterone are development of the sex characteristics including the development of the male reproductive tract and secondary sexual characteristics such as pubic and facial hair growth, increase in penis size, and development of prostate gland and scrotum (Johnson & Van de Loo, 2002). The anabolic effects of testosterone include increases in skeletal and muscular strength, growth of the long bones, thickening of vocal cords, increase in protein synthesis, decreased body fat, enlargement of the larynx, and development of the libido (Johnson & Van de Loo, 2002). The production and development of synthetic steroids has allowed manufacturers to minimize as many of the androgenic effects as possible to decrease these unwanted side effects (Johnson & Van de Loo, 2002). Steroid use aids individuals in improving their muscular strength and size; however there are some conditions that contribute to these improvements. Steroids may be taken orally or through injections, with injectable steroids being more slowly absorbed. Different types of synthetic steroids produce varying levels of androgenic effects (Johnson & Van de Loo, 2002).
Medicinal Uses of Steroids
Steroids may be used for several medicinal purposes including, for example, hormone replacement therapy, the stimulation of pubertal development, osteoporosis in women, to treat Turner syndrome, and late stage breast cancer (Johnson & Van de Loo, 2002). However, non-medicinal use focuses on the development of muscular strength in size. Muscular improvements occur when individuals
• "Intensely train in weight lifting immediately before using anabolic steroids and continue intensive weight lifting during the steroid regimen,
• Maintain a high-protein, high-calorie diet, and
• Measure their strength improvement using the same single repetition, maximal weight technique (i.e., bench press) they used in training" (Johnson & Van De Loo, 2002).
Steroid usage differs for endurance athletes seeking to slow the protein breakdown process during training versus athletes who seek power and explosiveness through increased strength (Johnson & Van de Loo, 2002). Steroids may also be taken using different patterns with the goal of decreasing the unwanted side effects and androgenic effects (Johnson & Van de Loo, 2002). These patterns include stacking, using more than one steroid at a time and pyramiding, starting steroid use at low doses and then increasing the dose gradually and then tapering off (Johnson & Van de Loo, 2002). While the improvements in muscular strength and size are the desired effects of steroid use, there are many unwanted and unhealthy physiological, cardiovascular, dermatologic, and psychological side effects of...
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