In terms of their profile, steroids have always seemed to be a major-league problem, with superstar athletes accused of using growth enhancers to build up their muscles, stats and fat contracts. But often overlooked is a residual effect of such ill-gained success: increasing steroid use by teens and even grade-school kids to gain an extra edge in sports, or simply appearance.

"It's a very big and growing problem, and in terms of pervasiveness and health effects, it’s much more serious with young people than it is with pro athletes," says endocrinologist Carlos Hamilton, MD, and professor of internal medicine at The University of Texas Medical School at Houston.

Indeed, the Drug Enforcement Administration reports that “abuse of anabolic steroids among young Americans has reached dangerous levels, and it puts our kids at increased risk of heart disease, liver cancer, depression, stunted growth and eating disorders, not to mention increased episodes of hostility and aggression.”

Texas is becoming the first state to do something about it. By law, this year begins a two-year, $6 million effort to test up to 50,000 of the state's 750,000 high school athletes for steroids.

Such tests are costly – about $140 each – and can't be expected to catch many offenders, who are estimated to be a small minority. Yet lawmakers see the mere threat of such random testing as a valuable deterrent.

Hamilton isn't so sure.

"Actually, the largest demographic group of anabolic steroid abusers is young women, even more so than jocks," he says. "They see movie stars and models with well–defined muscles and try getting those in a way that's not natural. They take anabolic steroids."

These underscore the distinction between two types of metabolism. “Catabolic” is the breaking down of tissue, as when you lose weight. “Anabolic” means building up tissue, whether naturally or with help from drugs.

“Normally there's a balance between anabolic and catabolic functions in the body,” Hamilton says. “But certain hormones increase the anabolic effect.”

Hamilton doesn’t think any steroids are inherently bad, “ just badly used."

You might take steroids for a testosterone or pituitary gland deficiency due to another medical condition. You might take cortisone steroids to treat inflammation. You might need to build up tissue after a debilitating disease, “so, steroids can be used beneficially. But very few teens need them in a legitimate way,” says Hamilton who also is a member of the World Anti-Doping Agency, which oversees such events as the Tour d’ France and the Olympics Games.

Stronger, leaner
Sicker, meaner

“What’s so sad is the effect on muscle – the effect teens want – is very temporary,” Hamilton says. “You may build up muscles for several weeks, but when you stop using steroids you go back to where you were, or perhaps worse off. You don’t get away with anything by using them. You pay a price and don’t get any long-term benefits.”

In fact, steroids can actually halt growth in a young person.

One side effect, especially in boys, is that steroids will cause you to grow at a faster rate for a short period of time. You build muscle, grow taller but you end up shorter than nature intended, Hamilton says. “A kid who’s 13 and takes anabolic steroids may be the biggest guy in eighth grade but the shortest guy when he’s 18.”

Related anger known as “roid rage” also is common in boys “who have trouble controlling aggression anyway,” says Hamilton, who also sees patients at Memorial Hermann Hospital-Texas Medical Center. “They may get into very serious problems with aggressive activities.”

For girls, steroids are worse because they can alter or halt their menstrual cycle. “This can lead to serious problems, including infertility,” Hamilton says.

Binge drinking, another indulgence by teens, is a serious mix with steroid use. “That’s a very bad combination for your liver,“ Hamilton says. “And the damage to your liver can be permanent.”

For people of all ages, steroids can have harmful effects on the liver, kidneys, circulation and cholesterol. And being young doesn’t make them any less harmful.

Easy to come by

Hamilton traces teen steroid use to the ‘80s but says it’s much worse today. In part that’s because the synthetically manufactured drugs, based on testosterone, are easy to find. In fact, in most countries they’re not controlled, resulting in an enormous global supply.

“Kids get them from friends or from the guy who works at the gym. But you also can buy them over the Internet,” Hamilton says. “Plug in ‘anabolic steroids’ on Google and you’ll find hundreds of sources to buy these drugs.” Online, marketing them as “dietary supplements” has enabled dealers to sell legally.

Girls seem to be more secretive about taking steroids, which can come in pill form or as injections. But many teens don’t have to hide steroid use from their parents because  some parents encourage their use.

"Many parents are complicit,” Hamilton says. “They want their son to be a star football player, and think the way to do that is to have him take pills and tack on 30 pounds of muscle. One father encouraged his son who was a rollerblade champion to take steroids to improve his performance, and it nearly ruined him.”

Hamilton has known cases of children 8 or 9 years old taking steroids.

“They want to be the best kid in Little League. They want to be able to throw hard like Roger Clemens.”

With such pressures in mind, Hamilton sees the problem as psychological as much as medical.

“Unfortunately, frightening adolescents is useless,” he says. “Congress can’t pass a law that will make them want to stop,” Hamilton says, and they’ll tune out the doctors who could warn them of the destruction to their bodies.  What really affects behavior in young people is other young people.

“Peer pressure can work in a positive way as well as a negative,” he says. “We need to foster peer pressure for playing by the rules and not cheating.” Hamilton says that children need to be reinforced to use good training procedures and nutrition to build muscle, and to use good athletic workout regimens to build skills, “not depend on drugs.”

He also feels superstar athletes, where the trend started, must be better role models.

“Too many have sent a message that if you want to compete at the very highest levels, the way to do it is by taking illegal substances.” Hamilton warns. “That message has to stop.”

 

Last Updated: 3-12-2008

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