Performance Enhancing Drugs: Anabolic Steroids

I posted last week about using dietary supplements as a way to improve athletic performance and gain a competitive edge; this week I am going to talk about performance enhancing drugs (PEDs).  My specific focus will be(anabolic) steroids, as the larger topic of PEDs is too broad to address in one blog entry.  Athletes who want to be the best at their sport will sometimes make the decision to utilize PEDs in order to gain that competitive edge.  These PEDs, while illegal, more importantly typically have damaging side effects from long-term use.  The focus of this blog is to make parents aware of the possibility that your child-athlete may be using steroids and how to recognize such use.  This post will not address the cultural pressures of sport that may cause young athletes to feel as though resorting to PED use is a key to their athletic success.

According to Drug Free Sport, Inc., PEDs are defined as, “any substance taken to perform better athletically.”  These substances typically fall in the following categories:

• Ergogenic aids
• Amphetamines
• Prescription drugs
• Alcohol
• Over-the-counter drugs (OTCs)
• Recreational and street drugs

Ergogenic aids is a particularly broad category that can include anabolic steroids, human growth hormone (HGH), ephedra (and its derivatives), and creatine to name a few.  Drug Free Sport, Inc. does provide some free information on its website, but is primarily a client-based service that provides information regarding many PEDs, banned substances and dietary analysis of dietary supplements.  Many NCAA institutions may have access to this resource as well as other leagues and teams.  If you’re wondering if a team or program your child is associated with has access, ask the appropriate administrator or coach.  If your child’s team or league does not have access, perhaps you could advocate for a membership as appropriate.  This site can be a valuable tool in learning more about what your child is ingesting and why they should avoid PEDs.

ANABOLIC STEROID USE IN TEENS

Last week I pointed you in the direction of the Taylor Hooton Foundation, whose mission is to educate us all on the prevalence of anabolic steroid (and more generally PED) use among middle school and high school athletes and non-athletes alike.  The organization was founded because of the suicide of Taylrr Hooton, a 17-year old from Plano, TX, as a result of using anabolic steroids.  According to their FACT SHEET, over 1.5 million teens (12-19 years old) admit to using steroids and it’s not just the boys.  The median age for using steroids for the first time is 15 years old.  Also, many users (62.5%) do so to improve their looks, not just their athletic performance.  Steroids can be found online in about 1 second.  Check out the fact sheet for more!

RECOGNIZING THE SIGNS OF USE

Anabolic steroids can result in a variety of physical and emotional signs that in combination should be a red flag for any parent.  The Taylor Hooton Foundation lists a variety of physical and psychological effects that range from acne, oily skin, and gynocomastia (male breasts) as well as severe mood swings, aggressiveness and sudden anger.  Girls who use steroids tend to develop typical male secondary sex characteristics such as deepened voice, facial hair, and irregular menstrual cycles.  Steroids negatively impact bone development and your liver, kidneys and heart.  These effects are often irreversible once you have discontinued steroid use.  Refer to this LINK for a complete description of all listed side effects.

The NATA Position Statement:  Anabolic-Androgenic Steroids (2012) takes a more clinician, evidence-based approach to addressing steroid use, but for those who are interested is some of the current references on the topic , you may find this source useful.  The statement reiterates and emphasizes the need for recognition and education around the topic of anabolic steroids, but includes information particularly relevant to college-age athletes.  The statement importantly notes there are situations where certain types of steroids may be used therapeutically, in very low doses.  Steroid abusers often uses extremely high doses of steroids in comparison. 

TALKING TO YOUR KIDS

One of the biggest challenges for all parents is talking to their kids about difficult topics, drug use (of any kind) among them.  As a college athletic trainer I always found it challenging to talk to adult athletes about difficult topics when they were not my children.  I can only imagine the difficulty for parents trying to reach a child.  I am falling back to the Taylor Hooton Foundation here.  They have put in the time and effort and have an organized list of pointers to help you talk to your children about steroids, click HERE to learn more.  Most importantly, you should talk to your children before they have an opportunity to use steroids, set the expectation that such behavior is inappropriate, unsafe and illegal.  If you believe your child is using steroids you should conduct a urine test.  If you’re unable to complete a home test, take your child to the physician and specifically request it be tested for steroids. Screening for steroids is not part of a typical urine test panel.  It is important that you make the difficult choice as a parent to address the drug use and be persistent until you have reached your child and change their behavior.  Your child’s life could depend on it, especially at the middle and high school level where there may not be an athletic trainer (or another educated individual)  looking out for their safety.

DRUG TESTING PROGRAMS

The NATA Position Statement recommends random drug testing (as allowed) as part of a regular abuse prevention program.  At the collegiate level, drug testing programs are often a regular part of athletic participation.  These tests not only screen for steroids, but other banned substances.  Make yourself familiar with the NCAA Banned Substance List to understand exactly what athletes are being tested for.  Remember, the NCAA has also partnered with Drug Free Sport, Inc., so use them as additional resource as necessary.  You can also learn more about the standard drug testing procedure through the NCAA website.

As a parent of a high school athlete you may not have regular, random drug testing to help you determine if your child is using steroids (testing minors without consent is not allowed), making it even more important for you to recognize the signs and address the matter immediately.  As a previously mentioned, if you believe drug testing is a necessary step you may be able to purchase a test kit, or request that your family physician compete a steroid test.

As you review some of these resources you’ll notice how dietary supplements keep coming up.  The reason for this is the purity issue that I addressed last week.  According to the Taylor Hooton Foundation up to 20% of dietary supplements are spiked with a banned substance (often steroids), which is why it’s important to know what your child is taking.  You may believe your child is taking something that is safe, effective and pure.  Remember, if you are going to utilize dietary supplements, use those that have been verified as pure by a third-party verification system.

In the end, as parents all you can do is educate yourself and then educate your children to make positive choices.  Unfortunately, positive choices aren’t always the easy ones and children can make poor choices under pressure.  I hope this post has given you a head start on learning how to recognize steroid use in young athletes and the strength to help you send a powerful message about the dangers of anabolic steroids.  I hope that no one ever has to take the difficult step of confronting a child about steroid use, but should that situation arise, the earlier you recognize the signs and intervene, the better for your child and his or her health and safety.

Submitted by Heather L. Clemons, MS, MBA, ATC