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Schools Struggle to Control Steroid Use

Scare tactics don't work, but peer-education programs offer hope

WEDNESDAY, May 12, 2004 (HealthDayNews) -- The abuse in U.S. high schools of steroids and other muscle-building substances is moving beyond athletics, experts say, with both boys and girls taking the drugs in increasing numbers to achieve what they believe to be "perfect" bodies.

"If you look at national studies, there are about a half million to a million kids in high school who have used or are using steroids," said Dr. Linn Goldberg, an expert on steroid abuse at Oregon Health Sciences University in Portland. "If you look at the data on athletes, they've gone anywhere from 4 percent to 12 percent on a statewide basis -- some states have a much bigger problem than others."

High school administrators are beginning to realize they have relatively few weapons with which to fight rising rates of steroid abuse. Testing for the drugs simply "isn't feasible," Goldberg said, because the average steroid screening costs more than $100 per sample. Some "schools in the United States can hardly afford books," he noted.

Testing may even be counterproductive, said Mitch Finnegan, director of health and physical education at the Weston Public Schools, in eastern Massachusetts.

"In some ways, testing almost normalizes the use of it," he said. "If I'm a high school athlete and suddenly it's such a major concern that they're testing me every year or every season to make sure I'm not using it, I'm probably going to assume that there's a lot of athletes who are using it."

But the problem keeps growing, fueled by headline-grabbing media coverage of pro athletes caught using steroids or steroid precursors such as androstenedione, linked to home run slugger Mark McGwire's then record-breaking 1998 season.

Steroids "really blasted onto the scene" in the 1988 Summer Olympics, Goldberg said, after Canadian sprinter Ben Johnson set new records -- only to be stripped of his medals after testing positive for steroids. Goldberg, who is also the U.S. Olympic Committee's crew chief for drug surveillance, said the Johnson scandal effectively "answered the question, 'Do steroids work?'"

Since that time, steroid and supplement scandals involving player after player have only heightened the drugs' mystique.

"I think pro athletes have a huge responsibility as role models, whether they want to accept it or not," Finnegan said. "It's almost as if, at the pro level, anything goes to increase your performance, which increases your marketability as an athlete."

But the price for increased performance can be dangerously high. Possible side effects of steroid abuse include high blood pressure and heart disease; liver damage and cancers; stroke and blood clots; nausea and vomiting; severe acne; and baldness. In addition, steroids can reduce sperm production, shrink the testicles, and cause impotence and irreversible breast enlargement in boys and men. Girls and women can develop more masculine characteristics such as deepening of the voice and excessive body hair, according to the National Institutes of Health.

Finnegan and Goldberg agree that even if the biggest sports stars warn kids about the dangers of steroids, it won't do much to curb abuse of the muscle-building substances.

And more and more teens are taking steroids not to make the team but to simply look "buff" and "hot."

"The national statistics show that steroid use is clearly not limited to athletes," Finnegan said. "There are many non-athletes who are using steroids to get the body they see on the magazines."

Girls are taking steroids, too -- U.S. Centers for Disease Control and Prevention survey of Louisiana high schools found 11.2 percent of boys taking the drugs, and 5.7 percent of girls.

Goldberg said girls are "taking them for different reasons. Coaches often say to girls, 'You know, you'd be faster if you lost a little weight.' It's a body-shaping thing -- you increase muscle tissue and lose fat."

So what can school administrators do to fight steroid and supplement abuse? Goldberg and his team of researchers think they've found a solution. With funding from the National Institute on Drug Abuse, they've developed a school-based, peer-to-peer educational program called Adolescent Training and Learning to Avoid Steroids (ATLAS) that seems to work.

Grim lectures from coaches and pro athletes can change the minds of children in grade school and middle school, "but when you get to high school you start to have much more peer influences," Goldberg said. In ATLAS, older boys talk teen-to-teen with boys a few years their junior.

"There's a big difference between a 14-year-old and a 17-year-old, and the 17-year-old wields a lot of power. These kids are a lot more influential than someone who's a national quarterback, a Barry Bonds, a Phil Jackson," Goldberg explained. Recent studies suggest the ATLAS program can result in an average 50 percent reduction in high school steroid abuse.

Finnegan has been using ATLAS at Weston for the past three years. "I've been in the [drug] prevention and treatment field, as well as teaching, for the past 20 years," he said, "and it's probably the most effective prevention program we've ever seen." He plans to introduce ATLAS's "sister" program for girls, ATHENA, to the Weston schools next year.

Parents have a major role to play, as well, Finnegan said. "Parents need to help their kids learn how to develop in healthy ways. I think the vast majority of parents are doing a great job on that, but there are a minority who push their kids so hard, and that includes pushing them to use supplements and steroids."

On Capitol Hill, lawmakers are moving to keep steroids and other supplements out of kids' reach. The Steroid Act of 2003, sponsored by Sens. Joseph Biden (D-Delaware) and Orrin Hatch (R-Utah), seeks to ban the sale of andro and other steroid precursors, and to fund programs like ATLAS and ATHENA in schools.

And in March, the U.S. Food and Drug Administration ordered a crackdown on online sales of andro. That's a move in the right direction, Finnegan said, since the Internet "is where most kids are getting supplements these days."

More information

For more on the dangers of steroids, visit the American Academy of Pediatrics. And for more details on the ATLAS program, check with Oregon Health & Science University.

SOURCES: Linn Goldberg, M.D., professor, medicine, head, Division of Health Promotion and Sports Medicine, Oregon Health Sciences University, Portland, and U.S. Olympic Committee Crew Chief for Drug Surveillance; Mitch Finnegan, director, Health and Physical Education, Weston Public Schools, Weston, Mass.
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