Introduction
Androgenic-anabolic steroids are not only used by elite and professional athletes but by adolescents as well. Adolescents use steroids because of pressures from their experiences in athletics, because they have problem behaviours, and because of issues with body image. These adolescents will experience side effects from steroid use, which are detrimental to their health. To deter adolescents from the use of steroids there are helpful programs that some high schools implement to help students make healthy choices in regards to their sports experiences.
Steroids and Physical Activity
Male adolescents who participate in competitive sports are likely to use androgenic-anabolic steroids (AAS). In 1997, DuRant, Middleman, Faulkner, Emans, and Woods conducted a study that showed participants who used steroids were likely to strength train more than five times a week and participate in three or more sports (p. 155). Denham (2009) explained that “a portion of adolescents who choose to experiment with AASs also seek to earn an athletic scholarship to college and may realize that without a scholarship, they will not be able to attend a 4-year institution directly from high school. Consequently, they opt to enhance their athletic performance as much as possible, using AASs to increase their bat speed in baseball or their tackling strength in football” (p. 2055). Males at the high school age feel these pressures and therefore turn to steroids. He also said that other students who are not interested in playing college sports might be motivated to use steroids for the sole purpose of improving their performance at the high school level (p. 2055).
On the other hand, not all steroid users are athletes. Corbin, Feyrer-Melk, Phelps, and Lewis (1994) found that a third of the athletes in their study knew nonathletes who used steroids (p. 155). Miller et al. (2005) showed that physical activity did not significantly predict adolescent steroid use. Athletic participation and strength conditioning activities were not considerably related with increased odds of steroid use (p. 1644). Bahrke, Yesalis, Kopstein, and Stephens (2000) said, “A considerable percentage of adolescent steroid users surveyed in other studies, ranging from 16% to 36%, were not athletes or did not participate in any routine exercise activity.” (p. 401). These studies showed that steroid use is a problem among different groups of adolescents, not just the stereotypical athlete.
Problem Behaviour Theory
Jessor’s problem behaviour theory suggests that problem behaviours are better predictors for steroids use than physical activity (as cited in Miller et. al, 2005, p. 1640). Problem behaviours tend to be learned together and are expected to be performed together. This theory also suggests that the motives for these behaviours include the need for adult status and peer approval. (p. 1640). Miller et al. showed in their study that steroid users took part more frequently in problem behaviours than nonsteroid users. In the same study there were four problem behaviours that were associated with steroid use: binge drinking, cocaine use, fighting, and sexual risk-taking (p. 1644). The study showed correlation between the frequency of smokeless tobacco and cocaine use with lifetime steroid use (p. 1646). When taking gender into consideration the findings showed, “The relationships between smokeless tobacco use and steroids use, between binge drinking and steroid use, and between cocaine use and steroid use, differed significantly” (p. 1646). Smokeless tobacco use was associated stronger with females than males, binge drinking was negatively associated with males but not females, and cocaine use was correlated with steroid use for males but not for females (p. 1647).
Body Image
Body image plays a large role in steroid use. Not all steroid using adolescents use steroids for athletic improvement. “Sport is not a necessary component of adolescents’ decisions to use anabolic steroids without medical sanction.” (Miller et al., 2005, p. 1648). Steroids are not only considered performance-enhancing drugs; they are also known as body image drugs, drugs used to improve one’s appearance (Rohman, 2009, p. 192).
Individuals who use steroids are sometimes found to have muscle dysmorphia. According to Strother, Lemberg, Stanford, and Turberville (2012), some men are affected by muscle dysmorphia in which, “an individual is over-concerned, or obsessed, with certain parts of their bodies, in which they misperceive as being irregular or extremely unattractive.” (p. 350). Men who have a height or weight that are less than average are more susceptible to this behaviour. (p. 350). It is unclear whether muscle dysmorphia is a cause or effect of AAS use (Rohamn, 2009, p. 195).
Increasing pressures from media play a great role in the causes of body image concerns. Over the past thirty years there has been an increase in the amount of images of semi-naked men in magazines as well as an increase in popular culture’s focus on muscularity. Even action figures have become more muscular between the years of 1964 and 1998 (Strother et al., 2012, p. 351). Today’s ideal appearance for boys is a muscular body with a large chest and shoulders and a slim waist (McCabe & Ricciardelli, 2004, p. 145). Leone and Fetro (2007) did a study comparing thoughts on steroids between older and younger groups of people. A subject from the “younger” group shared his thoughts on why steroids feel necessary. He said, “It is impossible to look the way some of these guys on the covers of magazines or on infomercials look. You gotta be taking something to get the edge over the next guy whether it’s to get the girl at the bar, the better job, or to be the better athlete.” (p. 535). This shows that some young men feel as though steroids are a necessity for obtaining an ideal body, as defined by social media. Another subject from the “younger” category said, “I know a couple of people who use (AASs)…athletes will take them for performance, but other people not into athletics will do it for a power trip in getting huge…and they are willing to sacrifice their health in getting there…” (p535). When the “older” category was presented with the same topic they emphasized the relationship between steroids and performance enhancement whereas the “younger” groups mentioned body image issues as having an impact on steroid use in addition to performance enhancement (p. 535).
Effects of Steroid Use
Adolescents who use steroids will experience many negative side effects. A list of the effects include: severe acne, musculoskeletal injuries like ruptured tendons and torn muscles, liver problems like jaundice and liver cancer, cardiovascular problems including stroke and hypertension, mental problems like anxiety, irritability, aggressiveness, insomnia, nightmares, depression, suicidal thoughts, mental confusion, hallucinations, paranoid personality disorder, schizophrenia, and physical and psychological dependence (Mazzeo & Ascione, 2013, p. 2016).
A long-term effect for using steroids is infertility in males. Injecting testosterone of a prolonged period of time causes the body to produce less testosterone of its own. Taking steroids reduces the release of pituitary luteinizing hormone. This hormone is induces the release of testosterone. Since production of this hormone is reduced, testosterone production is the body is also reduced (Mazzeo & Ascione, 2013, p. 2016).
Prevention of Steroid Use
Goldberg, Elliot, and colleagues developed the Athletes Targeting Healthy Exercise and Nutrition Alternatives (ATHENA) and Adolescents Training and Learning to Avoids Steroids (ATLAS) programs. These programs help steer adolescents into a healthy direction in their sports careers (Denham, 2009, p. 2056). Most efforts to prevent steroid use focus on the “at-risk athlete” (Miller et al., 2005, p. 1650).
First, Miller et al. defines ATLAS as “a school-based, team-centered program for male high school athletes” (p.1650). This program uses “positive peer pressure and role modeling” to prevent the use of steroids and performance-enhancing drugs. It also focuses on preventing the use of alcohol and other drugs. The program also emphasizes nutrition and exercise as healthy alternatives. ATLAS has produced immediate and sustained (one-year post program) reductions in steroid use. Second, ATHENA is a program targeting female high school athletes. It focuses on unhealthy eating habits and drug use. ATHENA has helped reduce the use of steroids and other performance-enhancing substances. It has also promoted better nutritional habits (p. 1650).
ATLAS and ATHENA are both carried out in similar ways. A group of people usually consisting of a coach and a few student athletes are selected as “squad leaders”. The program consists of ten sessions that each last for forty-five minutes. These programs are usually carried out throughout the season and on “light” practice days. The sessions include role-playing, student campaigns, public service announcements, and instructional, interactive games. The program encourages players to set goals and it also emphasizes nutrition. These sessions help students make healthy choices through their sports career (“ATLAS”, 2014).
These types of programs should target all types of adolescents, athletes and non-athletes. Miller et al. said, “Narrowly focused intervention programs have the virtue of targeting specific at-risk populations and tailoring to their needs, but do so at the expense of excluding other potential at-risk populations or missing the bigger causal picture”. They then conclude with suggesting that “future healthy education initiatives and programmatic interventions must not be limited to participants in organized sports programs; rather, they must directly target adolescents identified as at risk for other forms of substance use, taking into consideration the disparate problem behavioral patterns for girls and boys” (p. 1651).
Conclusion
Steroid use is not limited to the stereotypical high school athlete. Problem behaviour is a better indicator of steroid use than physical activity is. Adolescents who show problem behaviour and who are already have a rebellious personality are susceptible to steroid use. Those who have body image concerns that are brought on by social media are just as susceptible to steroid use than young competitive athletes. There are many negative side effects of prolonged steroid use. To avoid these side effects and use of steroids all together there are prevention programs that help steer young people in the right direction in their sports careers and they help them make healthy decisions throughout the rest of their lives.
This information should be applied and spoken about more in school systems today. Teachers and coaches should target the entire student body and not just the physical education classes. When assemblies in which harmful drugs are being talked about, steroids should be included. Effects and dangers of steroids should be stressed to the same extent as effects and dangers of doing other dangerous drugs. As well as talking about what not to do, healthy behaviours like exercise and nutrition should be emphasized.
Through school and social media attention has been brought to self-esteem issues in girls but not as much for boys. Young men deal with body image concerns due to ideals presented to them by society on how their bodies should look. There are many campaigns such as the “Dove Campaign for Real Beauty” that focus on body image issues for girls but boys should have campaigns similar to that as well. Overall it should be recognized that young men deal with similar issues regarding body image as girls.
References
ATLAS. (2014). OHSU Health Promotion & Sports Medicine. Retrieved from http://www.ohsu.edu/xd/education/schools/school-of- medicine/departments/clinical- departments/medicine/divisions/hpsm/research/atlas.cfm
Bahrke, M. S., Yesalis, C. E., Kopstein, A. N., & Stephens, J. A. (2000). Risk Factors Associated With Anabolic-Androgenic Steroid Use Among Adolescents. Sports Med, 6, 397-405.
Corbin, C. B., Feyrer-Melk, S. A., Phelps, C., & Lewis, L. (1994). Anabolic Steroids: A Study of High School Athletes. Pediatric Science, 6, 149-158.
Denham, B.E. (2009). Association Between Narcotic Use and Anabolic-Androgenic Steroid Use Among American Adolescents. Substance Use & Misuse, 44, 2043- 2061.
DuRant, R.H., Middleman, A.B., Faulkner, A.H., Emans, S.J., & Woods, E.R. (1997). Adolescent Anabolic-Androgenic Steroid Use, Multiple Drug Use, and High School Sports Participation. Pediatric Exercise Science, 9, 150-158.
Leone, J. E. & Fetro, J. V. (2007). Perceptions and Attitudes Toward Androgenic- Anabolic Steroid Use Among Two Categories: A Qualitative Inquiry. Journal of Strength and Conditioning Research, 12, 532-537.
Mazzeo, F. & Ascione, A. (2013). Anabolic androgenic steroids and doping in sport. Medicina Sportiva, 9, 2009-2020.
McCabe, M. P. & Ricciardelli, L. A. (2004). A Longitudinal Study of Pubertal Timing and Extreme Body Change Behaviors Among Adolescent Boys and Girls. Adolescence, 39, 145-166.
Miller, K. E., Hoffman, J. H., Barnes, G. M., Sabo, D., Melnick, M. J., & Farrell, M. P. ( 2005). Adolescent Anabolic Steroid Use, Gender, Physical Activity, and Other Problem Behaviors. Substance Use & Misuse, 40, 1637-1657.
Rohman, L. (2009). The Relationship Between Anabolic Androgenic Steroids and Muscle Dysmorphia: A Review. Eating Disorders, 17, 187-199.
Strother, E., Raymond, L., Stanford, S. C., & Turberville, D. (2012). Eating Disorders in Men: Underdiagnosed, Undertreated, and Misunderstood. Eating Disorders, 20, 346-355.