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On the Teen Scene :
Steroids and Sports Are a Losing Combination

by Raja Mishra, FDA Intern
June, 1995

( The following piece was written by a summer intern at the FDA's office of public affairs in 1995. It is included in our archives as a historical document...NOT as a source of primary, accurate information on GHB. Beware, it contains a fair number of inaccuracies. At the time of its writing, possession of GHB was not illegal, though it became a schedule I substance in March 2000, making both possession and sales illegal without a license. Various points in the text have been linked to sources of more correct information. See the main GHB Vaults for over 80 documents about GHB.)

This article is first in a series with important health information for teenagers.

While preparing for his prom night, a high school senior drank a "health formula," which he had been taking for some time to increase muscle and reduce fat. His evening of romance was never to be. Twenty minutes after drinking the formula, which contained GHB (an illegal drug promoted as an anabolic steroid alternative), he lapsed into a coma. His parents found him sprawled on the floor and rushed him to the hospital. Doctors said if he had been found half an hour later, he probably would have died.

* * * *.* These three cases, though different, all involve the illegal use of anabolic steroids or similar "performance-enhancing" drugs. What exactly are these drugs that have damaged so many lives? Steroids are a synthetic version of the human hormone called testosterone. Testosterone stimulates and maintains the male sexual organs. It also stimulates development of bones and muscle, promotes skin and hair growth, and can influence emotions. In males, testosterone is produced by the testes and the adrenal gland. Women have only the amount of testosterone produced by the adrenal gland--much less than men have. This is why testosterone is often called a "male" hormone.

The average adult male naturally produces 2.5 to 11 milligrams of testosterone daily. The average steroid abuser often takes more than 100 mg a day, through "stacking" or combining several different brands of steroids. Researchers first developed steroids in the 1930s to rebuild and prevent the breakdown of body tissues from disease.

The controversy surrounding steroids began in the 1950s during the Olympic Games when the athletic community discovered that athletes from Russia and some East European nations, which had dominated the games, had taken large doses of steroids. Many of the male athletes developed such large prostate glands (a gland located near the bladder and urethra that aids in semen production) that they needed a tube inserted in order to urinate. Some of the female athletes developed so many male characteristics, chromosome tests were necessary to prove that they were still women.

Even though the side effects of steroid abuse had become known, the demand for them increased in the athletic community. Since then, the sale of steroids has ballooned into a $100-million-a-year black market.

Dangers Abound
Steroids fool the body into thinking that testosterone is being produced. The body, sensing an excess of testosterone, shuts down bodily functions involving testosterone, such as bone growth. The ends of long bones fuse together and stop growing, resulting in stunted growth. Steroid abuse has many dangerous side effects (see box).

Adding to the danger is the way some steroids are manufactured and distributed. The drugs are often made in motel rooms and warehouses in Mexico, Europe, and other countries and then smuggled into the United States. The potency, purity and strength of the steroids produced this way are not regulated and therefore it is almost impossible for users to know how much they are taking. Counterfeit steroids are also sold as the real thing. So it's often impossible to tell exactly what some products contain.

New Trends
A new, alarming trend, is the use of other drugs to achieve the "performance-enhancing" effects of steroids. These steroid "alternatives" are sought in order to avoid the stiff penalties now in effect against those who possess anabolic steroids without a valid prescription. The two most common are gamma hydroxybutyrate (GHB) and clenbuterol.

GHB is a deadly, illegal drug that is a primary ingredient in many of these "performance-enhancing" formulas. The GHB that caused the prom night tragedy was marketed under the name "Somatomax PM." Rumors among teens that it caused a "high" increased the public health problems with GHB. In fact, the drug does not produce a high. It does, however, cause headaches, nausea, vomiting, diarrhea, seizures, and other central nervous system disorders, and, possibly, death.

Clenbuterol, another steroid "alternative," has become an extremely popular item on the black market. The drug is used in some countries for certain veterinary treatments, but is not approved for any use--in animals or humans--in the United States. In Spain, 135 people became ill with muscle tremors, fast heart rates, headaches, dizziness, nausea, fever, and chills after eating beef liver that contained residues of the drug. "The lack of information about clenbuterol is its greatest hazard. Most of the research we do have is from humans who ingested the drug by eating meat from animals who had been administered it, but as far as ingestion straight into humans, much work needs to be done," says Donald Legget, a compliance officer with FDA's Center for Drug Evaluation and Research who deals with enforcement of laws against steroid distribution (see "Show Animals Tested for Illegal Drug," in the Investigators' Reports section of this issue).

Why Does Anyone Use Them?
With so many harmful effects from steroids and similar illegal drugs, why do so many young people continue to use them? One answer is social pressures. Many young men feel they need to look "masculine," that is, strong and muscular. Bodybuilding stresses such muscularity, and some men--and women--abuse anabolic steroids to increase muscle mass and definition.

And then there's the "winning isn't everything, it's the only thing" philosophy common in so many school athletic programs. Some student athletes feel so pressured to succeed in their respective sports that they resort to steroids for help. Another reason, say many experts, lies in the basic nature of young people not to concern themselves with long-term effects. The desire to make the football team or to impress peers is much more immediate than the future prospect of possible damage to the liver, heart, and other vital organs.

In its effort to alert teenagers to the dangers of steroid abuse, FDA has developed a series of pamphlets, posters, and public service announcements. Recently, anabolic steroids were placed in the same regulatory category as cocaine, heroin, LSD, and other habit-forming drugs. This means that, in addition to FDA, the Drug Enforcement Agency helps to enforce laws relating to their abuse.

Celebrities like bodybuilding champs Arnold Schwarzenegger and Lee Haney and professional wrestler Jesse Ventura have spoken out against steroid use. Major magazines, ranging from Newsweek to Muscle and Fitness, have published articles warning of the dangers of steroid abuse.

The courts are handing down stiff sentences for people dealing in illegal steroids and similar drugs. Distributors have been sentenced to three to six years in jail and fined up to six figures. FDA, working with other law enforcement agencies, has made hundreds of arrests and broken up several large distribution and manufacturing rings.

Athletic organizations have joined the fight. The Olympic Games are now closely monitored to prevent athletes who use steroids from participating, as Ben Johnson found out. The National Football League has a strict testing policy in its training camps and hands down fines and suspensions for those who test positive, and bans for repeat offenders. The National Collegiate Athletic Association, too, has established stricter measures for testing and disciplining steroid users.

Although it may be true that in combination with intensive weight training and a high-calorie, high-protein diet, steroids can augment short-term muscle gain, teens need to ask themselves: Is it worth all the short-term health effects and the possibility of long-term, permanent damage? Is it worth the disgrace of being eliminated from competition, or even of being arrested?

After taking a long, hard look at the facts, most teens will realize that using drugs to boost athletic performance is a no-win situation.

Raja Mishra is a sophomore at the University of Maryland at College Park. He wrote this during a summer internship with FDA's Office of Public Affairs.

Steroids May Give You More Than You Bargained For

Established side effects and adverse reactions:

genital changes
water retention in tissue
yellowing of eyes and skin
oily skin
stunted growth
fetal damage
coronary artery disease
liver tumors and disease
In women: male pattern baldness,
hairiness, voice deepening, decreased
breast size, increased body hair,
and menstrual irregularities

Other possible side effects and adverse reactions:

abdominal pains
muscle cramps
unexplained weight loss/gain
nausea and vomiting
vomiting blood
bone pains
breast development in men
aggressive behavior
urination problems
sexual problems
high blood pressure
kidney disease