Teenage steroid use is alive and not so well

We were recently asked by a major news magazine if teenage steroid and PED use constitutes a significant health problem.  The answer: a resounding yes.

Like health problems such as child abuse, elder abuse and date rape, adolescent steroid use exists underground and sometimes undetectable.  Most physicians, parents, teachers, and others in contact with teens do not understand the issue.  How many doctors, for instance, work out at Gold's Gym (or 1 on 1 Elite Personal Fitness in Deer Park, TX) to understand the culture of covert PED use?

At our hospital -- the University of Iowa -- the lab tests to detect steroid use (detection of nandrolone, T:E ratio etc.) are not offered.  Clinicians and lab personnel do not appreciate the appropriate labs to detect the problem.  Therefore, when a 'bulked-up' teen athlete presents with unusually aggressive behavior, the possibility of steroid use is not considered or not investigated.  (Following a recent presentation on steroid use, this author was criticized because the issue was not clinically relevant.)

However, the International Herold Tribune points out that teen 'roid abuse exists, and can be deadly (also Boston Globe).

She just wanted six-pack abdominal muscles. So in the summer of 2003, Dionne Passacantando, a 17-year-old high school cheerleader, gymnast, and vice president of her Allen (Texas) High School class, made a decision she regrets. She bought anabolic steroids from a boy on the school football team.

"Nobody frowned upon it," she said. "It was easier for me to get those than it probably was to buy beer."

But after injecting herself with Winstrol every other day for five weeks, she became suicidal.

"I was the last person in the world you'd think would use anabolic steroids," she said.

There are those who argue that steroid abuse does not induce behavioral changes.  There are those who argue the drugs do not produce significant side effects.  Any story that purports those claims should be either regarded with skepticism, or perhaps treated with disdain (you decide).

There are those who say that steroid and PED use be treated like Lasik surgery, as an aid to performance improvement.  Anyone ever see a patient who underwent Lasik surgery murder his son, and his wife, then kill himself as Chris Benoit did?

The young lady from Texas (cheerleaders now use 'roids) knew about Tyler Hooton:

he July 2003 suicide of 17-year-old Taylor Hooton has haunted her.

Hooton and Roberts never met, though their schools are rivals just north of Dallas.

"We probably knew the same people and probably got our stuff from the same people," Roberts said.

Hooton was a 6-foot-2-inch, or 1.88-meter, 180-pound, or 82 kilogram, pitcher for his Plano, Texas, high school team. According to the Hooton family, Taylor was told by his coach that "he needed to be bigger" for his senior year. Taylor used steroids, became depressed, and hanged himself from his bedroom door on July 15, 2003.

His father, Don Hooton, started the Taylor Hooton Foundation to fight steroid abuse...

The week Taylor Hooton died was the week Dionne Roberts started using steroids, she said. She said at least half the Allen football team was on steroids.

"A lot of parents and coaches were OK with the fact that this was going on," she said. "I feel it was even encouraged to a point."

The school's athletic director, Steve Williams, disputes that.

"I'd have a hard time believing that's the truth," he said. "We have no knowledge of that. Are we naive to say steroids don't exist here? No."

Unfortunately the AD is wrong: physicians nurses, coaches, AD, and principals are not well educated about teen steroid use, and often unaware (in other cases coaches promote it).  While adolescent PED abuse is not public health problem #1, it is as not insignificant as some will tell you.

It won't be long until American teen females suffer the same problems the girls from the East German doping machine suffered: short term problems including voice changes, genital hypertrophy, and long term problems including mood changes and birth defects.  Then maybe someone will believe.

The IHT points out some of the studies:

Her story is part of a much larger picture. The Mitchell Report, which detailed steroid use in major league baseball, noted that while steroid use among high schoolers seems to be declining, it is still estimated that 3 to 6 percent of students in the United States have tried them. That means that, at a minimum, hundreds of thousands of high school students are using.

A recent report by the Oregon Health and Science University using data from the Centers for Disease Control said 5.3 percent of teenage girls admitted to using anabolic steroids, mostly for body-enhancing reasons or self-protection, not athletics. According to 2003 CDC data, seventh-grade girls were the fastest-growing group of steroid users, with more than 7 percent using them, the controversial report stated.

The prevalence of teen PED use is controversial:

Dr. Harrison Pope, professor of psychiatry at Harvard and director of biological psychiatry at McLean Hospital in Belmont, Massachussetts, said the number of girls doing steroids is greatly inflated. But Dr. Linn Goldberg, head of health promotion and sports medicine at Oregon Health and Science University and one of the lead authors of the university's report, scoffs at Pope's claim.

"That's like a blind man grabbing the tail of an elephant and saying the elephant is shaped like a snake," said Goldberg.

"It's a very secretive thing that is common with any drug abuser," said Roberts. "It's not something you flaunt. You don't want people to know."

Comments

[Steve]

I know you're a doctor, and I've liked what you've said in the past, but I think this goes too far. It's not just people who argue that steroids don't cause behavioral changes, it's science. Studies on steroids don't show a correlation between their use and behavioral changes. The behavioral problems that occur with users are no more frequent than their normal appearance in society. (this comes from studies cited by Eric Walker on his site about steroids and baseball http://steroids-and-baseball.com/)

Suicide is sad and what Chris Benoit did is terrible, but things like that happen to disproportionately more people who aren't using steroids than who are. This seems like nothing more than a scare tactic, like when Lyle Alzado was so sure that steroids caused his brain cancer and the media shouted it from the roof tops. It wasn't true and those who study adolescent behavior know that lying to them about why they shouldn't do something causes more people to do it.

Published reports have the number of teenage steroid users as being very very small. One is too many. We should be educating teenagers about the actual bad things that can happen when an immature body uses steroids.

[grg]

Steve. thanks for the comment.

First, I highly urge everyone to ignore cult web sites that cherry pick 'studies' or opinions from pseudo-scientists who never published a scientific paper in a life.

Second, the simple fact of the matter is that 'steroids' as a class induce profound behavioral changes. A subset of steroids is anabolic steroids, all analogs of testosterone. Testosterone induces male behaviors like dominance, aggression, and sexual rituals. This is a incontrovertible scientific fact.

The other anabolic steroids will likewise produce profound behavioral changes.

Having said that, we admit studies are not consistent on the issue of 'roid rage, or sudden explosive aggressive behaviors.

Third, anyone who says anabolic steroids are devoid of serious side effects just is woefully uninformed. If you see or hear that statement, you know you are dealing with a rank amateur.

Again, use caution when reading these fringe authors without scientific training, or with a particular ax to grind (in fact be skeptical of everything exempt what we say because we have a hotline to God :-) ). Just because I can dribble and shoot a basketball doesn't mean I am an NBA player.

thanks

[Steve]

How does one tell which studies are good and which studies are bad? Or how does the average person like me decipher which people behind the study are trustworthy and which aren't?

I've noticed that with HGH there are contradictory studies and since the studies i've read contradict what you've found, that seems to be the case with steroids too. Perhaps bad studies are the reason for this.

I've known a few anabolic steroid users (I know this is way to small a sample size) but they were aggressive people before they took the steroids, during, and after. Again, small sample size, but it seems logical that people willing to take steroids are already aggressive people. That's just an assumption, but it seems like that's a pretty hard thing to account for in studies. Are you aware of studies that have gathered data on personalities before gathering data on those same personalities on steroids? If that's something you've covered and I've missed, I apologize.

[grg]

Steve your obviously a thoughtful person; these are great questions.

Which studies are good? All scientific studies have weaknesses; it takes a great deal of work to determine the limitations and strengths of a particular study. One should gather all studies on the subject, then summarize all, not just studies that support one's position. When all studies are considered even experts will disagree.

There are so many relevant issues in looking at the value of a study; this is especially true in PEDs, where the street use is significantly different than the clinical use of the drugs. Doses, length of use, poly-drug use, genetic background, workout program, and method of evaluation all vary between the street and the 'lab'.

For instance, HGH when studied in 'clinical' doses, produces unimpressive strength results in studies. However, when combined with an anabolic steroids, HGH produces an additive effect.

Further, the doses of HGH used in clinical studies are lower than used on the street. Also the population may differ too: the response of a college student in a study likely differs from a world class elite athlete to the drug (HGH).

An IRB (investigation review board that approves all studies) would never allow the doses of drugs and the combinations of drugs used on the street; these doses and combinations would be medically way too dangerous for an ethical investigator to use on human subjects. However athletes and body builders use these doses on the streets (which are incredible).

For instance to look at the effect of nandrolone on bat speed, an investigator would design a double blind, placebo controlled, cross-over study using street doses of the drug. The investigator should recruit MLB players for the studies because ordinary people may not respond as well to the steroid. 30 players would take nandrolone, and face a standard pitching machine (or something) over a period of 3 months (let's say). 30 players should receive injections of placebo. Then the players all switch drugs for another 3 months.

You can see that study will NEVER be done. So what we are left with are imperfect studies that really don't approach the real world conditions. Experts all must use a measure of common sense and experience to judge the effects of drugs.

I would agree with you about more aggressive athletes seeking out steroids; in fact studies indicate this is the case -- a confounding variable -- and thus the question about the 'roid rage. Again what should be done is to give 2 groups of very aggressive athletes nandrolone v. placebo then measure their aggressiveness, or see how many murders and assaults differ between groups. As you can see that study will never be done.

What an expert has to do is to look at the data, then develop a theory that the preponderance of the evidence supports. These guys that develop the web sites have no expertise in this process; they have no clinical judgment and no scientific credibility.

Considering the basic physiological effects of testosterone on behavior -- aggressiveness, dominance, and sexual behavior, it would appear logical to me that used as a drug testosterone enhances aggressiveness.

I will also say that anyone who claims the PEDs have no serious side effects is simply horribly uniformed. Anyone in medicine knows this group of drugs produces numerous serious side effects. If you read that statement, put the paper down, take a shower, and double check that the world is still round...

thanks for the great questions!

[Not]

I am against the PEDs use in competition. The main problem that I see with HGH is that it is used by so many people as an antiaging drug. You can buy it on line.You see ads in most magazines. Antiaging clinics sell it. I don't know how the gorvenment is going to control the illegal use of something like HGH. It is like having a plastic surgery or a skin treatment or injecting botox. It is the result of scientific studies. Today science is moving in a very fast pace. I m completely skeptic about professional or amateur sports. I just try to do my own thing and forget about rolemodels or sports heroes.

[teen alcohol treatment]

A general class of chemical substances that are structurally related to one another and share the same chemical skeleton. thanks for the post.

-mj-

[legal steroids]

This is one of the best blog i have just seen, i am really feeling honor and pleasure that i am able to post my views here in this blog, a really appreciatable work done by webmaster of this blog.

[christian louboutin]

I am totally immersed myself in the excellent stuff.It is our great pleasure to share the wonderful blog with you. Best Regards!

[ferragamo shoes]

the information of this post is very relevant
for what i am looking for, thank you so much for sharing this one

[Mahidhar Reddy]

Regardless of your problem with Bigger Stronger Faster and your insensitive comments about the movie and the filmmaker, I find it disturbing how you attribute the Hooton suicide to steroids as a knee-jerk reaction without taking into consideration the Lexapro.

That level of intellectual dishonesty is one of a number of reasons why doctors are less-respected members of society than in the past. Keep up the implicit defense of the psychiatric racket while you're at it

[authentic air jordan shoes]

You can see that study will NEVER be done. So what we are left with are imperfect studies that really don't approach the real world conditions. Experts all must use a measure of common sense and experience to judge the effects of drugs.

[homes for sale newport coast]

Then the players all switch drugs for another 3 months.

[benefit cosmetic]

This article was written well, I really like, give me a great sense of, http://www.benefitcosmeticsale.com/

[supra shoes sale]

Only insiders know the talent within the Council's true feelings.http://www.suprafootwear4sale.com/

[replica chanel bags]

No one likes sunny days, the heart to tell people this sentence in the rain, rainy day to be a portrayal of a bad http://www.allbrandbag.com/ mood.http://www.chanelbags4sale.com/

[uggs for cheap]

Dad will take the time to hold each time I kissed and pro

[Cheap oakleys]

Thank you! I would now go on this blog every day!
http://www.ocheapoakleys.com

[cheap uggs]

Ambition is nothing but the memory of the slaves, to the birth of a vibrant, but it is difficult to grow.

[replica louis vuitton handbags]

This is a good article.wish everyone have a good day.

[rolex submariner replica]

have a great day

[Uggs Boots Sale]

that are too small when you wear heavy socks or pinches your legs due to your