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 STEROID ABUSE BY
SCHOOL AGE CHILDREN

O nce viewed as a problem strictly associated with body builders,

fitness “buffs,” and professional athletes, abuse of anabolic
steroids by school age children has significantly increased over the
past decade. The National Institute on Drug Abuse (NIDA) estimates
that more than a half million 8th and 10th grade students are now using
these dangerous drugs, and increasing numbers of high school seniors
do not believe steroids are risky.

Students are acquiring and taking anabolic steroids without any

knowledge of the dangers associated with steroid abuse. The short-
term adverse physical effects of anabolic steroid abuse are fairly well
known. However, the long-term adverse physical effects of anabolic
steroid abuse have not been studied, and as such, are not known. In
addition, this type of abuse may result in harmful side-effects as well
as serious injury and death. The abuser in most cases is unaware of
these hidden dangers.
Presented as a public service by:
This guide will help you understand why steroids are being misused,
Drug Enforcement Administration and how you can provide counseling and implement procedures to
Office of Diversion Control educate our youth about the dangers of these drugs. By working
Washington, D.C. 20537 together we can greatly reduce the abuse of anabolic steroids. It is
important to recognize this problem and take preventive measures to
protect our young people.

This publication is authorized for public dissemination. WHAT ARE ANABOLIC STEROIDS?
All material in this publication is in the public domain and Anabolic steroids are synthetically produced variants of the naturally
may be reproduced without the expressed permission of the occurring male hormone testosterone. Both males and females have
Drug Enforcement Administration. testosterone produced in their bodies: males in the testes, and
Citation of the source is appreciated.
females in the ovaries and other tissues. The full name for this
March 2004 class of drugs is androgenic (promoting masculine characteristics)
anabolic (tissue building) steroids (the class of drugs). Some of
the most abused steroids include Deca-Durabolin®, Durabolin®,

March 2004 1
Steroid Abuse by School Age Children

Equipoise®, and Winstrol®. The common street (slang) names for countries such as Mexico and European countries. Smuggling from
anabolic steroids include arnolds, gym candy, pumpers, roids, these areas is easier because a prescription is not required for the
stackers, weight trainers, and juice. purchase of steroids. Less often steroids found in the illicit market are
diverted from legitimate sources (e.g. thefts or inappropriate prescrib-
The two major effects of testosterone are an androgenic effect and an ing) or produced in clandestine laboratories.
anabolic effect. The term androgenic refers to the physical changes
experienced by a male during puberty, in the course of development to
manhood. Androgenic effects would be similarly experienced in a HOW ARE STEROIDS TAKEN?
female. This property is responsible for the majority of the side effects
of steroid use. The term anabolic refers to promoting of anabolism, Anabolic steroids dispensed for legitimate medical purposes are
the actual building of tissues, mainly muscle, accomplished by the administered several ways including intramuscular or subcutaneous
promotion of protein synthesis. injection, by mouth, pellet implantation under the skin and by applica-
tion to the skin (e.g. gels or patches). These same routes are used for
purposes of abusing steroids, with injection and oral administration
WHY ARE STEROIDS ABUSED? being the most common. People abusing steroids may take anywhere
from 1 to upwards of a 100 times normal therapeutic doses of anabolic
Anabolic steroids are primarily used by bodybuilders, athletes, and steroids. This often includes taking two or more steroids concurrently,
fitness “buffs” who claim steroids give them a competitive advantage a practice called “stacking.” Abusers will often alternate periods (6 to
and/or improve their physical performance. Steroids are purported to 16 weeks in length) of high dose use of steroids with periods of low
increase lean body mass, strength and aggressiveness. Steroids are dose use or no drug at all. This practice is called “cycling.”
also believed to reduce recovery time between workouts, which makes
it possible to train harder and thereby further improve strength and Doses of anabolic steroids used will depend on the particular objectives
endurance. Some people who are not athletes also take steroids to of the steroid user. Athletes (middle or high school, college, profes-
increase their endurance, muscle size and strength, and reduce body sional, and Olympic) usually take steroids for a limited period of time
fat which they believe improves personal appearance. A small number to achieve a particular goal. Others such as bodybuilders, law enforce-
of youths may take steroids to increase their body size to protect ment officers, fitness buffs, and body guards usually take steroids for
themselves from others. extended periods of time. The length of time that steroids stay in the
body varies from a couple of days to more than 12 months.

Examples of oral and injectable steroids are as follows:

WHERE DO YOU GET STEROIDS?
Doctors may prescribe steroids to patients for legitimate medical Oral Steroids Injectable Steroids
purposes such as loss of function of testicles, breast cancer, low red
blood cell count, delayed puberty and debilitated states resulting from • Anadrol® (oxymetholone) • Deca-Durabolin®
• Oxandrin® (oxandrolone) (nandrolone decanoate)
surgery or sickness. Veterinarians administer steroids to animals (e.g.
• Dianabol® (methandrostenolone) • Durabolin®
cats, cattle, dogs, and horses) for legitimate purposes such as to
• Winstrol® (stanozolol) (nandrolone phenpropionate)
promote feed efficiency, and to improve weight gain, vigor, and hair
• Depo-Testosterone®
coat. They are also used in veterinary practice to treat anemia and (testosterone cypionate)
counteract tissue breakdown during illness and trauma. For purposes • Equipoise®
of illegal use there are several sources; the most common illegal (boldenone undecylenate)
source is from smuggling steroids into the United States from other (veterinary product)

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Steroid Abuse by School Age Children

PHYSICAL & PSYCHOLOGICAL DANGERS The possession or sale of anabolic steroids without a valid prescription
is illegal. Simple possession of illicitly obtained anabolic steroids
Steroid users are vulnerable to physical and psychological side effects, carries a maximum penalty of one year in prison and a minimum
many of which are irreversible in women. The short-term adverse $1,000 fine if this is an individual’s first drug offense. The maximum
physical effects of anabolic steroid abuse are fairly well known. How- penalty for trafficking is five years in prison and a fine of $250,000 if
ever, the long-term adverse physical effects of anabolic steroid abuse this is the individual’s first felony drug offense. If this is the second
have not been studied, and as such, are not known. felony drug offense, the maximum period of imprisonment and the
maximum fine both double. While the above listed penalties are for
For Guys For Girls federal offenses, individual states have also implemented fines and
penalties for illegal use of anabolic steroids. State executive offices
• Baldness • Growth of facial and body hair have also recognized the seriousness of steroid abuse and other drugs
• Development of breasts • Deepened voice of abuse in schools. For example, The State of Virginia enacted a new
• Painful erections • Breast reduction law that will allow student drug testing as a legitimate school drug
• Shrinkage of testicles • Enlarged clitoris prevention program. Additional states and individual school districts
• Loss of function of testicles • Menstrual irregularities are considering implementing similar measures.

For Both The International Olympic Committee (IOC), National Collegiate

Athletic Association (NCAA), and many professional sports leagues
• Acne (e.g. Major League Baseball, National Basketball Association, National
• Jaundice (yellowing of the skin) Football League (NFL), and National Hockey League) have banned the
• Swelling – Fluid retention use of steroids by athletes, both because of their potential dangerous
• Stunted growth (close the growth plates in the long bones side effects and because they give the user an unfair advantage. The
and permanently stunt their growth) IOC, NCAA, and NFL have also banned the use of steroid precursors
• Increase in bad cholesterol levels (e.g. androstenedione) by athletes for the same reason steroids were
• Decrease in good cholesterol levels banned. The IOC and professional sports leagues use urine testing to
• Mood swings detect steroid use both in and out of competition.
• Increase in feelings of hostility
• Increase in aggressive behavior
COMMON TYPES OF STEROIDS ABUSED
LAWS AND PENALTIES FOR ANABOLIC STEROID ABUSE
The illicit anabolic steroid market includes steroids that are not com-
Concerns over a growing illicit market, abuse by teenagers, and the mercially available in the U.S. as well as those which are available.
uncertainty of possible long-term effects of steroid use led Congress in Steroids that are commercially available in the U.S. include
1991 to place anabolic steroids as a class of drugs into Schedule III of fluxoymesterone (Halotestin®), methyltestosterone, nandrolone
the Controlled Substances Act (CSA). (Deca-Durabolin®, Durabolin®), oxandrolone (Oxandrin®),
oxymetholone (Anadrol®), testosterone, and stanozolol (Winstrol®).
Under this legislation, anabolic steroids are defined as any drug or Veterinary steroids that are commercially available in the U.S. include
hormonal substance, chemically and pharmacologically related to boldenone (Equipoise®), mibolerone, and trenbolone (Revalor®).
testosterone (other than estrogens, progestins, and corticosteroids) Other steroids found on the illicit market that are not approved for
that promotes muscle growth. use in the U.S. include ethylestrenol, methandriol, methenolone, and
methandrostenolone.

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Steroid Abuse by School Age Children

STEROID ALTERNATIVES ARE ANABOLIC STEROIDS ADDICTIVE?

A variety of non-steroid drugs are commonly found within the illicit An undetermined percentage of steroid abusers may become addicted
anabolic steroid market. These substances are primarily used for one to the drug, as evidenced by their continuing to take steroids in spite
or more of the following reasons: 1) to serve as an alternative to of physical problems, negative effects on social relations, or ner-
anabolic steroids; 2) to alleviate short-term adverse effects associated vousness and irritability. Steroid users can experience withdrawal
with anabolic steroid use; or 3) to mask anabolic steroid use. Exam- symptoms such as mood swings, fatigue, restlessness, and depression.
ples of drugs serving as alternatives to anabolic steroids include Untreated, some depressive symptoms associated with anabolic
clenbuterol, human growth hormone, insulin, insulin-like growth factor, steroid withdrawal have been known to persist for a year or more after
and gamma-hydroxybutyrate (GHB). Examples of drugs used to treat the abuser stops taking the drugs.
the short-term adverse effects of anabolic steroid abuse are erythro-
poietin, human chorionic gonadotropin (HCG), and tamoxifen. Also,
diuretics and uricosuric agents may be used to mask steroid use. The STATISTICS
following chart illustrates how masking is accomplished:
The “Monitoring the Future” study conducted in 2002, determined that
since 1991 there has been a significant increase of steroid use by
Drug Group Drug or Effect How Drug Masks school age children. This annual study, supported by the NIDA and
Steroid Use conducted by the Institute for Social Research at the University of
Michigan, surveys drug use among eighth, tenth, and twelfth graders
Uricosuric Probenecid Decreases entry of in the United States. The first year data was collected on younger
Agents steroids into the urine students was in 1991. Since 1991 there has been a significant in-
crease in reported steroid use by teenagers. For all three grades, the
Diuretics Spironolactone, Dilutes steroid concen- 2002 levels represent a significant increase from 1991. The following
Furosemide tration in the urine chart illustrates the increase of steroid abuse among teenagers who
reported using steroids at least once in their lifetime:
Epitestosterone Decreases Testosterone Reduces detection of
to Epitestosterone ratio testosterone usage
Percent of Students Reporting Steroid Use 1991 - 2002

Over the last few years, a number of metabolic precursors to either

testosterone or nandrolone have been marketed as dietary supple- Year Eighth Grade Tenth Grade Twelfth Grade
ments in the U.S. These dietary supplements can be purchased in
1991 1.9% 1.8% 2.1%
health food stores without a prescription. Some of these substances
include androstenedione, androstenediol, norandrostenedione, 1999 2.7% 2.7% 2.9%
norandrostenediol, and dehydroepiandtrosterone (DHEA), which can
be converted into testosterone or a similar compound in the body. 2002 2.5% 3.5% 4.0%
Whether they promote muscle growth is not known.

The 2002 survey also indicated additional data related to steroid abuse
by school age children:

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Steroid Abuse by School Age Children

Percent of Students Reporting Steroid Use in 2002 A majority of the studies performed on steroid abuse indicate males
are twice as likely to abuse steroids as females.
Student Steroid Eighth Grade Tenth Grade Twelfth Grade
Use
HOW CAN WE CURTAIL THEIR ABUSE?
Past Month Use 0.8% 1.0% 1.4%
The most important aspect to curtailing abuse is education concerning
Past Year Use 1.5% 2.2% 2.5% dangerous and harmful side effects, and symptoms of abuse. Athletes
and others must understand that they can excel in sports and have a
Lifetime Use 2.5% 3.5% 4.0% great body without steroids. They should focus on getting proper diet,
rest, and good overall mental and physical health. These things are all
factors in how the body is shaped and conditioned. Millions of people
In addition, the 2002 survey also determined how easy it was for have excelled in sports and look great without steroids. For additional
school aged children to obtain steroids. The survey indicated 22% of information on steroids please see our website at
eighth graders, 33.2% of tenth graders, and 46.1% of twelfth graders www.DEAdiversion.usdoj.gov
surveyed in 2002 reported that steroids were “fairly easy” or “very
easy” to obtain. More than 57% of twelfth graders surveyed in 2002
reported that using steroids was a “great risk.” Also, another study
indicated that steroids are used predominately by males. The survey
determined the annual prevalence rates were two to four times as high
among males as among females.

The “Monitoring the Future” study also determined that misuse and
abuse of steroids is a major concern among school aged children.
Some of their findings are alarming and indicate a need for concern:

• A survey in 1999 determined that 479,000 students nationwide, or

2.9 percent, had used steroids by their senior year of high school.
• A survey in 2001 determined the percentage of 12th graders who
believed that taking these drugs causes “great risk” to health
declined from 68 percent to 62 percent.

The Center for Disease Control and Prevention (CDC) conducts the
Youth Risk Behavior Surveillance Study, a survey of high school
students across the United States. A survey conducted in 2001
indicated that 5% of all high school students reported lifetime use of
steroid tablets/injections without a doctor’s prescription. The survey
also indicated that 5.8% of ninth graders, 4.9% of tenth graders,
4.3% of eleventh graders, and 4.3% of twelfth graders reported
lifetime illegal use of steroids.

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Steroid Abuse by School Age Children

NOTES NOTES

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Steroid Abuse by School Age Children

NOTES

12 March 2004