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What's So Bad About Steroids?

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ERIC E. CORIS, M.D.

Published: November 16, 2007

"My butt hurts, doc!" Apparently the 17-year-old high school football player developed pain around his right buttock region that had become very intense over the last few days. Despite his significant embarrassment, he had to get the situation remedied. He had a fever and significant redness and swelling around the posterior.

After extensive questioning, I eventually coaxed out of him that he had established a habit of occasionally self-injecting anabolic steroids into his backside to try to increase his lean muscle mass, obtain strength gains in the weight room and achieve a competitive edge in the sport he loves.

I couldn't help but feel sorry for him. Actually, I can't help but feel sorry for the thousands of young male and female athletes across the United States who make the same decision every year. Sure, some of them know some of the risks involved, but do they truly understand the damaging effects steroids can have on a person's physical and mental health over time?

Steroid use is not confined to professional and college athletes. Approximately 6 percent of students in grades nine through 12 admit taking steroid pills or shots without a doctor's prescription — up from 3.7 percent in 1999, according to the Centers for Disease Control and Prevention.

The extent of the problem is beginning to be addressed by policy-makers. This year, Florida joined several other states in passing antisteroid legislation — but resources to enforce drug testing are limited. Florida's pilot program calls for random testing for anabolic steroids in just 1 percent of high school athletes.

Coaches and parents should be aware of the clues of possible steroid use, including acne, jaundice (yellowing in whites of eyes), baldness in boys, facial hair and deepening of the voice in girls, and rapid increase in body mass. With long-term use, young athletes can develop more serious complications including breast development and shrinkage of testicles, liver damage, increased risk for certain cancers, depression and extreme aggression, elevated blood sugar (occasionally to diabetic levels), increases in bad (LDL) cholesterol and decreases in good cholesterol (HDL), increased risk for heart attack and a greater risk of HIV (for those who inject steroids directly into their muscles). Steroids may also lead to use of other illegal substances.

In an age in which steroids have been implicated in record-breaking home runs, incredible cycling victories and a Super Bowl championship, the focus too often is on performance at all costs — worry about the consequences later. Unfortunately, the consequences aren't always later, and performance gains promised pale in comparison to the dangers associated with performance-enhancing drugs.

So how do we counter this disturbing trend among our young athletes?

Educate early and often, sending a strong message that steroids are NOT safe. Kids need to hear from coaches, parents and peers that their health is much more important than their performance on the playing field. While the possible deterrent effect of a drug testing program is promising, studies have shown that one of the most powerful ways to prevent substance abuse is through positive peer pressure.

ATLAS and ATHENA, nationally recognized, gender-specific programs developed by Oregon Health & Science University for male and female adolescent athletes, effectively use peer and team influences to promote healthy alternatives to steroids. Ideally, more standardized programs such as these will be adopted by school teams. Until then, please talk to your kids, your players and your teammates about the dangers of steroid use.

Dr. Coris is an associate professor in the Departments of Family Medicine and Orthopaedics and Sports Medicine and director of the Division of Primary Care Sports Medicine at USF Health.

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