msnbc.com
updated 2/5/2008 8:36:21 AM ET 2008-02-05T13:36:21

As Congress prepares for a Feb. 13 public hearing focusing on steroid use by Major League Baseball pitcher Roger Clemens, a new survey describes how professional athletes influence young people who decide to use performance-enhancing drugs.

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The confidential survey found that a majority of the students in grades 8 through 12 who admitted to using anabolic steroids say they would use a pill or powder to reach their athletic goals, even if it would harm their health or shorten their life.

Dr. Edward V. Craig, a sports medicine specialist and attending surgeon for the Hospital for Special Surgery in New York, explained to msnbc.com the effects of anabolic steroids on young bodies and the difficulties of testing teens for performance-enhancing drugs.

Q: As high school sports become even more competitive, there's a worry that more young people will be taking steroids. Is it more dangerous for teenagers to use steroids than for an older athletes?

A:
Steroid use in young people whose bodies are developing is very different from mature, professional athletes. Although use in both groups is a big problem, the issues are much more significant and potentially catastrophic for younger players.

Image: Dr. Edward V. Craig
Although steroid use is a big problem among professional athletes, the risks for younger players may be much greater, says Dr. Edward V. Craig, sports medicine specialist at New York's Hospital for Special Surgery.
Nearly 30 percent of steroid users experience adverse effects, only some of which are reversible when the drug is stopped. The side effects include acne, testicular atrophy, breast enlargement in males (gynecomastia) and hirsutism (excess facial hair). More serious reactions have been linked with steroids, such as suicidal behavior, heart attacks and liver damage.

There are some things that are unique to young athletes. Steroids load up a teenager with synthetic testosterone. This can lead to premature puberty. Among other problems, premature puberty in youngsters with growth plates that are open in bones causes the growth plates to close prematurely. The direct result is short stature.

Mood issues are much more acute in teens, so taking steroids may lead to more depression and aggressive behavior.

In addition, several studies have documented an association of steroid use with other high-risk behavior, such as driving drunk, having unsafe sex and using other illicit drugs. Teens, especially boys, are already a high-risk group so using steroids amplifies the problem.

Q: What do anabolic steroids do to the body in general?

A: Anabolic steroids act in the body similar to the way natural testosterone does. By increasing the number of muscle cells and causing them to hypertrophy, the muscles get bigger and stronger. The more steroids you take, the greater the effect.

Anabolic steroids also act to improve exercise tolerance, protect against muscle fiber damage and increase protein synthesis during recovery. Thus, an athlete who must compete on a regular basis, such as either starting or relief pitchers, may see this as a beneficial effect.

Less understood are the psychoactive effects, including a type of euphoria that may allow the athlete more frequent, intense and effective workouts.

The risks can increase when steroids are "stacked." Taken orally, by injection or even by a patch or gel on the skin, steroids are frequently used in combination to create a mega-dose regimen in four- to 12-week drug cycles.

Q: Are there other performance-enhancers being taken by teen athletes to make them more competitive?

A:
Many start with protein powders such as creatine. It's a commonly used nutritional supplement, although there is no long-term data on how harmful it is to the kidneys. Teens may also use the hormone androstendione, which turns into testosterone in the body. These supplements may not be as dangerous as steroids, but it’s a slippery slope for young people to start to take them to play better or look better. They often move onto steroids or other types of drugs such as stimulants or diuretics.

Q: Some states have limited steroid testing programs in high schools. Do you believe more testing will have an impact on steroid use among teenage athletes?

A:
The problem with testing is that it’s hard to know who to test. You have all these young people from recreational school athletes, to college athletes, down to Little League.

And when do you do the test? Just before events or between events? Some states have tried it prior to tournaments, but if athletes know when they’re going to be tested, they can stop using the drugs. It’s hugely expensive to have a state try to test every high school athlete. And some of the time, you may not be getting what they’re taking because some growth hormones don’t have a good test for them.

If it were random, unannounced testing, and if students who test positive were banned, maybe the fear factor would make some difference.

A better solution would be education about steroid risks and programs for supervised resistance training in kids, which has been shown to increase strength in young people up to 40 percent.                

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