Image: Schools and steroids
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Out of more than 45,000 students tested for performance enhancing drugs in Texas, 19 came up positive. The cost of the program over the two years was $3 million, or $157,894 per positive test.
By msnbc.com contributor
msnbc.com contributor
updated 8/26/2009 9:39:50 AM ET 2009-08-26T13:39:50

With the start of the new school year, thousands of high school student-athletes will face a trial that has nothing to do with wind sprints, push-ups, or drills honing their skills. They will be urinating into cups, so they can be tested for steroids, just like the pros.

This month, Illinois Governor Pat Quinn signed into a law an expansion of the state’s existing testing program for steroids and stimulants, so called “performance-enhancing drugs,” part of a nationwide trend to insure boys and girls are PED-free.

The law was not controversial; it unanimously passed the state’s legislature. Who would vote no? After all, goes the conventional wisdom, steroids kill, and lots of kids are using them because they want bigger muscles, faster times, more power, just like their pro sports idols. Testing will keep them pure.

But the conventional wisdom might be wrong.

Steroid use in schools may not be nearly as prevalent as has been assumed, say some experts who note that the dangers of doping have been hyped partly by politicians, partly by well-meaning but misguided parents, and partly by a growing drug testing industry. They also say testing kids for PEDs will not only prove ineffective, but counterproductive and wasteful.

At the moment, three states, New Jersey, Texas and Illinois, have active statewide mandated steroids testing. Florida’s program has been suspended due to a budget crunch but officials there hope to restart it. Some local districts and individual schools around the country also test, and there are calls for testing in many jurisdictions.

But the move to test, said Dr. Norm Fost, a University of Wisconsin pediatrician and bioethicist, is based on “mass hysteria and phenomenal hyperbole.”

“This is just like ‘Reefer Madness,’” he said, likening the push to the Depression-era anti-marijuana film which depicted high school students tuned into murderous lunatics.

Fost has been a long-time — if lonely — skeptic of anti-PED policies. But he has some allies in his opposition to school-based testing programs as they are currently constituted.

High costs, low impact
University of Michigan researcher Lloyd Johnston, who conducts an ongoing survey of teenage risk taking for the National Institute on Drug Abuse, believes testing is “very likely going to be a very expensive set of interventions with minimal impact.”

Hard numbers reported by states that test seem to bear that out:

  • In Texas, for the entire period of testing so far (February 2008 through May of 2009), 45,193 students have urinated into cups. Nineteen have come up positive. The cost of the program over the two years was $3 million, or $157,894 per positive test.
  • In Florida, the state spent $100,000 testing about 600 athletes during the 2007-2008 year and found one positive.
  • New Jersey has spent $100,000 per year over nearly three years, testing 500 students per year. So far there have been two positives.
  • During the 2008-2009 school year, Illinois spent $150,000 testing 684 students. Zero tested positive for unauthorized substances.

Dr. Linn Goldberg, an Oregon Health Sciences University physician and doping expert who studies drug use among young people, says he has found that testing not only has little impact as a deterrent, but that it may even backfire.

In 2007, Goldberg co-authored a study showing that “overall, drug testing was accompanied by an increase in some risk factors for future substance use.”

Goldberg surmises that testing gives the impression lots of kids are using. Students then look around, see that their peers are healthy, and conclude that perhaps drug use is not as dangerous as they've been told. 

Rather than testing, Goldberg said, “schools should do what they do best, and that’s educate.”

But such dissenting voices have been smothered amid the cacophony of Congressional hearings on steroid use in professional baseball, Tour de France scandals , statements from anti-doping agencies and testing companies warning of looming public health threats to children.

“I sat next to the governor of Texas before they started drug testing and I told him it was nuts,” Goldberg recalled. “It just makes no sense.”

The process Illinois followed was typical. Kurt Gibson, the assistant executive director of the Illinois High School Association, the state’s scholastic sports authority, says a task force it created sent materials about PEDs to schools and coaches and asked if there was a problem.

“The feedback was ‘Yes, there is,’” recalled Gibson. That answer was based on anecdotal comments, said Gibson, who favors testing for its supposed deterrent effect. Coaches asked their athletes if they knew of kids taking PEDs. “Those kids said ‘Yeah,’” Gibson explained, often pointing the finger at rival teams. “It was lots of stuff like ‘the kids in the other town are doing stuff.’”

Pete Tunnicliffe, the father of Matt, a senior cross country and track athlete at Prairie Ridge High School in Crystal Lake, Ill., said he’s “glad the state is taking action to help protect our children.”

After all, he said, everyone has read the headlines about professional baseball. “We do believe it filters down.”

Neither he nor his son are aware of any student athletes using performance-enhancing drugs, Tunnicliffe said, “but we follow the logic after what‘s happened at the professional level.” Slideshow: Baseball's steroid scandal

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Far less usage than previously thought
That logic leads to inflated estimates of school-age users, some say. When proponents of testing in Texas enlisted the help of former Chicago Bears linebacker Dick Butkus, the Hall of Famer released a statement saying “recent reports estimate that steroid use among high school students is gripping as many as one-in-10 students, including both young men and women.”

While accurate numbers are difficult to obtain because it’s illegal to possess the drugs without a prescription, no credible research study has ever shown anything close to a one-in-10 usage rate. The most recent data available from the Centers for Disease Control and Prevention show that the national median percentage of high school boys and girls who had ever in their lives used a steroid drug illicitly is 3.9.

Recent usage is far lower. The 2008 numbers for Johnston’s ongoing study showed that the percentage of students who used an illicit steroid in the last 30 days was just 0.6 percent. That is just slightly more than the percentage, 0.4, who had used heroin. Meanwhile, in the last 30 days, 12.5 percent had smoked marijuana, 14.9 percent had been drunk, and 12.6 percent had smoked cigarettes.

Rather than a growing problem, Johnston said, steroid use has been falling off.

Harvard psychiatrist and drug abuse researcher Dr. Harrison Pope adds that teens often misconstrue questions on surveys so that when they are asked if they ever used "steroids" that were not prescribed by a doctor, some conflate "steroids" with over-the-counter supplements, such as creatine.

But state legislators and school administrators have compared the small number of student athletes who test positive to supposed usage rates and hailed them as proof that testing acts as a deterrent.

The consequences for testing positive vary from jurisdiction to jurisdiction but typically involve suspension from the sport, education, and then having to retest negative after the suspension period before being allowed back. Suspension times vary state to state. In Texas it is 30 days for a first positive.

The hope that testing will be a deterrent is why Illinois is beefing up its testing and why, despite a budget crunch that forced it to reduce its layout for testing and scale back the program, Texas is forging ahead.

With steroid tests costing nearly $200 per sample, there has been a rise of what Johnston calls “a kind of testing industrial complex.” Fourteen companies submitted bids to conduct the Texas testing before the National Center for Drug Free Sport, a private Kansas City, Mo., company, won the contract. All have an incentive to promote the idea that testing kids for steroids is worth whatever schools can pay.

‘Issue is almost non-existent at high school level’
Regardless of the real rate of use, some scholastic athletic leaders have looked at the numbers and decided to resist the testing juggernaut.

Blake Ress, the commissioner of the Indiana High School Athletic Association believes that while testing makes for good politics — Texas Lt. Gov. David Dewhurst made it a signature campaign issue in 2006 — “in reality what research has been done shows the issue is almost non-existent at the high school level. Some say ‘Yes, but if we save one kid it’s worth all the money we spend.’ That’s a good public statement but is that really true? I don’t think it is worth all the energy and money and everything it takes to do it … but you never know what will happen when politics gets into it.”

Steroid risksAs Ress suggested, some argue the potential harm of steroids justifies the expense. Butkus’ statement in favor of Texas’s program, for example, asserted that steroids are “associated with heart disease, cancer, liver damage, other life-shortening conditions, and severe depression known as ‘roid rage.’”

New York state assemblyman Harvey Weisenberg has been introducing a school steroids bill for years. He’s made little progress, but plans to re-introduce it again during the next session because “steroids are so scary to me. We had hearings. A Mr. Universe testified about grapefruit-size tumors. Lyle Alzado, the pro football player, died of brain cancer. All the information is out there!”

Such arguments have been absorbed by parents, politicians and an often credulous press. One Texas parent told San Antonio NBC TV station WOAI that that “whether it’s a wrestler or a professional football player, they all go berserk. We certainly don’t need our students in high school going berserk.” But the facts are more nuanced.

“Lyle Alzado’s brain tumor had nothing to do with steroids,” Fost said. “There’s been tremendous hyperbole.”

So far, no one can say definitively just what long term effects, if any, illicit steroid use by older teenagers will have since it would be unethical to do a clinical trial to find out. Acute side effects can include acne, male pattern hair loss, a rise in “bad” cholesterol, shrinking testes, and possible emotional disturbance upon withdrawal. These symptoms are dose and time dependent and usually reversible. Steroids can also prematurely close the skeletal growth plates of younger children, and that’s not reversible.

Fost strongly believes that it’s a bad idea for kids to take steroids and endorses laws punishing the illicit provision of steroids to them, but, he said, “nobody is dropping like flies the way scare mongers would have you believe.” Meanwhile, he pointed out, “we have 400,000 people die from smoking every year and most of them started smoking as teenagers.”

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