Magazine article Clinical Psychiatry News

Teens and Steroids: A Dangerous Mix

Magazine article Clinical Psychiatry News

Teens and Steroids: A Dangerous Mix

Article excerpt

Any mention of teen drug abuse inevitably evokes images of troubled adolescents from dysfunctional families using cocaine, ecstasy, heroin--whatever they can get their hands by whatever means--to get high. The picture is accurate to some degree, but it's also incomplete.

Missing from that picture are the high-performing student athletes who do their families proud, the perfectionist fitness buffs whose internal personas become defined by their external appearance, and the little guys who know that the big guys get all of the attention and all of the dates. Unlike some of their drug-abusing peers, however, these kids are not interested in street drugs. They covet performance-enhancing drugs, including growth hormones and anabolic steroids. And while they are often just as desperate as their peers to get their fix, they're not taking the drugs to get high. They're taking them to get strong, to get lean, to get validation, and to get scholarships--and they're doing it under the noses of their parents, coaches, and teachers.

Since 1991, there has been a significant increase in anabolic steroid use among 8th, 10th, and 12th graders, according to a 2002 National Institute on Drug Abuse (NIDA) survey of middle and high school students. The Monitoring the Future (MTF) study determined that 1.9% of the 8th graders, 1.8% of the 10th graders, and 2.1% of the 12th graders surveyed in 1991 had reported using anabolic steroids without a prescription at least once in their lifetimes. By 2002, the respective rates were 2.5%, 3.5%, and 4.0%.

The Centers for Disease Control and Prevention's 2001 Youth Risk Behavior Surveillance survey of high school students across the United States produced higher numbers. In that study, 5.8% of 9th graders, 4.9% of 10th graders, 4.3% of 11th graders, and 4.3% of 12th graders reported lifetime use of steroid tablets or injections without a doctor's prescription.

Especially alarming are the ease with which steroids can be obtained and students' perceptions of the dangers associated with them. According to the 2002 MTF data, 22% of 8th graders, 33.2% of 10th graders, and 46.1% of 12th graders reported that steroids were "fairly easy" or "very easy" to obtain. And the percentage of 12th graders--the only grade for which such data are available--who perceive steroid use as harmful fell from a peak of 70.7% in 1992 to 55.7% in 2004, according to a more recent MTF survey. Similarly, the percentage of those who disapprove of steroid use has declined from 92.1% in 1992 to 87.9% in 2004.

Although adolescents who abuse alcohol and street drugs are often easy to spot--and in recent years society has gone to great lengths to reach them with preventive and treatment interventions--those who use performance-enhancing drugs are often less visible because there are far fewer of them and often they're doing "good" by winning games and earning kudos for their achievements or their improved physiques.

The actual parameters of the at-risk population are difficult to define and are clouded by certain stereotypes. Athletes who participate in organized team sports are not the only adolescents who use steroids. Bodybuilders and weight lifters use them, as do teens who aren't involved in sports but who use them to improve their appearance or self-esteem.

And steroid use is not for boys only. Adolescent girls are using them to gain an edge, both on and off the playing field. In one study by the division of health promotion and sports medicine at Oregon Health and Science University, Portland, one-third of high school girls in that state who admitted to ever using steroids were athletes, while two-thirds reported using the substances to get thinner. Not surprisingly, according to Dr. Linn Goldberg, head of the division, the girls in the latter category were also more likely to have eating disorders and to have abused diuretics, amphetamines, and laxatives to lose weight. …

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