ED 343 038 TITLE Anabolic National INSTITUTION · 2014-04-09 · anabolic steroids and related com-pounds on its banned list. Athletes who have used anabolic steroidsas well as some

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AnabolicNationalSeries.NationalNd.DHES-Pub(ADM))-91-18109113p.

Nationa.A. Clearinghouse on Alcohol and DrugInformation, P.O. Box 2345, Rockville, MD 20852.Reports - General (140)

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Steroids: A Threat to Body and Mind.Institute on Drug Abuse Research Report

Inst. on Drug Abuse (DHHS/PHS), Rockville,

MF01/PC01 Plus Postage.Adolescents; *Body Image; *Drug Use; *Health;Physical Characteristics; *Self Concept; YoungAdults*Steroids

This report, based on findings of recent studies onthe use of anabolic steroids in the United States, was written toeducate the public about these drugs and the dangers of misusingthem. It notes that the nonmedical use of anabollc/androgenicsteroids among adolescents and young adults is of growing concern,with possibly as many as half a million Americans under age 18abusing these drugs to improve their athletic performance,appearance, and self-image. Evidence is presented suggesting thatmedically unsupervised steroid use may pose severe risks to physicaland psychological health. One section describes valid medical uses ofanabolic steroids, explains what anabolic steroids are, and examinesif they really work. Other sections focus on a brief history ofsteroid use, abuse of anabolic steroids, and megadosing. A section onhealth hazards highlights dangers specific to men, specific to women,and common to both sexes. Special dangers to adolescents arediscussed, the threat of Acquired Immune Deficiency Syndrome throughneedle sharing is explained, and possible psychological effects ofsteroid use are considered. Questions are posed about the possibleaddictiveness of steroids, steroids on the black ,market aredescribed, and safe and healthy alternatives to steroid use aresuggested. Four methods of combating the nonmedical use of anabolicsteroids are recommended: testing, treatment, legislation, andeducation. The report'concludes with a list of relevant resources.(NB)

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ON

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.1 0.5

11111444111The nonmedical use of

anaboliclandrogenic

steroids among adoles-

cents and young adults

is osi growing concern.

As many as half a

million Americans

under age 18 may be

abusing these drugs to

improve athletic per-

formance, appearance

and self-image. Yet aF/,growing body of evidence sug-

gests that medically unsuper-

vised steroids use may pose

severe risks to physical and

psychological health.

This Research Report is

based on the findings of recent

studies on the use of anabolic

steroids in the United States.

Its goal is to educate the public

about these drugs and the

dangers of misusing them.

LI I IMPARTMENT Of FIXOCATFONOexe 0 Ethoopt.ona; Mostar( n WU, ,np.ovemOnt

EDUCATIONAL RESOURCES INFORMATIONCENTER IERICI

eocement nes teen ,ealneucee as/wowed ',an" tne parson nt owojimist,onOf tiersel,ng

r Mew cnsnyes nave peen moos to onweye,eproduceen eudidy

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41111A.

I A Threat

to Body

THE PRICE OF PERFECTION

and Mind

Shock waves went through the sports world when Canadi-an track superstar Ben Johnson was denied his gold medal atthe 1988 Olympics after tests showed he had taken anabolicsteroids. The incident called international attention to the useof anabolic steroids among world-class athletes to gain com-petitive advantagc.

Still, athletes and nonathletes alike persist in taking them.Teenagers are taking anabolic steroids not just to excel insports but to enhance their self-images by perfecting theirphysiques. There are even reports of male adults in physicallydemanding professions like law enforcement using them toappear tougher and more formidable.

As the drug grows in popularity so does awareness of theserious side effects it may cause. One of the most alarming isthe threat of AIDS. HIVhuman immunodeficiency viruscanbe transmitted if shared needles are used to inject the drug,

u S Department ot Health and Human Services Public Health Service Alcohol, Drug Abuse, and Mental Health Administration77.2't

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NIDA RESEARCH REPORT SERIES

But potential harm tophysical and psychologi-cal health is only one as-pect of this troubling

14 Question ofValues

The nonmedical use ofanabolic steroids raisesmore ethcial and moralissues. Engaging insteroids use is illegal.Users are likely to findthemselves acquiringthese drugs throughillicitand expensivechannels. The heavy de-mand for anabolicsteroids has given rise toa black market, withsales estimated at asmuch as $400 million ayear. Moreover, sup-plies, which are oftenillegally manufacturedand do not meet estab-lished standards, maybe contaminated.

Athletes who use thesedrugs are cheating. They gainfair advantage over opponents andviolate the ban on steroids imposed bymost major sports organizations.

an un-

Another Addictive Substance?Can anabolic steroids be added to

the list of addictive drugs? Early signspoint to addictive patterns amongusers. At the very least, users demon-strate an unwillingness to give upanabolic steroids even in the face ofpossibly dire consequences to theirhealth.

Stopping the TrendAs the health risks of anabolic

steroids become more apparent, ef-

2

"I daydreamed about

walking down the

hall in short shorts,

a tank top and a

great tan."Mark, 15

forts to curtail their usethrough education, legis-lation, and medical prac-ticesare intensifying.

For those alreadyhooked, kicking thesteroids habit is the bestchance to ebeape deva-stating side effects. Forpotential users, the solu-tion, of course, is tonever take the drug atall. There are other waysto be a winner athletical-ly and socially withoutharming health andwithout cheating.

USING ANABOLICSTEROIDS

Valid Medical UsesSteroids are drugs de-

rived from hormones.Anabolic steroids com-prise one group of thesehormonal drugs. In cer-tain cases, some mayhave therapeutic value.

The U.S. Food andDrug Administration has approvedthe use of selected anabolic steroidsfor treating specific types of anemia,some breast cancers, osteoporosis, en-dometriosis, and hereditary angio-edema, a rare disease involving theswelling of some parts of the body.

Some medical specialists believe thatanabolic steroids can improve the ap-petite and improve healing after sur-gery, but the FDA has withdrawn ap-proval for such uses since the claimsare vague and largely unsubstantiated.

What Are Anabolic Steroids?Anabolic steroidsor more precise-

ly, anabolic/androgenic steroidsbe-long to a group known as ergogenic,

or so-called "performance-enhanc-ing," drugs. They are synthetic deri-vatives of testmsterone, a natural malehormone.

"Anabolic" means growing orbuilding. "Androgenic" means "mas-cuhnizing" or generating male sexu-al characteristics.

Most healthy males produce be-tween 2 and 10 milligrams of testo-sterone a day. (Females do producesome testosterone, but in traceamounts.) he hormone's anabohceffects help the body retain dietaryprotein, thus aiding growth of mus-cles, bones, and skin.

The androgenic characteristics ottestosterone arc associated with mas-cuhnity. They foster the maturing ofthe male reproductive system in pu-berty, the growth of body hair andthe deepening of the voice. They canaffect aggressiveness and sex drive.

Do They Really Work?Anabolic steroids are designed to

mimic the bodybuilding traits ottestosterone while minimizing its

masculinizing" effects. There areseveral types, with various combina-tions of anabolic and androgenicproperties. The 1nternatkmal Olym-pics Committee to date has placed 17anabolic steroids and related com-pounds on its banned list.

Athletes who have used anabolicsteroidsas well as some coaches,trainers, and physiciansdo reportsigniticant increases in lean musclemass, strength, and endurance. Butno studies show that the substancesenhance performance.

Anabolic steroids do not improveagility, skill or cardiovascular capaci-ty. Some athletes insist that thesesubstances aid in recovery from inju-ries, but no hard data exists to sup-port the claim.

"There is little compelling scientific

evidence to support the concept that

steroids enhance athletic performance."

Theodore J. Cicero, Ph.D., andLynn H. O'Connor, Ph.D., 1990

"I wanted to be the best swimmer and

black female athlete ever."

Grace, 17

"Athletes would rather confess to

cocaine use than to steroids use."

Dr. Charles E. Yesalis,Pennsylvania State University

SPORTS ORGANIZATIONS OUTLAWINGANABOLIC STEROIDS

The International Olympics Committee banned steroids use by allathletes in its member associations in 1975. Since then most majoramateur and professional organizations have put the drugs on theirlist of banned substances. They include:

National Football LeagueNational Collegiate Athletic

Association

International Amateur AthleticFederation

International Federation ofBody Builders

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NIDA RESEARCH REPORT SERIES

A BRIEF HISTORY

Winning Through DopingThe drive to competeand to

winis as old as humankind.Throughout history, athletes havesought foods and potions to trans-form their bodies into powerful, well-tuned machines.

Greek wrestlers ate huge quantitiesof meat to build muscle, and Norsewarriorsthe Berserkersate hal-lucinogenic mushrooms to gear upfor battle.

The first competitive athletes be-lieved to be charged with doping"taking drugs and other nonfood sub-stances to improve performancewere swimmers in Amsterdam in the18605. Doping, with anything fromstrychnine and caffeine to cocaineand heroin, spread to other sportsover the next several decades.

Enter Anabolic SteroidsThe use of anabolic steroids by ath-

letes is relatively new. Testosteronewas first synthesized in the 1930'sand was introduced into the sportingarena in the 1940's and 1950's. Whenthe Russian weightlifting teamthanks, in pan, to synthetic testo-steronewalked off with a pile ofmedals at the 1952 Olympics, anAmerican physician determined thatU.S. competitors should have thesame advantage.

By 1958 a U.S. pharmaceutical firmhai developed anabolic steroids. Al-though the physician soon realizedthe drug had unwanted side effects,it was too late to halt its spread intothe sports world.

Early users were mainly bodybuild-ers, weightlifters, football players,and discus, shot put, or javelinthrowerscompetitors who reliedheavily on bulk and strength.

4

"There may be a

greater number of

cases of anabolic

steroid-induced

psychiatric illness

in this country than

had been assumed . . .

these effects may pose

a danger not only

to the steroids user

but to the public

at large."David Katz and

Harrison Pope,

Harvard University

THE POSITION OF THEMEDICAL COMMUNITY

The American Medical Associ-ation condemns the use of ana-bolic steroids by athletes. Othermedical associations have joinedwith the AMA in deploringsteroids abuse, including the:

American Academy ofPediatrics

American College of SportsMedicine

American OsteopathicAcademy of Sports Medicine

During the 1970's demand grew asathletes in other sports sought thecompetitive edge that anabolicsteroids seemed to provide.

By the 1980's, as nonathletes alsodiscovered the body-enhancing prop-erties of steroids, a black marketbegan to flourish for the illegal pro-duction and sale of the drugs for non-medical purposes.

ABUSING ANABOLICSTEROIDS

Who Takes Thernand Why?Today it is not only the college foot-

ball player or the professional weight-lifter or the marathon runner whomay use anabolic steroids.

It may be an 18-year-old wholoathes his skinny body. Or a 15-year-old in a hurry to reach maturity.

Or a policeman who wants moremuscle power on the job.

And the use of anabolic steroids isnot confined to males. l'rofessionaland amateur female athletestrackand field competitors, swimmers,bodybuildersfed the pressure to tri-umph. too.

Increasing numbers of adolescentsare turning to steroids for cosmeticreasons. In a 1986 survey, , as many as45 percent of 200 high school userscited appearance as a primary reasonfor taking steroids.

Young people who use steroidsdefy easy categorizing. They comefrom cities and rural areas, from poorfamilies and wealthy ones. They areof all races and nationalities. Thecommon link among them is the de-sire to look, perform and feel betterat almost any cost. Usersand espe-cially the youngare apt to ignore ordeny warnings about health risks. Ifthey see friends growing taller andstronger on steroids, they want the

same benefits. They want to believein the power of the drug,

How Prevalent is Use?Surveys and anecdotal evidence in-

dicate that the rate of nonmedicalsteroids use may be increasing.

In 1990, a N1DA survey of highschool seniors showed that nearly 3percent-3 percent of males and 05percent of femaksreported usingsteroids at some time in their lives.

'Me same survt. v 4lowed thatsteroids were used within the lastrear by nearly as many students ascrack cocaine and bv more studentsthan the hallucinogenic drug PCP.

Use among college temales appearsto have increased somewhat. A studyof 11 universities in 1984 found thatsteroids users were reported in onlyone women's sportswimmingat arate of 1 percent. In a tollow-up sur-vey in 1988, 1 percent ot women intrack and field and basketball alsoreported taking steroids.

Use among adult or professionalathletes has not been %yell docu-mented, although anecdotal evidencedearly supports the suggestion thatanabolic steroids have enjoyedpopularity among football players,weightlifters, wrestlers. and trackand field competitors, among others.

MEGADOSING

Anabolic steroids are usually takenin pill form. Some that cannot be ab-sorbed orally are taken by injection.The normal prescribed daily dose tormedical purposes usually averagesbetween I and 3 milligrams.

Some athletes, on the other hand,may take up to hundreds of milli-grams a day, far exceeding medicallyrecommended dosages.

A GLOSSARY OF TERMSDrug and steroids use in sports has spawned a glossary of its own:

Bknding. Mixing different drugs.Bulking up. Increasing muscle

mass through steroids.Cycling. Taking multiple doses of

steroids over a specified period oftime, stopping for a time and start-ing again.

Doping. Using drugs and othernonfood substances to improveathletic performance and prowess.

Ergogenic drugs. Performance-enhancing substances.

Megadosing. Taking massiveamounts of steroids, by injection or

Plateauing. When a drugbecomes ineffective at a certainlevel.

Roid rages. Uncontrolled out-bursts of anger, frustration or com-bativeness that may result fromusing anabolic steroids.

Shotgunning. Taking steroids ona hit-or-miss basis.

Stackiag. Using a combination ofanabolic steroids, often in combi-nation with other drugs.

Tapering Slowly decreasingsteroids intake.

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NIDA RESEARCH REPORT SERIES

Operating on tile er-roneous more-is-bettertheory, some athletes in-dulge in a practiceknown as "stacking."They take many types ofsteroids, sometimes incombination with otherdrugs such as stimulants.depressants, pain killers,anti-inflammatories, andother hormones.

Many users "cycle,"taking the drugs for 6 to12 weeks or more, stop-ping for several weeksand then starting an-other cycle. They maydo this in the belief thatby scheduling theirsteroids intake, they canmanipulate test resultsand escape detection. Itis not uncommon forathletes to cycle over aperiod of months oreven years.

HEALTH HAZARDS

Raising a Red FlagAlthough controlled

studies on the long-term outcome ofmegadosing with anabolic steroidshave not been conducted, extensiveresearch on prescribed doses formedical use has documented thepotential side effects of the drug,even when taken in small doses.Moreover, reports by athletes, andobservations of attending physicians,parents, and coaches do offer sub-stantial evidence of dangerous sideeffects.

Some effects, such as rapid weightgain, are easy to see. Some take placeinternally and may not be evident un-til it is too late. Some are irreversible.

6-

Anabolic steroids can halt growth prematurely in adolescents.

6

"I was more

aggressive, but is

aggressiveness bad?

Tony, former

steroids user

/1

The Dangers...to Men

Males who take largedoses of anabolic steroidstypically experiencechanges in sexual char-acteristics. Although de-rived from a male sexhormone, the drug cantrigger a mechanism inthe body that can actual-ly shut down thehealthy functioning ofthe male reproductivesystem. Some possibleside effects:

Shrinking of thetesticlesReduced spermcountImpotenceBaldnessDifficulty or pain inurinatingDevelopment ofbreastsEnlarged prostate

and to WomenFemales may experi-

ence "masculinization" aswell as other problems:

Growth of facial hairChanges in or cessation of themenstrual cycleEnlargement of the clitorisDeepened voiceBreast reduction

... and to Both SexesFor both males and females, con-

tinued use of anabolic steroids maylead to health conditions rangingfrom merely irritating to life-threatening. Some effects are:

AcneJaundiceTremblingSwelling of feet or anklesBad breath

Reduction in HDL. the "good"cholesterolHigh blood pressureLiver damage and cancersAching jointsIncreased chance ot injury to ten-dons, ligaments, and muscles

Special Dangers to AdolescentsAnabolic steroids can halt growth

prematurely in adolescents. Becauseeven small doses can irreversibly af-fect growth, steroids are rarelyprescribed tor children and youngadults, and only tor the severek ill.

The Office of the Inspector Generalin the U.S. Department of I lealth andI luman Services has gathered anec-dotal evidence that preteens andteens taking steroids max. be at riskfor developing a dependence on thedrugs and on other substances aswell.

The Threat of AIDSPeopk sometimes take iniections ot

anabolic steroids to augment oraldosages, using large-gauge, reusaNeneedles r. ,rmally obtained throughthe black market. If needles areshared. users run the risk ot transmit-ting or contracting the I UV intectionthat can wad to AIDS.

The Psychological EffectsScientists are just beginning to in-

vestigate the impact t.t anabolicsteroids on the mind and beha.Nlany athletes report "feeling good"about themselves while on a steroidsregimen. The downside, according toHarvard researchers, is wide moodswings ranging from periods ot vio-lent, even homicidal, episodes knownas "roid rages" to bouts of depressionwhen the drugs are stopped.

The Harvard study also noted thatanabolic steroids users may slitter

%J.

"If needles are shared, steroids users

run the risk of transmitting or

contracting the HIV infection that

can lead to AIDS."

7

NIDA RESEARCH REPORT SERIES

from paranoid jealousy, extreme irri-tability, delusions, and impairedjudgment stemming from feelings ofinvincibility.

ARE ANABOLIC STEROIDSADDICTIVE?

Evidence that megadoses of ana-bolk steroids can affect the brain andproduce mental changes in usersposes serious questions about possi-ble addiction to the drugs.

While investigations centinue, re-searchers at Yale University havefound that long-term steroids usersdo experience many of the charac-teristics of classic addiction: cravings,difficulty in ceasing steroids use andwithdrawal symptoms.

Pennsylvania State University re-searchers studied a group of highschool seniors who had developed apsychological, if not physical, depen-dence on anabolic steroids. Adoles-cent users exhibit a prime trait ofaddictsdenial. They tend to over-look or simply ignore the physicaldangers and moral implications oftaking illegal substances.

Certain delusional behavior that ischaracteristic of addiction can occur.Some athletes who "bulk up" onanabolic steroids are unaware of bodychanges that are obvious to others,experiencing what is sometimescalled reverse anorexia.

SUPPLY AND DEMAND:THE BLACK MARKET

Many users maintain their habitwith anabolic steroids acquiredthrough a highly organized blackmarket handling up to $400 millionworth of the drugs a year.

8

Until recently most undergroundsteroids were legitimately manufac-tured pharmaceuticals that werediverted to the black market throughtheft and fraudulent prescriptions.More effective law enforcement cou-pled with greater demand forcedblack marketers to seek new sources.

Now black-market anabolic steroidsare either made overseas and smug-gled into the United States or areproduced in clandestine laboratoriesin this country. These counterfeitdrugs may present greater healthrisks because they are manufacturedwithout controls and thus may be im-pure, mislabeled, or simply bogus.

Sales are made in gyms, health dubs,on campuses, and through the mail.Users report that suppliers may bedrug dealers or they may be trainers,

9

physicians, pharmacists, or friends.It's not hard for users to buy the

drugs or to learn how to use them.Many of them rely on an under-ground manual, a "bible" on steroidsthat circulates around the country.

SAFE-AND HEALTHY-.ALTERNATIVES

Anabolic steroids may have a repu-tation for turning a wimp into a win-ner or a runt into a hulk, but the truthis that it takes a lot more to be a starathlete.

Athletic prowess depends not onlyon strength and endurance, but onskill and mental acuity. It also de-pends on diet, rest, overall mentaland physical health, and genes. Ath-

letic excellence can be, and is,achieved by millions without relianceon dangerous drugs.

FIGHTING BACK

TestingThe major national and internation-

al sports associations enforce theirban against anabolic steroids byperiodic testing. Testing, however, iscontroversial.

Some observers say the tests arenot reliable, and even the Internation-al Olympic Committees tests, consid-ered to be the most accurate, havebeen challenged. Athletes can manip-ulate results with "masking agents"to prevent detection, or they can takeanabolic steroids that have calculabledetection periods.

Despite the problems, testing re-mains an important way of monitor-ing and controlling the abuse ofsteroids among athletes. Efforts areunderway to make testing moreaccurate.

TreatmentTreatment programs for steroids

abusers are just now being developedas more is learned about the habit.

Medical specialists do find persua-sion is an important weapon is get-ting the user off the drug. They at-tempt to present medical evidence ofthe damage anabolic steroids can doto the body. One specialist notes thatmedical tests, such as those thatshow a lowered sperm count, canmotivate male athletes to cease usage.

One health clinic considers the ana-bolic steroids habit as an addictionand structures treatment around thetechniques used in traditional sub-stance abuse programs. It focuses onacute intervention and a long-termfollow-up, introducing nonsteroi is

"We see. . . people not

being able to see their

lives falling apart,

people trying to get

off the drug and not

being able to."

Kenneth Kashkin

and

Herbert Kleber,

Yale University

For FurtherInformationNIDA Hotline1-800-662-HELP

Operated by the National Insti-tute on Drug Abuse, this is a con-fidential information and referralline that directs callers to drugabuse treatment centers in theirlocal community.

NCADI14300-729-6686

The National Clearinghouse forAlcohol and Drug Information(NCADI) provides information onall drugs, including alcohol. Freematerials on drug abuse are alsoavailable. If you wish to writeNCADI, the address is P.O. Box2345, Rockville, MD 20852.

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alternatives that that will maintainbody fitness as well as self-esteem.

LegislationBoth Federal and State governments

have cnacted laws and regulations tocontrol anabolic steroids abuse.

In 1988, Congress passed the Anti-Drug Abuse Act, making the distri-bution or possession of anabolicsteroids for nonmedical reasons aFederal offense. Distribution tominors is a prison offense.

In 1990, Congress toughened thelaws, passing legislation that classifiesanabolic steroids as a controlled sub-stance. The new law also increasespenalties for steroids use and traffick-ing. To halt diversion of anabolicsteroids onto the black market, thelaw imposes strict production andrecordkeeping regulations on phar-maceutical firms.

Over 25 states have passed laws andregulations to control steroids abuse,and many others are considering simi-lar legislation.

EducationPrevention is the best solution to

halting the growing abuse of anabolicsteroids. The time to educate young-sters is before they become users.

Efforts must not stop there, how-ever. Current users, as well ascoaches, trainers, parents, and medi-cal practitioners need to know aboutthe hazards of anabolic steroids. Theyoung need to understand that theyare not immortal and that the drugscan harm them. An education cam-paign must also address the problemof covert approval by some membersof the medical and athletic communi-ties that encourages steroids use.

The message needs to be backed upby accurate information and spread byresponsible, respected individuals.

NIDA RESEARCH REPORT SERIES

American College of Sports Medi-cine, "Position Stand on The Useof Anabolic/Androgenic Steroids inSports," 1984.

American Osteopathic Academy ofSports Medicine, "Policy Statementand Position Paper: Anabohc/Androgenic Steroids and SubstanceAbuse in Sport," May 1989.

Buckley, WE.; Yesalis, C.E.: VicaryJ.R.: Streit, A; Katz D.L.; Wright,j .E., "Indications of PsychologicalDependence Among Anabolic/An-drogenic steroids Abusers." Adap-tation from a paper, "Anabolicsteroids Use: Indications of Habit-uation Among Adolescents," Jour-nal of Drug Education, 1989.

Caro Ian, N.J., "The Treatment ofthe Ana'oolic steroids Addict." Un-published paper, 1991.

Cicero, T.J., and O'Connor, L.H.,"Abuse Liability of AnabolicSteroids and Their Possible Role inthe Abuse of Alcohol, Morphineand Other Substances," N1DA Re-search Monograph 102, 1990.

Dyment, P.G., and Goldberg, B..Committee on Sports Medicine,"Anabolic Steroids and the Adoles-cent Athlete," Pediatrics, January1989.

Frank le, M.A., 'Anabolic-Andro-genic Steroids; A Guide for thePhysician," The Journal of Mus-culoskeletal Medicine, November1989.

RESOURCESFried), K.E., "Reappraisal of theHealth Risks Associated with theUse of High Doses of Oral and In-jectable Androgenic Steroids,"N1DA Research Monograph 102, 1990.

Hecht, A., "Anabolic Steroids:Pumping Trouble," FDA Consumer,September 1984.

International Federation of Body-builders, "The Battle AgainstSteroids Goes On: Position Paperof the I.F.B.B," 1990.

Kashkin, K.B., and Kleber, H.D.,"Hooked on Hormones? An Ana-bolic Steroid Addiction Hypothe-sis," Journal of the American MedicalAssociation, December 1989.

Katz, D.L., and Pope, H.G., "Ana-bolic/Androgenic Steroid-InducedMental Status Changes," N1DA Re-search Monograph 102, 19941

Kennedy, N., "Steroid Studies: Es-timated Percentages of Use," Ap-pendix B of the Research Subcom-mittee of the Interagency TaskForce on Anabolic Steroids, Nation-al Institute on Drug Abuse, 1990.

Lombardo, J.A., "Anabohc/Andro-genic Steroids," N1DA ResearchMonograph 102, 1990.

Miller, R.W., "Athletes andSteroids: Playing a Deadly Game,"FDA Consumer, November 1987.

National Institute on Drug Abuse,"Anabolic Steroids: Is Bigger Betteror Just Big Trouble?," N1DA Notes,

Spring/Summer 1989.

National Institute on Drug Abuse,"Study of Athletes Shows Aggres-sion and Other Psychiatric Side Ef-fectF From Steroid Use," NIDAI.'otes, Spring/Summer 1989.

Norris, J.A., "FDA Warns: SteroidsMay Be Hazardous to YourHealth," Schools Without Drugs: TheChallenge, U.S. Department of Edu-cation, November 1987.

Office of Inspector General, U.S.Department of Health and HumanServices, "Adolescents and Steroids:A User Perspective," August 1990.

Office of Inspector General, U.S. De-partment of Health and Human Ser-vices, "Adolescent Steroid Use,"1990.

Stehlin, D., "For Athletes and Deal-ers, Black Market Stemids Are RiskyBusiness," FDA Consumer, 1987,

U.S. Food and Drug Administration,"The Blaclanarketing of Anabolic, Er-gogenic and Related PrescriptionDrugs for Athletic Enhancement: AnFDA Overview, " FDA Conswner, 1987

U.S. General Accounting Office,'Drug Misuse: Anabolic Steroidsand Human Growth Hormone,"August 1989.

Yesalis, C.E.; Anderson, W.A.;Buckley, W.E.: and Wright, J,E., "In-cidence of Non-Medical Use of Ana-bolic Steroids," NIDA ResearchMonograph 102, 1990.

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RESEARCH REPORT SERIES

Each issue of the Research Report Senes will provide brief butdetailed research findings on a single health issue that is of nation-al interest. The chief purpose of the Research Report Series is to edu-cate and inform the public about the dangers of substance abuse.The issues will refer to the latest scientific data and to NIDA sur-veys for determining trends.

The Research Report Series is produced by the Community andProfessional Education Branch, Office of Policy and External Affairs,NIDA. All materials appearing in the Research Report Series are inthe public domain and may be reproduced without permission fromNIDA. Citation of the source is appreciated.

To obtain additional copies of this issue, please call c r write theNational Clearinghouse on Alcohol and Drug Information, P.O. Box2345, Rockville, MD 20852, 1-800-SAY-NO TO (DRUGS).

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ADHHS Publication No. (ADM) 91-1810Alcohol, Drug Abuse, and Mental Health AdministrationPrinted 1991

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