Steroids

Anabolic steroids are among the drugs that are abused not for intoxication or to achieve a high, but for other desired effects. �''Anabolic�'' means muscle-building, and these steroids are available by prescription for a wide range of medical purposes, such as to treat anemia, osteoporosis, low testosterone levels, and loss of muscle mass from body-wasting diseases such as AIDS.

College and university students who abuse steroids generally are seeking performance-enhancing effects or to build muscle mass. Athletes are at particular risk for steroid abuse. Since a high is not the goal, in general these drugs are not taken spontaneously or recreationally, but according to a dosing schedule called �''cycling�'' where the steroids are taken orally or injected over a set period of time, followed by a period of no dosing, then a repeat of the cycle. People abusing these drugs will often combine different steroids (called �''stacking�'') in an effort to maximize the effects. They may vary the doses over the course of the cycle, increasing in strength or number of drugs stacked to a peak dosage, then decreasing gradually to the no-dose part of the cycle in a process called �''pyramiding.�''

Abuse

A good estimate of the prevalence of steroid abuse is difficult to ascertain, according to national experts that include the National Institute of Drug Abuse. Many drug abuse surveys do not include steroids in the drugs on which they collect data, and student athletes are reluctant to discuss steroid use, even anonymously, as they may be subject to severe penalties and restriction or elimination from competition as a result of reported steroid use. However, some data are available:

• A 2006 National Collegiate Athletic Association (NCAA) study estimated that about 1 percent of student athletes abused steroids, a rate estimated to be as much as three times the rate among non-athlete students.
• The Monitoring the Future national studies provide reliable statistics over time among youth (survey respondents are 8th, 10th, and 12th graders), showing steroid use varying between less than 1 percent to more than 2.5 percent over time and according to grade level

Consequences

Steroid abuse has a broad range of negative consequences ranging from severe acne to addiction, and in the most extreme cases, death. Harmful effects include hypertension; blood clotting; uncontrolled violence, including extreme irritability, hostility, and aggression; stunted growth; and several cancers, including liver, kidney, and prostate. In addition, men are subject to reduced sperm production, shrunken testicles, and breast enlargement; women can develop menstrual irregularities and growth of facial hair and other masculine secondary sex characteristics. Ironically, though steroids may be abused to enhance physical performance and improve body image, some of the side effects worsen appearance, such as jaundice, severe acne, premature baldness (in both men and women) and trembling.

It is possible to become addicted to steroids, and stopping steroid use suddenly can bring on withdrawal side effects that include both physical and psychological symptoms such as long-term depression and suicidality.

Effective Prevention

While steroid use is declining among college and university students, athletes still have triple the rate of steroid use compared to non-athletes. Therefore, it makes sense to specifically target athletes and steroid use as part of an environmental management approach to AOD prevention. For instance, encouraging faculty and athletic staff to be more engaged with students athletes helps create a healthy normative environment where steroid use is not expected or accepted. Coaches can also communicate and enforce substance-free training requirements to athletes as part of helping to enforce campus AOD policies.