Widespread misuse of steroids in athletes

Nutrition Health Review, Fall, 2002

Baseball team owners, players, and fans seem to agree on the importance of drug testing for steroids, according to current reports; however, the entire scope of performance-enhancing substances available for all athletes is vastly broader, and many of the drugs employed by athletes are not easily detectable, says a Penn State University researcher.

"The use, misuse, and abuse of drugs have long shaken the foundations of amateur and professional sports--baseball, football, track and field, gymnastics and cycling, to name just a few," says Dr. Charles Yesalis, Pedn State professor of exercise and sport science and health policy and administration.

"The-problem is not new. But like the rest of technology, doping in sport has grown in scientific and ethical complexity. In addition to drugs, we have natural hormones, blood doping, diuretics, nutritional supplements, social and recreational drugs, stimulants, and miscellaneous substances, some of which may not even be on any list of banned substances."

Even though drug testing technology struggles to keep up, an array of new and emerging technologies has arrived or is on the horizon with potential for abuse by athletes, including gene transfer therapy, stem cell transplantation, muscle fiber phenotype transformation, red blood cell substitutes, and new drug delivery systems, says Dr. Yesalis, coeditor with Dr. Michael Bahrke of a new book, Performance-Enhancing Substances in Sport and Exercise (Human Kinetics, 2002).

"It is not too hard to imagine the day when muscles can be selectively enlarged or contoured," according to the book. "Just imagine the consequences of a kinesiologist isolating specific muscles and selectively injecting designer genes into those muscles to maximize their function."

The new book brings together the latest and most comprehensive scientific information about performance-enhancing substances. Drug testing, legal and social issues, and future directions by sports governing organizations are also discussed.

"Sport has a responsibility to maintain a level playing field for the trial of skill," Dr. Yesalis says. "The use of chemical and pharmacologic agents is cheating--just like using a corked baseball bat. But unlike the bat, doping is shrouded in mystery. Athletes and their advisors are constantly seeking `gray areas' surrounding the rules, and if something is not explicitly banned, then why not try it. This slippery slope of rationalization is treacherous and appealing to a player or team seeking glory and money rewards."

In one chapter, "Drug Testing and Sport and Exercise," author R. Craig Kammerer suggests that improvement in current tests and developments in new methods will assist future policymaking by athletic federations. However, effective testing must become more widespread and should include unannounced testing outside of competition. Sanctions against athletes must be more fairly and uniformly applied, with thorough investigation to avoid false-positive results and ruining an athlete's career.

The difficulty of detecting and preventing the abuse of performance enhancing substances by adult athletes may seem futile, but it remains necessary as part of the effort to discourage abuse by youths who emulate professional athletes and who also seek a winning advantage, Dr. Yesalis notes.

A recent government study of adolescent drug use shows an alarming increase in anabolic steroid use among middle-school youths from 1998 to 1999, with an estimated 2.7 percent of eighth graders claiming that they have used the drugs. A larger survey by Blue Cross and Blue Shield estimates that one million U.S. children between ages 12 and 17 may have taken performance-enhancing substances, including creatine, the researchers say.

"Children and teens can seriously harm their future health by misusing these substances," Dr. Yesalis says. "For example, steroids alone can cause scarring acne, hair loss, and testicular atrophy and may increase the risk of stroke and heart disease. It is just as important to note that little is known about the health consequences of many of the other substances used to enhance performance. Yet some coaches and parents look the other way and even actively encourage the use of performance-enhancing substances in pursuit of scholarships and winning.

"There is too much fame and fortune to be gained by being a winner in sports," he notes. "It's interesting to see that baseball fans being polled support drug testing and a ban on steroids, but it will take fans of all major sports to take a stand by turning off their TV sets or not buying a ticket to sports events before adult athletes, coaches and team owners stop trying to cheat. And, that's probably not going to happen."