Steroid Use

February 28, 2005

In 2002-2003, tenth and twelfth grade males who were highly involved with an athletic team were more likely than those who did not participate to have used steroids in the last year. In grade 12, the contrast was 5.1 percent for males participating in athletics to a great extent compared with 2.2 percent for those not participating at all. (See Figure 1)

Importance

Anabolic-Androgenic steroids, the steroids commonly associated with athletes and body builders, are synthetically produced forms of the hormone testosterone. While doctors may prescribe steroids, youth may also take these substances illegally because of a desire for a more muscular or leaner appearance, or to enhance their strength, size, or aggressiveness in order to excel in athletics.

Steroid misuse or abuse has been associated with health problems and undesirable outcomes such as stunted growth, acne, insomnia, nausea/vomiting, hypertension, heart attack, liver damage or cancer, baldness, and increased risk of ligament and tendon injuries. Females may experience a deepened voice, increases in body and facial hair, menstrual irregularities, and an enlarged clitoris. Males may experience testicle shrinkage, infertility, and breast development. In addition several psychological effects, such as increased aggression and hostility, irritability, anxiety, paranoia, mood swings, depression, and suicidal thoughts may also occur.1
Adolescent steroid use has been associated with other risky behaviors such as drinking, use of other drugs, and tobacco smoking.2 One study found steroid users to have higher levels of STDs and were more likely to drink and drive or get into a fight than were their non-using peers. In addition, youth often share needles when using steroids, running the risk of contracting HIV or other diseases.3

Anabolic steroid users have also been found to exhibit symptoms of dependence and withdrawal similar to other abused drugs.4

Trends

Among twelfth graders, steroid use in the past year increased from 1.1% in 1992 to 2.1% in 2003. (See Table 1)

Steroid use among eighth and tenth graders was fairly consistent throughout the 1990s, remaining around 1 percent. In 1999, however, steroid use in the past year rose significantly to 1.7 percent for both grades. Steroid use continued to rise for tenth graders to 2.2 percent in 2000, before declining to 1.7 percent in 2003. Steroid use among eighth graders was 1.4 percent in 2003. (See Table 1)

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Differences by Gender

Males are more likely than females to have used steroids in the last year. In 2003, 3.2 percent of twelfth grade males had used steroids in the last year, compared with 1.1 percent of twelfth grade females. In the tenth grade, 2.3 percent of males had used steroids, compared with 1.1 percent of females and in the eighth grade, 1.8 percent of males had used steroids, compared with 1.1 percent of females. (See Table 1)

Differences by Race and Ethnicity

For eighth, tenth, and twelfth graders, among whites, blacks, and Hispanics, blacks have had the lowest rates of steroid use in the past year. (See Table 1)

Differences by Athletic Team Participation

Tenth and twelfth grade boys who participate on an athletic team to a great extent are more likely than those who do not participate on an athletic team to have used steroids in the last year. In 2002-2003, 5.1 percent of twelfth grade boys who participated on an athletic team to a great extent had used steroids in the last year, compared with 2.2 percent of those who did not participate on an athletic team. Among tenth graders, 4.1 percent of boys who participated on an athletic team used steroids in the last year, compared with 1.8 percent of boys who did not participate on an athletic team. (See Figure 1)

Note: Participation on athletic team was measured on a 5-point scale with the following categories: (1) Not at all, (2) Slight, (3) Moderate, (4) Considerable, or (5) Great Extent. In 2003, 36 percent of eighth graders, 35 percent of tenth graders, and 27 percent of twelfth graders reported participating on an athletic team to a "great" extent.

Related Indicators

Illicit Drug Use, School Athletics

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State and Local Estimates

2003 estimates for lifetime illegal steroid use are available for high school students (grades 9-12) for select states and cities from the Youth Risk Behavior Survey (YRBS) at http://www.cdc.gov/mmwr/preview/mmwrhtml/ss5302a1.htm#tab32 (See Table 33).

International Estimates

None available

National Goals

While steroids are not specifically mentioned, through its Healthy People 2010 initiative, the federal government has set a national goal to increase the "proportion of adolescents not using alcohol or any illicit drugs during the past 30 days."5

More information is available at: http://www.health.gov/healthypeople/document/html/objectives/26-10.htm
Additionally, since 1988, the Office of National Drug Control Policy has issued a yearly report that includes long-term goals to achieve the ultimate objective of "a drug-free America." The 2004 report outlines goals established in 2002 for "a 10 percent reduction in current use of illegal drugs by the 12-17 age group" in two years and "a 25 percent reduction for the same age group" in five years. The 2004 report also discusses the responsibility of professional athletes, coaches, owners, and union representatives to end the use of steroids in athletics, especially because the players are setting a dangerous and unhealthy example for many young Americans who look up to them. The report calls for more stringent drug policies in sports.

More information is available at: http://www.whitehousedrugpolicy.gov/publications/policy/ndcs04/index.html

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What Works: Programs that May Influence this Indicator

None available at this time.

Research References

1American Academy of Pediatrics, Medical Library. Steroids - Dangerous Side Effects.2002. http://www.medem.com/MedLB/article_detaillb.cfm?article_ID=ZZZT6QV5M7C&s...
2Rufant, Robert H., Escobedo, Luis. G., and Heath, Gregory W. 1995. "Anabolic-Steroid Use, Strength Training, and Multiple Drug Use Among Adolescents in the United States." Pediatrics 96(1): 23-28.
3Trenhaile, Jay, Choi, Hee-Sok, Proctor, Theron B., and Work, Patricia, B. 1998. "The effect of anabolic steroid education in knowledge and attitudes of at-risk preadolescents." Journal of Alcohol & Drug Education 43(2): 20-35.
4Gonzalez, Alejandro, McLachlan, Sean, and Keaney, Francis. 2001. "Anabolic steroid misuse: How much should we know?" International Journal of Psychiatry in Clinical Practice 5:159-167.
5U.S. Department of Health and Human Services. Healthy People 2010. Washington, DC: January 2000. Goal 26-10.hhttp://www.health.gov/healthypeople/document/html/objectives/26-10.htm

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Definition

Steroid use is defined as using steroids 1 or more times, without being instructed to do so by a doctor, in the past year.

Data Source

Data for 2002/2003 by gender: Child Trends analyses of Monitoring the Future National Survey Results on Drug Use, 1975-2003. Volume 1: Secondary school students: (NIH Publication No. 04-5507). Bethesda, MD: National Institute on Drug Abuse. Tables D-73 and D-74. Online. Available at http://www.monitoringthefuture.org/pubs/monographs/vol1_2003.pdf

Data for 1989-2003: Monitoring the Future National Survey Results on Drug Use, 1975-2003. Volume 1: Secondary school students: (NIH Publication No. 04-5507). Bethesda, MD: National Institute on Drug Abuse. Tables D-73 and D-74. Online. Available at http://www.monitoringthefuture.org/pubs/monographs/vol1_2003.pdf


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