Boys Cite Athletic Performance, ‘Looks’ : Use of Steroids by Youths Widespread, Study Finds

As many as half a million American high school seniors have used anabolic steroids--many of them in large doses, over extended periods of time and beginning at a young age, according to the first nationwide survey of steroid use among teen-age boys.

Most of the users in the survey of 3,403 students in 46 schools said they took the black-market drugs in hopes of improving their athletic performance. But a surprising 26.7% of the users said their prime motivation was to spruce up their appearance.

“They’re using it probably to look good, to pick up girls,” Dr. Richard H. Strauss, a steroid expert, said of the study published today in the Journal of the American Medical Assn. “That was a trend that we’ve been aware of, but not aware that it was that big.”

The study suggests that steroids, long associated with some professional athletes, have become drugs of abuse among teen-agers--a development that experts say is troubling because the side effects of steroids may be especially serious in adolescents.

Steroids--powerful natural or synthetic compounds including hormones--have been linked to reduced fertility, behavioral changes and possibly stunted growth in children. They have been used by athletes to improve muscle size, although there is argument over their real effect on performance.

Some experts said this week that steroids should now be included in drug education programs targeted to high school and junior high school students. The steroid problem, they said, reflects powerful cultural preoccupations shaping American adolescence.

“We are a culture that is very, very dependent upon physical appearance for measures of success,” said Dr. Adele Hofmann, past president of the Society for Adolescent Medicine and director of ambulatory pediatrics at Childrens Hospital of Orange County.

Dr. Wayne Moore, a pediatric endocrinologist in Kansas City, said boys are being channeled early into sports for which they may be physically unsuited. As a result, smaller teen-agers suddenly find themselves outstripped by their peers and unable to compete.

“If people would recognize that not everybody has the physical capacity to be football and basketball stars . . . (teen-agers) might not be in a situation where they are forced to take steroids to remain competitive,” Moore said.

First Systematic Study

The study, believed to be the first systematic attempt to explore illicit teen-age steroid use, found that 6.6% of the 12th-grade students surveyed said they were using or had used so-called anabolic-androgenic steroids.

More than a third of those had first used the drugs at age 15 or younger; another third had started at age 16. Forty percent said they had done at least five cycles--the six- to 12-week periods in which users generally take the drugs.

Nearly half said they had taken more than one drug at once. More than a third had taken the drugs both orally and by injection. Both of those practices suggest that the users were experienced and had been taking steroids for some time, the authors said.

Most of the users said they obtained steroids from black market sources, which included other athletes, coaches and people who frequent gyms. However, about one-fifth said their primary source was a health care professional--a physician, pharmacist or veterinarian.

“We didn’t anticipate (the rate of steroid use) being that high,” William E. Buckley of Pennsylvania State University said of his finding that 6.6% of seniors were users. “I personally would have thought that there was a significant problem if it came up with 3%.”

“It’s a very, very important piece of work,” said Dr. Don. H. Catlin, chief of clinical pharmacology at UCLA Medical Center and director of the laboratory that does drug testing for the National Collegiate Athletic Assn. “It’s telling us something that no one knew before.”

The study was headed by Buckley, an assistant professor of health education at Penn State. His co-authors include researchers with the Army and at Michigan State University.

Among the findings that experts found especially striking were the young age at which steroid use appears to start, and the fact that more than a quarter of the users said they took the drugs not for sports but to improve their looks.

Physical attractiveness is central to self-esteem in adolescents, said Dr. Laurence Steinberg, a professor of psychology at Temple University in Philadelphia. Teen-agers have long gone to extremes to make themselves attractive, he and others said.

Adolescents also have difficulty conceiving of long-term consequences, they said.

“These adolescents are thinking about the short-term gain,” said Stephen Franzoi, a social psychologist who has studied images of attractiveness. “They aren’t thinking about the long-term detriments that could come many years down the line.”

The long-term effects of steroid use remain a subject of scientific debate.

Steroids--many of which mimic the effects of male sex hormones--have legitimate uses in treating a number of conditions, including hormone deficiencies, skeletal disorders and the effects of radiation and chemotherapy.

For example, a study published Thursday in the New England Journal of Medicine found that adolescent boys with delayed development could be treated effectively with low doses of the steroid hormone, testosterone, without compromising, as has been feared, their final adult height.

Among other things, steroids stimulate the build-up of tissue. In some people, they may help increase muscular strength, when combined with intensive exercise and a high-protein diet. Users also report increased aggressiveness, which may help intensify training.

But steroids in large doses have been linked to the possibility of liver damage and an increase in risk factors for cardiovascular disease. Steroids also reduce sperm production, sex hormone output and sex drive, although those effects can be reversed.

Such side effects, seen in adults, may be more severe in developing adolescents, physicians say. Among other things, they say, steroids could cut short a child’s long-term physical development by briefly accelerating, then shutting off, bone growth.