THE NATION’S NEWSPAPER
Special
Reprint
Edition
As seen in
Sports
Reprinted from USA TODAY 2002
Kids, steroids don't mix
Yet many teenagers look up to ballplayers, do whatever it
takes to get big(ger), strong(er)
By Anita Manning
USA TODAY
Teenagers, looking up to those elite
athletes whose muscles ripple with
steroid-enhanced power, are picking up
some dangerous training tips, health
experts warn.
Several national youth surveys estimate steroid use by high school boys at
4%-6%, up to 12% in one study, and about
2% for girls.
And the numbers are rising. "I'd say
500,000 to 600,000 kids in the U.S. have
used these drugs at some time," says
researcher Charles Yesalis, professor of
exercise and sport science at Penn State.
"Right now steroid use is at an all-time
high."
One reason, experts say, is the example
set by professional and elite athletes.
After Mark McGwire set a record for
homers in a season in 1998 and admitted
using the legal supplement androstenedione, a steroid substitute, sales jumped
1,000% and steroid use by teens of high
school age crept upward. Among high
school seniors, disapproval of steroids
dropped from 91% in 1997 to 86% in
2001 while the belief that steroids pose a
great risk fell from 67% in 1997 to 59% in
2001, according to the 2001 Monitoring
the Future Survey conducted by the
University of Michigan's Institute for
Social Research and sponsored by the
National Institute on Drug Abuse.
"Athletes are cultural icons, and some
have great influence," says orthopedic
surgeon Nicholas DiNubile, team doctor
for the NBA's Philadelphia 76ers. "They
can use it in a positive or negative way,
but it's not neutral. They're more than
athletes."
agrees: "I don't worry about what guys
are doing. We've got better things to
worry about in this game than that. This
isn't the Olympics. If guys want to use
andro and creatine and all that stuff, it's
all right."
The topic became front-page news
again this year when retired MVPs Jose
Canseco and Ken Caminiti admitted
using steroids. A poll of 556 big-leaguers
conducted by USA TODAY in June found
89% believe there is some steroid use in
the game, 10% believe more than half of
their peers are users and 44% feel pressure to use steroids to compete.
But noted orthopedic surgeon James
Andrews, who treats pro and amateur
athletes in Birmingham, Ala., believes
young players model themselves after
their
grown-up
sports
heroes.
"Whatever is being done at the professional level is being handed down rapidly to the collegiate level, the high school
level and the pre-high school level."
A separate USA TODAY/CNN/Gallup
poll of baseball fans found 78% believe
steroids contribute to the recent glut of
offensive records. The season homer
record, which stood for 37 years, has
been surpassed six times in the last four
seasons. A record 62 homers were hit
last Tuesday in one day of games.
Some players agree. Chicago White Sox
shortstop Royce Clayton favors testing:
"It sends a message that steroids are a
substance you don't want to mess
around with and that there is no place
for them in the game. . . . We are role
models, and that's the most important
thing a player has to understand. As soon
as we test and the game is clean, the better it will be for everybody."
"I'll never hear that kind of number
without wondering" whether performance-enhancing drugs made it possible,
DiNubile says.
In USA TODAY's poll of players, 79%
support independent steroids testing.
Others have less concern.
"If guys are doing it, they're grown
men," Anaheim outfielder Garret
Anderson says. "Everybody is entitled to
make their own decisions."
Colorado outfielder Larry Walker
As kids use steroids, adults look other
way
While some doctors and researchers
believe moderate steroid use in adults
can have positive results with few side
effects, almost all doctors agree steroids
are dangerous for children and teens. But
steroid use continues to rise among
youngsters.
Yesalis, author of Performance
Enhancing Substances in Sport and
Reprinted with permission. All rights reserved.
Kids, steroids don't mix
Medical experts strongly oppose use by teenagers
Exercise, cites a study published in 2000
that found prevalent use among eighthgraders similar to that of high school
seniors. "We've shown use down to seventh-grade level," he says. "It's scary for
anybody to use these drugs, but in particular women and children." A 1999
Youth Risk Behavior Surveillance study
by the Centers for Disease Control and
the 2001 Monitoring the Future survey
both show steady growth in steroid use
by eighth- to 12th-graders.
down their growth plates. So if God had
intended them to be 6-2, they could end
up a muscular 5-4."
To counteract the negative effects,
steroid users combine drugs, a practice
that could increase risks for young people, says DiNubile, a spokesman for the
American Orthopaedic Society for Sports
Medicine. "The ones who are good at this
take diuretics to get rid of fluid retention,
they take anti-estrogens, they become
very sophisticated."
In a competitive society where "moral
standards are being swept under the
rug," Yesalis says, the temptation is to
reach the goal by any means.
"If you really believe in winning at all
costs, and that's how you raise your kids,
drug use is not illogical," he says. "I get
about one call a year from one or two
idiot parents who want my blessing to
their use of growth hormone or anabolic
steroids for a kid who is otherwise normal, but they want Johnny or Mary to be
a superstar. The conversations are very
short, and I'm not very polite.
It is not only young athletes who use
Top athletes have access to steroids
them, Yesalis says. Because steroids can
help turn a 100-pound weakling into a through physicians, but "kids buy black"Use of these drugs by kids in sports is
buff beach stud, they "make a young per- market stuff whose purity is questionwrong. No discussion."
son feel more popular, more
sexually attractive," he says.
Rapid changes are signs to watch
Severity and frequency of
But there is a price to pay.
Some
signs
of
steroid
use can be mistaken for normal teenage developinjuries rise
Anabolic steroids are synthetic drugs related to male ment, so it might be hard for parents, coaches and physicians to detect.
Nicholas DiNubile, assistant professor of orthopedic surgery at the
Unfortunately, DiNubile says,
hormones. They're used University of Pennsylvania Hospital in Philadelphia, says parents can look
young people often don't
medically to help AIDS for rapid changes such as:
believe that, in part because
patients improve strength
the medical community erred
and appetite and to treat men
* Improbable gains in lean body mass, muscle bulk and definition.
* Increased aggressiveness or emotional ups and downs.
in the 1970s and '80s by claimfor delayed puberty, impo* Advanced acne on chest and back.
ing steroids did not increase
tence and hypogonadism, a
* Early male-pattern baldness.
strength or muscle mass.
condition in which the testes
* Breast enlargement in boys.
are underactive.
"But the athletes knew, they
Parents should be aware that when young people try to go off steroids,
For young athletes, steroids there can be a sudden weight loss that can lead to depression in young peo- realized they were getting
increase muscle mass and ple whose body image is skewed, DiNubile says. "They think they've shrunk gains and started experimenting with different doses," he
strength and shorten the like air let out of a balloon."
says. "So when we came out
time for muscles to recover
Instead of resorting to steroids or other performance-enhancing suband said yes, it works but it's
from a workout. They also
not safe, they didn't believe
have the psychological effect stances, he says, parents can help their kids work on sports skill training
us." Adding to that is the uniof boosting assertiveness, and capitalize on their natural abilities. "Try to make your great athlete that
way," he says. "For many centuries, that's how great athletes were built."
versal belief of teenagers in
giving a "pumped-up mental
their indestructibility, he says.
attitude," DiNubile says.
"They really don't believe
The downside is that they can cause able," Yesalis says. "They're more prone these things can harm them."
hair loss, severe acne, infertility, mas- to cowboy chemistry," getting informaBut they can. Andrews says he has
culinization of women (deepening of tion from friends or the Internet, increasnoticed an alarming increase in the
voice, growth of body hair, smaller ing the risk of misuse.
instance and severity of ligament and
breasts) and feminization of men
Yet the demand continues unabated, tendon injuries. While he can't prove
(shrunken testicles, enlarged breasts).
Steroids also are thought to increase the driven by the desire to win and for the steroid use is a factor, he says these kinds
of injuries can result from stress on tenrisk of stroke, heart disease and liver money that brings.
dons caused by overdeveloped muscles.
cancer.
"I see the kids in the office," DiNubile "In baseball players, we see an increase
The drugs also can permanently stunt says. "The coaches look the other way; in the incidence of rotator cuff injuries, a
growth. "Seniors in high school have, on their parents want them getting that large increase in (injuries to elbow ligaaverage, grown to 95% of their adult scholarship. A lot of people look away ments) related to the stress of throwing,"
he says. The "real distressing aspect," he
height," Yesalis says, "but in seventh when it comes to steroids."
says, "is we're seeing these careergrade, they could permanently shut
Reprinted with permission. All rights reserved.
Kids, steroids don't mix
threatening injuries in the shoulders and
elbows of baseball players in younger
and younger age groups."
A USA TODAY database study showed a
32% increase in stints on the major
league disabled list in the last 10 years.
Injuries to large joints increased 58%,
while all other injuries increased only
5%. The number of injuries identified as
tendon or ligament injuries in baseball
jumped 224% between 1992 and 2001.
Andrews has completed a study, not
yet published, that looks at sports
injuries in athletes under 18 and found
elbow ligament injuries and shoulder
injuries in young athletes have increased
dramatically. He doesn't know why. "We
don't have the statistics to tell us what's
going on, but we're all worried," he says.
That's a concern, because prolonged
use of steroids is likely to increase the
chance of side effects, including those
that might be life threatening, he says. "I
don't want to say it's causing these
things all over the place . . . but we know
there are side effects and they're being
minimized by athletes. They think
they're invincible. But until we test for it
and know (who is using the drugs), we'll
be sitting here guessing.
"The problem is the almighty dollar.
Parents are doing whatever they can to
make professional athletes out of their
children. Some start planning at 2
years of age. There's a lot of enticement
to do what is necessary to enhance
performance."
Cincinnati outfielder Ken Griffey Jr.
sees the same problem at the major
league level. "All you can do is live your
life the right way and not worry about
the other guys. You see things and you
hear things, but what can you do? Guys
know the risks, but they also know
there's big money out there."
Messages from pros carry weight
The lure of big muscles, an athletic
scholarship or a pro career is irresistible
to many youngsters, DiNubile says. "We
need real vigilance here and for more
parents and coaches to be aware."
Doctors can issue warnings, but they
might not have much impact, he says.
Kids might need to hear it from more
influential sources.
"It would be tremendously helpful,"
DiNubile says, "if some sports heroes
would be more visible on this issue, be
willing to stand up, speak to our kids and
educate them. Because kids listen to
their heroes."
says he's disturbed by the suggestion
that steroid use by major leaguers will
create a cause-and-effect spike in use by
younger athletes. "If people make decisions based on something they've read
or what a sports figure says, if that's solely how they make decisions, then there's
obviously a lack of parenting," he says.
But others in baseball see a
responsibility.
"Our sport is a microcosm of society,"
Houston general manager Gerry
Hunsicker says. "We know that substance abuse, including steroids, is certainly a problem throughout our society.
To have our head in the sand and convince ourselves that it's not a problem is
probably a bit naive and irresponsible.
There's growing evidence steroids are
dangerous and can even be life threatening. It certainly behooves all of us to
come up with a meaningful education
and control policy."
Contributing: Mel Antonen, David Leon
Moore and Bob Nightengale
But Los Angeles first baseman Eric Karros
Reprinted with permission. All rights reserved.
Kids, steroids don't mix
APPLICATIONS:
DISCUSSION QUESTIONS:
popular culture, character education,
analysis, decision making, psychology,
bodily-kinesthetic intelligence
What do national youth surveys estimate steroid use to be among high school boys
and girls? Why are more kids turning to steroids? What side effects are associated
with performance-enhancing drugs? What type of physical and mental changes do
they cause? Which effects are short-term? Which are lasting? Do you think
teenagers have a "universal belief . . . in their own indestructibility"? If so, why
is this?
STANDARDS:
NPH-H.9-12.1
Health Promotion and Disease
Prevention
Students comprehend concepts related
to health promotion and disease prevention.
NPH-H.9-12.4
Influences on Health
Students analyze the influence of
culture, media, technology, and other
factors on health.
What athletes would you describe as cultural icons? Cite two examples of each
athlete's "great influence" on teens. Why is it unlikely that a major athlete's influence is neutral?
ACTIVITY:
Nicholas DiNubile, physician for the Philadelphia 76ers, says that steroids give
young athletes a "pumped-up mental attitude." As a class, brainstorm a list of
activities that foster this same feeling (e.g., running, yelling, chanting, team-building exercises, etc.). Then, perform as many of the options on your list as possible,
and assess the effectiveness of each.
NL-ENG.K-12.11
Participating in Society
Students participate as knowledgeable, reflective, creative, and critical
members of a variety of literacy
communities.
Source: Education World
APPLICATIONS: character education, self-esteem,
self-reflection
In small groups, answer the
following questions: 1.) For what
reasons (physical appearance, etc.) do
kids tease each other? 2.) Why do
children feel the need to hassle their
peers? 3.) What effect does teasing
have on a person? 4.) Have you ever
made fun of one of your classmates? If
so, how did you feel after?
The next time someone teases you,
remember that the person doing the
taunting may have low self-esteem.
By teasing you, your peer could be
trying to make him or herself
feel better.
With a partner, discuss an
interpersonal conflict that could arise
between you and a classmate. What
strategies and language could you use
to handle the situation calmly
and maturely?