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Helping Kids On Steroids: “Big Dreams” vs. “Getting Big”

Posted Feb 12 2012 10:01pm

Posted on | February 9, 2012 |

With the Super Bowl now in our tail lights, all that remains of this year’s NFL season are images of high performing, super-powerful, super-large, super-fast humans, and an equally large number of older retired players dealing with a range of disabilities that restrict quality of life. For a portion of this later group, the seeds of their disabling conditions were sown much earlier, in their high school years, when they decided to augment their natural physical gifts with steroids.

Latest surveys by the National Institutes of Health show that just over 2% of high school students have tried anabolic steroids.(1) These are synthetic chemicals that mirror the normally produced male sex hormone testosterone. The term “anabolic” refers to the chemical’s ability to enhance muscle size and strength.

Athletes who gain access to these drugs do it illegally through a shadowy network that can be found in communities large and small throughout America. The hand to hand distribution of these drugs is now further augmented by the Internet with online distribution. When kids take these substances, they do it orally or by injection, typically in cycles rather than continuously. The terms “cycling” and “stacking” (the use of different types of steroids in combination and series) refer to a complex scheduling with twists and turns supposedly designed to maximize the impact. This also suggests (accurately) that kids are infrequently doing this all on their own. Somebody knows. Somebody is advising. Somebody is rooting them on – getting them starting, reinforcing their dreams, binding through secrecy.

What a teen’s support network is not doing is discussing the short-term and long-term risks of anabolic steroids.

In general: Anabolic steroids bind to sex hormone (testosterone and estrogen) receptors on the cell. Once connected, the chemicals change the way the cell behaves and vary the focus and priorities of the genes inside that cell. The chemicals bind to many cells in many organs. It’s not surprising then that their use can ultimately lead to liver damage, fluid retention, high blood pressure, kidney failure, hair loss, acne, problems with fertility, infections like HIV if you are injecting, and more.(1)

As disturbing, and somewhat more mysterious, is the impact of anabolic steroids on mental functions. This form of drug won’t give you the immediate high that other drugs do, although users do report “feeling good about themselves” while on the drug. The problem is that those feelings come and go, and what family and friends see from the outside is quite different from what the kids experience (part of the time) on the inside. Often outsiders see extreme mood swings, increased anger and aggression, irritability, invincibility, impaired judgement – and sometimes, paronoia, mania, extreme jealousy, and violence.(2,3)

Are these drugs addictive? Animal studies say yes.(4,5) Human studies are equivocal, though users do experience withdrawal symptoms  including mood swings, fatigue, restlessness, loss of appetite, insomnia, reduced sex drive, steroid cravings, depression and higher rates of suicide. While they are on the drug, they are fixated on the primary goals (getting it, staying on cycle, and paying for it) and the secondary goals (bulking up, performing, getting noticed). That doesn’t leave much time for other goals like learning, growing, and maturing. For some (9.3%in one study) this conflict in goals, symptoms like insomnia and irritability, and the disruption in relationships with family and friends, makes users feel bad enough that they seek out other drugs to help them feel good again.(6,7)

Since the abuse of anabolic steroids has been shrouded in secrecy and denial, it’s not surprising that treatment of withdrawal and return to normalcy is hard to find. Those who have focused on helping these kids and their families say that clinical support combined with education and a resetting of goals is important. Translation: kids generally get hooked on these drugs while pursuing goals (success in sports, a better body, a college scholarship, major league stardom) that are unrealistic.

They’re young; they’re searching; they’re misguided – and with the help of the drugs – they’re in trouble. Reversing that is hard work for everyone – the kids, the parents, the teachers and coaches, the clinicians. But it can be done. It involves starting over, discovering a kid’s center and appropriate life goals, loving and supporting, and involvement and caring day in and day out in a kid’s life. In short, it requires active parenting, involved teaching, balanced coaching, and good doctoring and nursing.

.

Getting these kids well means substituting “big dreams” for “the dream of getting big”.

For HealthCommentary, I’m Mike Magee

References:
2. Pope HG Jr, Kouri EM, Hudson JI. Effects of supraphysiologic doses of testosterone on mood and aggression in normal men: A randomized controlled trial. Arch Gen Psychiatry 57(2):133–140, 2000.
3. Pope HG Jr, Katz DL. Affective and psychotic symptoms associated with anabolic steroid use. Am J Psychiatry 145(4):487–490, 1988.  http://ajp.psychiatryonline.org/article.aspx?Volume=145&page=487&journalID=13
4. Arnedo MT, Salvador A, Martinez-Sanchis S, Gonzalez-Bono E. Rewarding properties of testosterone in intact male mice: A pilot study. Pharmacol Biochem Behav 65:327–332, 2000.  http://www.ncbi.nlm.nih.gov/pubmed/10672986
5. DiMeo AN, Wood RI. Self-administration of estrogen and dihydrotestosterone in male hamsters. Horm Behav 49(4):519–526, 2006.  http://www.sciencedirect.com/science/article/pii/S0018506X05002576
6. Brower KJ. Anabolic steroid abuse and dependence. Curr Psychiatry Rep4(5):377–387, 2002.  http://www.ncbi.nlm.nih.gov/pubmed/12230967
7. Arvary D, Pope HG Jr. Anabolic-androgenic steroids as a gateway to opioid dependence. N Engl J Med 342:1532, 2000. http://www.nejm.org/doi/full/10.1056/NEJM200005183422018

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