Page 82 - Athletic Health Handbook
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These substances are synthetic athlete from maintaining the intense who is associated with the greatest
derivatives of the male hormone level of training. potential for abuse. Steroid use tends
testosterone that were developed to be maintained indefinitely in
to dissociate the anabolic from the Anabolic steroids can be taken these athletes, which increases their
androgenic effects of testosterone. orally or parentally. Both have similar abuse effect.
Testosterone itself is not effective effects. Testosterone is alkylated at
when taken orally or by injection the 17A position to form the oral The level of steroid use appears to
because it is susceptible to rapid compound or esterified at the 17ß have increased significantly over the
hepatic degradation. Historically, position to form the injectable agent. past three decades. A cursory review
the medical indications for AS have The oral compounds potentially have of the search engine, Google™ found
included the treatment of hygo- more adverse effects associated with approximately 55,900 Web sites
nadism, certain anemias, metastatic their use due to their passage through under the search words “anabolic
breast cancer, and severe catabolism the liver. However, the parental agents steroids.” Use among adolescents
secondary to trauma or surgery. A are potentially detectable for longer appears to be on the rise. Multiple
class of drugs known as ß2-agonists periods of time following their surveys have shown that 3 to 12
are not AS, though they do have discontinuation. Athletes frequently percent of secondary school males
anabolic effects. As a result, ß2- use combinations of both oral and admit to steroid use at some time.
agonists such as clenbuterol, terbu- injectable steroids at doses much Interestingly, more than one-third of
taline sulfate, and salbutamol higher than their therapeutic dosage. steroid users do not intend to partici-
(albuterol) have been added to the This technique is known as “stacking.” pate in interscholastic sports. One
IOC’s list of banned “anabolic agents.” Often, steroid users will “pyramid” survey of adolescents using anabolic
their administration patterns, moving steroid reported that 7 percent began
It appears that steroids used in from a relatively low dose at the using them at age 10 or younger.
conjunction with strength training beginning of a cycle to a higher dose, Users are more likely to be males and
do facilitate gains in size and strength and then tapering down the dose to use other illicit drugs, alcohol, and
over and above what would be at the end of the cycle. Individuals tobacco. Adolescent athletes are more
expected from training alone. These may also use an array of other drugs likely than non-athletes to use steroids.
agents do not affect aerobic capacity. concurrently to counteract the nega- Football players, weightlifters,
Size and strength gains are enhanced tive effects of the steroid. These wrestlers, track and field throwers,
through anti-catabolic, anabolic, and include anti-acne medications, and bodybuilders have the highest
motivational effects. The anti-cata- diuretics, and anti-estrogens. usage rates among adolescent
bolic effects (the most relevant) relate athletes. The effects of race/ethnicity,
to their ability to reverse the effects A dose response has been noted age, socioeconomic status, and
of cortisol (i.e., negative nitrogen between steroid dosage and lean body academic performance require further
balance and muscle wasting) which mass. Endurance athletes use steroids investigation. At the collegiate level,
is elevated during periods of stress primarily to block the catabolic several surveys have shown that the
or intense training. The anabolic effects of training. These athletes use incidence of AS use approximates
effects relate to their ability to induce dosages at or slightly below physio- 5 percent of NCAA Division I,
protein synthesis in muscle cells and logic level. Athletes in “strength 4 percent of Division II, and 2 percent
to stimulate the release of endoge- sports” generally use dosages 10 to of Division III athletes, with the
nous growth hormone. Users of AS 100 times physiologic levels. An highest use among football players.
also develop very aggressive personal- average cycle is for six to 12 weeks Female use rates are typically only
ities that allow more intense training. with a similar duration off-cycle. 1 to 2 percent.
These “positive” effects are reversible
since the size and strength gains Anabolic steroids are used Most athletes who use anabolic
rapidly disappear as soon as the primarily by two groups of athletes, steroids obtain the drugs illicitly,
drugs are discontinued due to the competitive and non-competitive. though 10–15 percent acquire them
significantly depressed levels of The competitive athlete uses these by prescription. The most common
endogenous testosterone in males agents to achieve defined strength source of “black market” AS in the
and the loss of exogenous hormone or performance goals in conjunction U.S. is the Baja California region
in females. The psychological effects with an aggressive training program. of Mexico. Other sources include
are also lost which prevents the The non-competitive group uses AS Russia, Poland, Hungary, Spain,
for cosmetic effects so as to develop and Italy. Counterfeit products
a muscular physique. It is this group

ANABOLIC STEROIDS AND THE ATHLETE 82
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