Doping among adolescent athletes

doi:10.1053/beem.2000.0051

Best Practice & Research Clinical Endocrinology & Metabolism

Volume 14, Issue 1, March 2000, Pages 25-35

https://doi.org/10.1053/beem.2000.0051 Get rights and content

Abstract

The use of drugs to enhance physical performance and appearance has been observed for thousands of years. Today individuals, including adolescents, continue to employ a wide variety of drugs in the hope of improving their athletic performance and looking better. Unfortunately, beyond the assessment of anabolic–androgenic steroid (AAS) use, very little is known regarding the use, safety and efficacy of other performance-enhancing drugs and nutritional supplements among adolescents. Most studies report that 3–12% of adolescent males admit to using an AAS at some time during their life. Among adolescent females, studies find that 1–2% report having used steroids. The current strategy for dealing with performance-enhancing drug use by adolescents is multi-faceted and primarily involves education and prevention strategies, interdiction and drug testing programmes. However, the demand for performance-enhancing drugs has been created by our societal fixation on winning and physical appearance. In order to alter the current use of performance-enhancing drugs by adolescents, we as a society must come to grips with our addiction to sport and the importance we place on winning and appearance. We must change our values.

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Cited by (113)

Performance-enhancing and health-compromising behaviors in youth sports: A systematic mixed-studies review
2022, Performance Enhancement and Health
Success in sports entails striving toward greater achievement and outstanding performance. In their pursuit of these goals, adolescent athletes use various means and resort to behaviors that may cause adverse consequences for their health. As they are still in the developmental stage, they are particularly vulnerable to unwanted health consequences. This study aimed to systematically review previous studies on the contextual and personal factors associated with adolescent athletes’ performance-enhancing and health-compromising behaviors. The review was conducted and reported in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses 2020 guidelines. Several databases were searched, including SPORTDiscus, Pubmed, PsycINFO, and Web of Science. The literature search and additional manual searches of sources yielded a total of 2,808 articles. These were screened against the inclusion criteria, and the remaining 15 were assessed for eligibility using Mixed Methods Appraisal Tool 2018. Convergent meta-integration with thematic analysis was performed by converting quantitative and qualitative data from young athletes aged 14–20 years into relevant codes and themes. Within these themes, the study's findings are presented through narratives that are perceived to influence young athletes’ use of doping and other behaviors that may lead to doping, such as the use of nutritional supplementation and non-prescription painkillers and playing despite being injured and having pain. Our findings indicate that athletes’ entourages (e.g., their coaches, peers, and parents) matter in a variety of ways in athletes’ socialization toward refraining from risking their health in pursuit of greater achievement and outstanding performance.
A model for evaluating the economic value of prevention programs for illicit use of anabolic androgenic steroids
2021, Health Policy
The illicit use of anabolic androgenic steroids (AAS) has become a societal concern. We developed a decision-analytic model for assessing the cost-effectiveness of preventive interventions targeting AAS-use. We used scenario analyses to demonstrate: a) the potential health economic consequences of AAS use in Sweden, and b) the cost-effectiveness of a hypothetical preventive intervention.
A population-based cohort model compared a hypothetical preventive intervention targeting AAS with a ‘no intervention’ scenario, from a limited societal perspective. The model simulated how a cohort of 18 year-old males transitioned between different states and predicted their health status and complications until the age of 41. Health outcomes were estimated as quality-adjusted life-years (QALY). Costs included intervention costs, drug costs, and costs of complications.
Total yearly costs related to AAS use amounted to nearly half a million US$, with the largest cost borne by the healthcare sector. Results suggest that AAS prevention could entail large costs and benefits with a mean incremental cost-effectiveness ratio of $550 per QALY, in a scenario where the intervention would decrease the probability of initiating AAS use by 5%.
Results show large AAS related costs, and suggest that the implementation of a preventive intervention could offer good value for money given different effectiveness scenarios. This model can be used to estimate the value of interventions targeting AAS use.
An examination of anti-doping education initiatives from an educational perspective: Insights and recommendations for improved educational design
2020, Performance Enhancement and Health
The World Anti-Doping Agency (WADA) has declared that education is a central focus of their anti-doping strategy. This is evident in the expansion of Article 18 of the 2021 World Anti-Doping Code that focuses on education. Furthermore, at the 2019 World Conference on Doping in Sport, they launched the International Standard for Education. International standards are technical documents that further harmonize anti-doping efforts, to which Code signatories are required to follow for Code compliance. Before this, WADA developed an online platform, ADeL, to consolidates all of its e-learning resources and in August 2019, they hired a Director of Education to lead their education strategy. While these developments are likely applauded by anti-doping advocates, historically the efficacy of anti-doping educational programs to increase athletes’ knowledge of doping has been very poor. The design of education programs has been criticized and even when they meet many of the current recommendations for program design, the results are not favorable. A partial explanation for this is that the design of past education programs has not been informed by principles from education and other related disciplines. This includes a lack of alignment between learning outcomes desired, the education activities performed, and the assessment of learning outcomes. In this monograph, previous educational initiatives are reviewed, and program design critiqued. WADA’s education strategy is examined before recommendations for improved education design are made. This includes greater reliance on education programs that are constructively aligned and provide opportunities for athletes to develop knowledge via retrieval tasks.
Death after misuse of anabolic substances (clenbuterol, stanozolol and metandienone)
2019, Forensic Science International
A 34-year old male was found breathless and panting at home by his girlfriend three hours after a gym workout. Minutes later, he collapsed and died. Autopsy, histological and chemical analyses were conducted. The examination of the heart showed left ventricular hypertrophy, while the right coronary artery showed only a small vascular lumen (3 mm in diameter), due to its anatomical structure. In femoral blood concentrations of approx. 1 μg/L clenbuterol, approx. 56 μg/L stanozolol and approx. 8 μg/L metandienone, with trenbolone (<limit of quantification (LOQ)) were detected. Additionally, there were positive results in urine for boldenone, clomiphene, trenbolone, metandienone, stanozolol, clenbuterol and drostanolone, along with indications of testosterone and/or testosterone prohormones having been taken. In consideration of all aspects of this case, in can be assumed that the long-term consumption of anabolic androgen steroids (AAS) caused apparently pathological changes of the heart. Over and above, the combination of anatomical (small lumed coronary artery, ventricular hypertrophy) and substance-induced risk factors led to the fatal cardiovascular failure.
Nandrolone combined with strenuous resistance training reduces vascular nitric oxide bioavailability and impairs endothelium-dependent vasodilation
2018, Steroids
Anabolic Androgenic Steroids (AASs) misuse has increased among adolescents and recreational athletes due to their potential effects on muscle hypertrophy. On the other hand, AAS might induce alterations on cardiovascular system, although some controversies regarding AAS on vascular properties remain unknown. To address this question, we aimed to investigate the effects of high doses of nandrolone combined with strenuous resistance training (RT) on function and structure of thoracic aorta. Rats were randomized into four groups: non-trained vehicle (NTV), trained vehicle (TV), non-trained nandrolone (NTN), and trained nandrolone (TN), and submitted to 6 weeks of treatment with nandrolone (5 mg/kg, twice a week) and/or resistance training. In vitro response of thoracic aorta to acetylcholine (ACh) was analyzed. Vascular nitric oxide (NO) and reactive oxygen species (ROS) synthesis were evaluated using 4,5-diaminofluorescein diacetate (DAF-2) and hydroethidine fluorescent techniques, respectively. Thoracic aorta was processed for microscopy analyses and tunica media thickness was measured. ACh-mediated relaxation response was impaired in endothelium intact aortic rings isolated from trained rats (TV and TN) as compared with their matched non-trained groups. TN rats showed reduced ACh-mediated vasodilatation than NTN rats. NO production and bioavailability decreased in thoracic aorta of nandrolone-treated rats in relation to their matched non-trained group (NTN vs. NTV; TN vs. TV). ROS production and tunica media thickness were increased in TN rats when compared with TV rats. These findings indicate that high doses of nandrolone combined with strenuous RT affect NO bioavailability and might induce endothelial dysfunction and arterial morphological alterations.
The psychology of doping
2017, Current Opinion in Psychology
Citation Excerpt :
Reasons discussed for why doping is problematic is that it endangers the health of athletes, goes against the integrity of sport, destroys the idea of a ‘level playing field,’ and does not set a good example for young athletes [2]. Although there are difficulties in estimating the prevalence of doping in sport, studies using self-report surveys conclude that rates may lie between 3 and 15% [3,4] with older and male athletes more susceptible to doping than younger and female athletes [5]. Recent years have seen a large increase in research related to the psychology of doping [6].
Doping is increasingly becoming a problem in both elite and recreational sports. It is therefore important to understand the psychological factors which can explain doping behavior in order to prevent it. The present paper briefly presents evidence on the prevalence of doping use in competitive sports and the measurement approaches to assess doping behavior and doping-related variables. Furthermore, the integrative theoretical approaches used to describe the psychological processes underlying doping use are discussed. Finally, the paper provides suggestions for appropriate measurement of doping behavior and doping-related variables, key preventive efforts against doping as well as avenues for future research.

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Regular ArticleDoping among adolescent athletes

Abstract

Drug and Alcohol Dependence

Journal of Adolescent Health

The struggle against doping and its history

Journal of Sports Medicine and Physical Fitness

Magic, science and drugs

Medical, legal, and societal implications of androstenedione use

Journal of the American Medical Association

Risk factors for anabolic-androgenic steroid use among adolescents

Sports Medicine

History of anabolic steroid use in sport and exercise

Drugs in sport. Part 1: problems in a turned-on world

Sports Illustrated

Drugs in sport. Part 2: something extra on the ball

Sports Illustrated

Drugs in sport. Part 3: high time to make some rules

Sports Illustrated

Estimated prevalence of anabolic steroid use among male high school seniors

Journal of the American Medical Association

Incidence of anabolic steroid use: a discussion of methodological issues

Youth risk behavior surveillance: United States

Morbidity and Mortality Weekly Report CDC Surveillance Summary

Characteristics of steroid users in an adolescent school population

Journal of Alcohol and Drug Education

National School Survey on Drugs and Sport. Final Report

Use of Performance Enhancing Substances by London Secondary School Students

Androgenic anabolic steroid use among male adolescents in Falkenberg

European Journal of Clinical Pharmacology

Factors associated with adolescent use of doping agents: anabolic–androgenic steroids

Addiction

Androgenic anabolic steroid use in matric pupils

South African Medical Journal

Prevalence of androgenic–anabolic steroid use in adolescents in two regions of South Africa

South African Medical Journal

Anabolic steroid use among students at a British college of technology

British Journal of Sports Medicine

Prevalence and risk factors for anabolic–androgenic steroid abuse in Australian high school students

International Journal of Andrology

Anabolic–androgenic steroids: current issues

Sports Medicine

Anabolic–androgenic steroids: an international perspective

Sport and Medicine

International conference on abuse and trafficking of anabolic steroids

International Journal of Drug Policy

The adolescents training and learning to avoid steroids (ATLAS) prevention program

Archives of Pediatric and Adolescent Medicine

Report of the International Conference on the Abuse and Trafficking of Anabolic Steroids

Drugs and cycling

USA Today

McGwire taking hits over use of power pill

USA Today

Ventura tells on himself in book

USA Today

Year of drugs: from baseball to swimming

USA Today

Review of 127 drug abuse prevention program evaluations

Journal of Drug Issues

Anabolic steroid education and adolescents: do scare tactics work?

Pediatrics

Effects of a multi-dimensional anabolic steroid prevention intervention: the adolescents training and learning to avoid steroids (ATLAS) program

Journal of the American Medical Association

A cognitive–behavioral approach to substance abuse prevention: one year follow-up

Addictive Behavior

Regular Article
Doping among adolescent athletes