"I'm 14 years old and I'm thinking about taking 50 ml of Deca Durabolin per week for four weeks. I know about the side effects of steroids on adults, but not on teens. Is there any side effects that I should know?"

That quote comes from an anonymous Internet user, highlighted in the "Boys at Risk" section of The Adonis Complex (2000: Free Press), a book that details male body obsession.

Because steroid use among kids is measured by the Centers for Disease Control and Prevention through self-reports from middle and high school students, no one knows the precise number who might be having similar thoughts or questions today. (In its June 2000 Youth Risk Behavior Surveillance report, CDC found that among twelfth graders, 3.3 percent of females and 6.4 percent of males reported using steroids at least once.)

Still, participants at the March 17, 2005 Congressional hearing on Major League Baseball's steroid policies, where six current and former Major League Baseball players—including Jose Canseco, Mark McGwire and Sammy Sosa—were subpoenaed to testify, seemed pretty concerned about the problem.

"Too many college athletes believe they have to consider steroids if they're going to make it to the pros; high school athletes, in turn, think steroids might be the key to getting a scholarship," said Rep. Tom Davis (R-VA), Chairman of the House Government Reform Committee.

"Kids need to understand that steroids aren't the way to go. To use them, it's bad," testified Sosa, who indicated during the hearing that he's never used them. "It's wrong, it's no good. They need to know that you can do the same things through hard work and dedication."

Will all the attention being paid to steroid use among Major League Baseball stars have any effect on steroid use among students in middle and high schools? To help answer that question, Connect for Kids interviewed Dr. Harrison Pope, a psychiatry professor at Harvard Medical School, who has extensively researched steroid use in American society. An avid weightlifter (he reports lifting six times a week), he also co-authored The Adonis Complex.

What makes some kids want to use steroids?

We've tried to find risk factors for steroid use. [In a past study,] we looked at approximately 100 young guys who lift weights, about half of whom had used steroids at some point, and the other half of whom were also avid weightlifters, but never had. We tried to figure out what features determined which ones became steroid users and which ones did not.

There were two features: One was conduct disorder: individuals who have done things like running away from home every night, playing hooky from school, stealing things, conning others, or using other illicit drugs. Those who had some form of conduct disorder were also more likely to use steroids. The second factor that predicted steroid use centered on a question we asked, "describe how you feel about your body appearance on a 100-point scale." Those who became steroid users were significantly more concerned about their body appearance than the ones who did not go on to become steroid users.

If you have a combination of both the conduct disorder and you have the body image disorder, that combination is the one most likely to precipitate using steroids at some point.

Some experts have recently said that Congressional hearings will not change anything regarding youth steroid use. Do you agree?

It's very hard to predict. As I mentioned in The Adonis Complex, there are some kids who when they become more knowledgeable about steroids, they are actually more likely to take them. There may be other people who are deterred from taking steroids after the publicity alerts them to potential side effects or dangers.

At your gym, have you seen teens who are obvious steroid users?

Of course. One of the things about anabolic steroid use is that you can readily recognize someone who has used them. They get bigger than any naturally occurring male would get. Not only do they get bigger, but also they get bigger in certain places. They have a disproportionate appearance, which looks odd to your eye. And the reason it looks odd to your eye is that the area around the shoulders, the upper body, gets disproportionately big relative to other parts.

That's something that I wish could happen more. I think that if everybody in the general public knew about this and could recognize one of these guys, that would take a lot of the glamour away from steroids. One of the things that gives them their glamour is the veil of secrecy where men who take them can still give the impression to unsuspecting bystanders that their appearance is due to hard work when, in fact, it's due to a drug.

So, could the attention of Congress help de-glamorize them?

I think that the more that can be done to try to expose steroid use, the better. If it gets to the point where everybody in the general public knows about this and it's all exposed, I think that will tend to take some of the glamour away from steroids. It will also deprive steroid users of one of their greatest assets, which is their secrecy.

Is steroid use among young people a new problem?

It's been a continuous problem among young people over much of the last ten or fifteen years. It's hard to judge whether it's really growing or not. These drugs have been readily available for a long time. In 1991, they were put under the jurisdiction of the Drug Enforcement Administration, that made them a little bit harder to get, but not much.

How do kids get steroids?

There are numerous Internet sites where you can have them mailed to you from outside the United States. Quite a number of subjects in our studies say they are able to get them from the Internet. There's a large black market. Of course, this is illegal, but the odds of them slipping through customs are pretty great.

Do steroids have the same side effects on a teenager as someone who is older?

An adolescent risks remaining shorter than average for the remainder of his life if he takes steroids before the typical adolescent growth spurt. As for other side effects, there is no reason that they would have a different effect on a teenager than someone of any other age. They'd be just as dangerous in anybody.

How are steroids administered?

Anabolic steroids can be taken orally or injected, typically in cycles of weeks or months. Cycling means you take many doses of steroids over a specific period of time, stop for a period, and start again. It is quite common that steroid users will take a combination of both oral and injectable steroids at the same time, a process that's known as stacking.

So, a teen can take steroids by himself?

Most of these kids who are doing them administer their own drugs.

The CDC has recently released numbers that indicate more girls are doing steroids, can you comment on that?

Let me tell you my opinion on that. I think that steroid use by girls is extremely rare. There have been some large, anonymous studies of high school and middle school students where they would give anonymous questionnaires to boys and girls. Occasionally, in these studies there were surprisingly high figures [for girls]. You have to allow that many of those responses may be false positives. A girl may say, 'Oh, the dermatologist gave me steroids to treat poison ivy' where she's confusing corticosteroids with anabolic steroids, which are two entirely different substances.

The problem is that in these anonymous surveys, the individual should be asked to write down the name or names of the steroids that they have taken. That would make it much easier to tell whether these positives were true or false.

Do more studies need to be conducted regarding youth steroid use?

Certainly. In fact, in my knowledge, I am the only person currently funded by the National Institute of Drug Abuse to do studies of illicit steroid users. The reason for this is not that the money is not there. There are very few scientists in the field who are experienced in doing these kinds of studies. This is a very secretive subculture. They are much harder to study than users of other illicit drugs.

How have you been able to connect with this subculture?

The main reason, I think, is because I lift weight six days each week. I know their culture very well. I have a certain advantage just from that. If someone comes in and is asked about using steroids, and, if he admits to using, he's essentially admitting to you that all of his physical prowess and muscularity and masculine appearance is partially attributable to just taking an illegal drug. There's a whole lot of psychology wrapped up in his muscles.

Resources:

• Youth Risk Behavior Surveillance reports
• "How to Tell if Your Teenager is Using an Illicit Substance"

Rob Capriccioso is a former staff writer for Connect for Kids.