Steroid Prevention Programs - High School Athletes
A NIDA-funded drug abuse prevention program is showing high school
football players that they do not need to take anabolic steroids
to build powerful muscles and improve athletic performance. By educating
student athletes about the harmful effects of anabolic steroids
and providing nutrition and weight-training alternatives to steroid
use, the program has increased football players' healthy behaviors
and reduced their intentions to use steroids.
Until now, anabolic steroids, drugs derived from the male hormone
testosterone, have rarely been the focus of drug abuse prevention
studies, says Dr. Ro Nemeth-Coslett of NIDA's Division of Epidemiology
and Prevention Research.
Student athletes in the ATLAS program learn that stunted growth
and many other harmful effects can result from steroid use.
This may be because steroids are not widely abused. Only about
2 percent of 8th, 10th, and 12th grade students have ever used steroids,
according to the NIDA-supported Monitoring the Future study for
1996. However, steroid abuse occurs more often among young people
who are involved in physical training because anabolic steroids
can increase muscle mass, strength, and stamina, Dr. Nemeth-Coslett
Although adolescent boys, particularly those involved in athletics
such as football or body building, make up the majority of high
school steroid users, national surveys show that adolescent girls
also are vulnerable to the lure of steroid use. (See Adolescent
Girls Abuse Steroids, Too) However, that lure contains a hook -
anabolic steroid use can have severe physical and emotional consequences
for both males and females. Physical effects can include stunted
growth, high blood pressure, and liver tumors. Psychological effects
can include wide mood swings that range from episodes of uncontrolled
anger and aggressiveness to clinical depression when steroid use
is stopped. (For more information, see Questions and Answers About
"The Adolescents Training and Learning to Avoid Steroids (ATLAS)
program uses a team-oriented educational approach that motivates
and empowers student athletes to make the right choices about steroid
use," says Dr. Linn Goldberg of Oregon Health Sciences University
in Portland, who led the research team that developed and tested
the program. The program consists of classroom, weight-training,
and parent information components. Together, they give student athletes
the knowledge and skills to resist steroid use and achieve their
athletic goals in more effective, healthier ways, he says.
In ATLAS's classroom component, football coaches and student leaders
conduct seven highly interactive sessions that explore the effects
of steroids, the elements of sports nutrition, and strength-training
alternatives to steroid use. These classes also hone the athletes'
decision-making and drug-refusal skills. In a typical session, the
football team is split into squads of six or seven students, with
student squad leaders conducting the sessions and teaching most
of the intervention, according to Dr. Goldberg. "It's kids
talking to kids; that's an important ingredient in our program,"
he says. Coaches, who have a substantial influence on these student
athletes, also play an important role on the steroid prevention
team, Dr. Goldberg says. Coaches introduce topics and wrap up each
session, he explains.
"The ATLAS program is voluntary, and students get no credit
for it, so it better be entertaining," he says. As a result,
ATLAS classroom sessions are designed to combine fun and games and
learning. Coaches move from squad to squad and introduce a topic,
such as the effects of anabolic steroids. Then squad leaders take
over and initiate an action game that incorporates the topic. For
example, players may toss a football to each other as they answer
questions about problems that stem from steroid use. "Although
they are playing a game, each one is paying attention and listening
because someone is flipping the ball to them," says Dr. Goldberg.
"No one is saying to them, 'Watch out, steroids cause liver
disease, acne, and so forth,'" he notes. "But while they
are laughing and having a good time, they are actually watching
and learning at every step of the way."
"Football players are athletes; they like to compete,"
Dr. Goldberg notes. Therefore, several games pit squads against
each other to try and earn the most points for correct answers about
weight training, nutrition, and steroids. In addition to games,
"students do mock public service announcements, they do 'rap,'
they do songs, and they do newspaper articles in the classroom sessions,"
Adolescent Girls Abuse Steroids, Too
What do anabolic steroids have in common with amphetamines, tobacco,
diet pills, laxatives, and anorectics? They all are drugs used by
adolescent girls seeking to stay thin, says Dr. Linn Goldberg of
Oregon Health Sciences University. The use of these drugs, which
often goes hand in hand with eating disorders, is particularly prominent
among adolescent girls engaged in athletic activities ranging from
track and field, soccer, basketball, and volleyball to school dance
and drill teams, Dr. Goldberg says.
Dr. Goldberg and his colleague Dr. Dianne Elliot have been conducting
preliminary research, funded by NIDA, to identify risk factors that
influence adolescent girls use of harmful drugs. Among other things,
the researchers have found that many adolescent girls use drugs
to maintain thinness, Dr. Goldberg says. National surveys indicate
that girls account for about one-third of the high school students
who abuse steroids, Dr. Goldberg says. The primary reason that these
girls use steroids is to lose fat and gain lean muscle, he says.
Dr. Elliot and Dr. Goldberg have already developed an effective
steroid prevention program for male high school athletes described
beginning on the previous page. Now, they are developing a similar
drug abuse prevention program for adolescent girls. In their future
research, the researchers hope to test the effectiveness of the
intervention in reducing drug use and eating disorders among female
athletes in Oregons public middle and high schools.
In ATLAS's weight-training component, research staff members conduct
seven hands-on sessions that teach the students proper weight training
techniques. These sessions are designed to help student athletes
build the muscular strength and agility needed to achieve their
athletic goals without using steroids.
In the parent information component, parents participate in an
information and discussion session about the program with the ATLAS
staff. The staff gives the parents a family sports nutrition guide
and encourages them to support and reinforce the antisteroid and
nutritional goals of the program at home. Students in the program
say their parents are more opposed to steroid use after the intervention
and often provide healthier meals at home, according to Dr. Goldberg.
Late last year, Dr. Goldberg reported results of an ongoing study
of ATLAS's effectiveness in preventing steroid use among more than
1,500 football players from 31 high schools in the Portland area.
Some 702 football players at randomly selected schools received
the 7-week program during football season. Another 804 football
players at matched schools served as a control group and received
only a standard informational brochure on the dangers of steroid
Assessments conducted immediately after the intervention and 1
year later show that, compared with control students, student athletes
who participated in the ATLAS program knew more about exercise,
nutrition, and the harmful effects of anabolic steroids. ATLAS participants
also had an increased sense of personal vulnerability to negative
effects of steroids, more unfavorable attitudes toward their own
and others' use of steroids, and reduced intent to use steroids.
ATLAS students also showed greater improvement in their nutritional
habits than did control students. For example, they were more likely
to eat high-protein low-fat meals at school, home, and fast-food
restaurants. In addition, ATLAS students were more likely than students
who did not participate in the program to use established weight-lifting
and strength-conditioning techniques.
"The prevention program gives student athletes the knowledge
and skills to resist steroid use and achieve their athletic goals
in more effective, healthier ways."
"The program's positive effects flow from changing the student
athletes' attitudes and perceptions about steroids and then changing
their nutrition and exercise behaviors," Dr. Goldberg says.
These changes in behavior are reinforced by conducting periodic
tests of the athletes' body composition, strength, and power. "If
they are training properly, they are a heck of a lot stronger. So,
it's real positive reinforcement to them," he says.
"Student athletes who participate in the ATLAS program achieve,"
Dr. Goldberg says. The year before they entered the program, the
football teams that were randomly assigned to receive the intervention
had much worse won-lost records in football than the teams in the
control group had, he says. At the end of the first year, the two
groups' records were about the same, but teams in the ATLAS program
did slightly better. At the end of the second year, the won-lost
records of the ATLAS teams were substantially better than those
of the control teams, with some of the ATLAS teams making the playoffs
at the end of the season. "I don't know whether these teams'
improved performance is due to the ATLAS program," Dr. Goldberg
says. "I do know some of those schools hadn't been to the playoffs
in 25 years. The data showing improvements in program participants'
body composition and muscle mass are consistent with these teams'
success," he says.