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Steroid use was initially confined to bodybuilders and professional athletes, but it has now become prevalent in various sections of society, including young aspiring athletes. As per estimates, over a million Americans have confessed to using steroids, with a significant number being high school students.

However, prolonged steroid use can lead to adverse health consequences. Both injectable and oral steroids have been linked to an increased risk of heart attack or stroke. Studies have shown that most oral steroids used for bodybuilding can cause liver damage.

Anabolic steroids are a group of synthetic substances that mimic the effects of male sex hormones like testosterone. They promote the growth of skeletal muscle (anabolic effects) and development of male sexual characteristics (androgenic effects) in both males and females. Therefore, the appropriate term for these substances is “anabolic-androgenic steroids,” but they are commonly referred to as “anabolic steroids” on this site.

Originally developed in the 1930s to treat hypogonadism, a condition in which the testes do not produce enough testosterone, anabolic steroids are now prescribed to treat steroid hormone deficiency such as delayed puberty and some types of impotence. Sometimes, they are also prescribed to counteract the wasting away of the body’s muscle mass due to diseases like some cancers and HIV infection.

However, since early animal research in the 1930s found that anabolic steroids could facilitate the growth of skeletal muscle, the drugs began to be abused by bodybuilders and weightlifters for that purpose. They later began to be abused by athletes in other sports because of their performance-enhancing capabilities. As a result, anabolic steroids have been banned from use by all amateur and professional sports organizations.

In some countries, no prescription is needed for anabolic steroids, and most of the illicit steroids sold in gyms, competitions, and mail-order operations are smuggled into the United States or produced in illegal laboratories or diverted from pharmacies. According to the National Institute on Drug Abuse, some commonly abused steroids include oral steroids like Anadrol, Dianabol, Oxandrin, and Winstrol, and injectable steroids like Deca-Durabolin, Depo-Testosterone, Durabolin, Equipoise, and Tetrahydrogestrinone (THG).

Steroidal supplements are substances marketed as hormone products or alternatives to anabolic steroids that claim to increase muscle mass and strength. Up until 2004, some steroid supplements like tetrahydrogestrinone (THG) and androstenedione (street name Andro) could be purchased legally at health food stores and other commercial outlets. However, Congress passed amendments to the Controlled Substance Act in 2004, making their sale illegal, except for dehydroepiandrosterone (DHEA).

The U.S. Food and Drug Administration (FDA) warns against bodybuilding products that are represented to contain steroids or steroid-like substances, as they are unapproved and misbranded drugs. These products are marketed as dietary supplements, but they could increase testosterone levels in the body like anabolic steroids, resulting in similar side effects. Although little research has been done on the side effects of these supplements, the FDA warns they can be harmful.

 

Depending on the type, anabolic steroids can be taken orally, injected intramuscularly, or applied through the skin as gels or creams. When used for medical purposes, anabolic steroids can be taken by intramuscular or subcutaneous injection, orally, pellet implantation under the skin or by application to the skin via patches or gels.

However, the size of the dosages used by steroid abusers can be much larger than those used for legitimate medical purposes. When steroids are abused for nonmedical purposes they are usually injected or taken orally.

When abusing steroids to body build or improve athletic performance, users may take dosages sometimes 100 times the normal prescribed therapeutic dose.

According to researchers, endurance athletes typically use dosages slightly below replacement levels of 5 to 10 mg/day.5 Sprinters will usually take 1.5 to 2 times replacement levels. Weight lifters and bodybuilders will take 10 to 100 times normal doses.

Women athletes use lower dosages than men, regardless of the sport for which they are training.

Cycling, Stacking, and Pyramiding

People who abuse anabolic steroids sometimes use different methods, or patterns, of usage based on their goals. Athletes may use steroids for a limited period of time to accomplish a specific goal, but bodybuilders may use steroids for long periods of time. They include:

Cycling

This method involves taking multiple doses over a specific period of time, stopping for a period, and then starting again. Typically, users will take steroids for six weeks to 16 weeks at a time, followed by several weeks of taking low doses or no steroids at all.

Athletes who know they are going to be tested – for example, during a specific event or competition – will time their cycle in hopes of passing the drug test. Cycling is also used to try to minimize the undesirable side-effects of steroids use.

According to Dr. James Tolliver a pharmacologist with the DEA, the reasons that users report that they use cycling include:5

  • Ensure peak performance during competition
  • Prevent detection of steroid use
  • Reduction of adverse effects
  • Reduction of tolerance development
  • Stacking

When abusers combine different types of steroids—such as those taken orally as well as those injected—it is called stacking. The idea behind the practice is that the different kinds interact to produce a greater effect.

Many users try stacking in hopes of increasing the effectiveness of the combination of steroids, but there is no scientific evidence to back that theory up.

According to the DEA’s Dr. Tolliver:5

  • Injectables may be stacked with oral preparations
  • Short-acting steroids may be stacked with longer-acting steroids
  • Stacking is never done in medical practice

Pyramiding

In this method, users start with low doses then increase the dosage or the frequency until they reach a peak at mid-cycle. Then they gradually reduce the dosage or frequency down to zero. Typically, the pyramid cycle will last six to 12 weeks. This is usually followed by a cycle when the user continues to train or exercise without taking steroids.

Pyramid users believe the method gives the body time to adjust to the high dosages and the drug-free period allows the body’s hormonal system time to recuperate. But again, the theory is not supported by scientific research.

Indications are that high doses or anabolic steroids increase irritability and aggression which may be caused by secondary hormonal changes. As with the health effects of steroids, most of the information about the behavioral effects of steroid abuse comes from case reports and small studies.

In these case studies, anabolic steroid abusers report that when they are taking steroids they are more likely to engage in aggressive behavior such as fighting, armed robbery, burglary, theft, and vandalism than they are when they are drug-free, according to the National Institute on Drug Abuse.

The NIDA reports four studies in which volunteers were given high dosages of anabolic steroids.7 In three of the studies, the volunteers reported greater feelings of aggression and irritability, although the effects varied widely between individuals.

Research Results Vary

In the fourth study, no such link to irritability and aggression was reported. The researchers speculated that it may be because some steroids, but not all, increase aggression.

In a few controlled studies, aggression or adverse behavior was reported after steroid abuse, but only by a minority of the volunteers in the studies.2

Anger, Hostility, Aggression or Violent Behavior

According to steroid abuse researchers, anger, irritability, hostility, aggression and/or violent behavior:

  • Increased likelihood with higher doses
  • Minor provocations evoke exaggerated responses
  • Occurs in some but not all anabolic steroid users
  • Presents danger to law enforcement
  • Presents danger to spouse, family, and friends
  • Unpredictable who will respond

Psychological Effects of Steroid Abuse

There have been some reports of psychotic and manic reactions in both men and women who abuse anabolic steroids, but these have been rare occurrences and researchers believe they have most likely occurred in users with prior mental illness.8

It is not known scientifically to what extent anabolic steroid use has on violence and behavioral disorders. The prevalence of extreme cases of violence among steroid abusers appears to be low, but as with the health effects, extreme violence could be underreported or underrecognized.

Some other psychological effects of steroid abuse that have been reported include:

  • Hallucinations and delusions
  • Manic behavior
  • Mood swings

Prompts Other Drug Use?

Some research has found that use of anabolic steroids may cause users to turn to other drugs to alleviate the negative effects. One study found that 9.3% of men who were being treated for heroin or other opioid abuse had abused steroid before doing any other drugs.7

Of that 9.3% in treatment, 86% said they initiated opioid use to counteract insomnia and irritability caused by their steroid use.

Some individuals who abuse anabolic steroids can develop patterns of behavior that are typical symptoms of people who are addicted. Those behaviors include continuing use despite negative consequences, spending excessive time and effort in obtaining drugs, and experiencing withdrawal symptoms when they stop using.

Some anabolic steroid users continue using the drugs despite experiencing physical problems and problems in their social relationships. The percentage of those who continue use in spite of negative consequences is not known.

Classic Addiction Symptoms

Many steroid abusers spend large amounts of time and money to obtain the drugs they use. When they stop taking steroids, users can experience withdrawal symptoms that can include mood swings, restlessness, loss of appetite, and craving for steroids.

Other withdrawal symptoms reported in case studies of people coming off anabolic steroids use include:9

  • Anorexia
  • Apathy
  • Decreased sex drive
  • Difficulty concentrating
  • Fatigue (extreme tiredness)
  • Feelings of anxiety
  • Headaches
  • Insomnia
  • Muscle and joint pain

One of the most serious withdrawal symptoms associated with stopping steroid use is depression because it can sometimes lead to suicide attempts, the NIDA reports. Research reveals that if untreated, depression associated with anabolic steroid withdrawal can persist for a year or longer after use of the drug stops.

What Treatments Are Effective for Steroid Abuse?

Treatment options recommended by the National Institute on Drug Abuse for anabolic steroid abuse are based more on case studies and physician experience rather than controlled studies. There has been very little research into treatment for steroid abuse.

The NIDA’s Research Report on anabolic steroids reported that few studies had been conducted on steroid treatment. These studies suggest that patients going through anabolic steroid withdrawal may only require supportive and educational therapy, in many cases. Though physicians need to evaluate them for suicidal thoughts due to steroid withdrawal.

If withdrawal symptoms listed above become severe or prolonged, patients are given medications to treat the specific withdrawal symptoms. For example, antidepressants for depression or analgesics for headaches and pain.

Some steroid withdrawal patients receive medication to help restore their hormonal systems. Others are treated with behavioral therapies for withdrawal symptoms that go beyond pharmacological treatment.

If you or a loved one are struggling with substance use or addiction, contact the Substance Abuse and Mental Health Services Administration (SAMHSA) National Helpline at 1-800-662-4357 for information on support and treatment facilities in your area.

For more mental health resources, see our National Helpline Database.

Preventing Steroid Abuse

Because the dangers of anabolic steroid abuse are so great and because there does exist a potential for some users to develop addictive-like behavior related to steroid use, efforts should be concentrated on preventing the use in the first place, especially among young student-athletes.

By far the most prevalent anabolic steroid prevention programs in the U.S. are those aimed at professional, Olympic and college athletes. Very few local school districts have established steroid prevention programs.

According to NIDA, an estimated 9% of secondary schools have drug testing programs for illicit drugs and less than 4% of high schools in the United States test their athletes for anabolic steroids.7

Even if such testing was more widespread, research has yet to clearly determine if drug testing is effective in reducing drug abuse. The NIDA is currently funding that research.

Scientific studies have shown that teaching youth about the adverse effects of steroids alone is not as effective in preventing steroid use as well as programs that present both the risks and benefits of using anabolic steroids. Students find a balanced approach more credible, the NIDA says.

Effective Prevention Programs Available

Although most secondary schools do not have official anabolic steroids prevention programs in place, there are programs available that have been shown to be effective in reducing steroid abuse, other substance abuse, and other risky behaviors.

Two of those programs, developed by Oregon Health & Science University and funded by the National Institute on Drug Abuse, are the Adolescents Training and Learning to Avoid Steroids (ATLAS) for high school football players and the Athletes Targeting Healthy Exercise and Nutrition Alternatives (ATHENA) for school girls on sports teams.

The NIDA reports that these two sophisticated approaches have shown promise in preventing steroid abuse among high school sports players.

The ATLAS Program

The ATLAS program is designed to show high school football players that they can build powerful bodies and improve their athletic performance without using dangerous anabolic steroids.10

The program not only provides education about the harmful side effects of anabolic steroids but also provides nutrition and weight-training alternatives to using steroids. According to NIDA research, the program has been successful in reducing the participants’ intentions to use steroids while increasing their healthy behaviors.

One of the hallmarks of the ATLAS program is that the football coaches and team leaders are the ones who teach the players about the harmful effects of steroids and other illicit drugs on sports performance. They also discuss how to refuse if they are offered drugs.

In controlled studies of the ATLAS program, researchers compared athletes in 15 high schools who were in the program with a control group who did not receive the training.

Effects of the ATLAS Program

After one year in the program, the ATLAS-trained students had:

  • Half the incidence of new anabolic steroids abuse
  • Increased protection against steroid and other substance abuse
  • Less abuse of alcohol, marijuana, amphetamines, and narcotics
  • Less abuse of athletic enhancing supplements
  • Less intention to abuse steroids in the future
  • Lower likelihood of engaging in hazardous substance abuse behaviors

The study found that ATLAS-trained athletes had less interest in trying steroids, less desire to abuse them, better knowledge of alternatives to steroid abuse, improved body image, and increased knowledge of diet supplements.

The ATHENA Program

The Athletes Targeting Healthy Exercise and Nutrition Alternatives (ATHENA) program were patterned after and similar to the ATLAS program, but designed for girls who participate in high school sports programs.

An early study of the ATHENA program found that before participating in the training, the control group and the ATHENA group exhibited similar risk behaviors.11 Participation in the ATHENA training significantly decreased those behaviors, the researchers found.

The female athletes who did not receive the ATHENA training were three times more likely to begin using diet pills during the sports season. They were twice as likely to abuse other body-shaping substances such as amphetamines, anabolic steroids, and muscle-building supplements during the season.

During the sports season, girls in the control group increased their use of diet pills, while those who received the ATHENA training, cut their diet pill use in half of their preseason usage.

Reduced Risky Behaviors

The ATHENA-trained girls reduced other risky behaviors. They were:

  • Experienced fewer injuries during the sports season
  • Less likely to be sexually active
  • Less likely to ride in a car with a drinking driver
  • More likely to wear seatbelts

The ATLAS and ATHENA programs for high school athletes has been endorsed by the United States Congress and the Substance Abuse and Mental Health Services Administration as a model program for secondary schools across the country.

Steroid use was initially confined to bodybuilders and professional athletes, but it has now become prevalent in various sections of society, including young aspiring athletes. As per estimates, over a million Americans have confessed to using steroids, with a significant number being high school students.

However, prolonged steroid use can lead to adverse health consequences. Both injectable and oral steroids have been linked to an increased risk of heart attack or stroke. Studies have shown that most oral steroids used for bodybuilding can cause liver damage.

Anabolic steroids are a group of synthetic substances that mimic the effects of male sex hormones like testosterone. They promote the growth of skeletal muscle (anabolic effects) and development of male sexual characteristics (androgenic effects) in both males and females. Therefore, the appropriate term for these substances is “anabolic-androgenic steroids,” but they are commonly referred to as “anabolic steroids” on this site.

Originally developed in the 1930s to treat hypogonadism, a condition in which the testes do not produce enough testosterone, anabolic steroids are now prescribed to treat steroid hormone deficiency such as delayed puberty and some types of impotence. Sometimes, they are also prescribed to counteract the wasting away of the body’s muscle mass due to diseases like some cancers and HIV infection.

However, since early animal research in the 1930s found that anabolic steroids could facilitate the growth of skeletal muscle, the drugs began to be abused by bodybuilders and weightlifters for that purpose. They later began to be abused by athletes in other sports because of their performance-enhancing capabilities. As a result, anabolic steroids have been banned from use by all amateur and professional sports organizations.

In some countries, no prescription is needed for anabolic steroids, and most of the illicit steroids sold in gyms, competitions, and mail-order operations are smuggled into the United States or produced in illegal laboratories or diverted from pharmacies. According to the National Institute on Drug Abuse, some commonly abused steroids include oral steroids like Anadrol, Dianabol, Oxandrin, and Winstrol, and injectable steroids like Deca-Durabolin, Depo-Testosterone, Durabolin, Equipoise, and Tetrahydrogestrinone (THG).

Steroidal supplements are substances marketed as hormone products or alternatives to anabolic steroids that claim to increase muscle mass and strength. Up until 2004, some steroid supplements like tetrahydrogestrinone (THG) and androstenedione (street name Andro) could be purchased legally at health food stores and other commercial outlets. However, Congress passed amendments to the Controlled Substance Act in 2004, making their sale illegal, except for dehydroepiandrosterone (DHEA).

The U.S. Food and Drug Administration (FDA) warns against bodybuilding products that are represented to contain steroids or steroid-like substances, as they are unapproved and misbranded drugs. These products are marketed as dietary supplements, but they could increase testosterone levels in the body like anabolic steroids, resulting in similar side effects. Although little research has been done on the side effects of these supplements, the FDA warns they can be harmful.

 

Depending on the type, anabolic steroids can be taken orally, injected intramuscularly, or applied through the skin as gels or creams. When used for medical purposes, anabolic steroids can be taken by intramuscular or subcutaneous injection, orally, pellet implantation under the skin or by application to the skin via patches or gels.

However, the size of the dosages used by steroid abusers can be much larger than those used for legitimate medical purposes. When steroids are abused for nonmedical purposes they are usually injected or taken orally.

When abusing steroids to body build or improve athletic performance, users may take dosages sometimes 100 times the normal prescribed therapeutic dose.

According to researchers, endurance athletes typically use dosages slightly below replacement levels of 5 to 10 mg/day.5 Sprinters will usually take 1.5 to 2 times replacement levels. Weight lifters and bodybuilders will take 10 to 100 times normal doses.

Women athletes use lower dosages than men, regardless of the sport for which they are training.

Cycling, Stacking, and Pyramiding

People who abuse anabolic steroids sometimes use different methods, or patterns, of usage based on their goals. Athletes may use steroids for a limited period of time to accomplish a specific goal, but bodybuilders may use steroids for long periods of time. They include:

Cycling

This method involves taking multiple doses over a specific period of time, stopping for a period, and then starting again. Typically, users will take steroids for six weeks to 16 weeks at a time, followed by several weeks of taking low doses or no steroids at all.

Athletes who know they are going to be tested – for example, during a specific event or competition – will time their cycle in hopes of passing the drug test. Cycling is also used to try to minimize the undesirable side-effects of steroids use.

According to Dr. James Tolliver a pharmacologist with the DEA, the reasons that users report that they use cycling include:5

  • Ensure peak performance during competition
  • Prevent detection of steroid use
  • Reduction of adverse effects
  • Reduction of tolerance development
  • Stacking

When abusers combine different types of steroids—such as those taken orally as well as those injected—it is called stacking. The idea behind the practice is that the different kinds interact to produce a greater effect.

Many users try stacking in hopes of increasing the effectiveness of the combination of steroids, but there is no scientific evidence to back that theory up.

According to the DEA’s Dr. Tolliver:5

  • Injectables may be stacked with oral preparations
  • Short-acting steroids may be stacked with longer-acting steroids
  • Stacking is never done in medical practice

Pyramiding

In this method, users start with low doses then increase the dosage or the frequency until they reach a peak at mid-cycle. Then they gradually reduce the dosage or frequency down to zero. Typically, the pyramid cycle will last six to 12 weeks. This is usually followed by a cycle when the user continues to train or exercise without taking steroids.

Pyramid users believe the method gives the body time to adjust to the high dosages and the drug-free period allows the body’s hormonal system time to recuperate. But again, the theory is not supported by scientific research.

Indications are that high doses or anabolic steroids increase irritability and aggression which may be caused by secondary hormonal changes. As with the health effects of steroids, most of the information about the behavioral effects of steroid abuse comes from case reports and small studies.

In these case studies, anabolic steroid abusers report that when they are taking steroids they are more likely to engage in aggressive behavior such as fighting, armed robbery, burglary, theft, and vandalism than they are when they are drug-free, according to the National Institute on Drug Abuse.

The NIDA reports four studies in which volunteers were given high dosages of anabolic steroids.7 In three of the studies, the volunteers reported greater feelings of aggression and irritability, although the effects varied widely between individuals.

Research Results Vary

In the fourth study, no such link to irritability and aggression was reported. The researchers speculated that it may be because some steroids, but not all, increase aggression.

In a few controlled studies, aggression or adverse behavior was reported after steroid abuse, but only by a minority of the volunteers in the studies.2

Anger, Hostility, Aggression or Violent Behavior

According to steroid abuse researchers, anger, irritability, hostility, aggression and/or violent behavior:

  • Increased likelihood with higher doses
  • Minor provocations evoke exaggerated responses
  • Occurs in some but not all anabolic steroid users
  • Presents danger to law enforcement
  • Presents danger to spouse, family, and friends
  • Unpredictable who will respond

Psychological Effects of Steroid Abuse

There have been some reports of psychotic and manic reactions in both men and women who abuse anabolic steroids, but these have been rare occurrences and researchers believe they have most likely occurred in users with prior mental illness.8

It is not known scientifically to what extent anabolic steroid use has on violence and behavioral disorders. The prevalence of extreme cases of violence among steroid abusers appears to be low, but as with the health effects, extreme violence could be underreported or underrecognized.

Some other psychological effects of steroid abuse that have been reported include:

  • Hallucinations and delusions
  • Manic behavior
  • Mood swings

Prompts Other Drug Use?

Some research has found that use of anabolic steroids may cause users to turn to other drugs to alleviate the negative effects. One study found that 9.3% of men who were being treated for heroin or other opioid abuse had abused steroid before doing any other drugs.7

Of that 9.3% in treatment, 86% said they initiated opioid use to counteract insomnia and irritability caused by their steroid use.

Some individuals who abuse anabolic steroids can develop patterns of behavior that are typical symptoms of people who are addicted. Those behaviors include continuing use despite negative consequences, spending excessive time and effort in obtaining drugs, and experiencing withdrawal symptoms when they stop using.

Some anabolic steroid users continue using the drugs despite experiencing physical problems and problems in their social relationships. The percentage of those who continue use in spite of negative consequences is not known.

Classic Addiction Symptoms

Many steroid abusers spend large amounts of time and money to obtain the drugs they use. When they stop taking steroids, users can experience withdrawal symptoms that can include mood swings, restlessness, loss of appetite, and craving for steroids.

Other withdrawal symptoms reported in case studies of people coming off anabolic steroids use include:9

  • Anorexia
  • Apathy
  • Decreased sex drive
  • Difficulty concentrating
  • Fatigue (extreme tiredness)
  • Feelings of anxiety
  • Headaches
  • Insomnia
  • Muscle and joint pain

One of the most serious withdrawal symptoms associated with stopping steroid use is depression because it can sometimes lead to suicide attempts, the NIDA reports. Research reveals that if untreated, depression associated with anabolic steroid withdrawal can persist for a year or longer after use of the drug stops.

What Treatments Are Effective for Steroid Abuse?

Treatment options recommended by the National Institute on Drug Abuse for anabolic steroid abuse are based more on case studies and physician experience rather than controlled studies. There has been very little research into treatment for steroid abuse.

The NIDA’s Research Report on anabolic steroids reported that few studies had been conducted on steroid treatment. These studies suggest that patients going through anabolic steroid withdrawal may only require supportive and educational therapy, in many cases. Though physicians need to evaluate them for suicidal thoughts due to steroid withdrawal.

If withdrawal symptoms listed above become severe or prolonged, patients are given medications to treat the specific withdrawal symptoms. For example, antidepressants for depression or analgesics for headaches and pain.

Some steroid withdrawal patients receive medication to help restore their hormonal systems. Others are treated with behavioral therapies for withdrawal symptoms that go beyond pharmacological treatment.

If you or a loved one are struggling with substance use or addiction, contact the Substance Abuse and Mental Health Services Administration (SAMHSA) National Helpline at 1-800-662-4357 for information on support and treatment facilities in your area.

For more mental health resources, see our National Helpline Database.

Preventing Steroid Abuse

Because the dangers of anabolic steroid abuse are so great and because there does exist a potential for some users to develop addictive-like behavior related to steroid use, efforts should be concentrated on preventing the use in the first place, especially among young student-athletes.

By far the most prevalent anabolic steroid prevention programs in the U.S. are those aimed at professional, Olympic and college athletes. Very few local school districts have established steroid prevention programs.

According to NIDA, an estimated 9% of secondary schools have drug testing programs for illicit drugs and less than 4% of high schools in the United States test their athletes for anabolic steroids.7

Even if such testing was more widespread, research has yet to clearly determine if drug testing is effective in reducing drug abuse. The NIDA is currently funding that research.

Scientific studies have shown that teaching youth about the adverse effects of steroids alone is not as effective in preventing steroid use as well as programs that present both the risks and benefits of using anabolic steroids. Students find a balanced approach more credible, the NIDA says.

Effective Prevention Programs Available

Although most secondary schools do not have official anabolic steroids prevention programs in place, there are programs available that have been shown to be effective in reducing steroid abuse, other substance abuse, and other risky behaviors.

Two of those programs, developed by Oregon Health & Science University and funded by the National Institute on Drug Abuse, are the Adolescents Training and Learning to Avoid Steroids (ATLAS) for high school football players and the Athletes Targeting Healthy Exercise and Nutrition Alternatives (ATHENA) for school girls on sports teams.

The NIDA reports that these two sophisticated approaches have shown promise in preventing steroid abuse among high school sports players.

The ATLAS Program

The ATLAS program is designed to show high school football players that they can build powerful bodies and improve their athletic performance without using dangerous anabolic steroids.10

The program not only provides education about the harmful side effects of anabolic steroids but also provides nutrition and weight-training alternatives to using steroids. According to NIDA research, the program has been successful in reducing the participants’ intentions to use steroids while increasing their healthy behaviors.

One of the hallmarks of the ATLAS program is that the football coaches and team leaders are the ones who teach the players about the harmful effects of steroids and other illicit drugs on sports performance. They also discuss how to refuse if they are offered drugs.

In controlled studies of the ATLAS program, researchers compared athletes in 15 high schools who were in the program with a control group who did not receive the training.

Effects of the ATLAS Program

After one year in the program, the ATLAS-trained students had:

  • Half the incidence of new anabolic steroids abuse
  • Increased protection against steroid and other substance abuse
  • Less abuse of alcohol, marijuana, amphetamines, and narcotics
  • Less abuse of athletic enhancing supplements
  • Less intention to abuse steroids in the future
  • Lower likelihood of engaging in hazardous substance abuse behaviors

The study found that ATLAS-trained athletes had less interest in trying steroids, less desire to abuse them, better knowledge of alternatives to steroid abuse, improved body image, and increased knowledge of diet supplements.

The ATHENA Program

The Athletes Targeting Healthy Exercise and Nutrition Alternatives (ATHENA) program were patterned after and similar to the ATLAS program, but designed for girls who participate in high school sports programs.

An early study of the ATHENA program found that before participating in the training, the control group and the ATHENA group exhibited similar risk behaviors.11 Participation in the ATHENA training significantly decreased those behaviors, the researchers found.

The female athletes who did not receive the ATHENA training were three times more likely to begin using diet pills during the sports season. They were twice as likely to abuse other body-shaping substances such as amphetamines, anabolic steroids, and muscle-building supplements during the season.

During the sports season, girls in the control group increased their use of diet pills, while those who received the ATHENA training, cut their diet pill use in half of their preseason usage.

Reduced Risky Behaviors

The ATHENA-trained girls reduced other risky behaviors. They were:

  • Experienced fewer injuries during the sports season
  • Less likely to be sexually active
  • Less likely to ride in a car with a drinking driver
  • More likely to wear seatbelts

The ATLAS and ATHENA programs for high school athletes has been endorsed by the United States Congress and the Substance Abuse and Mental Health Services Administration as a model program for secondary schools across the country.