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Anabolic Steroids and Anabolic Steroids and Performance-Enhancing Performance-Enhancing

SubstancesSubstances

Performance-enhancing Performance-enhancing drugs: Know the risksdrugs: Know the risks

Introduction:Introduction:

Are you hoping to gain a competitive Are you hoping to gain a competitive edge by taking muscle-building edge by taking muscle-building supplements or other performance-supplements or other performance-enhancing drugs? Learn how these enhancing drugs? Learn how these drugs work and how they can affect drugs work and how they can affect your health.your health.

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Most serious athletes will tell you that the Most serious athletes will tell you that the competitive drive to win can be fierce. competitive drive to win can be fierce. Besides the satisfaction of personal Besides the satisfaction of personal accomplishment, athletes often pursue accomplishment, athletes often pursue dreams of winning a medal for their dreams of winning a medal for their country or securing a spot on a country or securing a spot on a professional team. In such an professional team. In such an environment, the use of performance-environment, the use of performance-enhancing drugs has become enhancing drugs has become increasingly common. increasingly common.

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But using performance-enhancing drugs But using performance-enhancing drugs — aka, doping — isn't without risks. — aka, doping — isn't without risks. Take the time to learn about the Take the time to learn about the potential benefits, the health risks and potential benefits, the health risks and the many unknowns regarding so-called the many unknowns regarding so-called performance-enhancing drugs such as performance-enhancing drugs such as anabolic steroids, androstenedione, anabolic steroids, androstenedione, human growth hormone, erythropoietin, human growth hormone, erythropoietin, diuretics, creatine and stimulants. You diuretics, creatine and stimulants. You may decide that the benefits aren't may decide that the benefits aren't worth the risks. worth the risks.

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Anabolic steroidsAnabolic steroids What are they?What are they?

Some athletes take a form of steroids — known as Some athletes take a form of steroids — known as anabolic-androgen steroids or just anabolic steroids anabolic-androgen steroids or just anabolic steroids — to increase their muscle mass and strength. The — to increase their muscle mass and strength. The main anabolic steroid hormone produced by your main anabolic steroid hormone produced by your body is testosterone. body is testosterone.

Testosterone has two main effects on your Testosterone has two main effects on your body: body:

Anabolic effectsAnabolic effects promote muscle building. promote muscle building. Androgenic effectsAndrogenic effects are responsible for male are responsible for male

traits, such as facial hair and a deeper voice.traits, such as facial hair and a deeper voice.

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Why are these drugs so Why are these drugs so appealing to athletes?appealing to athletes?

Besides making muscles bigger, Besides making muscles bigger, anabolic steroids may help athletes anabolic steroids may help athletes recover from a hard workout more recover from a hard workout more quickly by reducing the muscle damage quickly by reducing the muscle damage that occurs during the session. This that occurs during the session. This enables athletes to workout harder and enables athletes to workout harder and more frequently without overtraining. In more frequently without overtraining. In addition, some athletes may like the addition, some athletes may like the aggressive feelings they get when they aggressive feelings they get when they take the drugs.take the drugs.

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Definition of Definition of Anabolic SteroidAnabolic Steroid

““Anabolic steroid” includes any drug or Anabolic steroid” includes any drug or hormonal substance chemically or hormonal substance chemically or pharmacologically related to testosterone, pharmacologically related to testosterone, all prohormones, including all prohormones, including dehydroepiandrosterone and all dehydroepiandrosterone and all substances listed in the Anabolic Steroid substances listed in the Anabolic Steroid Control Act of 2004. “Anabolic steroid” Control Act of 2004. “Anabolic steroid” does does notnot include estrogens, progestins, include estrogens, progestins, corticosteroids, orcorticosteroids, or mineralocorticoids.mineralocorticoids.

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Definition of Performance-Definition of Performance-Enhancing SubstanceEnhancing Substance

““Performance-enhancing substance” Performance-enhancing substance” means a manufactured product for oral means a manufactured product for oral ingestion, intranasal application or ingestion, intranasal application or inhalation containing compounds that:inhalation containing compounds that:– Contain a stimulant, amino acid, hormone Contain a stimulant, amino acid, hormone

precursor herb or other botanical or any other precursor herb or other botanical or any other substance other than an essential vitamin or substance other than an essential vitamin or mineralmineral

– Are intended to increase athletic performance, Are intended to increase athletic performance, promote muscle growth, induce weight loss or promote muscle growth, induce weight loss or increase an individual’s endurance or capacity increase an individual’s endurance or capacity for exercise.for exercise.

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Performance-Enhancing Performance-Enhancing SupplementsSupplements

The Dietary Supplement and Health Education The Dietary Supplement and Health Education Act of 1994 – Limits the Food and Drug Act of 1994 – Limits the Food and Drug Administration from regulating productsAdministration from regulating products

18.6% of U.S. supplements contain anabolic 18.6% of U.S. supplements contain anabolic steroids – International Olympic Committee steroids – International Olympic Committee (IOC) study of 240 supplements(IOC) study of 240 supplements

Many products contaminated: lead, pesticides, Many products contaminated: lead, pesticides, arsenic, mercuryarsenic, mercury

Strengths of the products available can vary Strengths of the products available can vary Effectiveness studies have not been Effectiveness studies have not been

performed among high school age athletesperformed among high school age athletes

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Variations of Steroids and Variations of Steroids and Performance-Enhancing Performance-Enhancing

SubstancesSubstances

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Why do students take anabolic Why do students take anabolic steroids or performance-steroids or performance-enhancing substances?enhancing substances?

To:To: Boost athletic performanceBoost athletic performance Build muscleBuild muscle Increase body massIncrease body mass Lose body fatLose body fat

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What influences a student to What influences a student to take anabolic steroids or take anabolic steroids or performance-enhancing performance-enhancing

substances?substances?

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Desire to Emulate Role Desire to Emulate Role ModelsModels

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Peer Pressure to SucceedPeer Pressure to Succeed

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Media InfluencesMedia Influences

Images that portray steroids in a positive lightImages that portray steroids in a positive light

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Cover Stories About Cover Stories About SteroidsSteroids

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Desired Body ImageDesired Body ImageBased on GenderBased on Gender

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Dangers of Anabolic Steroids Dangers of Anabolic Steroids and Performance-Enhancing and Performance-Enhancing

SubstancesSubstances

Steroids are dangerous for two reasons:Steroids are dangerous for two reasons:– They are ILLEGAL.They are ILLEGAL.– They can damage a person’s mental and They can damage a person’s mental and

physical health.physical health. If used by adolescents, can have permanent If used by adolescents, can have permanent

negative consequences negative consequences

RisksRisks Many athletes take anabolic steroids at doses that are Many athletes take anabolic steroids at doses that are

much higher than those prescribed for medical reasons, much higher than those prescribed for medical reasons, and most of what is known about the drugs' effects on and most of what is known about the drugs' effects on athletes comes from observing users. It is impossible athletes comes from observing users. It is impossible for researchers to design studies that would accurately for researchers to design studies that would accurately test the effects of large doses of steroids on athletes, test the effects of large doses of steroids on athletes, because giving participants such high doses would be because giving participants such high doses would be unethical. This means that the effects of taking unethical. This means that the effects of taking anabolic steroids at very high doses haven't been well anabolic steroids at very high doses haven't been well studied. studied.

Anabolic steroids come with serious physical side Anabolic steroids come with serious physical side effects as well.effects as well.

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Some Health Risks for Both Some Health Risks for Both Males and Females:Males and Females:

– Acne, really bad acne, Acne, really bad acne, especially on face and especially on face and backback

– Stunted growth in Stunted growth in teens (by causing teens (by causing bones to mature too bones to mature too fast and stop growing fast and stop growing at an early age)at an early age)

– High blood pressure, High blood pressure, unhealthy cholesterol unhealthy cholesterol changes, and heart changes, and heart diseasedisease

– Blood clots and strokeBlood clots and stroke– Liver damage, Liver damage,

jaundice, or liver jaundice, or liver cancercancer

– Headaches, aching Headaches, aching joints, and muscle joints, and muscle crampscramps

– Increased risk of Increased risk of ligament and tendon ligament and tendon injuries, which can injuries, which can end an athlete’s end an athlete’s career for goodcareer for good

– Needle sharing results Needle sharing results in higher risk for in higher risk for serious infections like serious infections like Hepatitis B and C or Hepatitis B and C or HIV, which causes HIV, which causes AIDS AIDS

– BaldnessBaldness

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Gender Differences and Risks Gender Differences and Risks of Drug Useof Drug Use

Young FemalesYoung Females

Self-esteemSelf-esteem Depression/moodDepression/mood Body image*Body image* Media*Media*

Young MalesYoung Males

Risky behaviorRisky behavior ImpulsivityImpulsivity Body image*Body image* Media* Media*

*Specific, based on gender

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Health Risks for Males:Health Risks for Males:

Shrinking of the testiclesShrinking of the testicles Low sperm countLow sperm count Impotence (inability to get an Impotence (inability to get an

erection)erection) Increased breast growth in males, Increased breast growth in males,

especially teensespecially teens Enlarged prostateEnlarged prostate

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Health Risks for Females:Health Risks for Females:

Breast shrinkageBreast shrinkage Male-type facial and body hair Male-type facial and body hair

growthgrowth Deepening of the voiceDeepening of the voice Problems with menstrual periodsProblems with menstrual periods Enlarged clitoris Enlarged clitoris

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Psychological Health Risks:Psychological Health Risks:

““Roid rage”- severe, aggressive behavior Roid rage”- severe, aggressive behavior that may result in violence, such as that may result in violence, such as fighting or destroying propertyfighting or destroying property

Severe mood swingsSevere mood swings Paranoia- extreme feelings of mistrust and Paranoia- extreme feelings of mistrust and

fearfear Anxiety and panic attacksAnxiety and panic attacks Depression and thoughts of suicideDepression and thoughts of suicide

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Definition of “Cycling”Definition of “Cycling”

Anabolic steroids are taken orally or Anabolic steroids are taken orally or injected, typically in cycles of weeks injected, typically in cycles of weeks or months, rather than continuously.or months, rather than continuously.

Cycling involves taking multiple Cycling involves taking multiple doses of steroids over a specific doses of steroids over a specific period of time, stopping for a period, period of time, stopping for a period, and starting again.and starting again.

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Definition of “Stacking”Definition of “Stacking”

Users often combine several different Users often combine several different types of steroids to maximize their types of steroids to maximize their effectiveness while trying to effectiveness while trying to minimize negative effects.minimize negative effects.

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Slang for anabolic steroids or Slang for anabolic steroids or performance-enhancing performance-enhancing

substancessubstances You may have heard steroids You may have heard steroids

called:called:– RoidsRoids– Juice Juice – HypeHype– PumpersPumpers– Gym CandyGym Candy– ArnoldsArnolds– GearGear– Weight TrainersWeight Trainers– StackersStackers– 420 (pronounced “four-twenty”)420 (pronounced “four-twenty”)

AndrostenedioneAndrostenedione What is it?What is it?

Androstenedione (andro) is a hormone produced by the adrenal Androstenedione (andro) is a hormone produced by the adrenal glands, ovaries and testes. It's a hormone that's normally glands, ovaries and testes. It's a hormone that's normally converted to testosterone and estradiol in both men and women.converted to testosterone and estradiol in both men and women.

Andro is available in prescription and nonprescription forms. The Andro is available in prescription and nonprescription forms. The prescription version is a controlled substance. Andro is also sold prescription version is a controlled substance. Andro is also sold without a prescription as a nutritional supplement. Manufacturers without a prescription as a nutritional supplement. Manufacturers and bodybuilding magazines tout its ability to allow athletes to and bodybuilding magazines tout its ability to allow athletes to train harder and recover more quickly. However, its use as a train harder and recover more quickly. However, its use as a performance-enhancing drug is illegal in the United States. performance-enhancing drug is illegal in the United States.

Scientific studies that refute these claims show that Scientific studies that refute these claims show that supplemental androstenedione doesn't increase testosterone and supplemental androstenedione doesn't increase testosterone and that your muscles don't get stronger with andro use. In fact, that your muscles don't get stronger with andro use. In fact, almost all of the andro is rapidly converted to estrogen, the almost all of the andro is rapidly converted to estrogen, the primary hormone in females.primary hormone in females.

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RisksRisks

Side effects of andro in men Side effects of andro in men include: include: AcneAcne Diminished sperm Diminished sperm

productionproduction Shrinking of the Shrinking of the

testiclestesticles Enlargement of the Enlargement of the

breastsbreasts

In women, side effects include: In women, side effects include: AcneAcne Masculinization, such Masculinization, such

as deepening of the as deepening of the voice and male-voice and male-pattern baldnesspattern baldness

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In both men and women, andro can decrease HDL cholesterol (the "good" cholesterol), which puts you at greater risk of heart attack and stroke.

Human growth hormoneHuman growth hormone

What is it?What is it?Human growth hormone, also known as Human growth hormone, also known as gonadotropin, is a hormone that has an gonadotropin, is a hormone that has an anabolic effect. Athletes take it to anabolic effect. Athletes take it to improve muscle mass and performance. improve muscle mass and performance. However, it hasn't been shown However, it hasn't been shown conclusively to improve either strength conclusively to improve either strength or endurance. It is available only by or endurance. It is available only by prescription and is administered by prescription and is administered by injection. injection.

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RisksRisks

Adverse effects related to human growth Adverse effects related to human growth hormone range in severity and may include: hormone range in severity and may include:

Joint painJoint pain Muscle weaknessMuscle weakness Fluid retentionFluid retention Carpal tunnel syndromeCarpal tunnel syndrome Impaired glucose regulationImpaired glucose regulation CardiomyopathyCardiomyopathy HyperlipidemiaHyperlipidemia

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ErythropoietinErythropoietin(EPO)(EPO)

What is it?What is it? Erythropoietin is a type of hormone used to treat anemia in Erythropoietin is a type of hormone used to treat anemia in people with severe kidney disease. It increases production people with severe kidney disease. It increases production of red blood cells and hemoglobin, resulting in improved of red blood cells and hemoglobin, resulting in improved movement of oxygen to the muscles. Epoetin, a synthetic movement of oxygen to the muscles. Epoetin, a synthetic form of erythropoietin, is commonly used by endurance form of erythropoietin, is commonly used by endurance athletes. athletes.

RisksRisksErythropoietin use among competitive cyclists was Erythropoietin use among competitive cyclists was common in the 1990s and allegedly contributed to at least common in the 1990s and allegedly contributed to at least 18 deaths. Inappropriate use of erythropoietin may 18 deaths. Inappropriate use of erythropoietin may increase the risk of thrombotic events, such as stroke, increase the risk of thrombotic events, such as stroke, heart attack and pulmonary edema. heart attack and pulmonary edema.

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DiureticsDiuretics What are they?What are they?

Diuretics are drugs that change your body's Diuretics are drugs that change your body's natural balance of fluids and salts natural balance of fluids and salts (electrolytes) and can lead to dehydration. (electrolytes) and can lead to dehydration. This loss of water can decrease an athlete's This loss of water can decrease an athlete's weight, helping him or her to compete in a weight, helping him or her to compete in a lighter weight class, which many athletes lighter weight class, which many athletes prefer. Diuretics may also help athletes pass prefer. Diuretics may also help athletes pass drug tests by diluting their urine and are drug tests by diluting their urine and are sometimes referred to as a "masking" sometimes referred to as a "masking" agent. agent.

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RisksRisksDiuretics taken an any dose, even medically recommended Diuretics taken an any dose, even medically recommended doses, predispose athletes to adverse effects such as: doses, predispose athletes to adverse effects such as:

DehydrationDehydration Muscle crampsMuscle cramps ExhaustionExhaustion DizzinessDizziness Potassium deficiencyPotassium deficiency Heart arrhythmiasHeart arrhythmias Drop in blood pressureDrop in blood pressure HeatstrokeHeatstroke DeathDeath

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CreatineCreatine What is it?What is it?

Many athletes take nutritional supplements instead of or in addition to Many athletes take nutritional supplements instead of or in addition to performance-enhancing drugs. Supplements are available over-the-performance-enhancing drugs. Supplements are available over-the-counter as powders or pills. counter as powders or pills.

The most popular supplement among athletes is probably creatine The most popular supplement among athletes is probably creatine monohydrate. Creatine is a naturally occurring compound produced by monohydrate. Creatine is a naturally occurring compound produced by your body that helps your muscles release energy. your body that helps your muscles release energy.

Scientific research indicates that creatine may have some athletic Scientific research indicates that creatine may have some athletic benefit by producing small gains in short-term bursts of power. benefit by producing small gains in short-term bursts of power. Creatine appears to help muscles make more adenosine triphosphate Creatine appears to help muscles make more adenosine triphosphate (ATP), which stores and transports energy in cells, and is used for quick (ATP), which stores and transports energy in cells, and is used for quick bursts of activity, such as weightlifting or sprinting. There's no bursts of activity, such as weightlifting or sprinting. There's no evidence, however, that creatine enhances performance in aerobic or evidence, however, that creatine enhances performance in aerobic or endurance sports. endurance sports.

Your liver produces about 0.07 ounces (2 grams) of creatine each day. Your liver produces about 0.07 ounces (2 grams) of creatine each day. You also get creatine from the meat in your diet. Creatine is stored in You also get creatine from the meat in your diet. Creatine is stored in your muscles, and levels are relatively easily maintained. Because your your muscles, and levels are relatively easily maintained. Because your kidneys remove excess creatine, the value of supplements to someone kidneys remove excess creatine, the value of supplements to someone who already has adequate muscle creatine content is questionable.who already has adequate muscle creatine content is questionable.

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RisksRisksSupplements are considered Supplements are considered food and not drugs by the food and not drugs by the FDA. This means FDA. This means supplement manufacturers supplement manufacturers are not required to conform are not required to conform to the same standards as to the same standards as drug manufacturers do. In drug manufacturers do. In some cases, supplements some cases, supplements have been found to be have been found to be contaminated with other contaminated with other substances, which may substances, which may inadvertently lead to a inadvertently lead to a positive test for positive test for performance-enhancing performance-enhancing drugs. drugs.

Possible side effects of Possible side effects of creatine that can creatine that can decrease athletic decrease athletic performance include: performance include:

Stomach crampsStomach cramps Muscle crampsMuscle cramps NauseaNausea DiarrheaDiarrhea Weight gainWeight gain

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CreatineCreatineWeight gain is sought after by athletes who want to Weight gain is sought after by athletes who want to

increase their size. But with prolonged creatine use, increase their size. But with prolonged creatine use, weight gain is more likely the result of water retention weight gain is more likely the result of water retention than an increase in muscle mass. Water is drawn into than an increase in muscle mass. Water is drawn into your muscle tissue, away from other parts of your body. your muscle tissue, away from other parts of your body. This puts you at risk of dehydration. This puts you at risk of dehydration.

High-dose creatine use may potentially damage your: High-dose creatine use may potentially damage your: KidneysKidneys LiverLiver

It appears safe for adults to use creatine at the doses It appears safe for adults to use creatine at the doses recommended by manufacturers. But it's unknown what recommended by manufacturers. But it's unknown what kind of effect taking creatine has over the long term, kind of effect taking creatine has over the long term, especially in teens and children. especially in teens and children.

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StimulantsStimulants What are they?What are they?

Some athletes use stimulants to stimulate the central Some athletes use stimulants to stimulate the central nervous system and increase heart rate and blood nervous system and increase heart rate and blood pressure. pressure.

Stimulants can: Stimulants can: Improve enduranceImprove endurance Reduce fatigueReduce fatigue Suppress appetiteSuppress appetite Increase alertness and aggressivenessIncrease alertness and aggressiveness

Common stimulants include caffeine and amphetamines. Common stimulants include caffeine and amphetamines. Cold remedies often contain the stimulants ephedrine Cold remedies often contain the stimulants ephedrine or pseudoephedrine hydrochloride. The street drugs or pseudoephedrine hydrochloride. The street drugs cocaine and methamphetamine also are stimulants. cocaine and methamphetamine also are stimulants. 3838

RisksRisksAlthough stimulants can boost physical performance and Although stimulants can boost physical performance and

promote aggressiveness on the field, they have side effects promote aggressiveness on the field, they have side effects that can impair athletic performance. that can impair athletic performance.

Nervousness and irritability make it hard to concentrate on Nervousness and irritability make it hard to concentrate on the game.the game.

Insomnia can prevent an athlete from getting needed sleep.Insomnia can prevent an athlete from getting needed sleep. DehydrationDehydration HeatstrokeHeatstroke

Athletes may become psychologically addicted or develop a Athletes may become psychologically addicted or develop a tolerance so that they need greater amounts to achieve the tolerance so that they need greater amounts to achieve the desired effect, meaning they'll take doses that are much desired effect, meaning they'll take doses that are much higher than the intended medical dose.higher than the intended medical dose.

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Other side effects include: Other side effects include: Heart palpitationsHeart palpitations Heart rhythm abnormalitiesHeart rhythm abnormalities Weight lossWeight loss TremorsTremors Mild hypertensionMild hypertension HallucinationsHallucinations ConvulsionsConvulsions StrokeStroke Heart attack and other circulatory problemsHeart attack and other circulatory problems

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The Bottom LineThe Bottom Line

Do performance-enhancing drugs boost Do performance-enhancing drugs boost performance? Some athletes may appear to performance? Some athletes may appear to achieve physical gains from such drugs, but achieve physical gains from such drugs, but at what cost? The long-term effects of at what cost? The long-term effects of performance-enhancing drugs haven't been performance-enhancing drugs haven't been rigorously studied. And short-term benefits rigorously studied. And short-term benefits are tempered by many risks. Not to mention are tempered by many risks. Not to mention that doping is prohibited by most sports that doping is prohibited by most sports organizations. No matter how you look at it, organizations. No matter how you look at it, using performance-enhancing drugs is risky using performance-enhancing drugs is risky business. business.

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Steroids are safe Taking any kind of steroid will result in death Injectable steroids are safer than oral steroids Steroids won’t really stunt your growth All steroids are pretty much the same Steroid abuse isn’t really a big problem in the U.S. All steroids are pills Only a certain kind of person uses steroids Steroids aren’t addictive Steroids aren’t as illegal as other drugs Steroids build muscle without working out Women don’t use steroids Roid rage isn’t real

A list (not inclusive) gathered from the following sites: – Association Against Steroid Abuse - Steroid Myths

http://www.steroidabuse.com/steroid-myths.html – Bodybuilding – The Myths and Dangers of Anabolic Steroid Usage

http://bodybuilding.about.com/od/supplementationbasics/a/steroiddangers.htm – Roid Report http://www.roidreport.com/steroids/steroid-myths/

Common MythsCommon Myths

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Additional ResourcesAdditional Resources Parent informational letter – The Mayo Clinic

http://www.mayoclinic.com/health/performance-enhancing-drugs/SM00045

Teen Health – Are Steroids Worth the Risk http://kidshealth.org/teen/food_fitness/sports/steroids.html

US Drug Enforcement Administration http://www.usdoj.gov/dea/concern/steroids.html

National Institute on Drug Abuse (NIDA) http://www.nida.nih.gov/Infofacts/steroids.html

Additional resources may be found on the Oregon Additional resources may be found on the Oregon Department of Education web site at Department of Education web site at http://www.ode.state.or.us/search/page/?id=2569