MORE THAN $100 million worth of steroids are bought and sold annually on the black market, the federal government estimates. Their use among athletes has, the government says, reached epidemic proportions.
Steroids were first manufactured in the 1930s to treat chronically ill people whose catabolic, or destructive, metabolisms could not produce protein, causing them to lose body mass. Medical researchers knew that the male hormone testosterone causes the retention of nitrogen, the source of amino acids and protein, and so increases muscle mass. They theorized that steroids, which are synthetic versions of testosterone, would reverse protein depletion in their catabolic patients. But in the early 1960s, this use of steroids was refuted by the National Academy of Sciences and subsequently replaced with intravenous feeding. Steroids were also once used to help speed the recovery of burn victims and surgery patients, but this was abandoned in the mid-'60s.
From the start, doctors knew the drugs had dangerous properties. For all their anabolic, or building-up, qualities, steroids also have androgenic effects. In men, they can decrease hormone levels and sperm production and cause breast development and prostate enlargement. In women, steroid use can bring about hair growth or baldness and deepening of the voice; menstruation may become irregular or stop; the breasts and uterus may shrink. According to FDA medical reports, steroids can also cause liver tumors, birth defects, impotence, psychotic episodes, atherosclerosis and acne.
Because the side-effects can outweigh the benefits, the medical use of steroids is limited, says Dr. Glenn Braunstein, director of the Department of Medicine at Cedars-Sinai Medical Center and a clinical professor at UCLA School of Medicine. He says legal steroids are prescribed in a handful of instances: for men who, because of a pituitary irregularity, have low levels of testosterone; to speed up maturation in certain children; to stimulate red-blood-cell production in sufferers of aplastic anemia; to combat a condition that causes fluid in the larynx, and to treat inoperable breast cancer. Medical experts estimate that 3 million Americans take steroids every year.
Dr. Gloria Troendle, a senior medical officer at the FDA, says the main reason steroids make athletes stronger is that they increase protein synthesis. Although there have been no scientific studies on their impact, evidence suggests that athletes who use steroids are 10% to 15% stronger than their drug-free counterparts. However, the American College of Sports Medicine, an organization for physicians and researchers, has stated that the drugs have not been shown to increase muscular strength.
Because steroids do not fall under the Controlled Substances Act, the federal government does not impose quotas on their manufacture. But the FDA has attempted to limit the availability of steroids; only about a dozen are approved for any medicinal application. None of the types popular among athletes is available without a prescription, and some are banned outright. The FDA says those favored by athletes include:
Nandrolone decanoate (known as Deca-Durabolin). An injectable steroid used to treat anemia caused by renal failure and delayed adolescence in boys.
Nandrolone phenpropionate (Durabolin). Also injectable, it is used to treat breast cancer.
Testosterone cypionate. An injectable steroid used in the treatment of inoperable breast cancer.
Oxymetholone (Anadrol-50) and Oxandrolone (Anavar). Taken in pill form, both are used to treat aplastic anemia.
Methandrostenolone (Dianabol). Once used to treat growth failure in young boys and osteoporosis, this oral steroid was taken off the FDA's approved-drug list in 1985.
Methanolone enanthate (Primobolin). A non-approved injectable steroid made of animal testosterone.
In 1986, the California Legislature classified steroids as controlled substances and imposed trafficking penalties of up to five years and $20,000.