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Adolescent Use of PEDs


About This Page

This page is one of several each providing a detailed analysis of one or another of the chief claims about the use of PEDs (Performance-Enhancing Drugs) in baseball. Though each, including this one, can be read "stand-alone", you really should first read the main page here, which summarizes all of the findings and sets them out them in a coherent presentation.


Extent of Use

No one disputes the assertion that PEDs of any sort, especially steroids, are very bad business for adolescents. The extensive earlier discussions here about the true side effects of PEDs have all been predicated on the subject being major-league baseball players, which is to say adult professional athletes. The biology of the human body before it completes its adolescent growth is significantly different in many ways from that of adults. (And, while we're at it, so is the biology of even adult females.)

There is not much dispute over the reality of PED use by adolescents, most especially young boys (though some use by girls is reported, too). What there is dispute over (though a lot less dispute than there should be) is the extent of that use. Use rates as high as 8% have been thrown around (see the so-called "Mitchell Report" for an example). But long-term, large-basis scientific studies of the problem just don't match the rhetoric.

The National Institute on Drug Abuse, which surveys about 50 thousand adolescents, in its report "National Results on Adolescent Drug Use: Overview of Key Findings, 2006" stated (with many more accompanying detailed supportive statistics) that:

Use was at 2.5% in 2004 and decreased significantly to 1.5% in 2005. It stands at 1.8% in 2006. Use at all grades is now down . . . .

As confirmation, ProjectEAT: Eating Among Teens, a five-year, longitudinal study of over a thousand youths, reports that:

Overall, 1.5% of adolescents reported using steroids.

Those statistics are not unique to this nation; studies in other nations show highly similar rates (for example,"The prevalence of the use of androgenic anabolic steroids by adolescents in a county of Sweden" showed about 1.45% use rate).

Nonetheless, though the use rates were always fairly low and continue to decline, it remains so that any is too much. So let us see why some adolescents use PEDs.


Reasons for Use

The "Role-Model" Claim

To some, "answers" come easy:

The youth of this country and other countries model their behavior after prominent athletes.
    --George Mitchell
ad featuring shoeless joe jackson

That gentle myth, one supposes, is in the tradition of that forlorn waif crying out "Say it ain't so, Joe". The proposition's truth is about the same as that of the tale of the waif.

Aside from meaningless personal estimates and unscientific "surveys" taken by popular media or groups with an obvious axe to grind, there is relatively little in the literature to suggest actual numbers--little, but not nothing.

In a paper entitled "Role Models, Ethnic Identity, and Health-Risk Behaviors in Urban Adolescents" [Arch Pediatr Adolesc Med, Yancey et al. 156 (1): 55], Yancey et al. reported that:

Fifty-six percent of respondents indicated that they had a role model. No differences were observed between boys (56%) and girls (56%), between younger teens (55%) and older teens (56%), or between those who had lived only in the United States (56%) vs those who had also lived somewhere else (57%).

72 of the 73 teens who identified sports figures as models were male. Among teens who had role models, 24% of African Americans, 20% of whites, and 15% of Latinos selected sports figures [weighted average = 18%]

There was no association of role model presence/absence with substance use. [Sorry, George.] There were no differences between teens naming a sports figure for a role model and teens selecting someone else with regard to grades, self-esteem, or ethnic identity. However, teens whose role models were sports figures were less likely to have used substances in the past week than teens who had other role models.


high-school baseball game

So not even one kid in five today has an athlete as a nominal "role model". And even though in general "role models" have nothing to do with substance abuse, those few who do self-identify as someone with an athlete as a role model--almost entirely male teenagers--are actually slightly cleaner than others with other role models.

Those are the facts as reported from actual studies. But we shouldn't even have needed such information when common sense says the same things. It takes quite a mental broad jump to get from the vague general idea of a "role model" to a belief that those kids having one will try to emulate that person in any and all activities whatever. Common sense suggests that while it's only a hop to the idea that some kids might, oh, wear their baseball caps back to front because they've seen athletes doing it, an awful long running start is needed to jump direct to the conclusion that high-school, or even middle-school, children are going to start a regular regimen of injecting potentially dangerous, certainly illegal, and above all very expensive substances merely on the grounds that "Wul, Doofy Jones does it, an I jus' wanna do everything Doofy does." Come on people: wake up and smell the coffee. And re-read that last paragraph boxed above.

Regrettably, some of those pushing the "misled waifs" line are parents whose children have been injured or even killed. Those bereaved parents, with whom everyone must deeply sympathize, urgently want us to finish the preceding sentence with "by steroids", because their children were using steroids at the time. But sympathy is not agreement. No matter how tragic and heart-rending, anecdotal evidence is just that: personal anecdote. And, as common sense should suggest, bereaved parents are the least likely possible source of reliable information: their child has died, they are confused, frustrated, and angry, and they want something simple and definite to blame for what was almost certainly a complex set of circumstances, possibly involving them.

For example, Mr. Mitchell has cited the now-often-quoted Don Hooton, whose son, as Mr. Mitchell puts it, "committed suicide after abusing anabolic steroids". Everyone has to sympathize deeply with Mr. Hooton, but the Mitchell assertion has no more meaning in itself, absent much other evidence, than if he had said that Mr. Hooton's son had died after eating bread. "After" does not equate to "as a result of"--thinking that it necessarily does is perhaps the most infamous elementary error possible in logic. Nor are Mr. Hooton's assertions, however heartfelt, about what "our kids" think and why they do things, including use PEDs, any sort of evidence. Absent much more proof, it is not even evidence of why Mr. Hooton's son did.

Fortunately, "common sense" being an oxymoron, we don't have to rely on it unaided. Numerous, comprehensive medical studies have shown the real reasons why the adolescents who use steroids do so. They are, by and large, rather sad. They also, by and large, have nothing to do with "hero worship." Let us review them in roughly the order that researchers have found them to be the priorities of adolescent users ("roughly" because not all causes have well-documented percentages associated).


Appearance

The first and foremost reported reason for use?

The main reason offered for drug misuse was to improve their appearance . . . . These male adolescents believed girls prefer boys with big muscles . . . .
    --"The prevalence of the use of androgenic anabolic steroids by adolescents in a county of Sweden"

Other studies have shown that steroid use by adolescents follows highly similar patterns in all nations. Still, we can get the same analysis closer to home:

Teens that take steroids have a strong sense that the way they look is simply not good enough. This is the emotional core of the problem.
    --"Teens and Steroids", from the Parenting Teens web site

But, though they should know, we could still say that that, too, is "anecdotal". So let's turn to some medical experts. Dr. Norman Fost (Princeton A.B., Yale M.D., Harvard M.P.H.), Director of the Program in Medical Ethics at the University of Wisconsin since 1973, past-Chairman of the American Academy of Pediatrics Committee on Bioethics (or, in short, a qualified expert), observed in an interview that:

There's very disturbing data about middle-school children, boys mainly, using anabolic steroids as part of weight lifting programs. According to one study, it's not football players for the most part, but boys who are doing it to make themselves more attractive to girls. The role models aren't athletes.

Numerous other studies report the same finding:

The misuse of androgenic anabolic steroids is a reality today among male adolescents. One of the main reasons is to improve appearance.
    -- Scand J Prim Health Care 2001; 19

Results indicate that magazine reading, social comparisons, and critical body image processing are important predictors of body image and eating disturbances for adolescent boys and girls.
    -- Sex Roles, Volume 48, Numbers 9-10 (389-399)

The major reasons for taking AS among young people involve improved sports performance and appearance.
    -- Sports Medicine for Specific Ages and Abilities, (ed. N. Maffuli), "Anabolic Steroid Use in Adolescents", P. Korkia [ISBN 0443061289]

That's it: kids who see themselves as the 98-pound-weakling want to become "babe magnets". If these poor devils have "role models", they are the countless fungible boy toys they see strutting their way through pop magazines (see the quotes above), movies, TV shows, and commercials for everything from cars to hooch. If there is a connection to baseball, it is MLB's fondness for sponsoring ball games with, yes, car and beer ads--among the worst offenders available for setting undesirable male role models.


Team Sports

high-school football

What may be the number two cause of steroid use is a desire to improve performance in team-sports activities (notably high-school football). Without rolling out yet another laundry list, it appears from the literature that potential adolescent users are informed, though often ill- and under-informed, about steroids, and typically undertake at least some investigation (often from poor sources) about them and other PEDs. That is not "hero-emulation" behavior: it is a calculated attempt to reach a well-defined personal goal.

What is more distressing is that it appears from the evidence that many school coaches, who have a great fiduciary responsibility to these kids, have made it clear, sometimes in a "nudge-nudge-wink-wink" way but too often expressly, that they will look away from, or even implicitly encourage, use of PEDs because "winning is everything". That is sick. But it is certainly not related to "hero worship" unless we consider those coaches "athletic heroes".

Kids are under pressure from their peers, their parents and their coaches to excel, so some turn to performance enhancing drugs. That pressure to succeed is communicated to the athlete. You want to please the coach. When I had done everything my body could do naturally, it wasn't enough. I wanted to play pro football, so I went to the strength coach and I asked him about steroids. He gave me a book. He never said, "No, you don't want to do that."
    -- Greg Schwab, associate principal of Tigard (Oregon) High School, former professional football player and steroid user




Almost half of respondents indicated they could obtain AAS if they so desired, and that other athletes, physicians, and coaches were listed as sources for AAS.
    --Stilger and Yesalis: Journal of Community Health, Volume 24, Number 2 (131-145)




These [steroid-prone] athletes had higher hostility, impulsivity, and a win-at-all-costs attitude.
    -- Elliot and Goldberg: Am J Sports Med. 1996;24(6 Suppl):S46-7.


Psychological/Psychiatric Problems

This is a major but sorely under-discussed aspect of teen PED use. The kinds of problems involved fall broadly into two classes: irrational body-image and clustered risk-taking.

Adolescent Body-Image Problems

stylized anorexic

That teenage boys want big muscles may seem somewhere between laughable and sad, but in far too many cases the problem is a lot more serious than wishful fantasizing about "babes". There is a well-recognized condition called "muscle dysmorphia"; it is essentially the exact obverse of anorexia in teenage girls, and is every bit as unfunny and dangerous as anorexia. Both anorexia and muscle dysmorphia can, in extreme cases, lead to death.

The term appears to have originated in a 1997 paper, "Muscle dysmorphia: An underrecognized form of body dysmorphic disorder" [Psychosomatics. 1997 Nov-Dec;38(6):548-57] by Pope et al. The Abstract of that paper states that:

In the course of several ongoing studies, the authors have encountered men and women who display a form of body dysmorphic disorder in which they become pathologically preoccupied with their degree of muscularity. This condition, which the authors have tentatively termed "muscle dysmorphia," may cause severe subjective distress, impaired social and occupational functioning, and abuse of anabolic steroids and other substances. Epidemiologic data suggest that muscle dysmorphia, though rarely recognized, may afflict substantial numbers of Americans.

In a subsequent paper, "Muscle dysmorphia in male weightlifters: a case-control study" [Olivardia et al., Am J Psychiatry. 2000 Aug;157(8):1291-6], appearing three years later, we find:

The men with muscle dysmorphia differed significantly from the normal comparison weightlifters on numerous measures, including body dissatisfaction, eating attitudes, prevalence of anabolic steroid use, and lifetime prevalence of DSM-IV mood, anxiety, and eating disorders. The men with muscle dysmorphia frequently described shame, embarrassment, and impairment of social and occupational functioning in association with their condition. By contrast, normal weightlifters displayed little pathology.

To understand a bit, consider the very name: muscle dys-morphia: dys, ill, abnormal, impaired; morphic, form or shape. As with anorexics, when these people look into a mirror, what they see is not what normal people looking at them see: they, no matter how vigorous or muscular they really are, see an undersized, inadequate body. There is no degree of development (as for anorexics there is no degree of thinness) that will satisfy them.

Impressive muscular development soon followed, and his weight shot up from 175 to 218 pounds. But he still felt too small and "not really all that muscular".

Again, it is the mass media, and especially advertising--not pro athletes--that seem to dominate influences on muscle-dysmorphic adolescents:

The media portrays [sic] images of men with muscular bodies and a "six pack" abdomen. These images can create body dissatisfaction in males. With the change in the way that the media and society in the United States look at men, so has the drive for men to achieve this ideal body image. Eating disorders, body dysmorphia, and strict exercise and diet regimens seem to plague young men as do the images in advertisements.
    -- "Eating Disorders in Men: Current Considerations"
      [Harvey and Robinson, Journal of Clinical Psychology in Medical Settings, Volume 10, Number 4 (297-306)]

Indeed, one study examined "action-figure" toys intended for young male children and found that over 30 years the toys' body dimensions had wildly inflated, to the point that their apparent musculature had become virtually impossible for real human beings (analogous to the "Barbie doll" phenomenon). My, we start them young.

At any rate, adolescents with muscle dysmorphia or just similar tendencies can scarcely be thought to be "modelling their behavior after prominent athletes"; and those adolescents are probably a good fraction of all adolescent steroid users.


Clustered Risk-Taking Problems in Adolescents

stylized anorexic

What is probably the lion's share of adolescent steroid use, though, comes from less-specialized psychological problems in adolescence. Study after study shows that teenage steroid users are very frequently also users of other drugs, many quite dangerous; further, those same abusers also almost all engage in many other high-risk behaviors, from violence and alcohol abuse to unprotected sex and weapons.

All too often, even in the scientific literature, we find as a recurring error the inability to distinguish case and effect when PED use shows--as it so very often does--as but one item in a constellation of high-risk behaviors. Indeed, there is actually a name for such a constellation: Jessor's problem-behavior syndrome for adolescents. That name turns up frequently in literature searches for adolescents and steroids.

(The curious can find a full exposition of the syndrome on Professor Jessor's own page about it, but it is not light reading.)

The significance of the data is that steroids are by no means a cause of any of that behavior: they are just one of the many symptoms of the underlying problem. Here are some representative comments to be found in the literature:

Based on a national sample of over 16,000 public and private high-school students (the 1997 Youth Risk Behavior Survey) . . . users had significantly greater odds of engaging in other illicit drug, alcohol, and tobacco use, fighting, suicide attempts, sexual risk-taking, vehicular risk-taking, and pathogenic weight-loss behavior, suggesting that steroid use is part of Jessor's problem-behavior syndrome for adolescents. Despite the stereotypical images of the male athlete user, both nonathlete and female users also faced elevated risks of multiple drug use and other health-compromising behavior. Thus this study rejects the view of steroid use as merely a logical extension of the male athletic cultural imperative.
      -- Sociological Perspectives, Winter 2002, Vol. 45, No. 4, Pages 467-489

These data suggest that other problem behaviors such as substance use, fighting, and sexual risk are better predictors of adolescent steroid use than physical activity.
      -- Substance Use & Misuse, Volume 40, Number 11, 2005 , pp. 1637-1657(21)

Use of doping agents probably involves more than a desire to enhance appearance or sports performance and appears to have much in common with use of alcohol, tobacco, and psychotropic drugs.
      -- Factors associated with adolescent use of doping agents: anabolic-androgenic steroids
         [Addiction, Volume 94, Number 4, 1 April 1999 , pp. 543-553(11)]

Adolescent AAS-use seems primarily to be another type of problem-behavior and only secondary [sic] is it associated with strength sport participation and disordered eating.
      -- "Use "Use of anabolic-androgenic steroids in adolescence: Winning, looking good or being bad?"
         [Wichström and Pedersen]

Such clustered-risk behavior has various roots, which adults have been trying to sort out for probably 50,000 years or more; but that they exist and, even in the more extreme forms, are all too common, is scarcely arcane knowledge. Steroids, as they became available, were simply added into the cluster. And, of course--bottom line--none of this has anything whatsoever to do with "modelling behavior after prominent athletes".


Summing the "Role-Model" Claim

To claim "Barry/Roger/Hezekiah made me do it" as a cause for adolescent steroid use gives us a fine chance to air out our vocabularies. From Roget's Thesaurus: babble, balderdash, baloney, bull, bunk, drivel, empty talk, foolery, foolishness, gibberish, hogwash, hooey, hot air, jive, malarkey, mumbo jumbo, palaver, poppycock, prattle, rubbish, silliness, trash.

There: that ought to about cover it.


This page is one of several each providing a detailed analysis of one or another of the chief claims about the use of PEDs (Performance-Enhancing Drugs) in baseball. Though each, including this one, can be read "stand-alone", you really should first read the main page here, which summarizes all of the findings and sets them out them in a coherent presentation.




You loaded this page on Thursday, 18 December 2014, at 06:24 EST.;
it was last modified on Sunday, 20 January 2008, at 21:42 EST.

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  • Overview and Summary
    a summary presentation of what appears in much more detail on the pages listed below

  • Actual Baseball Effects of PEDs
    two distinct, detailed analytic examinations of how PEDs might affect baseball statistics and of whether they have in fact done so, and why or why not, with links to several other such studies

  • Changes in the Baseball
    full discussions of the methods and results of two unrelated laboratory examinations of baseballs from several different years to see if there have been performance-affecting changes in the ball over time

  • The "Spliced" Power Factor
    a more detailed graphic explanation of what the "spliced" power factor graph is and how it is created

  • Medical Effects of PEDs
    comprehensive reviews of all the medical-side-effect claims about steroids, hGH, and other PEDs, supported by extensive citations from the established scientific literature of medicine

  • PEDs as Healing Agents
    looking into the claim that PEDs augment count-type records by allowing players to participate in more games than they could without chemical help

  • Adolescent Use of PEDs
    hard, scientific data from multiple extensive, long-term surveys of adolescent use of PEDs, detailing the actual extent of use, the established reasons for such use, and the true significance of "role models" in PED use

  • Ethical Issues in the Use of Performance-Enhancing Substances
    what professional medical ethicists have to say about how PED use in sports should be evaluated and why

  • Baseball and PEDs: Further Resources
    a select list of thought-provoking articles, essays, and books, a number of which are not cited elsewhere in these pages

  • Drugs in Sports: a Bookshop
    a collection of books relevant to drugs and sports, available for sale from this site

  • Eric Walker: Links
    baseball-related web pages by, about, or citing the webmaster of this site


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