There is a huge national concern over the misuse and abuse of anabolic steroids for enhancement of muscular stature and performance among competitive athletes. Latest estimates have shown that approximately 5% of all high school students have used anabolic steroids, with almost half of the high students believing that these drugs are not harmful to their health. Drug enforcement legislations have included anabolic steroids in its list of traffic-controlled substances (21 USC Sec. 801 1/22/02; Schedule III). However, the bigger picture of the medical and research benefits of anabolic drugs have been overlooked due to the sensationalize media coverage of these drugs. Current scientific researches are still inconclusive on whether anabolic steroids are extremely unsafe for administration, opposite to what has been actively claimed by anti-drug officials and government authorities.
The definition included substances that are chemically and pharmacologically similar to testosterone, estrogen, progesterone, as well as a very close likeness in its enhancement for muscle growth. The Act classified anabolic steroids in the same category as barbiturates and LSD precursors and claim that these substances result in dangerous effects to the human body. The Act declares that any individual caught in the possession of these anabolic steroids will be arrested and prosecuted. The list of anabolic steroids in the Act are continuously being updated, as new versions of these drugs are progressively being created through the years.
Drug Enforcement Administration
U.S. Department of Justice
Washington, D.C. 20038-8083
Anabolic androgenic steroids are testosterone derivatives that are mainly used for muscle and performance enhancement. These drugs are frequently used by competitive athletes in order to achieve an edge or better control of their physical strength and performance during professional sports games. Retrospective surveys indicated that anabolic steroids have been used since the 1960s to date (Duchaine, 1983), with current national user rates ranging from 3% to 9% among high school students alone. The exact effect of anabolic steroids in the developing human body has not been fully studied, and the increase in number of reports of teenage athletes committing suicide has called the attention of the legislation to assess and review drug enforcement laws covering this specific drug.
It has been reported that the prolonged use of anabolic steroids have may cause a number of adverse effects to the human body, including liver damage, gynecomastia, atherogenesis, psychiatric disorders such as aggression and violence, and even death (Balbigian, 2001; Brower, 2002; Glazer, 1991; Pope and Katz, 1990; Malone et al. 1995). Investigations on the nationwide use of anabolic steroids have prompted Congress to establish the Anabolic Steroid Control Act of 1990, which mainly indicates that the non-medical employment of anabolic steroids is punishable by law. Any violations will be penalized by at least 15 days to 5 years imprisonment and/or $1,000 to $1,000,000 fine, depending on the extent of the violation. So far, the general public has supported the Anabolic Steroid Control Act, mostly due to the massive and militant media coverage of the topic.
However, the actual negative effects of the use of anabolic steroidal drugs have not been comprehensively investigated to date, and that the reports that have been disclosed in the media have been isolated cases picked out from millions of cases of teenage users around the United States. Scientifically, the adverse effects from the prolonged use of anabolic steroids remain inconclusive to date, and in actuality, anabolic steroid use has been shown to be beneficial in the treatment of medical disorders.
In one report, it has lately been determined that the effect of an anabolic steroid to the treatment of weight loss in human immunodeficiency virus (HIV)-infected patients is equivalently effective and safe as compared to the commonly administered recombinant growth hormone that has been approved by the Food and Drug Administration (Storer et al. 2005). In another scenario, the administration of an anabolic steroid has been beneficial in prostate cancer patients by preventing further migration of prostate cancer cells to other parts of the body (Guerini et al. 2005). The anabolic steroid oxandrolone has been successfully used in the treatment of muscle loss in patients diagnosed with Duchenne muscular dystrophy and may be a potential powerful candidate for general treatment of such types of patients (Balagopal et al. 2006).
Scientific research shows that anabolic steroids provide more beneficial effects than what has been claimed by legislation as serious, adverse effects to the human body. More so, the negative reports that have associated with the use of anabolic steroids have not been investigated scientifically and have only achieved much attention through the help of media and press coverage. Therefore, it is imperative that the legislative bodies review the restrictions associated with the Anabolic Steroid Control Act of 1990 and fully determine the actual effects of anabolic steroid intake. It is regretful to know that there are other drugs and activities that are much more deleterious or harmful to people but are not actively controlled by the Senate, including smoking, cosmetic surgery and over-the-counter drugs such as aspirin and ibuprofen, which has caused even more cases of deaths and hospitalizations that anabolic steroids.
The Proposed Rule
Based on the above information on the current status, knowledge and use of anabolic steroids, we would like to propose that anabolic steroids be legalized for use in the United States. In turn, we would like to emphasize the need for further scientific research to determine the mechanisms of action of each type of anabolic drug to gain a better understanding of its indications and contraindications. There should be a comprehensive survey on the frequency of use of anabolic steroids across the human population, with stratified categories of users such as teenage athletes, geriatric patients, cancer patients, and so on. Any cases that report any adverse effect from use of anabolic steroids should be properly documented and analyzed. Should there be sufficient reason that anabolic steroids be stopped from circulation in the community, we are willing to review these effects once significant information has been gathered from reliable reports.
As the use of anabolic steroids is legalized, we in turn, propose that a nationwide surveillance program on the use of anabolic steroids be implemented by the Drug Enforcement Administration, as a measurement tool on the exact effects on the use of these substances. The information that will be gathered will be integrated into an national anabolic steroid database for analysis and interpretation. All anabolic steroid cases will be included in the database, including any advantages, disadvantages or no visible effects that may be related to the intake of this drug.
The surveillance program will be conducted for 2 years, of which at its culmination, will be evaluated and further amendments will be based on the results of the analysis and interpretation of this database. Such survey will provide a better understanding of the effects of anabolic steroid use, which will be more reliable, robust and scientific, and we will not have to depend on influences or propaganda from the media or other government officials.
Babigian A, Silverman RT (2001): Management of gynecomastia due to use of anabolic steroids in bodybuilders. Plast. Reconstr. Surg. 107:240–242.
Balagopal P, Olney R, Darmaun D, Mougey E, Dokler M, Sieck G and Hammond D (2006): Oxandrolone enhances skeletal muscle myosin synthesis and alters global gene expression profile in Duchenne muscular dystrophy. Am. J. Physiol. Endocrinol. Metab. 290:E530–E539.
Brower KJ (2002): Anabolic steroid abuse and dependence. Curr. Psychiatry Rep. 4:377–383.
Duchaine D., ed. (1983): Underground Steroid Handbook, 1st Ed. California: HLR Technical Books, 84pp.
Glazer G (1991): Atherogenic effects of anabolic steroids on serum lipid levels. Arch. Intern. Med. 151:1925–1933.
Guerini V, Sau D, Scaccianoce E, Rusmini P, Ciana P, Maggi A, Martini PGV, Katzenellenbogen BS, Martini L, Motta M and Poletti A (2005): The androgen derivative 5α-androstane-3β,17β-diol inhibits prostate cancer cell migration through activation of the estrogen receptor β subtype. Cancer Res. 65(12):5445-5453.
Malone DA Jr, Dimeff R, Lombardo JA, Sample BRH (1995): Psychiatric effects and psychoactive substance use in anabolic-androgenic steroid users. Clin. J. Sports Med. 5:25–31.
Pope HG Jr. and Katz DL (1990): Homicide and near-homicide by anabolic steroid users. J. Clin. Psychiatry 51:28–31.
Storer TW, Woodhouse LJ, Sattler F, Singh FB, Schroeder ET, Beck K, Padero MC, Mac P, Yarasheski KE, Geurts P, Willemsen A, Harms MK and and Bhasin S (2005): A randomized, placebo-controlled trial of nandrolone decanoate in human immunodeficiency virus-infected men with mild to moderate weight loss with recombinant human growth hormone as active reference treatment. J. Clin. Endocrinol. Metab. 90(8):4474–4482.