A major problem in both professional and elite amateur athletics is the misuse of anabolic steroids to increase muscle strength and/or muscle size. Their use is widespread among professional and college-level athletes, particularly in football players and weight lifters. These illicitly obtained drugs are readily available to athletes of almost any age; therefore, pediatricians must be concerned about the abuse of these drugs among their patients.
In 1976, the International Olympic Committee on Drugs banned the use of anabolic steroids by competitors and placed severe sanctions on violators. A comprehensive review of the medical literature was undertaken in 1984 by the American College of Sports Medicine and resulted in a position paper on anabolic steroid use in sports. In the paper, it was acknowledged that anabolic steroids can increase body weight (especially lean body weight) and, in combination with high-intensity weight training, can increase muscular strength in some highly conditioned athletes. It was also indicated that, although several controlled studies had been unable to demonstrate a strength advantage for those subjects taking the drugs, there were enough studies in which such an effect was shown to support the widespread belief among athletes that anabolic steroids are effective in increasing muscle power. The American College of Sports Medicine unequivocally condemned their use as performance-enhancing or "ergogenic" drugs.
Anabolic steroids (called "steroids" by athletes) are associated with a long list of potentially toxic effects. Adverse effects on the liver include benign and malignant tumors, toxic hepatitis, and peliosis hepatitis, the latter a rare disturbance within the liver in which multiple blood lakes develop that can rupture spontaneously and cause severe hemorrhage.
- Copyright © 1989 by the American Academy of Pediatrics