An Analysis of Steroid Use among High School Athletes
by
Janelle Mack
An Applied Research Project
Presented to the
Faculty of the Department of Public Policy and Administration, School of Business and
Public Administration
California State University, Bakersfield
In Partial Fulfillment of the Requirement for the Degree of
MASTER OF PUBLIC ADMINISTRATION
June 2008
Approved: ______
R. Steven Daniels, Ph. D. Date
Approved:______
B.J. Moore Date ii
Executive Summary
The purpose of this project is to determine the amount of knowledge that high school coaches and college athletes have of steroid use among high school athletes. There has been a problem with athletes using steroids, especially professionals. High school athletes are using steroids as well, which is even more dangerous. Their bodies may not be fully developed and they may not understand how drastic the side effects of steroid use can be. Using the surveys as a research tool will aid in my recommendations for high schools nationwide.
I surveyed the high school coaches of male and female soccer and track and field, wrestling, football, and baseball. I also surveyed college athletes of baseball and both male and female athletes, of soccer, and track and field. I interviewed two program administrators, one in favor of drug testing as a deterrent for steroid use among high school athletes, the other in favor of education as a deterrent. The interviews were used as resources and were compared to the answers given in the surveys.
The survey responses showed that the high school coaches and the college athletes overestimated the prevalence rate among high school athletes. Between the high school coaches and the college athletes, the average rate of steroids used nationally by high school athletes was about 9 percent. The actual prevalence rate among high school athletes ranges from about 1 percent to 6 percent (Green, 2007). College athletes and high school coaches overestimate steroid use among high school athletes by about 4%.
This difference is significant. In addition, 36 percent of the college athletes and 27 percent of the high school coaches said they were not at all knowledgeable of steroids.
These results suggest that education about steroids is critical in high school athletics. iii
Dedication
I would like to take the time to acknowledge those who have helped me throughout my college years, and on my final thesis paper. Being in the public administration program at California State University of Bakersfield has taught me a lot.
Working on this thesis paper has definitely given me new respect for those who have to gather research by conducting surveys. I will take the time to fill out more surveys if I am ever asked in the future.
I would first like to thank my family. My family has always been there for me no matter what. I would specifically like to thank my parents, Luther and Genie Mack.
They have always encouraged me, prayed for me, and stood by me through the good and bad times. I could not ask for better parents. I love you guys so much! I would also like to thank my grandmother, Helen, whose prayers kept me going. Her faith never fails and
I love her for that! I would like to thank my boyfriend, Qyntyn, for forcing me to stay up all night to work on this thesis. Thank you for the Starbucks, I love you!
I would also like to thank the athletic department, and specifically Tim La Kose.
I appreciate the guidance and support! Finally, I would like to thank R. Steven Daniels,
Chandra Commuri, Thomas R. Martinez, Jinping Sun and B.J. Moore for helping me become a better student. I appreciate their time and effort, but more importantly their encouragement. Grading all the thesis papers while keeping their sanity must have been extremely challenging. Thank you all for taking the time to help me despite your busy schedules. iv
Table of Contents
EXECUTIVE SUMMARY ...... II
DEDICATION ...... III
TABLE OF CONTENTS ...... IV
CHAPTER 1...... 1
BACKGROUND OF THE PROBLEM...... 1
STATEMENT OF THE PROBLEM ...... 1
RESEARCH METHODS ...... 2
IMPORTANCE OF THE STUDY ...... 3
CHAPTER 2...... 4
THE HISTORY OF STEROIDS...... 4
THE DEFINITION OF STEROIDS ...... 4
STEROID USE...... 5
REASONS FOR STEROID USE ...... 8
PROFESSIONAL ATHLETES HAVE AN EFFECT ON HIGH SCHOOL ATHLETES...... 9
EFFECTS OF STEROID USE ...... 10
THE PREVALENCE OF STEROID USE AMONG HIGH SCHOOL ATHLETES...... 12
POTENTIAL SOLUTIONS ...... 14
HYPOTHESES ...... 15
CHAPTER 3...... 16
RESEARCH DESIGN ...... 16
SURVEYS ...... 16
Sample of High School Coaches ...... 17
Sample of College Athletes ...... 18
INTERVIEWS ...... 19 v
CHAPTER 4...... 21
SURVEY RESULTS ...... 21
Steroids among High School Athletes...... 21
Comparison of National, California, and Kern County Steroid Use...... 21
Comparison of High School, College, and Professional Athletes...... 22
Knowledge ...... 23
Influence from Professional Athletes ...... 23
Solutions...... 23
Reasons for Steroid Use...... 24
INTERVIEW RESULTS ...... 25
The Start of Education and Drug-Testing ...... 25
Education versus Drug-Testing...... 26
Effectiveness ...... 28
Solutions...... 29
High School, College, and Professional Athletes Using Steroids...... 30
CHAPTER 5...... 32
SUMMARY ...... 32
CONCLUSION ...... 33
Prevalence of Steroid Use ...... 33
Knowledge ...... 34
RECOMMENDATIONS...... 34
REFERENCES ...... 37
APPENDICES ...... 40
APPENDIX A ...... 42
SURVEY FOR COLLEGE ATHLETES ...... 42
SURVEY ...... 43 vi
APPENDIX B...... 46
SURVEY FOR HIGH SCHOOL COACHES ...... 46
APPENDIX C ...... 50
INTERVIEW FOR PROGRAM ADMINISTRATORS...... 50
(LINN GOLDBERG, ATLAS & ATHENA) ...... 50
APPENDIX D ...... 65
INTERVIEW WITH FRANK URYASZ ...... 65
APPENDIX E...... 69
IRB APPROVAL ...... 69 1
Chapter 1
Background of the Problem
Steroids were introduced to the United States in the 1950s. They became very popular over a short amount of time. Although they were most popular among professional athletes, younger athletes eventually started using them as well
(Waddington, 2000).
There are now athletes of all ages that are using steroids. Unfortunately, the younger an athlete is who uses steroids, the more dangerous steroids can be. It is a possibility that high school athletes are using steroids because there is a lack of knowledge among high school coaches and athletes.
Athletes take steroids for many different reasons, but mostly to perform better in their sport. Although steroids are known as performance enhancing drugs, they can hurt the body over time. These drugs are common in sports such as track, weightlifting, baseball, and other sports that put a lot of stress on the body.
Statement of the Problem
High school coaches and college athletes know a lot about high school athletes.
Sometimes high school coaches know more about high school athletes than their parents.
My intentions, by using surveys as a research tool, are to find out how much they know about steroid use among high school athletes, and see how much of a problem they believe it to be. I will also determine if these coaches and athletes find education to be an effective solution for steroid use among high school athletes or if they believe that drug testing is an effective solution. 2
Research Methods
For this research paper, I used the Internet, books, and people for my resources. I created surveys that were given to college athletes and high school coaches. I also interviewed two program administrators. One program administrator was part of a program that uses the educational solution to deter student-athletes from steroid use. The other program administrator was a part of a program that is well known for using the drug-testing method for deterring athletes from using steroids.
The purpose of these surveys was to determine how much college athletes and high school coaches know about steroid use among high school athletes. The results of these surveys were compared to the facts that were collected throughout the research project.
The first group that I surveyed were the college athletes within the Bakersfield,
California area. College athletes range from about 17-25 years old, so remembering their high school years was not difficult. The survey examined general attitudes toward high school steroid use. It asks for prevalence estimations and comparisons to college and professional athletics. There were no questions asking about personal steroid use.
The next group of people that I surveyed were the high school coaches within the
Bakersfield, California, area. High school coaches deal with high school athletes nearly every day. Although the survey was slightly different so that the questions related to the present instead of the past, the questions still covered the same subjects. At times, coaches see and hear things that they are not meant to see and hear from their athletes.
Although athletes, or anyone using any drug, can be very manipulative, many coaches can tell when something is wrong with their athlete. When a coach works with his or her 3 athletes for so long, they develop relationships. After getting to know an athlete over a matter of time, coaches are able to determine if their behavior is suspect.
The interview subjects were used as credible sources. Both of these program administrators interviewed are professionals in their field. I used the answers provided from the interviews and compared them to the answers that were provided from the surveys.
Importance of the Study
With this project, I will compare high school coaches’ and college athletes’ knowledge about the prevalence of steroids among high school athletes. I will compare their survey answers to the actual national prevalence rate of high school athletes that are taking steroids. The interviews will be used as a resource to help me determine if the high school coaches and college athletes know which solution works best for high school athletes using steroids.
After this project is complete, I hope to have a better understanding of what high school coaches and college athletes think about steroid use. I also hope to recommend an adequate solution for high school athletes using steroids based on these survey answers. 4
Chapter 2
The History of Steroids
Although steroid use occurred prior to the 1950s, the drugs were not introduced into the United States until 1956. There had been rumors that athletes from the Soviet
Union were taking performance-enhancing drugs. These rumors were confirmed when the team physician Dr. John Ziegler accompanied the U.S. team in the 1956 World
Games in Moscow. He brought back with him testosterone, also known as Dianabol
(Waddington, 2000).
Dr. Ziegler tested this testosterone on some professional weight lifters, the weight lifting coach, and himself. The results were impressive. He noticed the increased muscle, but did not like the side effects. Some of the side effects of this testosterone included acne, hair loss, prostate enlargement, and shrinkage of the testicles
(Waddington, 2000). The popularity of these drugs was increasing, and by 1968, a third of the U.S. track team had used steroids (Waddington, 2000).
Dr. Ziegler started to notice the extremely high doses of Dianabol that the athletes were using. When Dr. Ziegler saw athletes abusing the testosterone, he realized he had made a huge mistake by bringing Dianabol into the United States. He has regretted it ever since (Waddington, 2000).
The Definition of Steroids
Anabolic steroids are defined in the book, Sports and Social Values. “Anabolic steroids are drugs, synthetic derivatives of the hormone testosterone that stimulate muscle growth and tissue repair” (Simon, 1985). The full name for anabolic steroids is anabolic– androgenic steroids. The anabolic half encourages the increase of the skeletal muscle. 5
The androgenic half of the steroid increases the growth of the male sexual characteristics
(Simon R., 1985).
According to the National Institute on Drug Abuse, anabolic-androgenic steroids were originally created to treat hypogonadism. This condition occurs when the testes of a male are not creating enough testosterone for what is considered regular growth, development, and regular sexual functioning (NIDA, 2006).
Steroids do not attack the human body like other well-known drugs, such as heroin or cocaine. Using large amounts of these drugs can lead to an overdose; this is not the case with steroids. In addition, taking different drugs like heroin and cocaine all at once can shut down the body. Using different steroids are common among athletes. This type of behavior will may not lead to an overdose, but, over time, it can cause a great deal of damage to the body.
Steroid Use
Although steroids are drugs, many people underestimate them. Some may believe that if a person has a handle on their steroid use, there are no dangers. The American
College of Sports Medicine and other medical groups disagree, saying there are serious side effects (Simon, 1985).
Athletes often take steroids in cycles. Instead of taking steroids on a continuous basis, consecutively every day, many athletes do what they call cycling. With cycling, athletes take more than one dose of steroids over a certain amount of time; they will then quit taking steroids for a while, and continue using when they are ready again (Kersey,
1996). 6
Steroids can be extremely dangerous, especially to teenagers. High school athletes may not be as educated about steroids as they should be. Steroids work differently in different bodies, but they are dangerous to everyone.
Greg Shepard, EdD, is the author of Bigger Faster Stronger: The proven system for building athletes (2004). Shepard believes that there are eleven reasons why steroids are very bad for high school athletes. He says that, although steroids are called performance-enhancing drugs, they should really be called performance-debilitating drugs.
• All athletes are different. What works for a body builder is not going to help a
baseball player. Steroids work for bodybuilders and power lifters for a while, but
it does not make sense for a baseball player to do the same. They all compete in
different sports and a baseball player needs to work out a different area than a
power lifter. Why take the same thing?
• Steroids have their highs and lows like any drug. Once an athlete starts taking
steroids, they may feel very good. Their weightlifting may increase for a while.
They decide they do not need to keep taking steroids because it was just a one-
time thing. After a certain amount of time, however, their weightlifting may
decrease. They will start taking steroids again because they cannot keep up with
the previous work out plan without steroids. To try to catch up to their previous
weight that they were lifting at the first time they took steroids, they start taking
steroids again. When an athlete takes steroids for the first time, they will most
likely see fast and dramatic results. There is a huge testosterone boost in the
body. This makes the body quit making its own testosterone because steroids 7
introduce large quantities artificially. Because of this, the athlete starts using even
more doses of steroids and taking different steroids at the same time (stacking).
He or she may have started out at taking 20 mg of steroids a day, but afterwards
their intake may increase to up to 500 mg a day.
• Many people do not believe that they can win without using steroids. On the
other hand, hard work and dedication has been proven to be effective among
athletes who win without steroids.
• People may believe that being aggressive is a good thing when it comes to sports.
Sometimes it is. When an athlete is using steroids; however, their aggression can
become out of control. While an athlete may believe that taking steroids will be
beneficial, they may not understand how uncontrollable their aggressiveness may
become. Too much uncontrolled aggression can lead to being kicked out of a
game, a sport, or even hurting someone emotionally and physically.
• Steroids are not only known for their ability to improve strength but also to
increase recovery time. Athletes take steroids to be able to work out longer and
harder as well as recover faster after difficult practices. This can actually have the
reverse effect and lead to more injuries.
• Athletes who use steroids, but try to hide it, are living double lives. They do not
only deal with the pressures of being perfect in their sport, but they add pressure
by trying to cover up their steroid use. Some athletes even sneak out of their
houses, and will travel as far as they need to in order to purchase steroids or
needles. 8
• Taking steroids takes away from the process of becoming a better athlete. Every
athlete lifts differently; knowing that you worked hard to get where you are
ethically is an achievement not many can share.
• When there is much pressure on an athlete’s shoulders, they may only think of
steroids. When an athlete is struggling, and looks to steroids to fix their
problems, they are using steroids as a crutch. The athletes who do not depend on
steroids, discipline themselves to be stronger than the situation or struggle they
are facing. That is something steroids can never teach.
• There is not really a point of no return for athletes, like body-builders, who are on
steroids. Whenever they reach their goal, they may not be satisfied still. This can
lead to injury and too much stress on the joints.
• History shows that athletes who take steroids are injured more than athletes who
do not take steroids. Steroids will not increase flexibility.
The best athletes do not use steroids. They do not need steroids to reach their goal (Shepard, 2004).
Reasons for Steroid Use
Steroid use is common in sports such as track, weightlifting, baseball, and other sports that put a lot of stress on the body. Athletes may take steroids because there is so much pressure. They feel they cannot achieve success by themselves alone. To be quicker, stronger, and better is a goal that many athletes try to achieve. There is much pressure to be the best when playing sports. Sometimes a team will have one person that they count on when the game is close or when they need to score. When everyone is counting on just one person, the pressure can be too much to handle. This may cause a student-athlete to start using steroids. 9
Another reason why athletes take steroids is to gain an advantage over their competition. If an athlete believes that their competition is taking steroids, they are going to take steroids. It is almost as if there is no other way to beat someone ethically if they are on steroids.
A survey reported in the journal Medicine & Science in Sports & Exercise was conducted in 2005-2006. This survey consisted of 3,200 students in 12 states, including
New Jersey, Philadelphia, New Mexico, Iowa, Wisconsin, Connecticut, Missouri, Ohio,
Colorado, New York, Minnesota, and California (Stenson, 2008).
Eighty percent of the youth that used these drugs believed that steroids would assist them in reaching their athletic goal as well as 35 percent of those who did not use steroids (Stenson, 2008). One may think that because there are so many side effects of steroids, athletes would stop taking them. This, however, is not the case. Sixty-five percent of steroid users and 6 percent of those who did not use steroids would use any pill or powder if it promised that they would achieve their athletic goal despite the harmful side effects of steroids. Fifty-seven percent of those who used steroids and 4 percent of those who do not use steroids would take any pill or powder if it promised to help them achieve their athletic goal even if it may decrease their lifetime (Stenson, J., 2008).
Professional Athletes Have an Effect on High School Athletes
It seems that steroid use is the worst in the professional sports. The media focuses a lot on professional athletes when there is a rumor about one of them using steroids. I would like to think that most professional athletes have an idea of what they are doing to their bodies when they are taking steroids. When one becomes a professional in a sport, 10 they are normally at the age where they have seen it all and heard it all. Younger athletes, however, may not know as much about steroids, which could cause their demise.
Of students in grades eight through 12 who confessed to taking anabolic steroids,
57 percent reported that professional athletes controlled their decision to use the drugs
(Stenson, 2008). Fifty-seven percent of the kids that used steroids and 12 percent of the kids that did not use steroids thought that professional athletes had the right to choose whether they would take steroids or not (Stenson, 2008). Some adolescent athletes will use steroids because they see that the professional level athletes using steroids have athletic success, so they will do whatever it takes to do the same.
In 2005, two teenage brothers passed away unexpectedly. Their parents believe that their children died from steroid use. They claim that their sons did not take steroids to get stronger, but because they wanted to be like the professional athletes (Livingstone,
2005). This reason may apply to many other high school victims as well.
Jay Hoffman, Chair of Health & Exercise Science at the College of New Jersey in
Ewig, believes neither the kids nor the professional athletes are being educated on steroid use. “I believe there is an inherent responsibility of being a role model. Whether they want it or not, it comes with the territory (Stenson, 2008, p.2).” Dr. Linn Goldberg, creator of the ATHENA and ATLAS programs agrees with Hoffman. “The mindset is that if [a pro athlete] had to use that, then may be I should use that (Stenson, 2008, p.3).”
Effects of Steroid Use
When athletes quit taking steroids, as they do through cycles, they may experience depression. This may create a dependency on the steroids. There may be an overly suspicious attitude of jealousy, irritability, delusions, and a false sense of 11 judgment coming from a feeling of immortality (Kersey, 1996). These overly aggressive outbursts are also known as ‘roid rages (Stenson, J., 2008). Drug Free Sport lists some common side effects of steroid use:
• cancer of the liver, prostate, kidney
• reduction in HDL the "good" cholesterol
• high blood pressure
• enlarged prostate
• liver damage
• aggressive behavior (‘roid rages)
• post-use depression
• aching joints
• injury to tendons, ligaments, and muscles
• blood coagulation disorders
• HIV disease from sharing needles
• acne, swelling of feet or ankles
• nosebleeds
• reduced libido
• increased sex drive
• increased fatty deposits
• heart arrhythmias
• stunted growth in immature individuals
• breast growth in males
• reduced sperm count 12
• shrinking of the testicles
• baldness
• body hair growth in female
• masculinization, clitoral enlargement, and breast reduction in females
The worst side effect, not listed, is death. Taylor Hooton, was a 17-year-old
baseball player who took his own life a month and a half after ending his steroid use.
This teenager in Plano, Texas, worked out three times every day. In three months,
Taylor increased his muscle by 30 pounds. As a sign of steroid use, Taylor also
started getting acne on his back as well as going through ‘roid rages. Although
Taylor’s parents knew something was wrong, they were not sure what the problem
was. The Hootons figured that Taylor was gaining muscle because he was working
out so hard. They did not know that under normal conditions, it is impossible for the
human body to gain 30 pounds of muscle that quickly (Stenson, J. 2008).
The Prevalence of Steroid Use among High School Athletes
Steroids were very popular among professional athletes when first introduced into the United States. They started to become popular among high school athletes as well. A study conducted by the Journal of Community Health in 1999 by Vincent G. Stigler, and
Charles E. Yesalis, reported that the mean age of high school students when they first took steroids is 14 years old. Out of 873 football players, 15 percent of those had taken anabolic-androgenic steroids (AAS) by the time they were ten years old (Stigler, 1999).
About half of 873 Indiana high school football players said they could get AAS if they really wanted it. They also said that other athletes, physicians, and coaches could 13 provide AAS, if they needed to get steroids (Stigler, 1999). An astounding 41 percent of the football players that used AAS recorded a physician or a coach as their first option for obtaining steroids (Stigler, 1999). Out of all of these football players, 6 percent said they were currently taking AAS (anabolic-androgenic steroids) or that they had used AAS before. The more years and athlete had in playing football, the more their AAS amount increased (Stigler, 1999).
From that same study, Out of those 873 athletes, there were 54 (6.3%) that admitted that they had used steroids in the past or that they were currently using steroids
(Stigler, 1999). The majority of the AAS users on the football team played the positions on the offensive line or the defensive line. Although athletes from all sports take steroids, they are more prevalent in wrestlers and football players (Stigler, 1999).
Since steroids can be taken either orally or through injection, 37 percent said that they had injected AAS into their system. These kind of steroid users (injectable users), are thought to be the hard-core steroid users (Stigler, 1999).
The prevalence of steroid use among high school athletes has changed since the late ‘90s. Surprisingly, steroid use has decreased among adolescent athletes. In 2004,
The Centers for Disease Control Youth Risk Behavior Surveillance (CDC, 2004) reported that about 6 percent of high school athletes used illegal steroids (Rosenfield, 2005). The prevalence was greater among the male athletes than among the female athletes. Three percent of female athletes admitted to steroid use. Male athletes almost doubled the female percentage, with 6 percent of male athletes admitting steroid use (Rosenfield,
2005). 14
The primary source for obtaining steroids for adolescent athletes was no longer coaches and physicians, although they were third and fourth on the list. The first place to get steroids became health clubs. Thirty percent of high school athletes said their primary source for obtaining steroids was at a health club. Twenty-nine percent said that they go to their teammates for steroids. Twenty-five percent of athletes claimed they obtained
AAS through their physician, and 16 percent said they got them from their coach
(Rosenfield, 2005).
As a secondary source, Sports Weekly claims that high school athletes are thought to be most at risk. In a 2005 article, author Seth Livingstone found that steroid use takes place in public areas such as locker rooms, weight rooms, and cafeterias. Although coaches and other athletes may know of steroid use, they are often incapable of doing anything about it. Sometimes coaches even look the other way. Even though some athletes know all of the risks of steroids, they are still willing to take them. The benefits outweigh the risks (Livingstone, 2005).
Potential Solutions
Education and drug testing are solutions that have been used to deter high school athletes from using steroids. Using education as a deterrent can cost as little as $11 per athlete. The athletes can learn about the pros and cons of steroid use, and understand what they do to the human body (Appendix C).
Drug testing is more expensive than education, with each test costing about $120 per athlete. If it is effective, then it may be worth the money spent on each high school athlete. This is a decision made by the high school. Drug testing is more of a scare 15 tactic, but sometimes adolescents need to be scared to stay away from a harmful substance (Appendix D).
Education is important for our young athletes because they can use it wherever they go. When they are pressured to take any kind of drug, they will be able to rely on their minds. If they decide to take the drugs, it will not be because of ignorance. I believe that drug testing can be used as a deterrent as well. I do not believe that it will be as effective of a deterrent as education will be. I think these two solutions can be most effective if they are implemented together, instead of seperately.
Hypotheses
Based on the research reported above, I will investigate the following hypotheses:
• High school coaches and athletes will believe that steroid use is a
major problem.
• High school coaches and athletes will overestimate the prevalence
of steroid use among high school athletes.
• High school coaches and athletes will estimate steroid use among
high school athletes as lower than use among college and
professional athletes.
• Both groups will have divided attitudes about the effectiveness of
drug education and drug testing programs.
16
Chapter 3
Research Design
My research design will be based on surveys and interviews. The surveys are important because they allow me to get an idea of what high school coaches and college athletes really think about the prevalence rate of steroid use among high school athletes.
With everyone remaining anonymous, it gives them a chance to be honest without having to worry about consequences.
The interviews are important because they will be used as a research tool. Both of the program administrators that are going to be interviewed are experts in their field.
This will be effective because the program administrators will be able to share their knowledge as well as their opinions. While one is in favor of education as a deterrent for high school athletes using steroids, the other is in favor of drug testing as a deterrent.
The answers to these interviews will be compared to the answers given from the surveys.
Surveys
I created similar surveys for high school coaches and college athletes. The surveys only differed in the period investigated. High school coaches were surveyed based on current knowledge and experience. College athletes were surveyed based on their past knowledge and experiences. These groups were asked to share their knowledge of the prevalence of steroid use among high school athletes, and how effective they believed certain solutions were for this problem. 17
Sample of High School Coaches
I focused my survey of high school coaches on the Kern County School District.
The high schools that participated in this research project were Liberty High School,
Bakersfield High School, East High School, West High School, Ridgeview High School,
Stockdale High School, South High School, North High School, Garces High School,
Centennial High School, Golden Valley High School, Arvin High School, Shafter High
School, Foothill High School, Frontier High School, Kern Valley High School and
Bakersfield Christian High School. Bakersfield Christian High School was the only high school that participated that was not a part of the Kern County School District. Other schools were not included because they either lacked sports teams altogether, they had not yet been built, or they were too far away.
Contacting high school coaches in the Bakersfield area was difficult. Most coaches were walk-on coaches (they were new to the high school) and did not have any contact information. Getting in contact with all athletic directors seemed the most logical option, which was my first step. They were asked to forward all surveys and consent forms to the coaches of the football, wrestling, baseball, track & field (male and female), and soccer (male and female) teams.
The second step I took was making phone calls to all of the high schools that I had previously e-mailed, except for Centennial High School who said they would not be participating. This involved talking to either the secretaries of the athletic departments or the athletic directors themselves. Through this method, I was able to get most of the coaches’ e-mail addresses. 18
The third step I took was e-mailing every coach of every sport that was needed to complete my research project. I sent about 50 surveys and consent forms to different e- mails. There would have been more e-mails sent out, but some high schools did not have coaches for the sports that I was looking for.
The final step I took was distributing the surveys and consent forms personally.
The closer high schools that I chose to go to were Ridgeview High School, Stockdale
High School, East High School, West High School, Liberty High School, Bakersfield
High School, and Bakersfield Christian High School.
It was difficult to gather surveys. Within the month of May, most high schools are getting ready for graduation and most of the sports are no longer in season. It was not only difficult to receive e-mails back from coaches, but it was difficult to find them on campus. I received 11 surveys altogether from high school coaches for a response rate of
22 percent.
Sample of College Athletes
As a coach at Cal State Bakersfield, it is easier to get in contact with college coaches. The women’s and men’s soccer team, and the women’s and men’s track and field team at Cal State Bakersfield participated in this survey. I extended my research project to Bakersfield College as well. In addition, steroids are common among football and baseball players, both of which Cal State Bakersfield does not have.
The first step I took was personally distributing the surveys and consent forms to the track and field coach, the women’s soccer coach, and the men’s soccer coach at Cal
State Bakersfield. The second step I took was e-mailing the women’s and men’s track and field coaches, the baseball coach, football coach, wrestling coach, and the women’s 19 and men’s soccer coaches at Bakersfield College. The third step I took was by calling
Bakersfield College and making follow up phone calls to all of the coaches.
The last step that I took was to personally distribute the surveys and consent forms to the coaches at Bakersfield College. I delivered 30 consent forms and surveys to the baseball coach whose team was competing in a tournament that following weekend.
It was easier to find Cal State Bakersfield athletes than it was Bakersfield College athletes. Bakersfield College has finals week a few weeks before Cal State Bakersfield does. Most of the athletes were given time off to study for their upcoming exams. I received sixty surveys and consent forms from college athletes.
Interviews
The second method I used to gather information on steroid use was interviews.
These interviews were compared to the answers from the surveys. The interviews will also aide in my recommendations for what could be an effective method for keeping our young athletes steroid free.
The two people who I chose to interview are professionals in their field. Dr. Linn
Goldberg believes in using education as a deterrence for high school athletes using steroids. He is the creator of two programs that educate high school athletes on the positives and negatives of steroids.
The second person I chose to interview was Mr. Frank Uryasz. Mr. Uryasz believes that drug testing can be used as a deterrent for high school athletes using steroids. He is part of an organization called Drug Free Sport that conducts drug tests nationwide as well as educates high school athletes on drug use. 20
The interview questions were categorized in the same way for each person interviewed. The first category involved Privacy Rights. This section focused on drug testing and the privacy rights, if any, that they may violate. The questions were different for each interviewee because it was specific to their field of expertise.
The second section was labeled The Reason for Your Program. In this section the interviewees were asked questions about their specific program and why it was beneficial. They were asked about the effectiveness of their program and how they measured the effectiveness of their program.
The final section was labeled Specifics on Steroid Use. This section focused on their knowledge of steroid use among athletes. It was also a chance to give their opinion on steroid use, and based on experience, explain why athletes use steroids.
.
21
Chapter 4
Survey Results
Steroids among High School Athletes
Out of the high school coaches and college athletes combined, only 20 percent of college athletes said that steroid use was not a problem among high school athletes. The majority of the high school coaches (90%) and college athletes (76%) said that there was little or somewhat of a problem with steroids among high school athletes. There were only 14% of high school coaches and college athletes combined that said that steroid use was very much a problem among high school athletes.
When college athletes and high school coaches were asked about the level of steroid use among high school athletes nationwide, the estimates were higher than I suspected. For the high school coaches, about 36 percent thought that the percentage of steroid use was between 0-4 percent, and 36 percent believed that it was over 15 percent.
The highest percent for college athletes was 30 percent saying that they believed that 8-
15 percent of high school athletes nationwide use steroids. Overall, high school coaches and college athletes estimated the prevalence of steroid use by high school athletes at about 9 percent. This is about 4 percent higher than the highest reported prevalence rate
(Green, 2007). Using a one-sample t-test, the overestimation was significant at the 0.05 level.
Comparison of National, California, and Kern County Steroid Use
College athletes and high school coaches were asked to compare steroid use among high school athletes nationally to steroid use among high school athletes locally. 22
When college athletes were asked if they believed that California high school athletes are more or less likely to use steroids than athletes nationally, 50 percent said there was not a difference. The high school coaches were close to the same number, about 46 percent of them said there was no difference at all. There was another 46 percent of coaches that said California athletes were likely to use steroids more than athletes were nationally.
Comparing high school athletes nationally to Kern County resulted in similar answers. Fifty-four percent of college athletes said that there was no difference between the high school athletes nationally using steroids and the high school athletes in Kern
County using steroids. The high school coaches felt the same way, with 55 percent of them saying that there was no difference between the two.
If these results were ranked by state and county, coaches and athletes believed that California high school athletes had the highest levels of steroid use, followed by all
U.S. high school athletes. Most subjects believed Kern County high school athletes to have the lowest rates.
Comparison of High School, College, and Professional Athletes
Forty-four percent of college athletes believed that high school athletes were less likely to use steroids than college athletes. Forty-six percent of high school coaches believed that high school athletes were more likely to take steroids than college athletes, and 46 percent believed high school athletes were less likely to take steroids than college athletes.
When asked to compare high school athletes to professional athletes, 40 percent of college athletes said that they believed that high school athletes were more likely to use steroids than professional athletes. High school coaches disagreed, because 36 23 percent of them believed that high school athletes were not likely to use steroids more than professional athletes.
Knowledge
The majority of the college athletes said that when they were in high school they did not have any knowledge of steroids at all. Thirty-six percent said that they were not at all knowledgeable. At least some of the high school coaches knew a little bit about steroids. Forty-six percent of the high school coaches asked said that they were somewhat knowledgeable about steroids.
Influence from Professional Athletes
Out of all of the answers to the surveys, the result of this question surprised me the most. Most of the high school coaches and college athletes thought that professional athletes that take steroids have some kind of influence on high school athletes that take steroids. Forty-six percent of college athletes believed that professional level athletes have moderate influence on athletes who use steroids in high school.
Eighty-two percent of the high school coaches believed that professional level athletes had a major influence on high school athletes who use steroids. The rest of the coaches (18 percent) said that professional athletes had a moderate influence on high school athletes using steroids.
Solutions
The majority of college athletes and high school coaches believed that drug testing was somewhat effective for deterring high school athletes from using steroids. 24
Thirty-six percent of college athletes and 55 percent of high school coaches thought drug testing can help young athletes at least slightly.
When these groups were asked about the other solution to steroid use, prevention programs, surprisingly, both groups agreed as well. The majority of college athletes, 52 percent, said they believed that prevention programs were effective. The majority of high school coaches, 73 percent, said the same thing. I would have thought that the majority of college athletes would have thought that drug testing was more effective than prevention programs.
Reasons for Steroid Use
In an open-ended question, the survey asked coaches and athletes to identify reasons why high school athletes took steroids. Although each response was unique, most respondents identified five common sets of reasons.
About 51 percent of the high school coaches and college athletes believed that high school athletes took steroids to improve their strength and performance. The second and third most common answers each were given by 15 percent of the respondents. The coaches and athletes suggested that high school athletes took steroids because they wanted to fit in or look good (image), or because they were trying to keep up with their competition and gain an advantage. About 11 percent of the high school coaches and college athletes believed that high school athletes took steroids to get a college scholarship. The fifth reason (reported by 8%) was that high school athletes took steroids because of pressure. Seven of the responses were missing or had no relevance to the question. 25
Interview Results
The Start of Education and Drug-Testing
I have considerable respect for Dr. Goldberg and Frank Uryasz. They both realized that there was a need among America’s athletes and did something about it. Dr.
Goldberg was first confronted by a medical student who was asked to give a presentation on anabolic steroid use to a high school football team. Dr. Goldberg told the student that he should not do the presentation until both the negatives and the positives of steroid use were studied. Dr. Goldberg and other researchers “studied the effect of a balanced presentation of the risks and benefits of steroids”.
Although this research improved knowledge, it did not alter the attitudes of the kids toward steroid use. The next year, Dr. Goldberg and the other researchers decided to try a negative approach. With this method, only the dangers and risks of steroid use were addressed. The results of this experiment proved the exact opposite. The students that were given only scare tactics said that they were even more eager to use steroids in the future than they were prior to the experiment.
After much research and time passed, Dr. Goldberg and the rest of the researchers decided to experiment with gender specific and “peer teaching in a team-based environment”. This is how ATHENA and ATLAS came to exist. The studies for both
ATHENA and ATLAS included over 4,000 student athletes. Statistics proved that these programs worked and still do to this day (Appendix C). The results completed by
Arizona State University were positive (Appendix C)
Mr. Uryasz used to work with the NCAA (National College Athletic Association).
He operated their drug-testing program for 13 years. Mr. Uryasz started Drug Free Sport 26 in 1999. He saw that drug testing was effective and wanted to work in a different organization.
Mr. Uryasz says there are surveys that are conducted by Drug Free Sport to determine the effectiveness of the program. All of the surveys are completely anonymous and confidential. Mr. Uryasz did not mention what the surveys found. There was a presentation, however, given by Mary Wilfert, who is in charge of making sure that
Drug Free Sport drug education programs and drug testing programs are effective. Ms.
Wilfert stated that NCAA started drug testing college football players in 1990. The surveys indicated that there was a decrease of steroid use among the athletes. In 1993, 5 percent of the football players admitted to using steroids. In 2001, however, only 3 percent of football players admitted to using steroid (Wilfert, 2005).
Education versus Drug-Testing
It is not surprising that Dr. Linn Goldberg’s only solution for deterring high school athletes from using steroids is education. The programs created by Dr. Goldberg
(ATLAS and ATHENA) are two programs that not only teach athletes about the positives and negatives of steroid use, but also offer solutions for steroid use.
Dr. Linn Goldberg made it clear that he does not believe drug testing deters high school athletes from using steroids. He believes scare tactics do not work for kids because kids do not scare easily. Dr. Goldberg quotes, “The only randomized control trial showed that drug testing was not consistently effective in reducing drug use
(deterrent effect). In fact there was no past 30 day self reported reduction in use.” Dr.
Goldberg does, however, believe that drug testing can be used to regulate steroid use 27 among high school athletes. Nevertheless, programs such as ATHENA and ATLAS are most effective as a deterrent.
Dr. Goldberg said that the materials needed for ATLAS and ATHENA cost about
$11.00 per athlete. Drug testing costs about $120.00 per athlete. Dr. Goldberg then asked me to think about a scenario. He told me that I was sick and went to the doctor to be treated. He then said that after the doctor had looked at my symptoms, he offered me treatment. The first treatment was expensive and was not proven to work (drug testing).
The second treatment was cheaper and had been proven to be effective (education). The answer was obvious. I understood his point and agreed that I would take the cheaper medicine that had been proven to work
Mr. Uryasz agrees with Dr. Goldberg that education should be the primary tool when it comes to deterring athletes from using steroids. Uryasz admitted that he paid attention to Dr. Goldberg’s ATLAS program and believes that it is beneficial. Mr.
Uryasz, did, however, express his concerns about the study that was done on ATLAS.
He said that he would like to see an outside evaluation conducted, not just evaluations conducted by Goldberg and his team.
Uryasz says that Drug-Free Sport not only drug tests, but educates as well. The staff at Drug Free Sport speak and deliver educational programs on different campuses.
There is also a resource exchange center. It is a drug and supplement hotline that certain sports organizations subscribe to. All NCAA athletes are able to call and learn more about steroids and other drugs. They can also learn of any banned substances by the
NCAA. 28
For Mr. Uryasz, education has to go hand in hand with drug testing. Education may work for some athletes, but it does not work for all. Since there are going to be athletes that take steroids regardless of their knowledge about them, they will still use steroids. This is where drug testing comes in. Both education, as well as drug testing, will work as deterrents.
Effectiveness
Dr. Goldberg does not believe in the effectiveness of drug testing. He says there are ways to cheat on drug-tests. There are substances people can take to cover up the drug in their system. There are designer steroids as well as products that store clean urine. There is also the fact that not all steroids show up on drug-tests.
Mr. Uryasz was well aware of the different ways athletes can cheat on drug tests.
He says that the people who give the athletes the drug tests know all of the ways an athlete can cheat on a drug test. The collectors go to the bathroom with the athlete to make sure they do not try to switch urine or cheat any other way.
As for the products that help dilute urine, Mr. Uryasz says that it does not matter.
If the urine sample is not concentrated enough, the athlete must stay at the collection site until the urine is concentrated enough to meet approval. This could take all day if it is necessary.
Mr. Uryasz says that it is true that there may be steroids that are not detected.
That is why all of the urine samples are sent to the UCLA research laboratories. These testers look for steroids that are known to those who are a part of Uryasz’s Drug Free
Sport, as well as steroids that may not be known to them. 29
I asked Mr. Uryasz how drug testing can be effective when athletes can take steroids and then when notified of a possible drug test, they just quit taking the steroids until the test is complete. He replied that because some athletes choose this method, drug tests should be unlimited.
To improve his programs, Mr. Uryasz is working on reducing the amount of notice athletes are given when they need to take a drug test. He says that in a perfect world, athletes would not be given any notice and drug tests would be given right away.
Uryasz and the people at Drug Free Sport are trying to reach their goal of that perfect world. Drug testing for the NCAA athletes used to be given when sports were in season only, now Drug Free Sport is in its third summer of testing athletes during the summer time.
Solutions
Dr. Goldberg says that although ATLAS and ATHENA have only been studied at the high school level, they can be used at the college level as well. He said there was a small intervention at Portland State University and the outcome seemed to be positive.
The intervention was conducted because the NCAA gave a grant to Dr. Goldberg’s programs. The programs (ATLAS and ATHENA) were both well liked and accepted by the athletes.
Dr. Goldberg believes that ATLAS and ATHENA could work for professional athletes, but there would have to be a program designed especially for each athlete. This would only be able to be conducted after there was a thorough evaluation of the dangers and protective components for each individual athlete. 30
Although Drug Free Sport deals mostly with college athletes, Mr. Uryasz says that there are high school associations within the United States that test athletes for drug use as well. The first state that used drug tests to test high school athletes was New
Jersey. Any athlete that competes in a championship must be tested. Florida was the next state to follow, but drug tests were given to every athlete that competed in a “high risk” sport. The strictest state is Texas. Texas gives drug tests to everyone that is a part of a sport. This includes about 26,000 athletes.
Mr. Uryasz says that it is difficult to deal with professional athletes because of labor unions. Programs become negotiated. Player’s associates are not normally looking for what is best for the athletes, unless they are forced by Congress. Drug testing can end careers, which is probably why it is such a big deal among professional athletes.
Although the Federal Government normally does not like to interfere with situations like these, there probably would not be any changes without them.
High School, College, and Professional Athletes Using Steroids
Even though Dr. Goldberg and Mr. Uryasz are both experts in their own field, they disagree on which group of athletes take steroids more. Dr. Goldberg believes that steroid use is more pervasive among young athletes. He says more youth take these substances (steroids). Dr. Goldberg quotes,” There are very few professional athletes, so there is much less volume of use. As a public health problem, it is worse among adolescents.”
Mr. Uryasz believes quite the opposite. He says there is not a lot of data when it comes to the extent of steroid use among professional athletes. He believes that it is fair to say that because professional athletes are getting older and getting paid a lot more, they 31 are looking for ways to extend their careers. Steroids are probably taken less in college and even less in high school.
Mr. Uryasz believes people are concerned because steroid use is increasing in high schools, not because the amount of high school athletes who are taking steroids is at a high number. High schools wanted to “nip that in the bud”. The national surveys on steroid use among high school students have shown a decrease, but high school coaches still believe that it is a problem. 32
Chapter 5
Summary
Dr. Ziegler was unaware of the dangers that steroids would cause when he first brought them into the United States (Waddington, 2000). Although his intentions may have been good, the drug called Dianabol created a new level of competition
(Waddington, 2000). It became almost impossible for athletes to compete effectively and ethically unless they were taking some kind of a performance-enhancing drug.
Drugs affect every athlete in different ways. Although some of the side effects are minor, with prolonged use and abuse, they can become very harmful (Livingstone,
2005). Perhaps, the most devastating reality of this research project is that adolescents are willing to give up years of their life for just a moment of glory (Stenson, 2008).
It would seem that the prevalence rate among high school athletes using steroids is at an all-time high. With the media focusing their attention on professional athletes every time there is mention of possible steroid use, it is hard to tell high school athletes that steroids do not work. Since professional athletes are using these performance- enhancing drugs and making a lot of money, there does not seem to be much to keep a young athlete from doing the same thing. Teenagers can be easily influenced, especially if they are looking for something to take the pressure off their shoulders or make them better at anything they want to be better at.
Nevertheless, the high school coaches and college athletes overestimated the prevalence rate of high school athletes by about 4 percent (Green, 2007). This means one of two things. The high school coaches and college athletes simply overestimated the 33 prevalence rate of high school athletes using steroids, which would be an easy thing to do because steroid use appears to becoming more popular among athletes overall. The second is that the high school athletes were not completely honest when these research surveys were conducted.
The interviews and the surveys showed that education and drug testing can be effective. Most high school coaches (about 73%), and college athletes (56%) believe that drug testing is either somewhat or very much effective for deterring high school athletes from taking steroids. As for prevention programs, 73 percent of high school coaches believe they are effective and 58 percent of college athletes agree.
Conclusion
Prevalence of Steroid Use
According to the surveys conducted, both high school coaches and college athletes believe that the steroid problem among high school athletes is bigger than what it actually is. There could be a couple of reasons for why this is. When the survey was conducted of high school students in 2007 by Monitoring the Future, there may have been high school students that were not completely truthful on their survey. This would make the percentage of high school students using steroids lower than what it should be.
Another possible conclusion is that the high school coaches and college athletes simply overestimated the prevalence rate of high school athletes using steroids. There have been problems with steroid use among professional athletes, which may cause someone to think that the problem is bad among high school athletes as well. The high school coaches and the college athletes both believed that professional level athletes use steroids more than high school athletes. 34
According to the interviews with Mr. Uryasz and Dr. Linn Goldberg, there were conflicting ideas. Mr. Uryasz believes that professional athletes probably use steroids more than high school athletes. He then said college athletes would come after that, and finally high school athletes were last. Dr. Linn Goldberg believes that steroid use is more prevalent among adolescents. He did not put the different levels in any particular order, but he did make the point that there are a lot less professional athletes than there are high school athletes.
Knowledge
According to the college athletes in this survey, most had no knowledge of steroids when they were in high school. Although the majority of high school coaches were somewhat knowledgeable of steroids, there was a high percentage of them that knew nothing about steroids.
This information suggests that high schools need to do better at educating their athletes. If high schools do not try to educate high school athletes, then coaches should.
High school athletes are looking to be better at their sport. With the pressure that weighs on their shoulders, the image they try to maintain and the competition they are trying to beat, they are looking for a little help. If they see this help in a pill or in a needle, the only one who can stop them at that moment is themselves.
Recommendations
Although the prevalence rate among high school athletes using steroids is not extremely high, high school athletes are still using them. My recommendations for the high schools throughout the nation are to educate their coaches and their athletes. They 35 can do this by bringing in programs like ATLAS and ATHENA. Teaching adolescents and coaches the pros and cons of steroids and other drugs in general will allow them to make better decisions. High school athletes can influence their teammates and save lives.
High school coaches can influence their athletes and be the role models that are needed in high schools. Winning is not everything, especially if lives are at stake.
High schools can implement their own educational programs to deter high school athletes from using steroids or any other drug. The problem with many high school drug programs is that they do not include steroids. Presentations and handouts are decent steps to educating athletes. I believe that our high school committees can do better by getting the athletes involved and participating in activities. By doing these recommended methods, they are learning and hopefully having fun at the same time. Results are achievable but the parents need to be willing to learn about steroids as well as the athletes. With both the parents and athletes learning, the prevalence rate of steroid use among high school athletes can decrease as well as the number of deaths that are cause by steroids.
It appears that high schools are trying to use drug testing as a solution for steroid use among high school athletes (Appendix D). I recommend these high schools research the evidence to find out which solution is most effective. The most expensive choice is not always the most effective one.
From my experience, the majority of high school athletes are going to do whatever they want to do. Drug testing can be effective if the consequences are harsh. If a student-athlete fails their drug test the first time, they should be banned from their sport for one year; however, they should keep being drug tested throughout the school year. 36
The second time they fail should be an even harsher punishment such as being banned from their sport another year, plus a certain number of hours of community service.
Athletes should not be given any amount of time to prepare for these drug tests; they should be tested on the spot. If a high school does use drug testing as a deterrent for high school steroid use, they must make sure that all drugs and steroids will show up on the tests.
37
References
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Female Students Reporting Anabolic Steroid Use. Vol. 161 (6) Retrieved March
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1&itool=EntrezSystem2.PEnt
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Training, and Multiple Drug Use among Adolescents in the United States.
Pediatrics, vol. 96. No.1
Drug Free Sport. Retrieved May 28, 2008 from http://www.drugfreesport.com/choices/
Green, A., G. (2007 Nov.). The Prevalence of Anabolic Steroid Use by Southern
California High School Athletes. UCLA Olympic Analytical Laboratory .Los
Angeles, CA.
GAO (2007 Nov. 29) Davis Hauls GAO Findings on Steroid- Abuse Prevention
Programs. Retrieved March 26, 2008 from 11tomdavis.house.gov/davis_
contents/news/Practice.aspx?NEWSIVD=60
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says, USAToday. Retrieved March 26, 2008 from http://www.usatoday.com/
news/washington/2006-08-28-anti-drug_x.htm
Livingstone, S. (2005, June 8) Fight Against Steroids Gaining Muscle in High School 38
Athletics. Sports Weekly. Retrieved march 15, 2008, from
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report_x.htm
McIntosh, P. (1979). Fair Play Ethics in Sport and Education, London: Heinmann
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Moore, L. D. (2005, May 4). School Tackles Alarming Subject: Steroid Use.
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05-04-hs-steroids-cover_x.htm
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from http://www.nida.nih.gov/ResearchReports/Steroids/AnabolicSteroids2.html
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Youth Trends. Retrieved April 9, 2008 from http://www.Drugause.gov/infofacts/
HSYouthtrends.html
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from http://www. Drugause.gov/infofacts/steroids.html
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Use. The New York Times. Retrieved April 11, 2008 from http://www.Nytimes
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Appendices 41
1. Surveys for College Athletes………………………………………………… A
2. Surveys for High School Coaches…………………………………………… B
3. Interview with Dr. Linn Goldberg……………………………………………. C
4. Interview with Mr. Frank Uryasz……………………………………………... D
5. IRB Approval Form …………………………………………………………... E 42
Appendix A Survey for College Athletes 43
Survey (For College Athletes)
1. Looking back to your time in high school, how much of a problem do you believe
steroid use was among high school athletes?
Very Much____ Somewhat____ Very Little____ Not At All____
2. Looking back to your time in high school, in your estimation, what percentage of
high school athletes nationwide used steroids?
0-4%____ 4-8%____8-15%____Over 15%____
3. Looking back to your time in high school, in your estimation how much more or less
likely were high school athletes to use steroids than college athletes?
Much More Likely____ More Likely____ No Difference____ Less Likely____ Much
Less Likely____
4. Looking back to your time in high school, in your estimation how much more or less
likely were high school athletes to use steroids than professional athletes?
Much More Likely____ More Likely____ No Difference____ Less Likely____ Much
Less Likely____
5. Looking back to your time in high school, in your estimation, how much more or less
likely were high school athletes to use steroids compared to Marijuana?
Much More Likely____ More Likely____ No Difference____ Less Likely____ Much
Less Likely____ 44
6. Looking back to your time in high school, in your estimation, how much more or less
likely were California high school athletes to use steroids than athletes nationally?
Much More Likely___ More Likely___ No Difference____ Less Likely____
Much Less Likely____
7. Looking back to your time in high school, in your estimation, how much more or less
likely were Kern Country high school athletes to use steroids than athletes
nationally?
Much More Likely____ More Likely____ No Difference____ Less Likely____ Much
Less Likely____
8. Looking back to your time in high school, how knowledgeable were you of steroid
prevention programs that were available for high school student athletes?
Very Knowledgeable_____ Somewhat Knowledgeable____ A Little
Knowledgeable____ Not At All Knowledgeable____
9. Looking back to your time in high school, in your opinion, why do you believe
athletes took steroids?
______
______45
______
______
10. In your estimation, how effective is drug-testing for deterring high school athletes
from taking steroids?
Very Effective___ Somewhat Effective___ Somewhat Ineffective____ Very
Ineffective____
11. In your estimation, how effective are prevention programs that educate high school
athletes about the dangers of steroid use?
Very Effective___ Somewhat Effective___ Somewhat Ineffective____ Very
Ineffective____
12. In your estimation how effective are prevention programs for drug/steroid use?
Very Effective____ Effective ____ Neutral____ Somewhat Effective____ Not
Effective____
13. How much influence do you believe professional level athletes using steroids have
on high school athletes taking steroids?
Major Influence____ Moderate Influence____ Minor Influence____ No
Influence____
46
Appendix B Survey for High School Coaches 47
Survey (For High School Coaches)
1. How much of a problem do you believe steroids are among high school athletes?
Very Much____ Somewhat____ Neutral____ Very Little____ Not At All____
2. In your estimation what percentage of high school athletes nationwide use steroids?
0-4%____ 4-8%____8-15%____Over 15%____
3. In your estimation how much more likely are high school athletes to use steroids than
college athletes?
Very Likely___ Likely___ Neutral____ Somewhat Likely____ Not Likely____
4. In your estimation are high school athletes more likely to use steroids than
professional athletes?
Very Likely___ Likely ___ Neutral____ Somewhat Likely____ Not Likely____
5. In your estimation how much more likely are steroids used among high school
athletes compared to Marijuana?
Very Likely____ Likely ____ Neutral____ Somewhat Likely____ Not Likely____
6. In your estimation are California high school athletes more or less likely to use
steroids than athletes nationally?
Very Likely___ Likely ___ Neutral____ Somewhat Likely____ Not Likely____
48
7. In your estimation are Kern Country high school athletes more or less likely to use
steroids
than athletes nationally?
Very Likely___ Likely ___ Neutral____ Somewhat Likely____ Not Likely____
8. How knowledgeable are you of drug/steroid prevention programs that are available
for high school student athletes?
Very Knowledgeable_____ Somewhat Knowledgeable____ A Little
Knowledgeable____ Not At All Knowledgeable____
9. In your opinion, why do you believe athletes take steroids?
______
______
______
______
______
10. In your estimation, how effective is drug-testing for deterring high school athletes
from taking steroids?
Very much___ Somewhat___ Very Little____ Not at All____
11. In your estimation, how effective are prevention programs for steroid use among high
school
athletes? 49
Very Effective___ Effective ___ Neutral____ Somewhat Effective____ Not
Effective____
12. In your estimation how effective is drug-testing?
Very Effective___ Effective ___ Neutral____ Somewhat Effective____ Not `
Effective____
13. In your estimation how effective are prevention programs for drug/steroid use?
Very Effective___ Effective ___ Neutral____ Somewhat Effective____ Not
Effective____
14. How much influence do you believe professional level athletes using steroids have on
high school athletes taking steroids?
A Lot of Influence____ Some Influence____ Neutral____ A Little Influence____ No
Influence____
50
Appendix C
Interview for Program Administrators
(Linn Goldberg, ATLAS & ATHENA) 51
Interview with Linn Goldberg
Privacy Rights
1. Do you believe that drug testing violates privacy rights?
This is a legal decision, not a physician decision. It is up to the court to decide. The U.S. Supreme
Court has ruled that testing is legal under certain circumstances. However, state courts can decide for each state. For instance, it is legal in Oregon, but illegal in the state of Washington. What I believe does not matter. If it is legal, then it should be studied to learn whether it works as a deterrent for student-athletes or students involved in extracurriculars.
2. If so, would there ever be a certain time where being tested for drug use wouldn’t be a
violation of privacy rights?
You are asking the wrong person. This is a legal issue. Who cares what I think! There are many
Constitutional rights that children and adolescents don’t have. They can’t vote! They can’t bear arms. In many locales children and adolescents have to wear bike helmets. Children and adults are subject to curfew laws and not adults.
3. If not is there a limit to being drug tested or should a student-athlete be drug tested at any time
and anywhere within reason?
Again, you are asking the wrong person. This is a legal question. What I believe is not relevant.
4. Do you believe drug-testing programs could ever be as effective as educational programs that
prevent steroid use?
The only randomized control trial showed that drug testing was not consistently effective in reducing drug use (deterrent effect). In fact there was no past 30 day self reported reduction in use.
- Scare Tactics do not work. (this type of scare tactics does not have anything to do
with drug testing. It is scare tactics educational approach that does not work for 52
steroid prevention. We published this in the journal, Pediatrics.
http://pediatrics.aappublications.org/cgi/content/abstract/87/3/283?maxtosh
ow=&HITS=10&hits=10&RESULTFORMAT=&fulltext=steroids&andore
xactfulltext=and&searchid=1&FIRSTINDEX=0&sortspec=relevance&reso
urcetype=HWCIT
- Anabolic Steroid Education and Adolescents: Do Scare Tactics Work?
PEDIATRICS Vol. 87 No. 3 March 1991, pp. 283-286
-
- If drug testing was a very effective deterrent, then athletes would not be failing drug
tests in higher numbers among Olympic athletes each year. If drug-testing worked
so well why do athletes keep failing them?
- STEROID Drug-Testing costs about $120.00 for one student, the materials needed
for ATLAS and ATHENA, which have been shown to be effective in reducing
substance use, including alcohol, narcotics, amphetamines, marijuana and reducing
the desire for young athletes to use steroids only cost $11.00 per student.
- Partnership for drug free America ads have not been shown to be effective. They
spend over $100 million on these ads, not because they are effective. They may give
the impression that the programs work, but the evidence is not there.
Anti-drug advertising campaign a failure, GAO report says
Updated 8/29/2006 8:54 http://www.usatoday.com/news/washington/2006-08-28-anti-drug-ads_x.htm
The Reason for Your Program 53
5. What is the goal of your program?
- ATHENA’s and ATLAS’s goal is to prevent young athletes from substance abuse and promote healthy alternatives (sports nutrition and strength training).
6. What tactics do you use to try to reach your goal?
- Team centered education harnesses the influence of peers who are aligned in their
goals and have camaraderie. Students are engaged in interactive activities that
foster behavior change. There is a squad leader for every 5 athletes. Everyone is
engaged in the activities of the squad. The squad leader can be trained in an hour
and a half. There is a dvd that lasts about fifteen minutes and everything is done
like a playbook. Discussions are encouraged and learning occurs that is peer taught
and coach facilitated.
- Peers taking to peers that are gender specific works, as young males and young
females have different reasons for using drugs and alcohol. Positive behaviors are
stressed rather than negative behaviors railed against. Because these are ready-
made teams, they are used to working together and have team leaders. Kids
influence kids and coaches encourage the health behaviors.
7. Have you met your goal, or are you on the verge of meeting your goal?
We would like ATLAS and ATHENA in every school, so we are far from meeting our dissemination goal. We have met our research goal, which is to study the effects of ATLAS
(Athletes Training & Learning to Avoid Steroids) and ATHENA (Athletes Targeting Healthy
Exercise & Nutrition Alternatives) and publish them in highly competitive, credible, peer reviewed journals. We are very pleased with the national awards (Exemplary Program, U.S.
Department of Education, Model Program: U.S. Department of Health & Human Services; Sports
Illustrated Champion Award, but there is a long way to go.
8. How many athletes have you helped so far? 54
Last year alone approximately 25, 000 athletes went through ATLAS and ATHENA. The year prior, there were about 12,000 athletes in programs in different states. We have been in about 30 states, but we don’t have data on many of the students, as we are not involved with every school, unless they ask us to assist or help them evaluate.
9. What was the reason for the start of your program?
- A Medical Student was asked to give a presentation on anabolic steroid use to a high school football team. I said he shouldn’t do it until he studied both the negative and positive effects of his presentation. We studied the effect of a balanced presentation of the risk and benefits of steroids. This improved knowledge, but did not change attitudes toward use of steroids. The following year we used a negative (risk-only approach, compared to a balanced approach, like the first year). The scare tactics approach had the opposite effects.
Students who were only given the scare tactics said they were more desirous of using steroids in the future. Over time we decided to try gender-specific, peer teaching in a team based environment. This is how we came up with ATLAS and ATHENA.
How do you measure the program’s effectiveness?
Both ATLAS and ATHENA were prospective randomized control trials. The studies had over
4,000 student-athletes involved. Statistics were done by Arizona State University. The results were overwhelmingly positive.
Arch Pediatr Adolesc Med. 2000 Apr;154(4):332-8.
BACKGROUND: Use of alcohol and other illicit drugs by adolescent male athletes is a significant problem. Participation in sports may encourage use of drugs that enhance athletic performance, especially anabolic steroids (AS).
Because, to our knowledge, no other intervention has successfully altered substance abuse by athletes, we developed and assessed the efficacy of a team- 55 centered, sex-specific education program designed to reduce adolescent athletes' intentions to use and use of AS and alcohol and other illicit drugs. METHODS:
We studied 31 high school football teams that comprised 3207 athletes in 3 successive annual cohorts (1994-1996). The intervention included interactive classroom and exercise training sessions given by peer educators and facilitated by coaches and strength trainers. Program content included discussion of sports nutrition, exercise alternatives to AS and sport supplements, and the effects of substance abuse in sports, drug refusal role-playing, and the creation of health promotion messages. Questionnaires assessing AS, the use of sport supplements and alcohol and other illicit drugs, and potential risk and protective factors were administered before and after the intervention (before and after the football season) and up to 1 year after the program. RESULTS: At season's end, intentions to use (P<.05) and actual AS use (P<.04) were significantly lower among students who participated in the study. Although AS reduction did not achieve significance at 1 year (P<.08), intentions to use AS remained lower (P = .02). Illicit drug use
(marijuana, amphetamines, and narcotics) was reduced at 1 year, whether alcohol was included (P = .04) or excluded (P = .02) from the index. Other long-term effects included fewer students reporting drinking and driving (P = .004), less sport supplement use (P = .009), and improved nutrition behaviors (P<.02).
CONCLUSIONS: Use of alcohol and other illicit drugs and associated harmful activities can be prevented with a sex-specific, team-centered education. School 56 athletic teams provide an optimal environment in which to provide drug prevention and health promotion education.
Arch Pediatr Adolesc Med. 2004 Nov;158(11):1043-9.
OBJECTIVES: To implement and to assess the efficacy of a school-based, sport team-centered program to prevent young female high school athletes' disordered eating and body-shaping drug use. DESIGN AND SETTING: Prospective controlled trial in 18 high schools, with balanced random assignment by school to the intervention and usual-care control conditions. PARTICIPANTS: We enrolled
928 students from 40 participating sport teams. Mean age was 15.4 years, 92.2% were white, and follow-up retention was 72%. INTERVENTION: The ATHENA
(Athletes Targeting Healthy Exercise and Nutrition Alternative) curriculum's 8 weekly 45-minute sessions were incorporated into a team's usual practice activities. Content was gender-specific, peer-led, and explicitly scripted. Topics included healthy sport nutrition, effective exercise training, drug use and other unhealthy behaviors' effects on sport performance, media images of females, and depression prevention. MAIN OUTCOME MEASURES: We assessed participants by confidential questionnaire prior to and following their sport season. We determined program effects using an analysis of covariance-based approach within the Generalized Estimating Equation framework. RESULTS: Experimental athletes reported significantly less ongoing and new use of diet pills and less new use of athletic-enhancing substances (amphetamines, anabolic steroids, and sport 57 supplements) (P<.05 for each). Other health-harming actions also were reduced
(less riding with an alcohol-consuming driver [P = .05], more seat belt use
[P<.05], and less new sexual activity [P<.05]). The ATHENA athletes had coincident positive changes in strength-training self-efficacy (P<.005) and healthy eating behaviors (P<.001). Reductions occurred in intentions toward future use of diet pills (P<.05), vomiting to lose weight (P<.05), and use of tobacco (P<.05) and muscle-building supplements (P<.005). The program's curriculum components were altered appropriately (controlling mood [P<.005], refusal skills [P = .05], belief in the media [P<.005], and perceptions of closest friends' body-shaping drug use [P<.001]). CONCLUSIONS: Sport teams are effective natural vehicles for gender-specific, peer-led curricula to promote healthy lifestyles and to deter disordered eating, athletic-enhancing substance use, and other health-harming behaviors.
- Through statistics.
10. Could your program be used for athletes of all ages, and at all levels?
- ATLAS and ATHENA have been studied in highs schools. Its effect may be positive
in college, as well, but it has not been studied in a randomized control trial. We have
done one small intervention at Portland State University and results appeared to be
positive. The intervention was done through a grant from the NCAA. It was highly
acceptable and the athletes liked it. We have no idea about professional athletes.
They would need a tailored program, designed after a full evaluation of the risk and
protective factors for each type of athlete. 58
- The program administrator from a drug-testing program may say that your program is not
effective, do you have something to say to this?
Look for the evidence of effectiveness. ATLAS and ATHENA have been published in high profile, peer reviewed scientific journals, including the Journal of the American Medical
Association. They were sponsored and the science was reviewed by the National Institutes of
Health, prior to evaluation of the study. The research plan was reviewed by peer scientists from universities all over the U.S. . Thus the methodology was considered to be of the highest order and the results published in leading journals. In addition, ATLAS and ATHENA have beend re- reviewed by national agencies, and given the highest awards possible. Both ATLAS and
ATHENA were reviewed by the Government Accountability Office, the evaluation arm of the
U.S. Congress, the U.S. Department of Health and Human Services and is listed by NREPP
(National Registry of Evidence-based Programs and Practices (NREPP), a service of the
Substance Abuse and Mental Health Services Administration (SAMHSA).
This is Representative Tom Davis’ press release on ATLAS and ATHENA after the GAO review. http://tomdavis.house.gov/davis_contents/news/PRArticle.aspx?NewsID=60
“The relevant statements from Congressman Davis (who led the steroid hearings in congress in
2005) stated the following: Davis cited a Government Accountability Office (GAO) study, released today, that said two prominent programs that have received backing from the National
Football League appear to be effective at reducing steroid use for up to a year after students take the courses. The ATLAS and ATHENA programs – gender-specific, student-led programs aimed specifically at discouraging steroid abuse – were shown to reduce not only steroid use but a variety of risky behaviors, including recreational drug use, teen sex and driving while drunk.”
59
Thus the science and merit have been assessed by the National Institutes of Health, the evaluations have been published and the publications and science reviewed by scientists from federal agencies. These programs have been vetted. Other programs should have to undergo these evaluations. No program is perfect, but these have been shown to be effective.
The U.S. Department of Education’s Expert Panel stated the following re: ATLAS.
Exemplary Programs
Athletes Training and Learning to Avoid Steroids
Athletes Training and Learning to Avoid Steroids is recommended as an exemplary Safe, Disciplined, and Drug-Free Schools program.
Program Description
Athletes Training and Learning to Avoid Steroids (ATLAS) is a universal program for high school male athletes. The goals of the program are to reduce anabolic steroid use and intent to use, reduce the use of alcohol and other illicit drugs, reduce the use of "athletic-enhancing" supplements, reduce substance abuse risk factors, promote substance abuse protective factors, improve nutrition behaviors, and improve athletic self-efficacy.
The rationale of the program is based on the premise that student athletes are an important group for health promotion and substance abuse prevention, as they can be role models and opinion leaders for other students. Their abstinence from drug 60 use has the potential to deter abuse in others. The success of ATLAS relies on an understanding of etiologic risks and protective factors.
ATLAS involves 10 classroom sessions (each 45 minutes long) in which students role-play, create campaigns, and play educational games. Instructional aids include pocket-sized food and exercise guides and easy-to-follow workbooks. Parents are involved with their child's homework and diet goals. The total classroom curriculum lasts nine hours. The classroom session time allotment is divided into
50 percent drug issues, 34 percent sport nutrition, and 16 percent exercise training.
In addition, ATLAS requires approximately 100 hours of team contact during the sport season.
The program has two components: the Instructor Package and the Athlete Packs.
The Instructor Package is a three-ring binder that includes instructions on how to train peer "squad" leaders, background information, and lesson plans for the 10- session curriculum. Also included in the Instructor Package are 10 Athlete Packs.
Each Athlete Pack contains 10 curriculum workbooks, 10 sports menu booklets that feature information on nutrition and specific athletic-enhancing snacks before and after training, and 10 training guides that cover strength training, weight lifting, and workout schedules.
Program Quality
61
Reviewers found that the scope and sequence of the activities led logically to the achievement of the program's clearly articulated goals. They lauded the program's congruence among mission, goals, objectives, activities, and intended behavior change. This program targeted a very specific audience, and its materials were appropriate to that audience.
Evidence of Efficacy
Reviewers found that the ATLAS evaluation studies were rigorous and methodologically strong, with excellent designs, internal validity, well-known measures, appropriate analyses, and statistically significant outcomes. The program used a pre-post test design with random assignments to control groups, large samples, multiple schools, longitudinal measures, and sophisticated analyses of the data. The researchers carefully and systematically addressed issues of retention, baseline equivalence, short-term and long-term effects, and both individual and school-level results. One reviewer pointed out that the program was thoughtfully contextualized in adolescent psychological and physical development theory and correctly identified and addressed potential statistical issues, such as ethnicity and a father's education at baseline.
Reviewers noted the consistent pattern and magnitude of the program's outcomes.
Each of the 14 effectiveness claims was substantiated with statistically significant results. Statistically reliable outcomes in favor of the treatment group were found 62 in almost all areas addressed by the program. Outcomes included the following: 1) reduced incidence and prevalence of drug use, intention to use and actual use of anabolic steroids, use of sport's supplements, and incidents of drinking and driving; 2) improved drug use resistance skills and perceptions of the harmful effects of anabolic steroids--including personal susceptibility to these harmful effects, perception of athletic competence, and sports nutrition behaviors; and 3) increased strength training self-efficacy and perception of a coach's intolerance of anabolic steroid use.
The evaluation design was a randomized cohort study, conducted over three consecutive years; two cohort studies had a one-year follow-up component and all three cohort studies had an end-of-the-season follow-up. Thirty-one schools in 10 cities and two states were studied, with random assignments of pair schools to experimental and control conditions. There were 15 experimental and 16 control schools and a sample of 3,207 athletes at pre-assessment. There was no differential dropout between experimental and control groups. Positive post-test findings were observed one year after baseline measurement, using a 168-item questionnaire based on prior research that indicated high item reliabilities, validity, and adequate sensitivity.
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11. Is there any way in which you would try to improve your program and what would that be? 63
We have refined the program based on scientific evidence. The programs undergo re-evaluation and refinement based on ease of dissemination measures. We update the knowledge portion of the program each year.
12. Why did you choose to be a part of this program?
I invented the program, based on the perception that there were going to be young athletes using these drugs and harming their health. We wanted to prevent this problem.
Specifics on Steroid Use
13. Are steroids easy to quit taking, or is rehabilitation necessary?
This has not been well studied. Steroids are at least psychologically addictive. Also, the depression that follows use does require an evaluation and potentially rehabilitation.
14. Why do you believe athletes take steroids?
- Male and female athletes take steroids for different reasons. For females, steroid use is related to disordered eating practices, depression and body image. Some use for performance enhancement. Some use for protection. Males are for athletic achievement, body image.
15. What method do you suggest for schools to use that are trying to prevent student-athletes from
taking steroids?
- ATLAS and ATHENA, as they are proven to work and the only programs shown to discourage steroid use.
16. How do you help a student-athlete quit steroid-use?
- Educate them and counseling.
17. Is there a way to cheat on a drug test?
- Yes
18. If so, how? 64
- there are masking agents, there are designer steroids, there are products that store urine that is clean. It all depends on the type of drug.
19. What are the worst steroids that a student-athlete can take? The term steroids should be
anabolic-androgenic steroids. The long acting, fat soluble steroids are likely the most
dangerous and stay in the body the longest.
20. What is something that you have learned about steroid use that you didn’t already know?
I have been studying steroid use for over 20 years. I have learned just about everything. Who uses, why they use and how to prevent use.
21. What would you tell someone who is thinking about taking steroids?
I would point out the positive and negative features and get family and friends involved in their dissuading the individual.
Do you believe steroid use is worse among high school, college, or professional athletes?
More youth take these substances, so it is worse among high school students because it is more pervasive. There are very few professional athletes, so there is much less volume of use. As a public health problem, it is worse among adolescents. 65
Appendix D Interview with Frank Uryasz 66
Interview Answers (Frank Uryasz, Drug Free Sport)
Privacy Rights
1. Do you believe that drug testing violates privacy rights? No, what the courts do in most cases, they balance the rights of the individual to the rights of the organizations. They are trying to guarantee safe competition. Diver of Stanford University felt his rights were violated after taking a drug-test. He went up against the NCAA in the Supreme Court. California Supreme Court ruled in favor of NCAA. The NCAA Maintained confidentiality, and made sure there was an opportunity for an appeal in the case of a positive drug test. There are four high school associations in the United States that have steroid programs. It first started with New Jersey, any athlete that competes in championship has to be tested. FL was the next state to follow, but it gave a drug test to any athlete competing in a “high risk” sport. Texas drug tests anyone who is competing, regardless of the sport. This includes about 26,000 athletes. 2. Is there a limit to being drug tested or should a student-athlete be drug tested at any time and anywhere within reason? It all depends on the organization. If a high school athlete tests positive in New Jersey, then that athlete will be ineligible for a year. If an athlete tests positive for a drug test in Florida and Texas they will be ineligible for a few months. There are Exit Tests, in order for athletes to restore eligibility. The organization will give the athlete a time and date, where they will test again. 3. Is it true that not all steroids will show up on drug tests? We always believe that there are steroids that aren’t seen. They go to research laboratories, UCLA gets results. They look for steroids we know about as well as steroids we don’t know about. 4. How can drug testing work for steroid users if they can just quit once they are tested and then start taking steroids again? It is important for the program to not have a limit for the number of times an athlete is drug tested. There should be no maximum number. The Reason for Your Program 5. What is the goal of your program? 67
The threat of testing is a deterrent for anabolic steroids and other drugs. Protecting the health and safety of athletes is our goal. Athletes shouldn’t have to compete against other athletes who are taking performance enhancing drugs. 6. What tactics do you use to try to reach your goal? Drug testing of course, but education is the primary tool. Despite education, people are going to use steroids anyway, which is why there is drug testing. There are a lot of athletes who don’t use steroids, it is important to understand why. I don’t use because I am concerned for my health, I consider it to be cheating. We are involved in education. Athletes can be educated though role models, or even government. We educate through two areas, number one, our staff does a lot of speaking and delivering educational programs on campus. Number two, we also have a resource exchange center. It is a drug and supplement hotline that sports organizations subscribe to. All NCAA athletes can call and find out more about steroids and other drugs. They can also find out what substances are banned from the NCAA. 7. Have you met your goal, or are you on the verge of meeting your goal? Education and testing has significantly reduced steroid use. It did peak in the late eighties but it has decreased. It is difficult for high school athletes in particular. No national studies for steroid use by high school athletes have been conducted. Studies among general high school, use is very small. It is difficult to measure changes. If we were to measure changes, it would probably be easier to measure changes in attitude and perceptions more than use. 8. What was the reason for the start of your program? I worked with the NCAA staff for 13 years operating a drug testing program. I started Drug Free Sport in ‘99. The reason for this was because I wanted to work in another organization, and I saw that drug testing was effective. 9. How do you measure the program’s effectiveness? We do the studies that are similar to what the studies the NCAA does. These surveys are anonymous and confidential. 10. Could your program be used for athletes of all ages, and at all levels? Yes, labor unions are involved, which is hard for professional athletes. Programs become negotiated. You want them to say they want the best for the athletes, but generally players associations don’t do that, unless they are forced to by Congress. But, normally, the federal government would like to stay out of it. We probably wouldn’t see changes without congress. Drug testing can end careers, which may be a reason drug-testing is such a big issue. 11. Is there any way in which you would try to improve your program and what would that be? 68
We are always working to improve our program. One way is to reduce the amount of notice that we give athletes. In a perfect world we would give them no notice. We will continue to work toward drug testing to be year round. Drug testing used to only be given during season, but we are now in our third summer of where we drug test athletes during summer. Specifics on Steroid Use
12. Why do you believe athletes take steroids? Two reasons; they know they enhance muscle strength, athletic performance, and two, purpose of rehabilitation and recovery of injury. 13. Is there a way to cheat on a drug test? We know all of them. We try to circumvent them though, you can substitute urine, adulterate the sample by putting a substance in the sample. We observe them. Our collectors go to the bathroom with the athlete. There are products that one can purchase and consume that dilute the sample. That reduces the likely hood of being caught. If the urine is diluted we will wait until the urine is concentrated. Athletes get to spend all day at the drug testing site if necessary. We will even have them pull their shirts way up, and their pants or shorts all the way down to the knees, if necessary. 14. What is something that you have learned about steroid use that you didn’t already know? The one thing I learned of the athletes that were using, is many are using them for rehab and for recovery. That motivation was something that I didn’t really understand prior to working in this business. It is a very private use, anabolic steroid use is closeted. 15. Do you believe steroid use is worse among high school, college, or professional athletes? There really isn’t any data about the extent of steroid use in professional sports. It’s fair to say given the amount of money and aging issues, that professional athletes are looking for ways to extend their careers. Steroids are probably taken less in college, and even less so in high school. What concerns people in high school is that it wasn’t the number of users, but that use was increasing. High school wanted to nip that in the butt. The national surveys on steroid use among high school students has shown a decrease. High school coaches, however, feel that it is a problem.
I did pay attention to ATLAS, we need more educational models for high school athletes. ATLAS is a good program, but I think there needs to be an outside evaluation. Not just Goldberg and other doctors. If ATLAS works at the high school level it doesn’t mean it is going to work at any other level.
I believe even though they did try it on one college, there was a funding issue.
Education has to go hand in hand. Education works but not for everyone. Both education as well as drug testing will work. Education doesn’t work for everyone. 69
Appendix E IRB Approval