If you thought performance-enhancing drugs were only used by Olympic and professional athletes, you are wrong. Kids in high school, junior high and middle school are taking them. Here is some information that you need to know about these substances.

What are performance-enhancing drugs and supplements?

Performance-enhancing drugs and supplements are used to boost athletic performance, ward off fatigue and enhance physical appearance. They are also taken to increase muscle mass and energy, but they can cause serious harm. Here is a look as some of the substances that young athletes may be using.

Creatine: Creatine is an over-the-counter supplement best known for improving performance in sports involving short bursts of high intensity activity, such as power lifting, wrestling and sprinting. Side effects include stomach pain, nausea, diarrhea and muscle cramps. High doses of creatine may be associated with kidney, liver or heart problems, and even high blood pressure, though definitive links to severe illness haven’t been established.

Teens may take creatine to bulk up. What actually happens is that your muscles draw water away from the rest of the body. The bulking up you experience is often the result of the extra water stored in your muscles, not increased muscle mass. You do not gain extra strength from water. But you may get seriously dehydrated from the redirection of you body’s water to your muscles.

The effect of creatine on children and teens has not been studied. Most studies of adults have followed participants for only a short time, so long-term effects are not known.

Androstenedione (andro): Proponents of andro claim it boosts the testosterone production, which in turn increases muscle mass, energy and strength. In reality, andro does none of these things.

On October 22, 2004, the Anabolic Steroid Control Act of 2004 classified andro as a controlled substance, adding it to the list of banned anabolic steroids and making its use as a performance-enhancing drug illegal.

Side effects of andro differ for men and women. In men it can actually decrease the production of testosterone while increasing the production of estrogen. Side effects in men include acne, diminished sperm production, shrinking of the testicles and enlargement of the breasts. In women, side effects include acne and masculinization, such as deepening of the voice and male pattern baldness. Andro might also stunt growth by prematurely closing bone growth plates in young athletes.

In men and women, supplemental andro can decrease high density lipoprotein (HDL) cholesterol (“good cholesterol"). Lower HDL puts you at greater risk of heart attack and stroke.

Ephedra: Ephedra is a plant that contains the chemical ephedrine, a stimulant similar to amphetamines. Athletes may take an over-the-counter supplement containing Ephedra to reduce physical fatigue, lose weight or improve mental alertness.

In late December 2003, the Food and Drug Administration announced the ban of Ephedra from the marketplace because of health concerns.

Also known a ma-huang and popotillo, Ephedra can cause such side effects as strokes, seizures and heart attacks. Ephedra can raise your blood sugar and cause an irregular heart rhythm. Long-term use can lead to addiction.

Anabolic steroids: Anabolic steroids are taken orally and by injection. In the United States, this group of performance-enhancing drugs is typically available only by prescription.

Anabolic steroids are particularly dangerous for adolescents because their bones are still developing. Anabolic steroids can halt bone growth and damage the heart, kidneys and liver.

Signs of anabolic steroid use are easier to detect than are those of creatine, andro and Ephedra. Signs that an athlete may be taking anabolic steroids include increased acne and male pattern baldness. If a female athlete takes anabolic steroids, she may develop male characteristics, such as a deeper voice or dark facial hair. These are not life threatening but they are the most obvious signs. The more dangerous physical conditions, such as liver tumors, increased blood pressure and elevated cholesterol will not be visible. These conditions can cause great harm. The long-term effects on young athletes' fertility are unknown.

Young athletes who take anabolic steroids may have angry outbursts known as “roid rage.” They may seem unusually moody and may experience depression when they stop using the drugs. Other frightening signs of steroid use are paranoia, hallucinations and psychosis.

How many teens use performance-enhancing drugs?

It’s difficult to know precisely how many teens use performance-enhancing drugs. One reason is that scientists rely on kids involved in sports as their source of information. Obviously, some kids who take surveys will not admit drug use. Testing for drugs in youth sports is an expensive and complex issue that makes widespread testing impractical.

The use of anabolic steroids by young athletes has increased primarily among weightlifters and gymnasts. Studies suggest that five to 11 percent of high school boys and .5 percent to 2.5 percent of high school girls have tried anabolic steroids.

Why do teens take them?

Given all the negative effects associated with performance-enhancing drugs, it seems strange that healthy children and young adults would want to risk their health. However, teens tend to deny their mortality and take risks they might not take if they were older and wiser. Here are some situations in which they might consider taking performance-enhancing drugs.

• Most athletes reach a plateau at some point in their training. Performance-enhancing substances may help them move beyond it.
• Athletes make sacrifices to pursue their sport. When the effort doesn’t yield the desired results, they become frustrated enough to take them.
• Even athletes making good progress with their training may become curious and take performance-enhancing drugs just to see what will happen.
• Some athletes give in to peer pressure.
• The use of performance-enhancing substances is accepted by a significant number of athletes, and in some sports, athletes may feel little pressure not to take drugs.
• The psychological effects of some substances, such as greater aggression, feeling of invincibility and euphoria, may be pleasurable enough that an athlete doesn’t want to stop taking banned drugs.
• Athletes know that some of their competitors take them.
• No tests are available for some drugs, so there is no chance of getting caught.
• Parents and coaches may ignore signs of performance-enhancing drug use in teens who appear to be elite level athletes.

What can parents do?

If you are worried that your teen may be using performance-enhancing drugs or supplements, here is what you can do:

• Educate yourself. Reading this information is an important first step. Find out if your state high school athletic association or your teen’s school or coach has a policy that prohibits use of these substances.

• Be clear about your expectations as parents. Tell your teen that until the long-term effects of performance-enhancing drugs on young athletes are known, you expect him or her to avoid them. Make no exceptions. Teach your teen that short-term gains can lead to long-term problems.

• Discuss ethics, dangers and proper training. Do you recall what the term noble athlete means? Simply stated, it means that athletes compete fairly. The use of performance-enhancing drugs is a form of cheating that can lead to health problems and even death. Another key message is that a well balanced diet and rigorous training are the true keys to athletic performance.

• Talk with your teen’s coach. Let the coach know you have talked with your athlete and you do not approve of performance-enhancing drugs. Ask about the school’s drug use policy.

• Monitor your teen’s purchases. Take a close look at the over-the-counter preparations your athlete takes. Check closely to see what the ingredients are. Pay close attention to what your athlete purchases on the Internet.

For more information about performance enhancing drugs and supplements, speak with a specialist at Saint Vincent Sports Medicine by calling 814-835-2035.

Disclaimer: This content is reviewed periodically and is subject to change as new health information becomes available. The information provided is intended to be informative and educational and is not a replacement for professional medical evaluation, advice, diagnosis or treatment by a health care professional.