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Anabolic androgenic steroid (AAS) use is rapidly becoming a public health problem for the United States as well as many Western countries. The British Medical Association Board of Science and Education revealed the prevalence in UK fitness centers to be around 13%, whereas in dedicated bodybuilding gyms, the prevalence rate peaks at almost half of all members. Adolescents are the most studied population for the prevalence of AAS abuse and research has indicated national AAS abuse rates were 4.3% and 2.2% for males and females, respectively (3.3% overall). While AAS have legal therapeutic use for specific medical disorders, healthy individuals use and abuse them to enhance physical performance or alter their physique.
However, AAS are not the only consideration with athletes trying to obtain an edge on the competition. Dietary supplements are also an avenue athletes turn to in order to enhance performance and alter their physique. The dietary supplement industry is loosely regulated and are not subject to the same pre-approval requirements and quality tests as FDA-approved medication.
Research suggests that high school athletes are less likely to use steroids if their peers and parents disapprove, indicating that peers and parents can be strong partners in prevention efforts. Presenting both the risks and benefits of anabolic steroid use is more effective in convincing adolescents about steroids' negative effects, apparently because the students find a balanced approach more credible. Furthermore, research has demonstrated a comprehensive approach educating athletes about the harmful effects of anabolic steroids and providing nutrition and weight training alternatives to steroid use through the Adolescents Training and Learning to Avoid Steroids (ATLAS) program, has increased a football players’ healthy behaviors and reduced their intensions to misuse steroids. Studies have demonstrated after one year of the ATLAS program, football student athletes had less use of anabolic steroids and less intention to misuse them in the future and less misuse of “athletic enhancing supplements”.
Athletic trainers may interact with individuals who use or intend to use AAS, therefore, it is imperative that athletic trainers understand these prohibited substances so they can identify a current user while educating those who are considering using with the current and accurate evidence to prevent usage and potential negative consequences. Health care professionals and educators should be aware of the dynamic, social process of AAS abuse. Active monitoring for AAS abuse and maintaining an open, honest, and evidence-based dialogue with all stakeholders, including athletes, coaches, administrators, parents, advisory groups, and others, is vital.
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