The Sturm und Drang of anabolic steroid use: angst, anxiety, and aggression / , Leslie P. Henderson

• Trends in Neurosciences 35 (2012) 6 (1 June); p. 382-392
• PMID: 22516619
• PMCID: PMC4127319
• DOI: 10.1016/j.tins.2012.03.001

Abstract

Anabolic androgenic steroids (AAS) are illicitly administered to enhance athletic performance and body image. Although conferring positive actions on performance, steroid abuse is associated with changes in anxiety and aggression. AAS users are often keenly invested in understanding the biological actions of these drugs. Thus, mechanistic information on AAS actions is important not only for the biomedical community, but also for steroid users. Here we review findings from animal studies on the impact of AAS exposure on neural systems that are crucial for the production of anxiety and aggression, and compare the effects of the different classes of AAS and their potential signaling mechanisms, as well as context-, age- and sex-dependent aspects of their actions.

Neuropsychiatric Effects of Anabolic Steroids in Male Normal Volunteers / Tung-Ping Su, Michael Pagliaro, Peter J. Schmidt. - (Journal of the American Medical Association 269 (1993) 21 (2 June); p. 2760-2764)

• PMID: 8492402
• DOI:10.1001/jama.1993.0350021006003

Abstract

Objective: To evaluate the acute effects of anabolic steroids on mood and behavior in male normal volunteers.

Design: A 2-week, double-blind (subject and rater), fixed-order, placebo-controlled crossover trial of methyltestosterone.

Setting: An inpatient research unit at the National Institutes of Health.

Subjects: A volunteer sample of 20 men who were medication free, free of medical and psychiatric illness, not involved in athletic training, and had no prior history of anabolic steroid use.

Intervention: A sequential trial for 3 days each of the following four drug conditions: placebo baseline, low-dose methyltestosterone (40 mg/d), high-dose methyltestosterone (240 mg/d), and placebo withdrawal.

Main outcome measures: Mood and behavioral ratings were completed during each drug condition and included both subjective and objective measures.

Results: Significant (P < .05) albeit subtle increases in symptom scores were observed during high-dose methyltestosterone administration compared with baseline in positive mood (euphoria, energy, and sexual arousal), negative mood (irritability, mood swings, violent feelings, and hostility), and cognitive impairment (distractibility, forgetfulness, and confusion). An acute manic episode was observed in one of the 20 subjects, representing a 5% incidence, even under these conservative conditions. An additional subject became hypomanic. Baseline characteristics including family psychiatric history or previous drug abuse did not predict symptom changes.

Conclusion: This is the first placebo-controlled prospective study demonstrating the adverse and activating mood and behavioral effects of anabolic steroids.

AUSTRALIAN SPORTS DRUG AGENCY 1992-93 ANNUAL REPORT
© Commonwealth of Australia
ISSN 1037-378

CONTENTS
Page
List of Tables 10
List of Appendices 11
Summary of Compliance with Reporting Guidelines 13

Chapter One
Introduction 14
Objects, Functions and Powers 16
Responsible Minister 18
Membership 19
Board Meetings 19
The Staff of the Agency 21
Publications and Presentations 21
Social Justice 22
Special Operational Issues 26
Summary of Outcomes for 1992-93 28
Outlook of Activities for 1993-94 31

Chapter Two
Policy and Research Program 35
Objective 35
International Initiatives and Activities 35
Policy Development within Australia 44
Legislation 54
Research 56

Chapter Three
Drug Testing Program 63
Objective 63
Drug Testing Management System 63

Chapter Four
Education Program 66
Objectives 66
School-based Education Programs 66
Sports-based Education Programs 68
Information Services 69

Chapter Five
Executive-Corporate Operations Program 73
Objective 73
Finance 73
Memorandum of Understanding with the Australian Government Analytical Laboratories 74
Office Services 76

Chapter Six
Financial Statements F1-F12

TABLES
Table 1 Agency papers and presentations 1992-93 80
Table 2 Drug testing statistics 1992-93 85
Table 3 Drug testing statistics by State and sex 1992-93 86
Table 4 Summary of defaults 87
Table 5 Summary of defaults by sport 89
Table 6 Summary of substances found in positive drug tests 90
Table 7 International sporting events held in Australia and tested by ASDA 91
Table 8 Agency staffing levels 92
Table 9 Five-year targets for user-pay drug testing services 93

Appendices
Appendix 1: Guidelines for the content, preparation and presentation of annual reports by statutory authorities 94
Appendix 2: Establishment chart of the Australian Sports Drug Agency 97
Appendix 3: Memorandum of Understanding between the Governments of Australia, Canada and the United Kingdom concerning the reciprocal development and enforcement of measures against anti-doping (1990) 98
Appendix 4: Self-assessment guidelines for a national anti-doping program 102
Appendix 5: International Olympic Charter Against Doping in Sport —
model for a national anti-doping program 104
Appendix 6: Arrangement between the Government of Australia and the Government of New Zealand concerning the reciprocal development and enforcement of measures against doping in sport 106
Appendix 7: Types of harm caused by drug use 108
Appendix 8: International Olympic Committee Medical Commission List of doping classes and methods of doping - March 17, 1993, 110
Appendix 9: Summary of IOC doping classes and methods 117
Appendix 10: Clenbuterol 121
Appendix 11: Dope control laboratories accredited by the IOC 122
Appendix 12: Ottawa Charter for Health Promotion 127
Appendix 13: Community development of drugs in sport programs - the role of professionals 130

Anabolic steroids--the drugs that give and take away manhood. A case with an unusual physical sign / A. Stanley, M. Ward

• Medicine, Science and the Law 34 (1994) 1 (1 Januay); p. 82-83
• PMID: 8159080
• DOI: 10.1177/002580249403400115

Abstract

A case is presented in which the abuse of anabolic steroids by a body builder led to an unusual physical sign. The case discusses the effects that anabolic steroid abuse can have upon manhood. The frequency of anabolic steroid misuse is increasing. The implications of this with respect to psychiatric illness and violent crime are discussed. It is well known that the use of anabolic steroids among young men, body builders in particular, is growing apace (Perry and Littlepage, 1992), and they may be aware of the risks of impurity and contamination. There is a wide range of anabolic steroids in use; they are often used in doses of greater than 1 mg/kg per day. As well as single use, the misuser may 'stack' (use more than one at a time) or 'pyramid' (use increasing doses of a given drug) the steroids (Kennedy, 1990). The physical and psychiatric effects of anabolic steroids are well known (Kashkin and Kleber, 1989; Brower, 1992; Pope and Katz, 1988). However, we describe a case with psychiatric symptoms, a violent outburst and a unique (?) physical sign.

Anabolic Steriod and Human Growth Hormone Abuse : Creating an Effective and Equitable Ergogenic Drug Policy / George Fan. - University of Chicago Legal Forum (1994) 1, article 19; p. 439-470)

The goal of this Comment is threefold. First, it shows that
HGH and steroids are so similar in terms of their limited clinical uses, the number and demographics of abusers, and the side
effects associated with abuse that any difference in penalties is
unjustified. Second, the Comment compares the side effects and
medical uses of HGH with other drugs in Schedule III of the CSA
and concludes that HGH should be classified as a Schedule III
drug. Finally, this Comment explores alternative avenues of
deterrence, including education and social sanctions.

Psychological characteristics of adolescent steroid users / K.F. Burnett, M.E. Kleiman. - (Adolescence 29 (1994) 113; p. 81-89)

• PMID: 8036984

Abstract

The Millon Adolescent Personality Inventory and the Profile of Mood States were used to assess a broad range of psychological characteristics in 24 adolescent athletes who reported steroid use. In addition, a steroid knowledge questionnaire was administered and an evaluation of physical symptoms of steroid use was conducted. Corresponding data were obtained from 24 adolescent athletes who did not use steroids, and 24 nonathletic adolescents. Although some personality variables differentiated between athletes and nonathletes, no personality variables significantly differentiated between athletes who used steroids and athletes who did not use steroids. Steroid users, however, had significantly higher levels of muscular density and hardness, bloating, gynecomastia, and acne than did athletes who did not use steroids; steroid users who were currently on a steroid use cycle had significantly more depression, anger, vigor, and total mood disturbance than those who were not on a cycle. Prospective longitudinal studies are needed to develop our understanding of psychological issues related to adolescent steroid use.

The Millon Adolescent Personality Inventory and the Profile of Mood States were used to assess a broad range of psychological characteristics in 24 adolescent athletes who reported steroid use. In addition, a steroid knowledge questionnaire was administered and an evaluation of physical symptoms of steroid use was conducted.

Corresponding data were obtained from 24 adolescent athletes who did not use steroids, and 24 nonathletic adolescents.
Although some personality variables differentiated between athletes and nonathletes, no personality variables significantly differentiated between athletes who used steroids and athletes who did not use steroids. Steroid users, however, had significantly higher levels of muscular density and hardness, bloating, gynecomastia, and acne than did athletes who did not use steroids; steroid users who were currently on a steroid use cycle had significantly more depression, anger, vigor, and total mood disturbance than those who were not on a cycle.

Risk factors for anabolic-androgenic steroid use in men / K.J. Brower, F.C. Blow, E.M Hill. - (Journal of Psychiatric Research 28 (1994) 4 (July-August); p. 369-380)

• PMID: 7877116
• DOI: 10.1016/0022-3956(94)90019-1

Abstract

The illicit use of anabolic steroids to enhance athletic performance and physical appearance can cause numerous psychiatric and other adverse effects. In order to prevent steroid use and its negative consequences, knowledge of risk factors is needed. We conducted an anonymous survey of 404 male weight lifters from community gymnasiums who completed a 20-min, self-administered questionnaire. The sample for this study included all 35 men who were thinking about using steroids ("high-risk" nonusers), 50 randomly selected nonusers who were not thinking about using steroids ("low-risk" nonusers) and all 49 steroid users. The three groups differed in age, training characteristics, other performance-enhancers tried, body image, acquaintance with steroid users, and perception of negative consequences. When groups were compared along a continuum from low risk to high risk and from high risk to actual use, we found increasing amounts of competitive bodybuilding, performance-enhancers tried, and steroid-using acquaintances. Groups did not differ in their use of addictive substances. Nearly three-fourths of the high-risk group felt "not big enough," compared to 21% of the low-risk group and 38% of the steroid users (p < .001). These data suggest that steroids do work to increase satisfaction with body size, and that dissatisfaction with body size may contribute to the risk of using steroids.

Chad Starkey, Thomas E. Abdenour, David Finnane
Journal of Athletic Training Volume 29 * Number 2 * 1994
Department of Physical Therapy at Northeastern University
in Boston, MA 02115.

Since the inception of NCAA-mandated drug screening in 1986, college athletic trainers have found themselves involved at various
levels in institutional drug-screening programs. Several legal, moral, and ethical questions have been raised regarding the drug screening of college athletes, and studies have been conducted to rate athletes' attitudes toward this practice. We examined the responses of certified athletic trainers employed in college settings
to ascertain their attitudes toward the drug screening ofathletes in general, and, specifically, how they view their role in this process.

Surveys were distributed to 500 college athletic trainers randomly selectedfrom the membership database maintained by the National Athletic Trainers' Association, Inc (Dallas, TX).

The results of this survey indicate that the majority of athletic trainers feel that their association with the drug-screening process places them in the dual role of police and counselor, but that this relationship does not negatively affect their rapport with their athletes. Opinions regarding the drug-screening process and the importance of education in deterring drug use are somewhat dependent upon the athletic trainer's involvement in the drug-screening process. Athletic trainers possess a stronger desire to serve as resource persons who organize substance abuse education programs ratherthan serving as administrators of the sampling process.

Psychiatric and medical effects of anabolic-androgenic steroid use. A controlled study of 160 athletes / Harrison G. Pope Jr, David L. Katz. - (Archives of general psychiatry 51 (1994) 5 (May); p. 375-382)

• PMID: 8179461
• DOI: 10.1001/archpsyc.1994.03950050035004

Abstract

Background: We sought to expand on preliminary findings suggesting that anabolic-androgenic steroids produce psychiatric effects in some athletes who use them.

Methods: We compared 88 athletes who were using steroids with 68 nonusers, using the Structured Clinical Interview for DSM-III-R to diagnose psychiatric syndromes occurring in association with steroid use (if applicable) and in the absence of steroid use. Demographic, medical, and laboratory measures were also performed.

Results: Steroid users displayed more frequent gynecomastia, decreased mean testicular length, and higher cholesterol-high-density lipoprotein ratios than nonusers. Most strikingly, 23% of steroid users reported major mood syndromes--mania, hypomania, or major depression--in association with steroid use. Steroid users displayed mood disorders during steroid exposure significantly more frequently than in the absence of steroid exposure (P < .001) and significantly more frequently than nonusers (P < .01). Users rarely abused other drugs simultaneously with steroids.

Conclusion: Major mood disturbances associated with anabolic-androgenic steroids may represent an important public health problem for athletes using steroids and sometimes for the victims of their irritability and aggression.

Recommendation & Explanatory Memorandum on Measures to Restrict the Availability of Anabolic Steroids / Monitoring Group of the Anti-Doping Convention. - Strasbourg : Council of Europe (CoE), 1994

• Council of Europe Recommendation (94) 2 ; 14-16 June 1994)
• Consolidated text of two CoE documents:
  • 1.) Recommendation on Measures to restrict the availability of Anabolic Steroids (94/2)
  • 2.) Explanatory Memorandum to Recommendation (94/2)