So many important issues, so little time. The teen sports physical has a lot of ground to cover and young athletes are bound to feel like they're being interrogated. Sex, drugs, alcohol, tobacco and bodybuilding steroids?
The last question caused my patient, a slender but muscular 17-year-old girl, to shake her head and laugh. Still, if you're going to ask one athlete these questions, you have to ask all the kids, otherwise you run the risk of profiling non-users and overlooking the less obvious participants.
Since the 2008-09 school year, the Illinois High School Association has required all student-athletes to sign a form acknowledging the association's right to perform random steroid testing at IHSA-sanctioned sporting events.
Are steroids really an adolescent issue? Well, though the National Institute on Drug Abuse reports that steroid use among teens has generally dropped over the past decade, it still occurs in a subset of the adolescent population, more often among boys.
Results of the NIDA-sponsored 2009 Monitoring the Future Survey show that males continue to use anabolic steroids at a higher rate than females: 1 percent of eighth-grade boys, 0.5 percent of eighth-grade girls, 2.5 percent of 12th-grade boys and 0.4 percent of 12th-grade girls self-report steroid use within the past year.
NIDA experts explain that anabolic steroids are synthetic versions of male sex hormones first developed in the 1930s to treat endocrine abnormalities. These substances, available in injectable, oral, and topical gel and cream forms, have gained popularity as drugs of abuse primarily due to their ability to promote skeletal muscle growth.
While many anabolic steroid users are athletes hoping to shortcut their way to improved performance, the drug abuse institute also finds steroid use by non-athletes looking to improve their body image through increased muscle and reduced body fat, as well as among adolescents engaging in other risk-taking behaviors.
Steroid-induced increases in muscle mass and strength often come at a price. Steroid use can become addictive and has been linked to - among many other medical conditions - the development of severe cystic acne, short stature, episodes of delusions and rage, high blood pressure, heart disease, liver tumors, shrinkage of the testicles and breast development in males, and excess body hair and male-pattern baldness in females.
Noting that non-medical anabolic steroid use has been illegal since 1990, the National Strength and Conditioning Association has issued a position statement rejecting the use of steroids and other performance-enhancing drugs in athletics. The association bases its anti-steroid policy on "ethics, the ideals of fair play in competition, and concerns for the athlete's health."
The NSCA encourages athletes to become more informed about the risks of anabolic steroid abuse and to focus on proper conditioning, training and nutrition - the trio of natural performance enhancers. The association also urges coaches at all levels to set realistic goals for their young athletes in an effort to reduce the lure of anabolic steroids and other illegal performance-enhancing drugs.
• Dr. Helen Minciotti is a mother of five and a pediatrician with a practice in Schaumburg. She formerly chaired the Department of Pediatrics at Northwest Community Hospital in Arlington Heights.