Johnny, a young man who lives in a small midwestern town, is an illegal drug user. His habit started slowly, but has grown quickly. He now must resort to stealing to support it. Lately, his friends and family have noticed some troubling changes in him. Johnny's drug habit however, is quite different from what most would probably expect, since he is only 14 years old. The money he steals comes from his mother's purse and his father's wallet. The noticeable changes are his expanding neck and his violent moods.

Johnny's drug of choice? Anabolic steroids.

A Quiet, But Dangerous Habit

Illegal steroid use by Olympic, college, and professional athletes often makes the news, but the abuse of these drugs by teenagers has not received as much attention. What is most troubling is that the health dangers can be especially devastating for teenagers.

What Are Anabolic Steroids?

Taken as a pill or as an injection, anabolic steroids are derived from and mimic the effects of the male sex hormone testosterone. Both men and women naturally produce testosterone, although women make very small amounts.

In males, testosterone's role in the body is two-fold. First, it maintains the reproductive system, including production and maintenance of the male sexual characteristics, such as a deeper voice, increased body hair, larger body size, and greater muscle mass. Second, for a short period of time at the onset of puberty, testosterone production rises dramatically to stimulate the bulk of the physical maturation process, including full bone growth.

It is this ability to promote muscle growth, increase lean body mass, and decrease body fat that entices teenagers to take anabolic steroids. Those striving to improve their strength, speed, and stamina often see steroids as a quick way to lift heavier weights and look bigger.

Side Effects

Unfortunately, the high doses that are necessary to affect these body changes come with health dangers. Teens are at risk for irreversible stunted growth. This happens because the bones are stimulated to grow and mature too quickly, then stop growing earlier than they normally would.

Anabolic steroids can produce adverse side effects in men and women of all ages, including:

• Acne
• Swelling of ankles and feet
• Yellowing of the eyes and skin (jaundice), which indicates liver damage
• Reduced high-density lipoprotein (HDL or "good") cholesterol
• Increased low-density lipoprotein (LDL or "bad") cholesterol
• Painful joints
• High blood pressure
• Increased susceptibility of ligaments, tendons, and muscles to injury
• Mood swings, including uncontrolled anger and aggressiveness, extreme irritability, paranoid jealousy, and impaired judgment stemming from feelings of invincibility
• Possible development of psychological dependence on anabolic steroids
• Possible increased risk of cancer, heart disease, and/or heart attack
• Possible infection with AIDS or hepatitis if steroids are taken via injection with a shared needle

Some side effects specific to men include:

• Shrinking of the testicles
• Baldness
• Enlargement of the prostate
• Pain or difficulty urinating
• Reduced sperm count, which can lead to infertility
• Inability to get an erection—impotence
• Development of breasts, often irreversible

Side effects specific to women include:

• Overall masculinization, including the growth of facial hair and a deepening of the voice (may be permanent)
• Changes in menstruation cycle (menstruation stops or is reduced)
• Enlargement of the clitoris
• Reduction in breast size

Black Market Sources and Stacking

Because most anabolic steroid users acquire the drug illegally via the black market, they may receive impure or tainted steroids. This presents many health risks.

Another danger is stacking, which involves taking several types of steroids at once to enhance the effects. These combinations multiply the risks.

Teens who abuse anabolic steroids often know about the dangers, but are driven by a desire to be bigger, stronger, and better than their peers.

Train the Right Way

If your teen wants to strength train with weights, help them do it the right way, with proper training and diet. If they have to train for a specific sport or want to attain specific fitness goals, consider getting a trainer who can help them plan a routine and modify it as their needs change. Talk to your teen's doctor before they take any supplements. Some supplements interact with medications, while many have no benefit.

Athletes need the support of friends, parents, and coaches to avoid the traps of steroid use. Encourage open conversations about steroid use, and let your teen know they can come to you if they suspect a friend or teammate may be in trouble with steroids.