Teen athletes and performance-enhancing substances: What parents can do

Are you the parent of a student athlete? If you are, your life is probably as hectic as your child's. Your teen may be the one dribbling the ball, swinging a bat or swimming laps, but you're the one driving carpool, washing uniforms, preparing two dinners — one for your child and one for the rest of the family — as well as attending practices, games and competitions.

But of all the things you do as the parent of a student athlete, have you taken the time to talk to your child about the dangers of performance-enhancing drugs and supplements? If you thought performance-enhancing drugs and supplements were used by Olympic athletes only, you're wrong. Kids in high school, junior high and even middle school are taking them. And your child could be among them.

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're also taken to increase muscle mass and energy. But they can cause serious harm. Here's a look at some of the substances your son or daughter might 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, although definitive links to severe illness haven't been established.

Although teens may be taking creatine to bulk up, what actually happens is that your muscles draw water away from the rest of your body. The bulking up you experience is often the result of the extra water stored in your muscles, not increased muscle mass. You don't gain extra strength from water. But you may get seriously dehydrated from the redirection of your body's water to your muscles.

The effects of creatine on children and teens haven't been studied. And most studies of adults have followed participants for only a short time — as little as six weeks — so the long-term effects are unknown.

Androstenedione (andro)
Proponents of andro claim it boosts testosterone production, which in turn increases muscle mass, energy and strength. In reality, andro doesn't do any of that.

On Oct. 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 your child's growth.

In men and women, supplemental androstenedione can decrease high-density lipoprotein (HDL) cholesterol (the "good" cholesterol). Lower HDL levels put 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 as ma-huang, popotillo and ephedrae herba, ephedra can cause such side effects as strokes, seizures and heart attacks — even death. Ephedra can raise your blood sugar and cause an irregular heart rhythm. Long-term use can lead to addiction. If you check the labels of sports energy drinks or energy bars, you may find they include ephedra.

How widely used are performance-enhancing drugs among teens?

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 won't admit using drugs. And testing for drugs in youth sports is an expensive and complex issue that makes widespread testing impractical.

In a survey conducted by Mayo Clinic in 1999, 8.2 percent of teenage athletes reported that they used creatine. This included male and female athletes as young as 14. In other surveys of youth athletes, creatine use ranged from 5.6 percent to 16.4 percent.

The use of anabolic steroids by young athletes has increased, primarily among weightlifters and gymnasts. Studies suggest that 5 percent to 11 percent of high-school boys and 0.5 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. But 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 may 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 peer pressure not to take drugs.

• The psychological effects of some substances, such as greater aggression, feelings of invincibility and euphoria, may be pleasurable enough that an athlete doesn't want to stop taking banned drugs.

• Performance-enhancing drugs may help an athlete develop a body that increases self-esteem and gains him or her admiration from friends, family members and potential girl- or boyfriends.

• Athletes know that some of their competitors take them.

• No tests are available for some drugs, so there's 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 you can do

Is your teen under a lot of pressure? Does your teen plan to compete for athletic scholarships? If so, he or she is under considerable pressure to succeed. And besides the pressure from coaches, parents and peers, teens place a lot of pressure on themselves. Not surprisingly, the pressure may force them to consider using performance-enhancing drugs and supplements.

Try to relieve your teen of this pressure. Reassure your teen of your love and support — even when your child doesn't perform well in competitive sports. If you're worried that your teen may be using performance-enhancing drugs or supplements, here's what you can do:

• Educate yourself. Reading this article 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. If you have time, get involved by writing a letter to the appropriate state agency. Some states have banned all performance-enhancing drugs, including those available over-the-counter.
• 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. Remind your son or daughter that using a performance-enhancing drug not only is similar to cheating, but also could lead to health problems or death. Another key message is that a well-balanced diet and rigorous training are the true keys to athletic performance. You can also appeal to your child's vanity, describing the side effects of performance-enhancing drugs. For example, you can point out that anabolic steroids can cause acne.
• Talk with your teenager's coach. Let the coach know you've talked with your teen and that you don't approve of performance-enhancing drugs. Ask the coach about the school's position on performance-enhancing drugs. Another option is to contact the athletic director of your local school district.
• Monitor your teen's purchases. Take a close look at over-the-counter preparations your teenager takes. Check closely to see what the ingredients are. Pay close attention to what your teen purchases on the Internet.

All children attend health education classes in school. But ultimately it's up to you to talk with your son or daughter about performance-enhancing drugs. Now that you've armed yourself with the facts, you're ready. Remember — teens are smart, they ask tough questions, and they tend to deny risks to their health. So do your best to convey the message that performance-enhancing drugs are risky business.