- by Dr. Robert C. Martin

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Sports have become phenomenally popular worldwide. Successful athletes frequently become instant celebrities, with lucrative commercial opportunities. Unfortunately, some of those athletes use illegal substances to give themselves a competitive edge. A 1997 poll in Sports Illustrated asked current and aspiring US Olympic athletes' two questions. The first was whether they would take a banned performance-enhancing drug if they were guaranteed to both win their athletic event and not get suspended for drug use. The second question was whether they would take the same substance if it would enhance their ability to win every competition for the next 5 years but then result in death. Remarkably, 98% responded "yes" to the first question, and more than 50% responded "yes" to the second question.

Because successful athletes are looked on as role models in our society, many people in the general population try to emulate their actions, even when that involves taking substances with major side effects that can cause permanent physical harm and even death. For example, it is estimated that as many as 3 million athletes in the United States have used anabolic steroids for non-medically prescribed applications.

Historically, using performance-enhancing drugs is nothing new in sport. The first Olympic games took place in Greece in 776 BC. From sources documenting specific training and dietary regimens for athletes in ancient times we know that some of them ate hallucinogenic mushrooms and sesame seeds to enhance performance. Although the modern Olympic games commenced in 1896, scientific and medical interest in the diet and training of Olympic athletes did not begin until 1922. Testosterone, the primary male hormone, was first synthesized in 1935, and in the 1940's, athletes began taking derivatives of testosterone known as anabolic steroids to increase muscle mass. Throughout the 1950's and 1960's, amphetamines and anabolic steroids were used extensively in sports. After many years of use the side effects of these drugs became evident such as damage to the liver, reproductive organs, heart and skin. Anabolic steroids can also cause tendons to rupture, psychosis and suicidal behavior. Despite the risks associated with taking these substances athletes continue to use them to gain an advantage over their competitors. Contrary to what most people think this is not just a problem of professional athletes.

The prevalence of self-reported use of anabolic steroids by adolescent athletes is as high as 11% for boys and 2.5% for girls. Other data shows that 4.4% of all male high school seniors had initiated steroid use at 16 years of age or younger. In studies of adults the prevalence of self-reported steroid use has been as high as 15%. The National Football League first tested for anabolic steroids in 1988 and reported 6% of professional football players had taken them.

Unfortunately, some athletes have developed a "win at any cost" mentality. They are willing to do whatever is needed to enhance their chances of victory, even if it is both illegal and potentially physically harmful. We must take every opportunity to educate young people in sports who may be tempted to experiment in this area. Hopefully inspiration will come from athletes like Lance Armstrong who just won the Tour de France for the third time in record fashion during which he repeatedly tested negative for banned substances.