It is difficult to access the effects associated with AAS
due to numerous methodological shortcomings of many investigations.
They include inappropriate sampling strategies, lack of adequate
control groups, use of varying types, doses and length of administration
of AAS, and the variety of techniques employed to evaluate the
psychological and behavioral outcomes (Bahrke, Yesalis, &
Wright, 1990).
To further problems, most AAS used by athletes are obtained
through the black market making its actual content uncertain
(Bahrke, Yesalis, & Wright, 1990). Samples of AAS found in
the black market often do not contain the ingredients declared
on the label (Walters, Ayers, & Brown, 1990).
 The
effects of AAS vary significantly depending upon the type and
dose of AAS as well as for different individuals and situations
(Yesalis, Wright, & Bahrke, 1989). It may be a serious error
to overgeneralize the effects and potential side effects of specific
AAS to all other AAS. Likewise, it may be also erroneous to assume
the effects and potential side effects of certain steroid use
in relatively large dosage and/or long duration will have the
same effects and potential side effects at a relatively lower
and/or shorter duration.
Some authors attempt to dramatize the dosages of AAS used
by the athletes by drawing reference to the dose usually administered
for specific diseased individuals. This is a misleading reference
to judge athletic dosages, since AAS are often used in varying
dosages for different purposes. For example, Hurley, Seals, Hagberg,
Goldberg, Ostrove, Holloszy, Wiest, & Goldberg (1984) explain
that Oxymetholone (Anadrol) was used by one subject in an average
dosage of 87.5 mg/day. They point out that this dosage is 5.8
times that usually administered for androgen deficiency. The
subjects dosage was approximately 1 mg/kg body weight per day.
The actual recommend dosage for children and adults is 1-5 mg/kg
body weight per day for a minimum of 3 to 6 months (Physicians
Desk Reference, 1993)! Conversely, it is difficult to extrapolate
the potential side effects of a certain steroid therapy on medical
patients, or even a "normal" population for that matter,
to a given athletic population.
Yesalis, Wright, & Bahrke (1989) state;
- "Some members of the sports medicine community have,
with the best intentions, adapted a conservative strategy and
used strong, but often unfounded, pronouncements regarding the
adverse effects of AAS. Athletes, on the other hand, have simply
not witnessed long time AAS users 'dropping like flies'. This
aggressive health education strategy does not seem to have had
a major impact on use of AAS and has very likely added to the
lack of credibility of the sports medicine and scientific communities
in this area. For over 2 decades it was denied (and still is
by some) that AAS enhance physical capacities or performance.
Athletes were told, until 1984, that any weight gained while
taking AAS was merely the result of fluid retention and that
any strength gain was largely psychological (a placebo effect)."
Furthermore, Yesalis, Wright, & Bahrke, (1989) point out
all of the effects of AAS have been demonstrated to be fully
reversible within several months following cessation of use;
except changes in in myocardium which has not been followed.
Although, it has been argued that the long term effects of chronic
AAS use can not be determined with current data. A epidemiological
investigation has been proposed to study the long term effects
of AAS. The study costing approximately $1 million was approved
but was never funded.
Some experts believe legislation against drugs in sports will
only increase an already thriving black market and organized
crime (as what has already began to occur with AAS) (Di Pasquale,
1992b). Traditional drug education has been ineffective. The
use of drugs will likely continue, especially if the incentives
associated with winning remain so high (Di Pasquale, 1992b; Landry
& Primos, 1990).
Di Pasquale (1992b) proposes;
- "Education, an anti-prohibitionist stance, and extensive,
realistic, and knowledgeable medical input and monitoring would
make a substantial difference in how and when drugs are used.
The result would be fewer short and long term side effects (both
due to excessive use of these compounds and to contaminated or
dangerous black market drugs), less crime and violence, and likely,
in the long term, a decrease in the overall use of performance-enhancing
compounds."
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