Interventions

Adolescent anabolic steroid abuse has been a pertinent issue within the last decade in the United States. Due to increased use among teens within the past decade, there have been many implementations as well as programs set in order to try to intervene with this trend. The Anabolic Steroids Control Act of 1990 was the first step towards federal intervention. This act was later amended with the Anabolic Steroid Control Act of 2004 which redefined anabolic steroid to mean any drug or hormonal substance, chemically and pharmacologically related to testosterone (108th Congress, 2004). This law put possession punishable by up to a year in prison and a fine of at least $1000 (Association Against Steroid Abuse). Additionally, selling steroids or even possessing steroids with an intent to sell may face up to five years in prison plus parole and sizable fines . This strategy generally addresses the key determinant of risk factors as well as the ease of attaining steroids.

In addition to this law, there was also prevention programs established for adolescents, targeting mainly teens aged 13-18. The most widespread drug prevention program is ATLAS (Athletes Training and Learning to Avoid Steroids), which is implemented within schools. ATLAS was designed for male high school athletes to attempt to stop drug use and promote healthy diet and exercise alternatives to drugs. The curriculum consists of 10 45-minute interactive classroom sessions and 3 exercise training sessions taught by peer educators, coaches, and strength trainers. In these classes, they discuss sports nutrition, exercise alternatives to anabolic steroids and sports supplements, and the effects of substance abuse in sports (Substance Abuse and Mental Health Services Administration, 2012). With this knowledge, the key determinants of body image and desire to improve performance are addressed since the negatives behind those positives are exposed.

Due to the effectiveness that this form of intervention has proven, the first primary intervention that I would recommend is continual education of adolescents in school on anabolic steroids. The key determinant that this desire in gains in body image by adolescents, which generally encompasses increased muscle mass and strength for males and losing weight for females. There have been several studies and intervention programs that show the success of such educational programs. In teaching teens the effects of anabolic steroids through school, a large sample of individuals can be reached and in turn, many students become more cautious when it comes to using anabolic steroids. For example, in the ATLAS program, since its implementation, there have been more than 1,500 football players from 31 high schools in the Portland area that stopped using steroids (Office of Juvenile Justice and Delinquency Prevention, 2011).

The second form of intervention would tackle behavioral key determinants. It has been documented that about 25 percent of male weightlifters that abused steroids reported memories of childhood physical or sexual abuse. Female weightlifters that were raped were also twice as likely to report use of anabolic steroids when compared to those who had not been raped (National Institute on Drug Abuse, 2001). Also, behavioral problems such as substance abuse, fighting, low self-esteem, and depression are common predictors of adolescent steroid use (Irving, Wall, NeumarkSztainer, & Story, 2002). Due to this fact, individual counseling within the school or suggested by the school for students exhibiting such behaviors or students that personally seek out counseling would benefit from trying to fix the internal issues that may be causing them to take anabolic steroids. This serves as secondary intervention for the students that have already started taking steroids.

A third form of intervention would be active drug testing. This would take into consideration the key determinants of risky behavior of adolescents, as well as the ease to attain steroids by teens since there would be consequences behind taking steroids. According to a 2005 "Monitoring the Future Survey", the annual prevalence of steroid use among males gradually increased, from a 1.5% use in 8th grade to 2.5% use in 10th grade to about a 3.3% use in 12th grade.  Also, between 1998 and 2003, the percentage of 12th-grade students who perceived steroids as risky and disapproved their use dropped from 68% to 55%, despite increased health warnings (National Institute on Drug Abuse, 2001). In order to address the fact that adolescents are becoming increasingly comfortable with the idea of steroids alongside the fact that they are easy to attain, random drug tests for athletes that attend competitions would be a major determinant for the adolescent for whether or not it is worth it to take steroids. This would be secondary prevention since the adolescent would have to have taken steroids to be detected and also primary for students that choose not to take steroids because they know such tests will be conducted.

The best form of intervention for anabolic steroid use among adolescents has seemed to point greatly towards prevention through education of the effects of anabolic steroids. Most individuals that abuse steroids have a false perception of what the steroid can do to help, although are not aware of all the negatives associated with anabolic steroid abuse. Since many individuals will not go out and look for counseling, such programs that are taught in schools to a greater population of students would benefit larger numbers. Also, in active drug testing, the issue of invasion of privacy as well as the costs of doing so both financially and morally within the school system would cause trouble when actually trying to implement them. In addition, athletes are not the only individuals that take steroids, so it would not cover everyone that steroids could affect.

References
Association Against Steroid Abuse . (n.d.). Legal ramifications of steroid abuse. Steroid Abuse , Retrieved from http://www.steroidabuse.com/legal-ramifications-of-steroid-abuse.html

Irving, L. M., Wall, M., Neumark-Sztainer, D., & Story, M. (2002). Steroid use among adolescents: Findings from Project EAT. Journal of Adolescent Health, 30, 243–252.

National Institute on Drug Abuse. (2001). Anabolic steroid abuse . National Insititute on Drug Abuse Research Report series, NIH Pub Number: 06-3721, Retrieved from http://www.drugabuse.gov/publications/research-reports/anabolic-steroid-abuse

Office of Juvenile Justice and Delinquency Prevention. (n.d.). Ojjdp model programs guide . (2011).Athletes Training and Learning to Avoid Steroids (ATLAS), Retrieved from http://www.ojjdp.gov/mpg/Athletes Training and Learning to Avoid Steroids (ATLAS)-MPGProgramDetail-592.aspx

S. 2195--108th Congress: Anabolic Steroid Control Act of 2004. (2004). In www.GovTrack.us. Retrieved April 6, 2013, from http://www.govtrack.us/congress/bills/108/s2195 

Substance Abuse and Mental Health Services Administration. Intervention summary. (2012). ATLAS (Athletes Training and Learning To Avoid Steroids), Retrieved from http://www.nrepp.samhsa.gov/ViewIntervention.aspx?id=77