National athletic trainers' association position statement: Anabolic-androgenic steroids

Journal of Athletic Training

Volumn 47, Issue 5, 2012, Pages 567-588

  Kersey, Robert D ^a   Elliot, Diane L ^b   Goldberg, Linn ^b   Kanayama, Gen ^c   Leone, James E ^a,d   Pavlovich, Mike ^e   Pope, Harrison G ^c  

^a CALIFORNIA STATE UNIVERSITY   (United States)

^b OREGON HEALTH AND SCIENCE UNIVERSITY   (United States)

^c HARVARD MEDICAL SCHOOL   (United States)

^d BRIDGEWATER STATE UNIVERSITY   (United States)

^e Westcliff Compounding Pharmacy   (United States)

Author keywords

Abuse; Androgen; Athletes; Doping; Drugs; Ergogenic aids; Sport; Testosterone

Indexed keywords

ANABOLIC AGENT; DRUG DERIVATIVE; TESTOSTERONE; TESTOSTERONE DERIVATIVE;

ADDICTION; ARTICLE; ATHLETE; ATHLETIC PERFORMANCE; DOPING; HEALTH CARE PERSONNEL; HEALTH EDUCATION; HUMAN; PRACTICE GUIDELINE; SPORT; SPORTS MEDICINE;

ANABOLIC AGENTS; ATHLETES; ATHLETIC PERFORMANCE; DOPING IN SPORTS; HEALTH EDUCATION; HEALTH PERSONNEL; HUMANS; SPORTS; SPORTS MEDICINE; SUBSTANCE-RELATED DISORDERS; TESTOSTERONE; TESTOSTERONE CONGENERS;

EID: 84867928878     PISSN: 10626050     EISSN: None     Source Type: Journal    
DOI: 10.4085/1062-6050-47.5.08     Document Type: Article

References (149)

1. Dotson JL, Brown RT. The history of the development of anabolicandrogenic steroids. Pediatr Clin North Am. 2007;54(4):761-769.
2. Hoberman JM, Yesalis CE. The history of synthetic testosterone. Sci Am. 1995;272(2):76-81.
3. McCabe SE, Brower KJ, West BT, Nelson TF, Wechsler H. Trends in non-medical use of anabolic steroids by U.S. college students: results from four national surveys. Drug Alcohol Depend. 2007;90(2-3):243-251. (Pubitemid 47287715)
4. Fitch KD. Androgenic-anabolic steroids and the Olympic Games. Asian J Androl. 2008;10(3):384-390. (Pubitemid 351584114)
5. Todd T. Anabolic steroids: the gremlins of sport. J Sport Hist. 1987;14(1):87-107.
6. Ottenbacher KJ, Ottenbacher ME, Ottenbacher AJ, Acha AA, Ostir GV. Androgen treatment and muscle strength in elderly men: a meta-analysis. J Am Geriatr Soc. 2006;54(11):1666-1673. (Pubitemid 44665204)
7. Basaria S, Wahlstrom JT, Dobs AS. Clinical review: anabolicandrogenic steroid therapy in the treatment of chronic diseases. J Clin Endocrinol Metab. 2001;86(11):5108-5117. (Pubitemid 33070222)
8. Kersey RD. Anabolic-androgenic steroid use among California community college student-athletes. J Athl Train. 1996;31(3):237-241. (Pubitemid 126490095)
9. Perry PJ, Lund BC, Deninger MJ, Kutscher EC, Schneider J. Anabolic steroid use in weightlifters and bodybuilders: an Internet survey of drug utilization. Clin J Sport Med. 2005;15(5):326-330. (Pubitemid 41376954)
10. Ebell MH, Siwek J, Weiss BD, et al. Strength of recommendation taxonomy (SORT): a patient-centered approach to grading evidence in the medical literature. Am Fam Physician. 2004;69(3):548-556. (Pubitemid 38176273)
11. Buttner A, Thieme D. Side effects of anabolic androgenic steroids: pathological findings and structure-activity relationships. Handb Exp Pharmacol. 2010;195:459-484.
12. Casavant MJ, Blake K, Griffith J, Yates A, Copley LM. Consequences of use of anabolic androgenic steroids. Pediatr Clin North Am. 2007;54(4):677-690. (Pubitemid 47302016)
13. Thevis M, Schanzer W. Synthetic anabolic agents: steroids and nonsteroidal selective androgen receptor modulators. Handb Exp Pharmacol. 2010;195:99-126.
14. Kicman A. Pharmacology of anabolic steroids. Br J Pharmacol. 2008;154(3):502-521. (Pubitemid 351744954)
15. Srinivas-Shankar U, Wu FC. Drug insight: testosterone preparations. Nat Clin Pract Urol. 2006;3(12):653-665.
16. Freeman ER, Bloom DA, McGuire EJ. A brief history of testosterone. J Urol. 2001;165(2):371-373. (Pubitemid 32060415)
17. Calof OM, Singh AB, Lee ML, et al. Adverse events associated with testosterone replacement in middle-aged and older men: a meta-analysis of randomized, placebo-controlled trials. J Gerontol A Biol Sci Med Sci. 2005;60(11):1451-1457. (Pubitemid 41798454)
18. Isidori AM, Giannetta E, Granfilli D, et al. Effects of testosterone on sexual function in men: results of a meta-analysis. Clin Endocrinol (Oxf). 2005;63(4):381-394. (Pubitemid 41442332)
19. Bolona ER, Uraga MV, Haddad RM, et al. Testosterone use in men with sexual dysfunction: a systematic review and meta-analysis of randomized placebo-controlled trials. Mayo Clin Proc. 2007;82(1):20-28. (Pubitemid 46036318)
20. Tracz MJ, Sideras K, Bolona ER, et al. Clinical review: testosterone use in men and its effects on bone health. A systematic review and meta-analysis of randomized placebo-controlled trials. J Clin Endocrinol Metab. 2006;91(6):2011-2016. (Pubitemid 43854973)
21. Pope HG, Katz D. Psychiatric effects of exogenous anabolicandrogenic steroids. In: Wolkowitz OM, Rothschild AJ, eds. Psychoneuroendocrinology: The Scientific Basis of Clinical Practice. Washington, DC: American Psychiatric Press; 2003:331-358.
22. Maravelias C, Dona A, Stefanidou M, Spiliopoulou C. Adverse effects of anabolic steroids in athletes: a constant threat. Toxicol Lett. 2005;158(3):167-175. (Pubitemid 41074813)
23. Kawada S, Okuno M, Ishii N. Testosterone causes decrease in the content of skeletal muscle myostatin. Int J Sport Health Sci. 2006;4:44-48.
24. Orr R, Fiatarone Singh M. The anabolic androgenic steroid oxandrolone in the treatment of wasting and catabolic disorders: review of efficacy and safety. Drugs. 2004;64(7):725-750. (Pubitemid 38471373)
25. Isidori AM, Giannetta E, Greco EA, et al. Effects of testosterone on body composition, bone metabolism and serum lipid profile in middle-aged men: a meta-analysis. Clin Endocrinol (Oxf). 2005;63(3):280-293. (Pubitemid 41233445)
26. Grimes DA, Gallo MF, Grigorieva V, Nanda K, Schulz KF. Steroid hormones for contraception in men: systematic review of randomized controlled trials. Contraception. 2005;71(2):89-94. (Pubitemid 40222059)
27. Johns K, Beddall MJ, Corrin RC. Anabolic steroids for the treatment of weight loss in HIV-infected individuals. Cochrane Database Syst Rev. 2005;(4);CD005483.
28. Kong A, Edmonds P. Testosterone therapy in HIV wasting syndrome: systematic review and meta-analysis. Lancet Infect Dis. 2002;2(11):692-699. (Pubitemid 35265065)
29. Moyle GJ, Schoelles K, Fahrbach K, et al. Efficacy of selected treatments of HIV wasting: a systematic review and meta-analysis. J Acquir Immune Defic Syndr. 2004;37(suppl 5):S262-S276. (Pubitemid 39602328)
30. Ferreira IM, Brooks D, Lacasse Y, Goldstein RS. Nutritional intervention in COPD: a systematic overview. Chest. 2001;119(2): 353-363. (Pubitemid 32163743)
31. Rambaldi A, Iaquinto G, Gluud C. Anabolic-androgenic steroids for alcoholic liver disease: a Cochrane revew. Am J Gastroenterol. 2002;97(7):1674-1681. (Pubitemid 34761388)
32. Villaca DS, LerariO MC, Dal Corso S, Neder JA. New treatments for chronic obstructive pulmonary disease using ergogenic aids. J Bras Pneumol. 2005;32(1):66-74.
33. Conway AJ, Handelsman DJ, Lording DW, Stuckey B, Zajac JD. Use, misuse and abuse of androgens: The Endocrine Society of Australia consensus guidelines for androgen prescribing. Med J Aust. 2000;172(5):220-224. (Pubitemid 30140126)
34. Wroble RR, Gray M, Rodrigo JA. Anabolic steroids and preadolescent athletes: prevalence, knowledge, and attitudes. Sport J. 2002;5(3):1-8.
35. Centers for Disease Control and Prevention. Youth Risk Behavior Surveillance - United States: surveillance summaries, 2009. MMWR Morbid Mortal Wkly Rep. 2010;59(SS-5).
36. Kokkevi A, Fotiou A, Chileva A, Nociar A, Miller P. Daily exercise and anabolic steroids use in adolescents: a cross-national European study. Subst Use Misuse. 2008;43(14):2053-2065.
37. National Collegiate Athletic Association. National Study of Substance Use Trends Among NCAA College Student-Athletes. Indianapolis, IN: National Collegiate Athletic Association; 2012.
38. Tricker R, O'Neill MR, Cook D. The incidence of anabolic steroid use among competitive bodybuilders. J Drug Educ. 1989;19(4): 313-325. (Pubitemid 20099104)
39. Horn S, Gregory P, Guskiewicz KM. Self-reported anabolicandrogenic steroids use and musculoskeletal injuries: findings from the Center for the Study of Retired Athletes health survey of retired NFL players. Am J Phys Med Rehabil. 2009;88(3):192-200.
40. Wagman DF, Curry LA, Cook DL. An investigation into anabolic androgenic steroid use by elite U.S. powerlifters. J Strength Cond Res. 1995;9(3):149-154.
41. Buckley WE, Yesalis CE 3rd, Friedl KE, Anderson WA, Streit AL, Wright JE. Estimated prevalence of anabolic steroid use among male high school seniors. JAMA. 1988;260(23):3441-3445. (Pubitemid 19003122)
42. Stilger VG, Yesalis CE. Anabolic-androgenic steroid use among high school football players. J Community Health. 1999;24(2):131-145. (Pubitemid 29162838)
43. vandenBerg P, Neumark-Sztainer D, Cafri G, Wall M. Steroid use among adolescents: longitudinal findings from Project EAT. Pediatrics. 2007;119(3):476-486. (Pubitemid 46407516)
44. Bolding G, Sherr L, Elford J. Use of anabolic steroids and associated health risks among gay men attending London gyms. Addiction. 2002;97(2):195-203. (Pubitemid 34112378)
45. Baker JS, Graham MR, Davies B. Steroid and prescription medicine abuse in the health and fitness community: a regional study. Eur J Intern Med. 2006;17(7):479-484. (Pubitemid 44708733)
46. Dodge TL, Jaccard JJ. The effect of high school sports participation on the use of performance-enhancing stustances in young adulthood. J Adolesc Health. 2006;39(3):367-373. (Pubitemid 44224126)
47. The European School Survey Project on Alcohol and Other Drugs. The 2007 ESPAD Report: Substance Use Among Students in 35 European Countries. Stockholm, Sweden: The Swedish Council for Information on Alcohol and Other Drugs; 2009.
48. Kanayama G, Gruber AJ, Pope HG, Jr, Borowiecki JJ, Hudson JI. Over-the-counter drug use in gymnasiums: an unrecognized substance abuse problem? Psychother Psychosom. 2001;70(3): 137-140. (Pubitemid 32429714)
49. Santos AM, da Rocha MS, da Silva M. Illicit use and abuse of anabolic-androgenic steroids among Brazilian bodybuilders. Subst Use Misuse. 2011;46(6):742-748.
50. Clark AS, Henderson LP. Behavioral and physiological responses to anabolic-androgenic steroids. Neurosci Biobehav Rev. 2003;27(5): 413-436. (Pubitemid 37167993)
51. Hartgens F, Kuipers H. Effects of androgenic-anabolic steroids in athletes. Sports Med. 2004;34(8):513-554. (Pubitemid 38981844)
52. Ozcelik O, Haytac MC, Seydaoglu G. The effects of anabolic androgenic steroid abuse on gingival tissues. J Periodontol. 2006;77(7):1104-1109. (Pubitemid 44725015)
53. Hoffman JR, Faigenbaum AD, Ratamess NA, Ross R, Kang J, Tenenbaum G. Nutritional supplementation and anabolic steroid use in adolescents. Med Sci Sports Exerc. 2008;40(1):15-24.
54. Pope HG Jr, Kouri EM, Hudson JI. Effects of supraphysiologic doses of testosterone on mood and aggression in normal men: a randomized controlled trial. Arch Gen Psychiatry. 2000;57(2):133-140. (Pubitemid 30075263)
55. Parssinen M, Seppala T. Steroid use and long-term health risks in former athletes. Sports Med. 2002;32(2):83-94. (Pubitemid 34161069)
56. Hoffman JR, Ratamess NA. Medical issues associated with anabolic steroid use: are they exaggerated? J Sports Sci Med. 2006;5(2):182-193.
57. Lichtenbelt WDVM, Hartgens F, Vollaard NBJ, Ebbing S, Kuipers H. Bodybuilders' body composition: effect of nandrolone decanoate. Med Sci Sports Exerc. 2004;36(3):484-489. (Pubitemid 38298701)
58. Bhasin S, Woodhouse L, Casaburi R, et al. Older men are as responsive as young men to the anabolic effects of graded doses of testosterone on the skeletal muscle. J Clin Endocrinol Metab. 2005;90(2):678-688. (Pubitemid 40279179)
59. Rogerson S, Weatherby RP, Deakin GB, et al. The effect of shortterm use of testosterone enanthate on muscular strength and power in healthy young men. J Strength Cond Res. 2007;21(2):354-361.
60. Bhasin S, Storer TW, Berman N, et al. The effects of supraphysiological doses of testosterone on muscle size and strength in normal males. New Engl J Med. 1996;335(1):1-7. (Pubitemid 26230806)
61. Giorgi A, Weatherby RP, Murphy PW. Muscular strength, body composition and health responses to the use of testosterone enanthate: a double blind study. J Sci Med Sport. 1999;2(4):341-355. (Pubitemid 30043851)
62. Borst SE. Interventions for sarcopenia and muscle weakness in older people. Age Ageing. 2004;33(6):548-555. (Pubitemid 39504285)
63. O'Shea JP. The effects of an anabolic steroid on dynamic strength levels of weightlifters. Nutr Rep Int. 1971;4:363-370.
64. Johnson LC, Fisher G, Silvester JL, Hofheins CC. Anabolic steroid: effects on strength, body weight, oxygen uptake and spermatogenesis upon mature males. Med Sci Sports 1972;4(1):43-45.
65. Hervey G, Knibbs A, Burkinshaw L, et al. Effects of methandienone on the performance and body composition of men undergoing athletic training. Clin Sci (Lond). 1981;60(4):457-461. (Pubitemid 11123453)
66. Storer TW, Magliano L, Woodhouse L, et al. Testosterone dosedependently increases maximal voluntary strength and leg power, but does not affect fatigability or specific tension. J Clin Endocrinol Metab. 2003;88(4):1478-1485. (Pubitemid 36636978)
67. Kanayama G, Hudson JI, Pope HG, Jr. Long-term psychiatric and medical consequences of anabolic-androgenic steroid abuse: a looming public health concern? Drug Alcohol Depend. 2008;98(1-2):1-12.
68. Pope HG Jr, Katz DL. Psychiatric and medical effects of anabolicandrogenic steroid use: a controlled study of 160 athletes. Arch Gen Psychiatry. 1994;51(5):375-382. (Pubitemid 24176815)
69. Gruber AJ, Pope HG Jr. Psychiatric and medical effects of anabolicandrogenic steroid use in women. Psychother Psychosom. 2000;69(1):19-26.
70. Choi PY, Pope HG, Jr. Violence toward women and illicit androgenic-anabolic steroid use. Ann Clin Psychiatry. 1994;6(1): 21-25. (Pubitemid 24222613)
71. Perry PJ, Kutscher EC, Lund BC, Yates WR, Holman TL, Demers L. Measures of aggression and mood changes in male weightlifters with and without androgenic anabolic steroid use. J Forensic Sci. 2003;48(3):646-651. (Pubitemid 36538838)
72. Petersson A, Garle M, Granath F, Thiblin I. Morbidity and mortality in patients testing positively for the presence of anabolic androgenic steroids in connection with receiving medical care: a controlled retrospective cohort study. Drug Alcohol Depend. 2006;81(3):215-220. (Pubitemid 43152447)
73. Petersson A, Garle M, Holmgren P, Druid H, Krantz P, Thiblin I. Toxicological findings and manner of death in autopsied users of anabolic androgenic steroids. Drug Alcohol Depend. 2006;81(3): 241-249. (Pubitemid 43152450)
74. Thiblin I, Kristiansson M, Rajs J. Anabolic androgenic steroids and behavioral patterns among violent offenders. J Forensic Sci. 1997;8(2):299-310. (Pubitemid 27405839)
75. Thiblin I, Parlklo T. Anbolic androgenic steroids and violence. Acta Psychiatrica Scand Suppl. 2002;106:125-128.
76. Klotz F, Garle M, Granath F, Thiblin I. Criminality among individuals testing positive for the presence of anabolic-androgenic steroids. Arch Gen Psychiatry. 2006;63(11):1274-1279. (Pubitemid 44708086)
77. Yates WR, Perry PJ, MacIndoe J, Holman T, Ellingrod V. Psychosexual effects of three doses of testosterone cycling in normal men. Biol Psychiatry. 1999;45(3):254-460.
78. Su TP, Pagliaro M, Schmidt PJ, Pickar D, Wolkewitz D, Rubinow DR. Neuropsychiatric effects of anabolic steroids in male normal volunteers. JAMA. 1993;269(21):2760-2764. (Pubitemid 23154250)
79. Brower KJ. Anabolic steroid abuse and dependence. Curr Psychiatry Rep. 2002;4(5):377-387.
80. Malone DA Jr, Dimeff RJ, Lombardo JA, Sample BR. Psychiatric effects and psychoactive substance use in anabolic-androgenic steroid users. Clin J Sport Med. 1996;5(1):25-31.
81. Schmidt PJ, Berlin KL, Danaceau MA, et al. The effects of pharmacologically induced hypogonadism on mood in healthy men. Arch Gen Psychiatry. 2004;61(10):997-1004. (Pubitemid 39336533)
82. Kanayama G, Brower KJ, Wood RI, Hudson JI, Pope HG Jr. Anabolic-androgenic steroid dependence: an emerging disorder. Addiction. 2009;104(12):1966-1978.
83. Kanayama G, Hudson JI, Pope HG Jr. Features of men with anabolic-androgenic steroid dependence: a comparison with nondependent AAS users and with AAS nonusers. Drug Alcohol Depend. 2009;102(1-3):130-137.
84. Kanayama G, Brower KJ, Wood RI, Hudson JI, Pope HG Jr. Treatment of anabolic-androgenic steroid dependence: emerging evidence and its implications. Drug Alcohol Depend. 2010;109(1-3):6-13.
85. Kanayama G, Barry S, Hudson JI, Pope HG Jr. Body image and attitudes toward male roles in anabolic-androgenic steroid users. Am J Psychiatry. 2006;163(4):697-703. (Pubitemid 44464581)
86. Cole JC, Smith R, Halford JCG, Wagstaff GF. A preliminary investigation into the relationship between anabolic-androgenic steroid use and the symptoms of reverse anorexia in both current and ex-users. Psychopharmacology (Berl). 2003;166(4):424-429. (Pubitemid 36469945)
87. Tan RS, Scally MC. Anabolic steroid-induced hypogonadism: towards a unified hypothesis of anabolic steroid action. Med Hypotheses. 2009;72(6):723-728.
88. Frye CA. Some rewarding effects of androgens may be mediated by actions of its 5α-reduced metabolite 3α-androstanediol. Pharmacol Biochem Behav. 2007;86(2):354-367.
89. Peters KD, Wood RI. Androgen dependence in hamsters: overdose, tolerance, and potential opioidergic mechanism. Neuroscience. 2004;130(4):971-981. (Pubitemid 40094629)
90. Kanayama G, Pope HG, Cohane GH, Hudson JI. Risk factors for anabolic-androgenic steroid use among weightlifters: a case-control study. Drug Alcohol Depend. 2003;71(1):77-86. (Pubitemid 36734861)
91. Arvary D, Pope HG Jr. Anabolic-androgenic steroids as a gateway to opioid dependence. New Engl J Med. 2000;342(20):1532. (Pubitemid 30318288)
92. Garevik N, Rane A. Dual use of anabolic-androgenic steroids and narcotics in Sweden. Drug Alcohol Depend. 2010;109(1-3):144-146.
93. Pope HG Jr, Kanayama G, Hudson JI. Risk factors for illicit anabolic-androgenic steroid use in male weightlifters: a crosssectional cohort study. Biol Psychiatry. 2012;71(3):254-261.
94. Dhar R, Stout CW, Link MS, Homoud MK, Weinstock J, Estes NM III. Cardiovascular toxicities of performance-enhancing substances in sport. Mayo Clin Proc. 2005;80(10):1307-1315. (Pubitemid 41395964)
95. Vanberg P, Atar D. Androgenic anabolic steroid abuse and the cardiovascular system. Handb Exp Pharmacol. 2010;195:411-457.
96. D'Andrea A, Caso P, Salerno G, et al. Left ventricular early myocardial dysfunction after chronic misuse of anabolic androgenic steroids: a Doppler myocardial and strain imaging analysis. Br J Sports Med. 2007;41(3):149-155. (Pubitemid 46579900)
97. Hasson N, Salem M, Sayed M. Doping and effects of anabolicandrogenic steroids on the heart: histological, ultrastructural, and echocardiographic assessment in strength athletes. Hum Exp Toxicol. 2009;28(5):273-283.
98. Melchert RB, Welder AA. Cardiovascular effects of androgenicanabolic steroids. Med Sci Sports Exerc. 1995;27(9):1252-1262.
99. Kasikcioglu E, Oflaz H, Umman B, Burgra Z. Androgenic anabolic steroids also impair right ventricular function. Int J Cardiol. 2009;134(1):123-125.
100. Nottin S, Nguyen LD, Terbah M, Obert P. Cardiovascular effects of androgenic-anabolic steroids in male bodybuilders determined by tissue Doppler imaging. Am J Cardiol. 2006;97(6):912-915.
101. Baggish A, Weiner R, Kanayama G, et al. Long-term anabolicandrogenic steroid use is associated with left ventricular dysfunction. Circ Heart Fail. 2010;3(4):472-476.
102. Hartgens F, Rietjens G, Keizer HA, Kuipers HA, Wilffenbuttel BH. Effects of androgenic-anabolic steroids on apolipoproteins and lipoprotein (a). Br J Sports Med. 2004;38(3):253-259. (Pubitemid 38748112)
103. Santora LJ, Marin J, Vangrow J, et al. Coronary calcification in body builders using anabolic steroids. Prev Cardiol. 2006;9(4):198-201.
104. Soe KL, Soe M, Gluud C. Liver pathology associated with the use of anabolic-androgenic steroids. Liver. 1992;12(2):73-79.
105. Ding EL, Song Y, Malik VS, Liu S. Sex differences of endogenous sex hormones and risk of type 2 diabetes: a systematic review and meta-analysis. JAMA. 2006;295(11):1288-1299.
106. Beiner JM, Jokl P, Cholewicki J, Panjabi MM. The effect of anabolic steroids and corticosteroids on healing of muscle contusion injury. Am J Sports Med. 1999;27(1):2-9. (Pubitemid 29056674)
107. Marshall-Gradisnik S, Green R, Brenu EW, Weatherby RP. Anabolic androgenic steroids effects on the immune system: a review. Cent Eur J Biol. 2009;4(1):19-33.
108. Walker J, Adams B. Cutaneous manifestations of anabolicandrogenic steroid use in athletes. Int J Dermatol. 2009;48(10): 1044-1048.
109. Melnik B, Jansen T, Grabbe S. Abuse of anabolic-androgenic steroids and bodybuilding acne: an underestimated health problem. J Dtsch Dermatol Ges. 2007;5(2):110-117. (Pubitemid 46212727)
110. Daher EF, Silva GB Jr, Queiroz AL, et al. Acute kidney injury due to anabolic steroid and vitamin supplement abuse: report of two cases and a literature review. Nephrology. 2009;41(3):717-723.
111. Herlitz LC, Markowitz GS, Farris AB, et al. Development of focal segmental glomerulosclerosis after anabolic steroid abuse. J Am Soc Nephrol. 2009:21(1):163-172.
112. Barros TSP, Santos MBF, Shinozaki EB, Santos JFF, Marchini L. Effects of use of anabolic steroids on the masticatory system: a pilot study. J Oral Sci. 2008;51(1):19-24.
113. Masteralexis LP. Drug testing provisions: an examination of disparities in rules and collective bargaining agreement provisions. New Engl Law Rev. 2006;40:775-788.
114. Goldberg L, Elliot DL, MacKinnon DP, et al. Outcomes of a prospective trial of student-athlete drug testing: the Student Athlete Testing Using Random Notification (SATURN) study. J Adolesc Health. 2007;41(5):421-429. (Pubitemid 47562800)
115. Bahr RT, Tjornhom M. Prevalence of doping in sports: doping control in Norway, 1977-1995. Clin J Sport Med. 1998;8(1):32-37. (Pubitemid 28050889)
116. Elliot DL, Goldberg L, Moe EL, Defrancesco CA, Durham MB, Hix-Small H. Preventing substance use and disordered eating: initial outcomes of the ATHENA (Athletes Targeting Healthy Exercise and Nutrition Alternatives) program. Arch Pediatr Adolesc Med. 2004;158(11):1043-1049. (Pubitemid 39458492)
117. Goldberg L, Elliot DL, Clarke GN, et al. Effects of a multidimensional anabolic steroid prevention intervention: the Adolescents Training and Learning to Avoid Steroids (ATLAS) program. JAMA. 1996;276(19):1555-1562. (Pubitemid 26384737)
118. Goldberg L, MacKinnon DP, Elliot DL, Moe EL, Clarke G, Cheong J. The Adolescents Training and Learning to Avoid Steroids program: preventing drug use and promoting healthy behaviors. Arch Pediatr Adolesc Med. 2000;154(4):332-338. (Pubitemid 30198478)
119. Elliot DL, Moe EL, Goldberg L, DeFrancesco CA, Durham MB, Hix-Small H. Definition and outcome of a curriculum to prevent disordered eating and body-shaping drug use. J Sch Health. 2006;76(2):67-73. (Pubitemid 43446069)
120. Nilsson S, Allebeck P, Marklund B, Baigi A, Fridlund B. Evaluation of a health promotion programme to prevent the misuse of androgenic anabolic steroids among Swedish adolescents. Health Promot Int. 2004;19(1):61-67. (Pubitemid 38364804)
121. Backhouse S, McKenna J, Patterson L. Social Science Research Fund: Prevention through Education: A Review of Current International Social Science Literature. Leeds, UK: Leeds Metropolitan University, Carnegie Research Institute; 2009.
122. Elliot DL, Goldberg L, Moe EL, et al. Long-term outcomes of the ATHENA (Athletes Targeting Healthy Exercise & Nutrition Alternatives) program for female high school athletes. J Alcohol Drug Educ. 2008;52(2):73-92.
123. Ranby KW, Aiken LS, MacKinnon DP, et al. A mediation analysis of the ATHENA intervention for female athletes: prevention of athletic-enhancing substance use and unehealthy weight loss behaviors. J Pediatr Psychol. 2009;34(10):1069-1083.
124. MacKinnon DP, Goldberg L, Clarke GN, et al. Mediating mechanisms in a program to reduce intentions to use anabolic steroids and improve exercise self-efficacy and dietary behavior. Prev Sci. 2001;2(1):15-28.
125. Leone JE, Gray KA, Rossi JM. Using the transtheoretical model to explain androgenic-anabolic steroid use in adolescents and young adults, part one. Strength Cond J. 2008;30(6):47-54.
126. Leone JE, Gray KA, Rossi J, Colandreo RM. Using the transtheoretical model to explain androgenic-anabolic steroid use in adolescents and young adults, part two. Strength Cond J. 2009;31(1):13-22.
127. Graham MR, Davies B, Grace FM, Kicman A, Baker JS. Anabolic steroid use: patterns of use and detection of doping. Sports Med. 2008;38(6):505-525. (Pubitemid 351704855)
128. Kanayama G, Cohane GH, Weiss RD, Pope HG Jr. Past anabolicandrogenic steroid use among men admitted for substance abuse treatment: an underrecognized problem? J Clin Psychiatry. 2003;64(2):156-160. (Pubitemid 36268318)
129. Kanayama G, Boynes M, Hudson JI, Field A, Pope HG Jr. Anabolic steroid abuse among teenage girls: an illusionary problem? Drug Alcohol Depend. 2007;88(2-3):156-162. (Pubitemid 46509465)
130. Fahey TD, Brown CH. The effects of an anabolic steroid on the strength, body composition, and endurance of college males when accompanied by a weight training program. Med Sci Sports. 1973;5(4):272-276.
131. Stromme S, Meen HD, Hakvaag A. Effects of an androgenicanabolic steroid on strength development and plasma testosterone levels in normal males. Med Sci Sports Exerc. 1974;6(3):203-208.
132. Baume N, Schumacher YO, Sottas PE, et al. Effect of multiple oral doses of androgenic anabolic steroids on endurance performance and serum indices of physical stress in healthy male subjects. Eur J Appl Physiol. 2006;98(4):329-340. (Pubitemid 44490056)
133. Parssinen M, Kujala U, Vartiainen E, Sarna S, Seppala T. Increased premature mortality of competitive powerlifters suspected to have used anabolic agents. Int J Sports Med. 2000;21(3):225-227. (Pubitemid 30260844)
134. Thibliin I, Lindquist O, Rajs J. Cause and manner of death among users of anabolic androgenic steroids. J Forensic Sci. 2000;45(1):16-23. (Pubitemid 30041604)
135. Bahrke MS, Yesalis CE III, Wright JE. Psychological and behavioural effects of endogenous testosterone and anabolic-androgenic steroids: an update. Am J Sports Med. 1996;22(6):367-390. (Pubitemid 26421779)
136. Midgley SJ, Heather N, Davies JB. Levels of aggression among a group of anabolic-androgenic steroid users. Med Sci Law. 2001;41(4):309-314. (Pubitemid 33598113)
137. Pagonis TA, Angelopoulos NV, Koukoulis GN, Hadjichristodoulou CS, Toli PN. Psychiatric and hostility factors related to use of anabolic steroids in monozygotic twins. Eur Psychiatry. 2006;21(8):563-569. (Pubitemid 44855527)
138. Pope HG Jr, Katz DL. Homicide and near-homicide by anabolic steroid users. J Clin Psychiatry. 1990;51(1):28-31. (Pubitemid 20042565)
139. Thiblin I, Runeson B, Rajs J. Anabolic androgenic steroids and suicide. Ann Clin Psychiatry. 1999;11(4):223-231.
140. Melloni RH Jr, Connor DF, Hang PTX, Harrison RJ, Ferris CF. Anabolic-androgenic steroid exposure during adolescence and aggressive behavior in golden hamsters. Physiol Behav. 1997;61(3):359-364. (Pubitemid 27148602)
141. Pope HG Jr, Gruber AJ, Choi PY, Olivardia R, PHillips KA. Muscle dysmorphia: an underrecognized form of body dysmorphic disorder. Psychosomatics. 1997;38(6):548-557. (Pubitemid 27528338)
142. Wood RI. Anabolic steroids: a fatal attraction? J Neuroendocrinol. 2006;18(3):227-228.
143. Leone JE, Sedory EJ, Gray KA. Helping athletes: recognition and treatment of muscle dysmorphia and related body image disorders. J Athl Train. 2005;40(4):352-359. (Pubitemid 43119531)
144. Brower KJ. Anabolic steroids abuse and dependence in clinical practice. Phys Sportsmed. 2009;37(4):130-140.
145. Pope HG, Kean J, Nash A, et al. A diagnostic interview module for anabolic-androgenic steroid dependence: preliminary evidence of reliability and validity. Exp Clin Psychopharmacol. 2010;18(3): 203-213.
146. Harmer PA. Anabolic-androgenic steroid use among young male and female athletes: is the game to blame? Br J Sports Med. 2010;44(1):26-31.
147. Goldberg L, Bents R, Bosworth E, Trevisan L, Elliot DL. Anabolic steroid education and adolescents: do scare tactics work? Pediatrics. 1991;87(3):283-286.
148. Goldberg L, Bosworth EE, Bents RT, Trevisan L. Effect of an anabolic steroid education program on knowledge and attitudes of high school football players. J Adolesc Health Care. 1990;11(3): 210-214. (Pubitemid 20148104)
149. Board of Certification. Role Delineation Study: Practice Analysis. 6th ed. Omaha, NE: 2011.