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Parents should be aware that by the time their child is playing junior high school sports, other kids on the team are probably taking ergogenic substances that are banned and/or untested for long-term side affects on adolescents. Most studies report 8 to 10 percent user rates for anabolic steroids in high school boys, and a recent study indicated that girls are beginning to take steroids as well. Even more shocking, a survey-study of junior high students found that 2 to 3 percent of junior high students reported taking anabolic steroids.

Signs of Anabolic Steroid Use:

• Rapid change in body build compared to peers, with muscle being put on much more quickly than previously and compared to peers.

• Psychological symptoms: rage, temper, aggressiveness, getting into fights.

• Rapid onset of acne.

Medical Conditions Associated with Steroids:

Anabolic Steroids: Premature puberty, development of facial hair (girls), increased risk of liver cancer

Diuretics: electrolyte abnormalities leading to cardiac arrhythmia

Creatine: water retention, increased risk of kidney failure

What to Do if You Suspect Your Child May Be Using Steroids:

• Discuss it. Take your child to a neutral site, away from home and distractions such as siblings, and discuss your concerns honestly and openly. Don’t go behind their back!

Get professional help. Even if your child says, “I won’t do this anymore,” he probably will. When winning becomes the only focus, thinking turns cloudy. The best thing to do is seek help outside of school. Start with your pediatrician. A local adolescent-medicine doctor would also be an important resource.

• Use thoughtful discouragement. If kids are taking anabolic steroids, they are most certainly taking them to improve their sports performance. Parents and coaches need to understand that these substances work: athletes actually do get stronger and faster with anabolic steroids. You must acknowledge these benefits before discouraging use or you will lose credibility with your child. You must point out, however, that the downside of anabolic steroids outweighs the good. Using these substances increases the risk of liver cancer, heart disease, stroke, and infertility, and in kids who haven’t started puberty, they decrease adult size.

Discuss with other parents. If one athlete is caught taking steroids chances are many others on the team are doing the same thing. For parents, it’s important not to bury your head in the sand and pretend that it couldn’t be happening with your child. If others on the team are doing this, your child has at least thought about it too.

Dr. Jordan Metzl, M.D. is the Medical Director at the Sports Medicine Institute for Young Athletes in Manhattan and the author of  The Young Athlete: A Sports Doctor's Complete Guide for Parents.