Steroids Statistics

Background Behind Steroids Statistics

The use of performance enhancing drugs of any type and the drive to use them either for professional sport or for personal use is not something new[1], and certainly not a product of the modern age of science either. It is a very well-known fact that anabolic steroid use in fact began thousands of years ago (approximately 3,700 years ago), where the very first recorded use of anabolic steroids was circa 1700 BC where the ancient Greek Olympic athletes and competitors would consume sheep and bull testicles in mass quantities in order to ingest the anabolic steroids contained within[2]. Today, the process and science is obviously quite different, but despite what the common individual might believe (or have been lead to believe), anabolic steroid use is actually quite prevalent, widespread, and continually on the rise despite the prohibition that has been placed upon them in the United States.

Although as a drug, anabolic steroids are perhaps the most seldom used; but one must also understand that the category of drug that anabolic steroids fall under is of a completely different category in comparison to every other prohibited or illicit drug – anabolic steroids and other related hormones are utilized by those attempting to maximize their athletic potential by increasing levels of hormones which are already in their bodies. This is not putting foreign substances into the body to feel some euphoric effect that is not natural. With this being said, it must first be clarified that anabolic steroids are completely legal in the majority of nations and regions in the world. Even in the Western world, the UK (England) does not impose penalties on the personal possession and use of anabolic steroids, where such activity is perfectly legal. The same is true for Canada. The complete prohibition of anabolic steroids (buying, selling, using, possessing anabolic steroids) is almost exclusively an American concept. This article will focus almost solely on anabolic steroid use in America and the Western world.

Anabolic steroids, although not as popular of a drug as the majority of other drug types (recreational drugs such as marijuana, cocaine, opiates, amphetamines, methamphetamines, etc.), they are extremely widespread and popular than originally thought (among various subcultures)[3]. These subcultures include the athletic and gym cultures, and among these subcultures, anabolic steroid use is far more prevalent than the average population would ever think or expect. However, it must also be understood that the total demographics of anabolic steroid users and how much of the population utilizes anabolic steroids is very difficult to determine due to a variety of different factors.

Influences of Popularity

The question as to why anabolic steroids have become so popular over the years among the various subcultures is a popular question. The answer lies in the decision to legislate and prohibit anabolic steroids themselves, which has served to increase the popularity of these drugs.

It was during the mid to late 1980s that the drum beat of the anti-steroid hysteria created by the media and government grew increasingly louder and louder. Penalties were now imposed for anabolic steroid trafficking as the anti-steroid hysteria and propaganda grew louder and louder on the television, on the radio, in the newspapers, and in the magazines. Such sentiment gradually increased in intensity until such point as anabolic steroids were legislated and prohibited by being added to the controlled substances list under the Anabolic Steroid Control Act of 1990. Not only did such legislation impose extremely cruel punishments upon the trafficking of anabolic steroids, but the end user themselves were now treated as criminals in the United States. Other countries did not follow entirely suit and enacted more lenient laws under pressure from the United States government.  Ironically, as the intensity of such an environment of prohibition increased, the demand for anabolic steroid products soared. Such a shift in the supply and demand dynamics is unsurprisingly very typical of prohibition laws, as evidenced by history.

This, as a result, had also generated a heaving explosion of the black market supply and trafficking of anabolic steroids. Whenever prohibition of any particular substance increases, demand will always increase as a result. The mid-late 1980s could also be said to be intrinsically responsible for the increase in general awareness and popularity of anabolic steroids. It was only during this time period (mid-late 1980s) that bodybuilding’s popularity had been in full swing among the general public. This popularity, tempered with the increasingly massive amount of sensationalist media coverage of anabolic steroids, allowed the public to become increasingly aware of anabolic steroids in numbers that would have otherwise never become as widespread otherwise. This is what in turn fuelled a greater increase in demand for anabolic steroids as more and more people were enticed to attempt to try anabolic steroid use as a result of the increasing media coverage of the subject. The attempt to demonize and discourage individuals from attempting anabolic steroid use had totally failed as a result.

Portrayal by the Mass Media and Government

Steroids statistics are often manipulated by the mass media and the government in an effort to sway the opinions of the general public, and that the real truth behind them is a striking reality to the average individual, who is vastly uneducated on the topic. The media portrayal to the general public of the average anabolic steroid user is that of either a professional athlete attempting to “cheat” at sport, or more commonly, that of a low income, uneducated, and mindless big brutish person that occupies all of his time in the gym, and spends all of his money on supporting his anabolic steroid use. Other stereotypical portrayals by the media is that a large percentage of anabolic steroid users as being teenagers and high school athletes, which is also inaccurate. In addition to these stereotypes, other false details include: the common portrayal and idea of widespread sharing of needles and syringes, as well as the stereotypical imagery of anabolic steroid users injecting themselves in the gym locker rooms. All three of these stereotypes are outright extreme sensationalized exaggerations as well as lies. Very frequently when the mass media portrayal of anabolic steroid users is of these stereotypes, no valid steroids statistics or any evidence is brought forth to support these claims.

True Facts and Real Steroids Statistics

The true facts lay in the raw data that has been gathered and studied, which can be easily accessed by any individual, and with the advent of the internet it is easier to unveil the truth now more than ever. Individuals should be encouraged to think for themselves and to be critical of the media and the government’s claims. Because information is so easily accessible, access to real true steroids statistics is not a difficult task, and in this current information age in which we all live where every individual has access to the truth at their fingertips, ignorance of the truth and the facts is not an excuse – it is a choice.

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Specifically, within the United States alone, studies have landed the total number of anabolic steroid users for non-medical purposes in the range of 1 – 3 million individuals, which is approximately 1% of the total population in the United States[4]. This is a perfect indication that the claims by the media and the government that anabolic steroids are a “national health crisis” are blatantly and excessively exaggerated. Within these demographics, a number of studies conducted in the United States has determined that the average anabolic steroid user is in fact that of a middle-class heterosexual male of the average median age of approximately 25 – 35 years, and are neither competitive bodybuilders at any level, nor are they professional or amateur athletes at any level either, and these anabolic steroid users are simply utilizing anabolic steroids for purely cosmetic improvement purposes[5]. Furthermore, a 2007 study has demonstrated that 74% of all anabolic steroid users for non-medical purposes held post-secondary college or university degrees, and far less had failed high school than the average person typically expects of anabolic steroid users[6]. That same study has also determined that the average anabolic steroid user held a much higher employment rate in addition to an overall higher household income than that of the rest of the general population. It can be concluded from this data that the truth in regards to anabolic steroid use among the general population are not athletes, are not teenagers or children, and are highly educated, law abiding, taxpaying, contributing citizens that are simply attempting to enhance their personal physique and performance in relation to their training in the gym.

With this having been established, the real specific statistics as to adult and teenage/adolescent steroids statistics will be examined, and the common misconceptions and myths will be debunked. In addition, the analysis of the real health risks where steroids statistics are concerned in regards to anabolic steroid use will be covered, and the myths and exaggerations in regards to the health risks will be debunked.

Adult Steroids Statistics

Steroids Statistics: Real Information Concerning Use, Safety, and Health Among Adult Users

The mass media and government would have everyone believe that there are steroids statistics that demonstrate the claims that anabolic steroids are extremely harmful and lethal drugs that are killing people every day. The mass media and the government will frequently overstate, embellish, and outright lie concerning the dangers related with anabolic steroid use. Media and government channels will regularly define anabolic steroids wrongfully as drugs that exhibit a very low safety threshold and that the use of anabolic steroids is that of an extremely dangerous practice which will often result in acute and chronic injury and death. The facts and real steroids statistics have shown us throughout the previous 60 years of anabolic steroid use among athletes, bodybuilders, and the average ‘gym rat’ that anabolic steroid use is in fact a very safe practice when performed thoughtfully following ensuring that strict guidelines and conditions are followed and met, which can be defined as sensible and proper anabolic steroid use. When these guidelines and conditions are not followed or outright broken, this is when use becomes dangerous.

The fact is that anabolic steroids do present various health risks – they are not without their faults and potential risks, as with anything. However, the context under which they are utilized presents a vast difference in how much of a risk is being taken. Responsible and judicious anabolic steroid use among healthy adult males is a significantly different situation in comparison to anabolic steroid use among children, teenagers, and females. Within the context of healthy adult male anabolic steroid use, the associated and proposed risks plummet by a massive degree, and from what we already know from studies referenced above, the average anabolic steroid user is in fact not teenagers and nor are they athletes, but are healthy adult males in the median age range of 25 – 35 years of age. Other more recent studies have also supported this fact among steroids statistics, where a 2006 study that surveyed 500 anabolic steroid users found that almost 80% of these users were not competitive athletes or bodybuilders but instead average adult physically active males[7]. Furthermore, the majority of anabolic steroid users are short-term users that do not engage in lifetime use (either in cycles or constant use), and that the rate of actual lifetime use among anabolic steroid users was found to be 0.9% for males, and 0.1% for females5. What this means is that only 0.9% and 0.1% of all male and female anabolic steroid users respectively will engage in lifetime use (mostly via subsequent cycles), while the rest will only utilize anabolic steroids once or a handful of times during their life.

The actual details in regards to how safely anabolic steroids can be utilized among healthy adult males, with the issue of safety referring specifically to the anabolic steroids themselves (no outside drugs or factors) is fairly well-known and well documented. Such information in-depth can easily be accessed by viewing other articles concerning this subject, such as Steroids Side Effects and Effects of Steroids. However, studies utilizing real world dosages and cycles have demonstrated that the isolated responsible use under certain guidelines entails very minimal risks to one’s health, so much so that the media-pushed notion that engaging in an anabolic steroid cycle with moderate doses is the equivalent of playing Russian roulette is just not true. One study in 2001 investigating supraphysiological bodybuilding doses of Testosterone (600mg weekly for 20 weeks) on 61 healthy males aged 18 – 35 demonstrated no significant impact on prostate-specific antigen (PSA), no impact at all on hepatotoxicity (liver strain), no negative impact on sexual function, and no negative impacts on psychological function with the only negative effect experienced being a slight negative alteration in cholesterol values which promptly returned to normal in the weeks following cessation of the anabolic steroids[8]. An additional study was conducted on 30 HIV+ males where the anabolic steroid Deca-Durabolin was administered at supraphysiological bodybuilding doses of 600mg weekly for 16 weeks, and once again, no negative changes were observed in the subjects with the exception of a very minor decrease in HDL (good) cholesterol[9]. As a matter of fact, one group of subjects engaging in weight training had actually experienced improvements in cholesterol values.

There also exist questions in regards to safety among steroids statistics concerning the safety of injection practices and actual physical use of the substances, the real statistics demonstrate surprisingly safe use practices among anabolic steroid users. This is contrary to what the media and government outlets would have the public believe, where their portrayal is that of needle-sharing, dirty injection procedures in gym locker rooms, and anabolic steroid users that are generally stupid concerning their use. The real facts in steroids statistics have shown that anabolic steroid users are of a much higher level of education surrounding their use than those of any other recreational drug. Studies have determined that anabolic steroid users actually engage in thorough research of the drugs they are using (or are going to use) far more than other drug user types that do not do so at all[10]. However, one problem found within this dynamic is that the majority of sources consulted by most anabolic steroid users are that of friends, non-medical guides and hand books, internet websites, and bodybuilding magazines. These sources can provide faulty misinformation concerning anabolic steroid use, but this dynamic is the result of the illicit and illegal status imposed upon anabolic steroids, and it is therefore almost impossible for anabolic steroid users to receive proper medical guidance. This is a direct result of anabolic steroid prohibition. The statistics in regards to unsafe injection and administration practices are extremely low among anabolic steroid users, where studies have found that only 13% of surveyed users reported unsafe injection procedure, which included the re-use and sharing of needles as well as the sharing of multi-dose vials7. One other particular study in 2007 had actually discovered that the sharing of needles among anabolic steroid users was in fact less than 1% in many cases, which serves to therefore lower the overall average in the incidence of needle sharing than once thought[11].

Finally, and this might be one of the most important steroids statistics gathered that should be mentioned when the issue of safety and harm reduction is concerned, the same 2007 study mentioned several times earlier had found that 66% of non-medical anabolic steroid users are willing to seek medical supervision in regards to their steroid use6. This same study had found that 58% of users did not possess trust in their doctors, 92% felt that the medical establishment’s knowledge of anabolic steroid use for the purpose of physique and performance enhancement was severely lacking, and 99% felt that the general public held an extreme level of an exaggerated view of the side effects of anabolic steroid use. The fact that a very large amount of anabolic steroid users wish to seek proper medical assistance and guidance in regards to their use should be strikingly surprising to the average individual, and it should also indicate the intent of the majority of anabolic steroid users to want to engage in safe, responsible harm-reduced use of anabolic steroids – all very beneficial and positive things which are currently extremely difficult to attain due to the legal status of anabolic steroids in the Western world.

Teenage/Adolescent Steroids Statistics

Steroids Statistics: Real Information Concerning Use, Safety, and Health Among Teenage and Adolescent Users

The use of anabolic steroids among underage users, which refers to teenagers and adolescents is indeed a concern. It has been determined thus far throughout this article that the demographics and facts in regards to steroids statistics demonstrate that the vast majority of anabolic steroid users, upwards of 80% or greater, consist of healthy male adults – not athletes, and not teenagers or children. However, the use of anabolic steroids among teenagers and in high school is still an occurrence and is indeed a concern. But is this still as much of a concern as the media has made it out to be to the general public? Is it as bad as they say it is? Is it really a massive crisis among high schools and high school level sports? The fact is that it is not, but it does exist and the real facts and data will be outlined here, and the myths and lies propagated by the mass media will also be discussed here as well.

First we must look at the risk that anabolic steroids pose to underage individuals such as teenagers and adolescents. Anabolic steroid use, as demonstrated earlier through evidence in the form of studies, anabolic steroid use among healthy adult males is in fact a practice that can be done with relative safely. This is not the case with teenagers and adolescents, however. Teenagers and adolescents are at a time in life where their bodies are still under development and have yet to fully mature. The fact is that teenagers and adolescents risk long-term changes if anabolic steroids are utilized at this point in their lives, and these changes can be potentially damaging for life. There is in fact a significant amount of data in existence that demonstrates a large number of teenage athletes whom have utilized anabolic steroids and experienced stunted growth[12]. There is no exact or specific known age at which the growth plates in growing adolescents close, although much evidence indicates that a large portion of humans continue to grow linearly until the age of 24. The general figure given is that most individuals will continue to grow until the age of 21 – 24 and some even longer. Various studies have demonstrated that teenage males at an average age of 14 years old that were treated with Testosterone Enanthate at a dose of 500mg administered once every two weeks for half a year exhibited stunted growth to the extent that final height was reduced by 3 inches in comparison to their predicted final height growth if Testosterone had not been administered[13]. The guidelines and stipulations that deem what moderate appropriate and responsible anabolic steroid use is exclude the use of any anabolic steroids under any circumstances by teenagers and children (unless it is therapeutically initiated by a doctor).

The risks associated with teenage anabolic steroid use have been established, and now the actual teenage steroids statistics will be examined thoroughly to determine the truth. The Journal of the American Medical Association studied anabolic steroid use among teenagers in 1988, and in this study the participation rate among high school students was 68.7%, and individually was approximately 50%. The survey was conducted across 46 American high schools, consisting of 12th grade students (male) whom all answered a list of questions in regards to the issue of anabolic steroids and their possible use. Of those grade 12 male students surveyed, it was established that 6.6% had used anabolic steroids with 2/3 of those students being 16 years old or younger at the time of their first anabolic steroid use[14].

In later years, further studies were conducted (as well as surveys) with the next major studies in 1990. In this study, high school students were questioned and surveyed once again, which was a total of 2113 students. Both male and female students had this time been surveyed. Of the 2113 students, 1028 consisted of males, while 1085 consisted of females. The results determined that 94 of the 2113 students surveyed (which comes to approximately 4.4%) professed to using anabolic steroids. 67 students (6.5%) of the male group had reported anabolic steroid use, and 27 students (2.5%) of the female group professed to using anabolic steroids. Of the students surveyed, it was found that the athletic students (1436 of the 2113 studied) fell under a greater percentage of anabolic steroid users, which was found to be 79 (5.5%) of the 1436 athletic students. The non-athletic students consisted of 636 of the 2113 students studied. Of those, 15 were determined to be non-athletic students (2.4%) of the total 636 that admitted to anabolic steroid use[15]. The complete and final results confirmed that nearly 4% of the studied high school students were found to engage in anabolic steroid use at some point during their high school years.

Following these studies in the years to come, high school anabolic steroid use among students did not drop – but it had not increased either! However, the media had been projecting a wrongful message to the general public that anabolic steroid use among high schools and youth is an “epidemic”. Even the Centers for Disease Control and Prevention (CDC) claimed that “the use among high school students had increased by more than double” after it had conducted a number of studies on high school related anabolic steroid use during the years of  1991 until 2003. However, the real truth behind these twisted facts and media-fuelled hysteria is that in 2003 a survey of 15,000 students was conducted, of which it was determined that 6% acknowledged to using anabolic steroids. If one were to trace the history and trends among these high school steroids statistics and examine the study from 1988 mentioned previously, it can easily be seen and noted that the number of anabolic steroid users among high school students was situated at the exact same point – 6%. It had not reduced, but had also not increased. This is contrary to the claims by the media that, once again, the anabolic steroid problem among high school students and youth is a “rampant epidemic” and an “increasing concern”. It is in fact outlined in a 2005 study conducted by the CDC that among students surveyed and questioned in grades 9 – 12, the percentage was that of 6.1% that had used anabolic steroids[16]. This is demonstrable, once again, that the numbers have not increased as the media has consistently been telling the population, where claims by the media have often been seen to soar as high as 20 – 90%. However, it is very clear through the various studies conducted that the numbers have in fact remained at a stable and steady 6%, and have not ascended to any higher numbers[17]. Other research is indicative in fact that between high school and post-secondary education (college and university) and thereafter, the progressive use of anabolic steroids among individuals actually declines17.

Following the evidence provided by the cited steroids statistics, it can be easily seen that actual anabolic steroid use by high school teenagers is extremely miniscule. Following this, the actual numbers behind the use among teenagers remains static. Furthermore, when compared to the use of recreational drugs, a 2004 study has demonstrated that grade 12 students (the only grade of students examined), only approximately 3.4% had used anabolic steroids. In contrast to recreational drug use of other types of drugs, this same study had found that of the examined grade 12 students, 76.8% had consumed alcohol alongside other recreational street drugs such as: Marijuanna, Cocaine, MDMA, and various others, which, for those drugs, resulted in a far higher rate of use than anabolic steroids in comparison.

The raw steroids statistics as well as the real facts and truth demonstrates clearly that the claims made by the media and politicians essentially stems from overly emotional reaction, thought process, and decision making. In addition, much of the evidence that has steered the decision making by policymakers and politicians regarding these issues has not been grounded on solid scientific data and evidence, but has in its place been constructed upon hearsay and unreliable and unfounded anecdotal evidence that has been twisted to favor only one side concerning the issue of anabolic steroids. This has been verified in congressional hearings where solid scientific data and proof had been disregarded and rejected in favor of assertions made by the parents of a child who committed suicide, and stated that the suicide had been caused by anabolic steroid use alone. At the same time, there exist a plethora of medical professionals that disagree with what has been said and accepted, and these professionals vehemently oppose this faulty logic and mawkishness, such as Dr. Jack Darkes who happens to be an assistant professor in the Department of Psychology and the Director of Interventions at the University of South Florida. Dr. Jack Darkes not only disagrees with this flawed reason and judgment, but has also warned against these foolish practices of blaming the suicide of a teenager (or any life) to only one single sole solitary factor (referring in this case to the the use of anabolic steroids).

Steroids Statistics Among Teenage and Adolescent Users In Other Western Countries

The details and steroids statistics in regards to other Western countries is lacking, but there exist a small amount of data concerning anabolic steroid use among Canadian students.

One particular study conducted in 1996 examined the use of anabolic steroids among students on a national level, which utilized a survey system and questionnaires. 16, 119 students were examined nationwide from each of the five major regions within Canada, and of those 16, 119 students, approximately 30% reported using anabolic steroids[18].

Harm, Risk, and Fatality Steroids Statistics

It has been mentioned previously in this article that anabolic steroids are frequently portrayed by the media as extremely lethal substances that will cause debilitating problems or acute death. Anabolic steroids are perhaps the only drug that possesses a stigma that they do. So much so, in fact, that the average person has been ‘brainwashed’ to think extremely ludicrous ideas in regards to what these substances do. Merely mention the word “steroids” to the average person and the person is very likely to lash back and provide some extreme descriptor of anabolic steroids as a drug that will cause one to bald, lose all of their genitals, get cancer, and transform into a raging psycho destructive to everything around them. Much of the evidence disproving the claims that anabolic steroids are a ‘lethal’ drug has been presented throughout this article thus far.

But what about the claims that people are dying constantly from anabolic steroid use? Or that people who have used anabolic steroids are dying of heart attacks 20 years later? The fact of the matter is that the latter statement about anabolic steroid users dying 20 years later is very much inconclusive – no long-term studies have ever been conducted on anabolic steroid use, and so neither side (proponents or opponents) of anabolic steroids use can claim that these drugs definitely do or do not cause long term severe health risks. However, the fact of the matter is that there exist millions of anabolic steroid users who have utilized anabolic steroids throughout the previous 60 years that are still alive today and in good health[19]. The cases in which a known steroid user or person with a history of steroid use undergoes a heart attack at a later age are isolated incidents that are associated with other factors whereby anabolic steroids were not the sole key components in regards to the individual’s demise.

Although the steroids statistics in regards to the risk and fatalities is very small (and very much due to the fact that these drugs are not as lethal as claimed to be and have not killed as many individuals as people have been led to believe), some data does exist to support the fact that these drugs are not killing individuals left, right, and center. First of all, medical literature has demonstrated only three cases of oral anabolic steroid associated severe liver problems and tumors in all history of anabolic steroid use, which were all related to the excessive abuse in both dose and duration[20] [21]. Furthermore, injectable anabolic steroids are virtually harmless to the liver as evidenced by studies involving administration of extreme doses of injectable Testosterone[22] (with exceptions to only one known major injectable anabolic steroid, Winstrol). Oral anabolic steroids that are C17-alpha alkylated (which is approximatel 95% of all oral anabolic steroids) are known to be liver toxic to varying degrees, but serious liver complications are known to result from only excessive abuse in either duration or dose (or both) – not responsible proper use following guidelines.

Even Robert Tan, M.D., who happens to be the creator and manager of the Houston-based OPAL (Optimal Aging and Longevity) Medical Clinic, which focuses on male health and longevity, has stated that “Public policy and public opinion have been based on people who use steroids in larger amounts”[23]. In general, the steroids statistics where harm and fatalities of anabolic steroid users are concerned is very difficult to quantify due to the fact that first of all, anabolic steroids in general are not acutely lethal enough to land significant amounts of users in the hospital emergency rooms (compared to other drug type abuse). The second reason is because the majority of deaths or severe harm to health of known anabolic steroid users have almost always been accompanied with other contributing factors that often play a greater role in the individual’s death or harm than anabolic steroids alone, and these include:

– The individual’s personal history of any medical problems (congenital or otherwise).
– Any unknown underlying medical indications.
– The abuse of other illicit substances (cocaine, MDMA, methamphetamine, alcohol, etc.).
– Various other factors of outside influence.

To date, there has never been a single death in history attributed solely to anabolic steroids whereby the coroner upon examination of the deceased’s body has marked the cause of death as anabolic steroids.

Medical References:

 

[1] “A short doping history”. Anti-Doping Hotline. Archived from the original on 2007-10-08. Retrieved 2007-04-24.

[2] “A Brief History of Drugs in Sport” by Charlie Francis

[3] Current concepts in anabolic-androgenic steroids. 8.Evans, N. A. Am. J. Sports Med. 32:534-542, 2004.

[4] “Use of doping agents, in particular anabolic steroids, in sports and society”. Sjöqvist F, Garle M, Rane A (May 2008). Lancet 371 (9627): 1872–82. doi:10.1016/S0140-6736(08)60801-6. PMID 18514731.

[5] “Anabolic-androgenic steroid use in the United States”.Yesalis CE, Kennedy NJ, Kopstein AN, Bahrke MS (1993). JAMA 270 (10): 1217–21. doi:10.1001/jama.270.10.1217. PMID 8355384.”

[6] A league of their own: demographics, motivations and patterns of use of 1,955 male adult non-medical anabolic steroid users in the United States. Cohen, J.; Collins, R.; Darkes, J.; Gwartney, D. (2007). Feedback 4: 12. doi:10.1186/1550-2783-4-12. PMC 2131752. PMID 17931410. //www.ncbi.nlm.nih.gov/pmc/articles/PMC2131752/.

[7] Anabolic Androgenic Steroids: A Survey of 500 Users. Andrew B. Parkinson, Nick A. Evans. Med Sci Sports Exerc. 2006;38(4):644-651.

[8] Testosterone dose-response relationships in healthy young men. Shalender A, Woodhouse Let al. Am J Physiol Endocrinol Metab 281: el172-81 (2001).

[9] Metabolic effects of nandrolone decanoate and resistance training in men with HIV. Sattler et al. Am J Physiol Endocrinol Metab 283: e1214-22.

[10] A study of 100 anabolic-androgenic steroid users. Copeland J, Peters R, Dillon P (March 1998). Med. J. Aust. 168 (6): 311–2. PMID 9549549. http://www.mja.com.au/public/issues/mar16/copeland/copeland.html.

[11] Trends in non-medical use of anabolic steroids by U.S. college students: Results from four national surveys. McCabe SE, Brower KJ, West BT, Nelson TF, Wechsler H (2007). Drug and alcohol dependence 90 (2–3): 243–51. doi:10.1016/j.drugalcdep.2007.04.004. PMC 2383927. PMID 17512138. //www.ncbi.nlm.nih.gov/pmc/articles/PMC2383927/.

[12] Hormonal doping and androgenization of athletes: a secret program of the German Democratic Republic government. Franke WW, Berendonk B. Clin Endocrinol. 2001 Jun 10;178(1-2):215-20.

[13] The results of short-term (6 months) high-dose testosterone treatment on bone age and adult height in boys of excessively tall stature. Bramswig JH, von Lengerke HJ et al. Eur J Pediatr. 1988 Nov;148(2):104-6.

[14] JAMA 1988 Dec 16;260(23):3441-5.

[15] Am J Dis Child. 1990 Jan;144(1):99-103.

[16] J Sch Nurs. 2005 Dec;21(6):333-9.

[17] Anabolic steroid usage in athletics: facts, fiction, and public relations. Berning JM, Adams KJ, Stamford BA. J Strength Cond Res. 2004 Nov;18(4):908-17.

[18] The use of anabolic-androgenic steroids by Canadian students. Melia P, Pipe A, Greenberg L. Clin J Sport Med. 1996 Jan;6(1):9-14.

[19] “‘Roid Warrior: Bob Clapp believes those who hate anabolic steroids are a bunch of scrawny puritanical dimwits”. Robert Nelson. Phoenix NewTimes News. Thursday, Aug 15 2002  . http://www.phoenixnewtimes.com/2002-08-15/news/roid-warrior/. Retrieved 3/6/2013.

[20] Hepatocellular carcinoma associated with recreational anabolic steroid use. Gorayski P, Thompson CH, Subhash HS, Thomas AC. Br J Sports Med. 2008 Jan;42(1):74-5; discussion 75.

[21] Bodybuilder death steroids warning. Express and Star 2009 09/04. Epub. www.expressandstar.com

[22] Enzyme induction by oral testosterone. Johnsen SG, Kampmann JP, Bennet EP, Jorgensen F. 1976 Clin Pharmacol Ther 20:233-237

[23] “Roid Rave: Steroids, They Do A Body Good?”. Jordan Heller. May 03, 2009. http://thefanzine.com/roid-rave-steroids-they-do-a-body-good/ . Retrieved 3/6/2003.