Roid Rage

steroids--and the guys who take them--are getting bigger. YOU GOT A PROBLEM WITH THAT?

He was a big guy, a side of beef, nose tackle on an ACC varsity team. Six-four, 275. And strong—on the bench press, he could do 30 reps of 225 pounds. But you need muscle to play nose tackle, and this big boy had 21 percent body fat. That worked fine on the gridiron, but off it, he found that pretty coeds don't exactly melt at the sight of 21 percent body fat.

So when a shoulder injury ended his football career in 1999, he immediately began sculpting his body into something more fulfilling. "I wanted more than anything to step into the dance club or gym, or out on campus, and turn heads," he says. Hitting the gym got him most of the way there but left him short of the brute physicality he craved. There is a limit to the muscle a man can pack on—and how quickly he can do it—without chemical assistance. Dietary supplements and protein powders are two options, but the most direct route involves anabolic steroids.

Three hundred dollars got him 600 tabs of a (continued on page 156)Roid Rage(continued from page 129) steroid called Dianabol, enough for seven weeks (anabolics are generally used in cycles of six to 12 weeks). Combined with a furious workout regimen, the drug worked wonders: "I was as hard as a damn chiseled block of granite," he boasts. "I had striations running across my chest, veins busting through my skin, and my skin looked paper-thin. Guys looked at me in awe. I had girls looking at me in shock."

Ecstasy gets the drug-scare headlines these days, and heroin retains its tragic glamour, but steroids are the drug of choice on college campuses—or anywhere you find young men. No one knows exactly how many guys have tried them, but estimates run as high as 3 million. In fact, steroids have a whole new market—and it's extending far beyond jocks and hard-core bodybuilders. For a growing number of young men, it's about the emotional rewards of hypermasculinity.

"Steroids have become mainstream," says Dr. David Rosen, chief of teenage and young adult health at the University of Michigan. "They're no longer used solely by athletes for performance purposes. They're being used as cosmetic agents—a way of looking better, of looking buff."

Studies show increasing use among teenagers and others. One of the most frequently cited surveys indicates three percent of teen boys have sampled steroids. That may not seem like many, but it's a 50 percent rise over 10 years.

Others calculate the numbers to be even higher. The authors of The Adonis Complex: The Secret Crisis of Male Body Obsession cite a 1988 nationwide survey of 3403 high school seniors in which 6.6 percent reported use (or past use) of anabolic steroids—an average of one kid in 15. Those stats were backed up by a 1993 study in The New England Journal of Medicine that put the figure at 6.5 percent.

"Let's assume the 6.5 percent rate of steroid use among high school boys has remained stable over the past 12 years," write Adonis Complex authors Harrison Pope, Katharine Phillips and Roberto Olivardia. "About 25 million American men have turned 18 during the past 12 years. That would mean more than 1.5 million men have used anabolic steroids before the age of 18."

The numbers get larger as high school students move on to college and college students graduate into the real world, according to experts, who pin the total at 2 million to 3 million. Whatever the figure, an alarm has been sounded. The National Institute on Drug Abuse cites side effects that range from the relatively mild, such as acne and shrinking testicles, to the more severe, such as heart trouble and liver and prostate cancer.

Others claim the menace of steroids is vastly inflated, and a clamorous debate has ensued: Will steroids fry your liver, shrivel your balls and hot-wire your psyche? Do they really work? And why are so many men using them?

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Anabolic steroids, in the simplest terms, are synthesized tissue-building male hormones related to testosterone. They were developed in the Thirties to treat men whose testes produced abnormally low amounts of testosterone, inhibiting normal development and sexual functions. There are now some 100 varieties of oral, injectable and topical steroids with names such as Anadrol, Dianabol and Deca-Durabolin. They are illegal without a prescription.

These steroids have legitimate applications, most notably in curbing muscle deterioration in people with HIV or AIDS. Synthetic testosterone is also used in hormone-replacement therapy to buck up the flagging sex drives of elderly men. And the World Health Organization is testing it as a male contraceptive (one side effect of continued use is a depressed sperm count).

Most steroid users, of course, have none of these problems. James (not his real name), a 33-year-old Colorado man, fits the more typical profile: In a rush to hugeness—and the respect it would confer—he decided the known risks of the drug were worth the chance to bulk up. "You know how you are at that age," he says. "If someone had asked me, 'Would you like to be huge, a guy people look up to, and take 10 years off your life, or would you rather be an average Joe and keep those 10 years?' my attitude was, Yeah, go ahead, take the 10 years!"

Standard antidrug rhetoric—drugs are bad for you, just say no—doesn't seem to steer men like James away from steroid use. "The warnings contradict their own experience," says Jim Wright, senior science editor of Flex magazine, one of the titles in muscle magnate Joe Weider's stable of fitness publications. "Kids aren't stupid—they know longtime steroid users aren't keeling over dead in the gym." Furthermore, they know (or suspect) that their favorite athletes and action-film stars got their bulging pecs and six-lane chests from roids. They want that look, in a hurry. Focused on what they believe to be the short-term benefits of a juiced physique—the respect of other guys, the sexual attention of women—they give scant thought to the long-term implications of what they're putting in their bodies.

"Kids wouldn't care if steroids caused cancer," says Wright, who holds a doctoral degree in zoology and has researched steroid use for years. "They can't spell patience, let alone display it."

"Imagine," says Harrison Pope, a psychiatry professor at Harvard Medical School and chief of the Biological Psychiatry Laboratory at McLean Hospital, "that a drug existed for women that would rapidly make them more attractive, had effects that lasted long after the drug was stopped, wouldn't be picked up on routine random drug testing and had no obvious immediate medical dangers. How many women would take it?"

Dr. Pope is reading aloud from a chapter of The Adonis Complex that debunks common misconceptions about anabolics—that they're only slightly effective (they're fantastically effective) and that they'll immediately screw you up (not usually). His point is: Why wouldn't a guy gunning for muscularity consider steroids? If he has checked them out, he recognizes the truth and concludes that doctors have exaggerated the problems and understated the benefits.

At the same time, he sees signs in our society of a relaxed attitude toward banned substances. More voices are calling for an end to the war on drugs. In the same way that medical-marijuana initiatives around the country spotlight the positive effects of pot, the use of anabolics in HIV and AIDS treatments puts a different face on steroids. We're unraveling the human genome, there's talk of designer babies and cosmetic surgery is so common it's noteworthy only when it involves teenage pop stars. In a time when researchers talk frankly about cloning people instead of sheep, can a guy be blamed for wondering what harm can be caused by a few shots of testosterone?

Human motivation is murky business, but Pope and his co-authors blame a large percentage of steroid use on what they call the Adonis complex—a deep-seated discontent men have with their bodies. Their book presents this anxiety as a broad social phenomenon of which steroid abuse is a symptom. It is fostered, they propose, by a pop culture that, through movies, magazines, comic books and sports, foists on us a largely unattainable ideal of manhood.

Body dissatisfaction is nothing new for women, but it is for men. Forty-three percent of guys in a 1997 survey were unhappy with their appearance, nearly triple the number from a similar study done in 1972. Thus the reported rise in male cosmetic surgery and the fussy routines of vanity. We're putting the man in manicure.

"I believe that the respect, admiration and celebrity that professional football players enjoy has led both boys and men to think they have to be huge to be men," says Steve Gallaway, author of The Steroid Bible and proprietor of anabol icsteroids.com, a website dedicated to steroids.

"I've been in this business 22 years," says Charles Yesalis, a professor of kinesiology at Pennsylvania State and editor of the book Anabolic Steroids in Sport and Exercise. "There's no doubt in my mind that athletes play a role in the mainstreaming of steroids."

Pope and his co-authors contend that body anxiety is coded into our boys' toys. Their book dwells at length on action figures, notably G.I. Joe. His rock-ribbed fighting spirit has been increasingly matched by a brute physicality since his introduction in 1964. Beneath his fatigues, that first model depicted a normal adult body. By the mid-Nineties, G.I. Joe Extreme seemed like the hyper-muscled product of a military gene lab—were he a full-size man, he'd have a 55-inch chest and 27-inch biceps—"bigger than that of most competition bodybuilders," the book points out.

Toys, comic books and video games (Duke Nukem guzzles steroids to boost his power) are the stuff of modern boyhood. Do they push boys toward steroid use in the same way that Barbie dolls supposedly foster eating disorders in girls?

"I certainly think it's true for young men," Dr. Rosen says. "As they're presented with more unrealistic, unattainable ideas of what guys should be, they have to reach further to meet that goal." In one survey, researchers let teenage boys choose their ideal body types from computer images. Most selected one unattainable without steroids.

Outgrowing their toys doesn't necessarily curtail the desire. Men are bombarded by media images that celebrate unnaturally muscular physiques: the pumped-up human cartoons of professional wrestling, the chemically etched models on the covers of fitness and muscle magazines who are often paired with gorgeous women in swimsuits. (Wright allows that many men pictured in Flex use steroids but says the magazine emphasizes nutrition and gym regimens.)

When Pope and his colleagues asked college men to select a computer image of an ideal body, on average they chose one with 28 more pounds of muscle than they had. (By contrast, middle-aged men, perhaps surrendering to biological inevitability, chose a body type similar to their own.) In a study by Psychology Today, men were asked how many years of their lives they'd give up in exchange for achieving their ideal body. Seventeen percent said they'd sacrifice more than three years.

It's also important not to underestimate the role women play. It can be hard to tell if a guy is pumping up for his own self-esteem or because he wants to get laid—or if there's a difference. "You have no idea until you experience it, the feeling you will get to have girls everywhere checking you out," boasts one post on anabolicsteroids.com. "It must be tough on those girls to see a physique like mine, then go back to their average Joe boyfriends."

Says Wright, "Guys have been using steroids to enhance their sexual experience for decades. There can be a big effect on sexual stuff—attitude, performance, etc."

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Feminism, too, has had an impact. One load-bearing pillar of the Adonis complex theory is the idea of "threatened masculinity." That is, as women have made inroads into traditionally masculine areas of achievement—boardrooms, military, social clubs—some men attempt to reestablish male dominance by muscling up. "No matter the triumphs of feminism," Pope and company write, "no matter what laws are passed to ensure equality between the sexes, no matter what crowning achievements women accomplish, they will never, ever be able to bench-press 350 pounds."

It all sounds sensible and logical—the insidious sway of pop culture, the fear of assertive women—but Wright thinks it's mostly shit. "My take is that media influence is a scapegoat for many factors that cause people to exhibit self-destructive behaviors or personality disorders," he says. "A more muscular G.I. Joe isn't going to inspire steroid use any more than it's going to create an overwhelming desire in a youngster to get a buzz cut and invade Grenada."

He does allow that society's bulked-up physical ideal contributes in a general way to a guy's desire to be larger than life, since, in the carnival atmosphere of American culture, you have to be sensational to get noticed. That's basically what it's about, Wright says: getting noticed. Steroid users are driven by a primal urge to "be somebody"—not G.I. Joe, just someone powerful and respected. A shirtful of muscles is a surefire way to achieve that. "Give a young man a choice between having an IQ of 170 and a muscular body weight of 270," he says, "and there's no question in his mind who's going to be the most popular and influential."

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Heart disease. Prostate cancer. Liver and kidney problems. High blood pressure. Shrinking testicles. Impotence. Baldness. Acne. Feminine breast tissue. A decreased sex drive. Those are some of the conditions routinely ascribed to steroid abuse. In teenagers, excessive use can stunt natural bone growth. Psychological effects are said to include aggressive behavior, even violence-so-called roid rage. "These are dangerous substances," Dr. Alan Leshner of the National Institute on Drug Abuse declares flatly.

One of the myths The Adonis Complex seeks to dispel is that steroid use poses immediate medical dangers. "There are immediate psychological dangers and long-term medical dangers," Pope says. "So I'm not saying the drugs aren't dangerous. But if you ask a typical high school boy who has used steroids, he'd say he hasn't felt any physical effects and that, anecdotally, he doesn't know anyone who has."

"Most data on the long-term effects of anabolic steroids on humans come from case reports rather than formal epidemiological studies," the NIDA's website tells us. "From the case reports, the incidence of life-threatening effects appears to be low, but serious adverse effects may be underrecognized or underreported. Data from animal studies seem to support this possibility. One study found that exposing male mice for one fifth of their life span to steroid doses comparable to those taken by human athletes caused a high percentage of premature deaths."

But the view from the other side of the needle is that doctors have overdramatized the risks of steroids while failing to acknowledge how effective they are.

"Bodybuilders saw with their own eyes the results of steroid use in the gym," Gallaway says. "As a result, the medical community lost a lot of credibility." He doesn't pretend there aren't dangers—"anabolic steroids are serious drugs that have the potential to cause major side effects," he says—but wants to see the drugs evaluated without hype.

Some side effects (acne, testicular atrophy) subside once a guy stops taking steroids. Others don't. "Many steroid users undergo liposuction to fix the gynecomastia" (the development of female breast tissue), Gallaway says.

"Are anabolics really dangerous? The answer is absolutely not," Wright says. The proof is in the gym, he asserts, where plenty of longtime users are not dying of liver cancer or heart disease. "There are a lot of people who take steroids—I've known hundreds—and they're basically pretty normal people. It's evident from the number of people still alive that 25 years of continual use hasn't done a whole lot of damage. This isn't heroin."

This is the point in the debate where someone usually brings up NFL great Lyle Alzado, who believed that steroids incubated his fatal brain tumor. But science hasn't proved that link, Gallaway says. Wright is more emphatic. "It certainly was not from steroids," he says. "No case in the annals of medicine or science has even remotely associated that type of cancer with anabolic steroids. I find it amazing that talk about steroids leads to Lyle."

Karl Friedl is research manager for the Military Operational Medicine Research Program. In a chapter on the medical consequences of the drug in his Anabolic Steroids in Sport and Exercise, he plants himself in the middle ground of the debate on medical side effects. "From the evidence of studies of anabolic steroid administration, it is not readily apparent that we can attribute significant adverse health effects to anabolic steroids as a general class," he writes. But he warns that specific types of steroids foster specific health consequences. "An athlete would be foolish to conclude there is a safe way to use anabolic steroids."

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It seemed like the thing to do at the time. James' girlfriend had just pissed him off, so he bent over, got a gonzo grip on the bottom edge of her car and just turned the sucker over. "When you're doing that kind of stuff," he says of steroids, "it's pretty easy to put your back into it and go to town."

OK, so it was a little four-banger Fiero, and it was sitting on an incline; he's not exactly the Incredible Hulk. James doesn't tell the story to illustrate his strength, but rather to explain the aggressive mood changes that came over him while he was on steroids—which is why he quit.

"I was picking fights right and left," he says. "I was a big asshole." That sort of psychological short circuit, Pope says, is the real danger of steroid use. In his book he cites a batch of dramatic, Jekyll-Hyde instances of users flying off the handle: A bodybuilder with no history of instability is enraged by an innocent remark by a convenience store clerks So he kidnaps and shoots her, leaving her paralyzed. A cop with a clean record gets juiced on steroids, beats up a driver who cuts him off and eventually turns to crime and murder. In other words, roid rage.

That was James, all right. "You'd be in your car and some guy next to you checks out your rig and you're like, 'What're you looking at?' Next thing you know you're brawling in the street." That sort of thing persuaded James to quit. "I wasn't very nice. I didn't like the person I was becoming."

According to several studies, men who take less than 300 milligrams of testosterone a week rarely go nuts. But doses of 500 or 1000 milligrams—common in illicit use—increase the incidence of aggressive behavior.

For most users, that aggressiveness manifests itself as an increased desire to work out; they channel it into the gym. Profound personality changes are rare, Pope stresses, and aren't confined to bodybuilders; some men in their study had never been near a gym. "You can't explain it away as a personality defect," he says. He suspects some so-far-undiscovered biological predisposition may be at work.

Wright, however, senses a subtle demonizing of bodybuilding in the way that the talk about roid rage has focused largely on gym rats. "I don't believe steroids make you psychotic," Wright says. Look at the many anabolic users in the HIV community: "They are not becoming crazed partner-beaters, robbers or criminals of any kind," he says. "If steroids are so dangerous, where are all the reports of violence among those individuals?"

Wright agrees that steroids may trigger psychological problems in some men who have a predisposition toward violent behavior. "It's personality first," Wright insists. "I don't think that there's any question about the chicken or the egg here."

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The steroid phenomenon isn't hidden. Unprescribed use of the drug is illegal, but it's far from underground. There are ads in the backs of respectable magazines. Websites run coy disclaimers about steroid users' needing a doctor's prescription, then offer detailed instructions for bodybuilding with anabolics—a use doctors rarely prescribe for. Elite athletes are booted from competition or tainted with suspicion of enhanced performance so often that the sight of Bulgarian weight lifters sent packing from Sydney hardly raised an eyebrow. "More and more," says steroid researcher Charles Yesalis, "people have come to believe that only stupid people get caught."

It's no less blatant at the gym, where steroids are the subject of elaborate networking arrangements. Seasoned users mentor new ones. One contributor to anabolicsteroids.com writes of a Miami gym, "You could go into the bathroom and find d-bols [Dianabol] on the floor. Syringes stuck in the ceiling tiles." Even allowing for a degree of boastful exaggeration, that's pretty blatant behavior. Although Wright says steroid use is probably higher in California and Florida—areas that have flourishing body cultures—you can find the drugs in gyms in the smallest towns.

Mexico has long been a traditional source of black-market anabolics. Last year Australian journalist Mark Forbes ventured into the pharmaceutical bazaars of Tijuana for a series of articles in The Age on the illicit trade of Aussie-made steroids. He walked into a pet store that carried a few token dog supplies among the shelves of anabolic steroids and loitered as wholesome American boys lined up to buy the drugs, haggling over the price in time-honored Tijuana fashion. "In 15 minutes the store has sold nearly $20,000 worth of steroids with not a peso spent on pet supplies," he wrote.

"Walking into the trade in Tijuana was an eye-opener," he says. "The scale was a genuine surprise. Guys were handing over thousands of dollars. One told me he was planning to resell back in the U.S. for a healthy profit. A couple of older guys came in and bought 20 or 30 vials, clearly for dealing."

If it's not Mexico, it's Europe or Asia, thanks largely to the Internet. "What we've started seeing are these Internet pharmacies," says Dean Boyd, a spokesman for the U.S. Customs Service, the agency charged with intercepting steroids. "They're based overseas, and they will sell you anything, whether you have a prescription for it or not."

In January, Customs and Drug Enforcement Agency officers busted two men in New York City for receiving 3.25 million steroid pills—the largest seizure of anabolics in U.S. history. It was part of what Boyd identifies as an 87 percent increase in steroid seizures in the last year, from 1.3 million doses in fiscal 1999 to 2.5 million in fiscal 2000.

The steroid subculture is flourishing, doing brisk business at the intersection of some of our most powerful contemporary forces: our desire to look perfect and our demand for immediate results. "As more people become aware of steroids and the fact that they're not the scourge of mankind they've been made out to be, more mainstream guys want to use them," Wright observes. "Not just serious bodybuilders, but lawyers, businessmen and doctors."

"We live in a country that increasingly believes the end justifies the means," Yesalis says. "More people practice situational ethics, moral relativism and other such bankrupt philosophies." There are more forces than ever nudging guys toward steroid use—G.I. Joe, football studs or the simple desire to be a bigger, sexier dude—and there are fewer considerations, medical or moral, urging them to just say no.

"I was as hard as a damn chiseled block of granite. I had girls looking at me in shock."