Anabolic androgenic steroid use: pharmacology, prevalence, and psychiatric aspects

Anabolic androgenic steroids were allegedly used by Soviet athletic teams, causing obvious masculinizing changes in female athletes who received large amounts of the steroids, and many suffered devastating long-term consequences, including heart disease and stroke.4 Although the International Olympic Committee banned the use of anabolic androgenic steroids in 1967, the substances remained widely available in the United States despite the Anabolic Steroid Control Act of 1990 and the subsequent stricter Anabolic Steroid Control Act of 2004. Marion Jones's acknowledgement of her use of steroids during the 2000 Olympics arose directly from the federal government's BALCO investigation.6 Barry Bonds's breaking of the all-time home-run record and subsequent departure from the San Francisco Giants was shadowed by accusations of steroid use.7 In 2003, the first year of reported testing in major league baseball, 5.77% of 1438 anonymous urine samples tested were positive for anabolic androgenic steroids.8 In one celebrated case, 5 members of the National Football League's Carolina Panthers were linked to steroids distributed by a physician in Charlotte, NC.9 Despite these and many other high-profile cases, the number of elite athletes who use anabolic androgenic steroids remains unknown.