ATHENA Targets Steroid Abuse

By Staff

Coaching Management, 13.9, October 2005,

Take competitive young athletes dedicated to performing at their best, have them play a sport with components of power and speed, and mix in the idea that a toned, muscular look is necessary at all costs. You may have a recipe for dangerous abuse of anabolic steroids.

Steroid abuse is generally considered far less common than the use of so-called recreational drugs, but many experts believe it is increasing among college and high school students. The National Institutes of Health’s ongoing Monitoring the Future study found in its 2004 survey that 270,000 eighth, 10th, and 12th graders nationwide (3.4 percent) admitted steroid use, and noted a 62 percent increase in use among 12th graders since 1991. A Texas A&M study cited in a multi-part Dallas Morning News special report into high school steroid use said that nearly 42,000 Texas students in grades seven through 12 (2.3 percent) had used steroids.

Much of the attention has focused on males, athletes in particular, but Congress held a hearing in the spring on females’ use of illegal performance-enhancing substances. A U.S. Centers for Disease Control and Prevention survey suggested that 5 percent of high school girls have abused steroids. And when the Oregon Health and Sciences University assessed its steroid abuse-prevention programs in 13 Oregon high schools, it found twice as many female non-athletes used steroids as athletes, which researchers attributed to a desire to look thin yet fit.

What is a coach’s role in addressing steroid abuse? Are there right ways and wrong ways to talk about it? What’s a good way to raise the subject?

An answer might lie in Athletes Targeting Healthy Exercise and Nutrition Alternatives (ATHENA), a drug abuse-prevention program developed by OHSU and endorsed by federal agencies. ATHENA is designed for female athletes and, like its male counterpart Athletes Training and Learning to Avoid Steroids (ATLAS), which is endorsed by the U.S. Center for Substance Abuse Prevention and cited in a 2004 federal law on steroids, it focuses not on the dangers of using steroids but on teaching positive alternatives.

ATHENA targets two major precursors to steroid abuse: disordered eating practices and depression, says Linn Goldberg, Professor of Medicine and head of the Division of Health Promotion & Sports Medicine at OHSU. “The program is designed to make girls understand that what they do affects how they feel, and teach them how to do things that can help them avoid depression, because depression is linked to substance abuse in girls,” says Goldberg.

ATHENA tackles disordered eating not with scare tactics, which Goldberg says studies show don’t work, but by presenting alternatives. “It provides tools to succeed,” he says. “We don’t talk about calories for girls. We talk about eating carbohydrates and protein—carbohydrates as fuel for their body for high-intensity exercise, protein for their muscle and bone strength, and calcium for bone strength and muscle activity. We tell them, ‘Here are the positive things you get, and this is what you need.’ We don’t say ‘Watch your calories.’”

The dangers aren’t ignored, but are presented less as a warning than as information. “We tell them what really happens, both the positive and the negative,” Goldberg says. “Steroids make you stronger. We don’t deny that at all. They make you faster. And they work more quickly than food and proper training. But proper training gets you where you want to go. We tell them the fastest way to get off a five-story building is to jump. If you’ve got a small safety net, you might hit it or you might miss it. It’s a great risk. Going down the stairs is going to take longer, but it’s the safest way.”

ATHENA can be worked into a program on light practice days, with a team broken into small groups led by trained facilitators, says Wendy Stammer, Head Volleyball Coach at Lakeridge High School in Lake Oswego, Ore., one of the schools where the program was tested. Stammer believes it was effective at getting across appearance-acceptance messages, with athletes engaging in creative activities such as their own advertising campaigns to counter societal expectations.

“At my high school, there have been problems with bulimia and anorexia, and it was really important for the players to hear what kinds of things are good to eat and what they should stay away from,” Stammer says. “Before, on many tournament days, they would bring in a lot of junk food. Now the girls are bringing healthy food that will give them sustained energy. It’s not good for athletes to diet during the season, and they needed to hear that from somebody other than me.”

ATHENA works through a series of peer-to-peer activities, but coaches still have a role in preventing steroid abuse, whether working through a formal program or not. A key point for coaches, says Frank Uryasz, President of the National Center for Drug Free Sport, is to make sure you aren’t sending mixed messages. Young athletes can misunderstand an admonition to gain strength, he says, especially if the coach doesn’t explain the right ways to achieve it and the risks of taking substance-enhanced shortcuts.

“That silence can be interpreted as approval for turning to various substances,” Uryasz explains. “We can educate with brochures, posters, and educational sessions, but I don’t know of any greater prevention tool than a strong non-use message from a coach.”

Uryasz says many athletes don’t have using steroids in mind when they first try to gain strength or alter their appearance. Instead, an athlete might take a protein or amino-acid supplement, such as creatine, and when it doesn’t show sought-after results, steroids become the next step.

“I’m convinced that dietary supplements are the training wheels for anabolic steroid users,” Uryasz says. “Many people don’t realize the connection between the use of supplements and steroids, but athletes will often use a host of dietary supplements before resorting to a steroid.”

For more information about ATHENA go to: