Source: New York Times
Date: 4 March 2003

Addictive Effects of Steroids Raise
Questions About Users' Awareness


Mario J. Vassallo is a former semipro football player, a former steroid user and now the lead researcher in a Central Michigan University study of the addictive effects of steroids.

"From my own personal experience," he said, "and 36 of the 38 guys I interviewed said the same thing: once you take start taking steroids, within the first three days, it's a different life you're leading. You feel invincible, on top of the world. Within two weeks, you feel your workouts change. You used to do an hour and a half and get tired. You can change to two hours a day and feel ready to go back and do the same thing. And the pump you get, you don't want to lose it."

The question he was answering was simple. People associated with the Bay Area Laboratory Co-Operative, or Balco, which is at the center of a federal investigation into the distribution of steroids, say that they dealt only in vitamin and mineral supplements. So if prosecutors are right and what Balco really sold was a new designer steroid, tetrahydrogestrinone, or THG, is it possible that its customers could not have known what they were taking?

Some of the athletes who testified before a federal grand jury in San Francisco have told reporters that they have never taken steroids. Their powerful physiques, they said, came from hard workouts and careful eating. And the slimmer physiques that some reporters say they have spotted since the investigation began, they said, came from hard workouts and careful eating.

The Yankees' Jason Giambi, for example, said reports that he had lost 20 pounds were exaggerated. He lost four, he said, by giving up fast food and "cleaning up" excess fat.

But some have hedged. Barry Bonds's lawyer told Reuters that his client, Balco's most famous customer, might have unknowingly taken steroids hidden in the company's nutritional shakes. Reactions to that from doctors who are steroid experts and from steroid-taking gym rats are mixed.

Dr. Harrison G. Pope Jr., chief of the biological psychiatry laboratory at McLean Hospital at Harvard, said it was possible "in theory" that an athlete would not know he was taking a steroid because different users experience different effects. Some have bouts of rage, for example, while others do not, even with high doses.

"But if somebody is an elite athlete," Pope said, "it would seem rather implausible that they would not be very precisely interested in what they were taking."

Steve Downs, chairman of the World Natural Bodybuilding Federation, which sponsors drug-free bodybuilding contests, said that some top athletes "have had their hands held all the way through their careers." If they are told a product is legal, he said, "they just close their eyes and take whatever's pushed at them."

But Patrick Keogan, an electric company lineman who is a former steroid user and was once arrested on charges of selling designer steroids, begs to differ.

"No one," he said, "is that ignorant."

In the 1990's, Keogan put in five years in a gym trying to bulk up, spending $200 a week on legal supplements from the health food store where he worked. He could never get himself to weigh more than 150 pounds or lift more than 185 pounds on an incline bench.

Within 20 weeks of starting on steroids, he weighed 200 pounds, he said. "People would come into my shop and ask me, `Does Patrick still work here?' " Eventually, he said, "I could put on three plates — that's 350 pounds — and do 15 reps, and the last one went up as quickly as the first."

Eventually, Keogan was injecting three drugs a day; experts say injectable steroids cause fewer problems than pills. Hospitalized with the bloody urine of kidney damage, "I just laid off the orals and doubled my injectables," he said.

And everyone noticed his bouts of rage.

"It was happening in traffic, even at work," Keogan said. "The cops were even called there. On the rare occasion I went a day without going after somebody, I'd make a mental note of it: `Hey! I didn't go after anybody today.' "

He quit, Keogan said, after he jumped out of his car to fight someone and realized that he had left his car rolling forward with the door open and his baby in the back seat.

Quitting with a psychiatrist's help "turned me into the incredible shrinking man," he said. He dropped to 160 pounds. His hair, thinned by steroids, did not return.

The first clinical signs of steroid use, said Dr. Gary I. Wadler, a professor of medicine at New York University who helped write international anti-doping codes, are irritability, acne on the back and tender breasts.

"You know things are happening to you within a month or two," Wadler said. But even sooner than that, he said "you see yourself bench-pressing more, your recovery times are faster, and your muscle builds."

Vassallo confirmed that, describing how he went from being able to bench-press 225 pounds 8 times to doing it 23 times.

He never had rages, he said, but "I was just more on edge over little things." His interviews suggested that "if you already had a short fuse, it enhanced it."

Both he and Dr. Joann Dahlkoetter, a marathon winner and sports psychologist at Stanford University's medical center, said the first question most male athletes ask is whether their testicles will shrink. The answer is yes, but they grow back when you stop, Vassallo said. They shrink because the flood of testosterone negates the body's need to make any. But because testosterone breaks down into estrogens, men's voices may rise, and their breasts get larger. In women, the extra testosterone can make the clitoris grow and the face sprout thick hair.

In the long term, steroids raise cholesterol level and blood pressure, creating the risk of heart attack and stroke. The liver can malfunction, so jaundice yellows the eyes and skin. Adolescents stop growing because the growth plates in the bones close prematurely.

The most devastating effects may not appear for years, Wadler said. But the immediate effects are so obvious that the athletes in the Balco case cannot say, "I didn't know," he said. "I don't buy that one," he said. "If you're taking THG, you know."

The world of building muscle, many experts said, is filled with denials, lies and advice given with a wink and a nod.

Web sites like, for example, advertise what appear to be legal diet supplements and workout clothing. But the moderated discussion groups, using pseudonyms, are filled with detailed advice on how to find and inject steroids, human growth hormone and insulin, which is used as a booster. Sometimes they warn that insulin, for example, can quickly induce coma and death.

One discussion group is set up for users to post pictures of drugs they have bought, asking other users whether they look genuine, or of batches of injection solution they have cooked up at home, asking whether they look right.

Keogan, who used to operate in that world, said he was skeptical even of "natural" contests for which contestants have to pass both urine and polygraph tests. The winners' bodies are virtually identical to those in contests in which steroids are routine, he said. Bodybuilders say they can pass lie-detector tests by taking Valium to calm down, he said. And, naming a well-known "natural bodybuilding" contest, Keogan added, "I've sold to people who took first place in Musclemania."

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