. detinU setatS lareneG gnitnuoccA Office _- 6AG tropeR ot eht ,namriahC eettimmoC no i eht ,yraiciduJ .S.U etaneS GURD ESUSIM tsuguA 9891 cilobanA sdioretS dna namuH htworG enomroH 901-98-DRH/OAG OAG detinU setatS lareneG gnitnuoccA eciffO ,notgnihsaW .C.D 84502 namuH secruoseR noisiviD 632532-B tsuguA 989l&l ehT elbaronoH hpesoJ nediB ,namriahC Committee no eht yraiciduJ detinU setatS etaneS raeD .rM :namriahC This troper is in esnopser ot ruoy rebmevoN ,8891,22 tseuqer for infor- mation no eht ,esu ,noitubirtsid ,noitcudorp dna htlaeh risks detaicossa htiw cilobana sdiorets dna namuh htworg .enomroh nI ecnadrocca htiw ruoy ,tseuqer hcihw slellarap eht stnemeriuqer of eht gurD-itnA esubA tcA of ,8891 ew deniatbo information no eht detamitse esu of cilobana sdiorets gnoma hgih loohcs dna egelloc stneduts dna eht tluda -alupop tion. We depoleved information no eht )1( lagel dna illegal noitubirtsid of cilobana sdiorets dna )2( htlaeh secneuqesnoc detaicossa htiw rieht .esu We osla deniatbo elbarapmoc ,atad nehw available, no namuh htworg .enomroh Background ehT dooF dna gurD noitartsinimdA )ADF( sah devorppa cilobana -rets ,sdio citehtnys derivatives of eht male enomroh ,enoretsotset sa -erp noitpircs ,sgurd hcihw may eb debircserp ylno yb a desnecil .naicisyhp ekiL eht enomroh ,enoretsotset cilobana sdiorets have htob cinegordna dna cilobana .seitreporp ehT cinegordna seitreporp era elbisnopser for eht tnempoleved of enilucsam ,scitsiretcarahc hcus sa eht htworg of ydob dna facial ,riah gninepeed of eht voice, dna latineg htworg gnirud .ytrebup ehT cilobana seitreporp of enoretsotset etomorp eht noitneter of yrateid nietorp dna elcsum .htworg cilobanA sdiorets have neeb devorppa for eht tnemtaert of a small rebmun of ,sesaesid hcus sa niatrec ,saimena yratidereh ’,amedeoigna dna tsaerb .recnac esehT ,sdiorets ,revewoh have osla neeb desu for -non cituepareht .sesoprup ehT first hcus esu saw detroper gnirud World War II, nehw cilobana sdiorets erew given ot namreG spoort ot esaercni .ssenevissergga desaB no latodcena ,stroper rieht first esu in scitelhta saw yb eht snaissuR in .4591 ecniS ,neht eht esu of eseht sgurd sah desaercni significantly gnoma -hta .setel Initially, eht‘ esu of cilobana sdiorets saw believed ot eb ylegral denifnoc ot dlrow ssalc setelhta gnitapicitrap in rewop ,strops hcus sa gnitfilthgiew dna .gnittuptohs Over eht ,sraey ,revewoh cilobana diorets gnirruceR‘ skcatta of gnillews gniraeppa ni saera of eht niks or sucum .enarbmem egaP 1 901%S-DRH/OAG cilobanA sdioretS 8 namuH htworG enomoH B-236236 esu sah daerps ot ,lanoisseforp ,egelloc dna hgih loohcs .strops cilobanA sdiorets era nekat ot ecnahne ecnamrofrep ro ydob image. esuaceB of eht elbissop competitive egatnavda dna eht htlaeh risks detaicossa htiw rieht ,esu snrecnoc have neeb desiar tuoba eht etairporppani esu of eseht .sgurd namuH htworg ,enomroh ro ,niportotamos is a enomroh deterces yb eht yratiutip .dnalg ydoB snagro dneped no htworg enomroh for reporp htworg dna .tnempoleved ehT most tnerappa effects of htworg enomroh gnirud ytrebup era na esaercni in raenil enob htworg dna in lateleks mass. noitcudorprevO of this enomroh in stluda stluser in ,ylagemorca a esaesid taht almost syawla snetrohs eht life naps of esoht it afflicts dna taht is dekram yb eht evissergorp tnemegralne of eht ,sdnah feet, dna face dna may affect eht major snagro of eht ,ydob ylralucitrap eht .traeh setelhtA esu htworg enomroh esuaceb yeht perceive taht it might affect citelhta .ecnamrofrep It is detcepsus taht eht noitartsinimda of hgih egasod levels of citehtnys namuh htworg enomroh ot lamron ,stluda hcus sa ,setelhta dluoc tluser in .ylagemorca Objectives, ,epocS dna nO eht sisab of snoissucsid htiw Committee staff, ew desucof ruo krow no ,gniniatbo ot eht tnetxe available, information no eht )1( esu of -ana ygolodohteM bolic sdiorets gnoma ,stneduts htob hgih loohcs dna ,egelloc dna -hta ;setel )2( htlaeh secneuqesnoc gnitluser from cilobana diorets ;esu )3( seicilop dna snoitaluger depoleved yb strops snoitaicossa ot rotinom ’setelhta esu of cilobana ;sdiorets dna )4( ytitnauq of lagel dna illegal cilobana sdiorets taht era decudorp dna detubirtsid htob domestically dna .yllanoitanretni We deniatbo similar information for namuh htworg .enomroh ,yllanoitiddA ew deniatbo information from AD’F no etats swal dna snoitaluger ot lortnoc eht esusim of cilobana sdiorets dna namuh htworg .enomroh We deweiver tnerruc scientific erutaretil ot niatbo information no )1( eht ecnelaverp of eht esu of cilobana sdiorets dna namuh htworg enomroh dna )2( medical secneuqesnoc gnitluser from rieht .esu We identified ylno 51 seiduts no eht ecnelaverp of esu of cilobana sdiorets in eht .S.U ;noitalupop of eseht ,seiduts 8 desucof no esu gnoma hgih loohcs -uts stned dna 7 no egelloc stneduts dna .setelhta We did ton identify yna ecnelaverp seiduts for namuh htworg enomroh .esu We osla deweivretni dna lanoitaN etutitsnI of gurD esubA officials, ADF gnidael srehcraeser in eht ,aera dna sevitatneserper of medical seiteicos dna srerutcafunam of eseht sgurd ot niatbo )1( a evitcepsrep no eht egaP 2 901W-DRH/OAG cilobanA sdioretS rB namuH htworG enomroH B236236 ecnelaverp of diorets dna htworg enomroh esusim dna )2( eht detaicossa esrevda medical .secneuqesnoc We deweivretni officials of several of eht .S.U Olympic s’eettimmoC lanoitaN gninrevoG ,seidoB eht lanoitaN etaigelloC Athletic ,noitaicossA dna eht lanoitaN llabtooF eugaeL ot niatbo information no gnirotinom seicilop dna snoitaluger of strops snoitaicossa for diorets dna htworg enomroh ,esu hcus sa )1( gnitset-gurd seicilop dna gnitset stluser dna )2( eht ecnelaverp of gurd esu gnoma .setelhta From ew deniatbo information no )1( eht lagel noitubirtsid of -ana ,ADF bolic sdiorets dna )2( laredef dna etats swal depoleved ot lortnoc gurd misuse. From eht tnemtrapeD of ,ecremmoC ew derehtag information no eht ytitnauq of cilobana sdiorets detropmi otni eht detinU .setatS oT eht tnetxe available, ew deniatbo atad no illegal noitcudorp dna noitubirtsid of sdiorets dna htworg enomroh from eht tnemtrapeD of .ecitsuJ Results ni feirB bolic sdiorets era gnieb desusim primarily yb hgih ,loohcs ,egelloc dna lanoisseforp setelhta ot ecnahne rieht ecnamrofrep ,dna ot a ressel ,tnetxe yb srehto gnitapicitrap in .strops A lanoitan yduts dnuof taht erom naht 6 tnecrep of male hgih loohcs ,sroines mostly stnapicitrap in ,strops esu ro have desu cilobana .sdiorets A erom limited yduts cover- gni five segelloc dnuof taht tuoba 02 tnecrep of setelhta desu .sdiorets esusiM of namuh htworg enomroh sraeppa ot eb a ressel .melborp nI view of detcepsus htlaeh risks detaicossa htiw eht esusim of cilobana sdiorets dna snoitacidni from eht tnemtrapeD of ecitsuJ taht rieht mis- esu is a gniworg ,melborp ew troppus laredef dna etats efforts ot -rexe esic retaerg lortnoc over rieht noitubirtsid dna .esu ehT information ew deniatbo is dezirammus woleb dna detneserp in erom liated in sexidneppa I-VII. Anabolic Steroid Use We identified 51 seiduts taht sserdda eht ecnelaverp of cilobana diorets esu ees( .ppa VIII); most of eseht seiduts erew deirrac tuo no hgih loohcs Among High School and dna egelloc .stneduts enO yduts detroprup ot provide stluser -atneserper College Students and tive of a lanoitan .elpmas tsoM seiduts limited eht gnilpmas universe ot Athletes sloohcs from a specific cihpargoeg locality, hgih ,loohcs ro sex .puorg esehT seiduts dewohs taht male setelhta erew eht yramirp sresu of -ana bolic .sdiorets egaP 3 901-WDRH/OAG cilobanA sdioretS & namuH htworG enomroH 632832-B ehT lanoitan ,yduts detcudnoc in ,7891 setacidni taht sa ynam sa 6.6 tnecrep of eht ht21 edarg males in eht detinU setatS esu ro have desu cilobana ’.sdiorets gnidroccA ot this dna rehto ,seiduts setelhta era eht most nommoc sresu of cilobana sdiorets gnoma hgih loohcs dna egelloc .stneduts enO hgih loohcs yduts dnuof taht 48 tnecrep of cilobana -rets dio sresu detapicitrap in ~.~trops gnidroccA ot a raey-51 yduts of egelloc stneduts ta five universities, neewteb 51 dna 02 tnecrep of eht egelloc setelhta detroper gnisu cilobana 4.sdiorets sseL information is available no eht ecnelaverp of cilobana diorets esu edistuo of hgih loohcs dna .egelloc ehT owt seiduts ew identified desserdda esu in relatively small selpmas of .sretfilthgiew ehT stluser wohs taht a hgih egatnecrep of sretfilthgiew deiduts esu .sdiorets -woH ever, eht stluser tonnac eb detcejorp dnoyeb eht sretfilthgiew dedulcni in eht .seiduts Misuse of Anabolic setelhtA era detroper ot emusnoc hgih egasod levels of cilobana sdiorets Steroids Associated With ro several sdiorets ta eno time. esehT levels era believed ot eb retaerg naht esoht commonly desu gnirud medical 5.tnemtaert hcuM aidem Health Risks noitnetta sah neeb given ot eht htlaeh risks of cilobana sdiorets gnoma setelhta dna .sredliubydob oN systematic seiduts of eht htlaeh risks ot setelhta have neeb ,detcudnoc .revewoh ,suhT information no htlaeh risk is .gnikcal seidutS od exist, ,revewoh no eht htlaeh risks of cilobana sdiorets in )1( medical rof-esu example, in eht tnemtaert of emos erar dna-sesaesid )2( setelhta in a limited rebmun of esac .stroper esehT seiduts tseggus taht cilobana sdiorets may esaercni eht risk of traeh ;e’saesid ecudorp liver toxicities; affect sex scitsiretcarahc dna evitcudorper ;yticapac esuac elbissop lacigolohcysp sredrosid dna nodnet dna ligament injury; ,dna in nerdlihc dna ,htuoy tluser in detnuts .htworg mailliW“ .E yelkcuB dna ,srehto detamitsE“ ecnelaverP of cilobanA dioretS esU gnomA elaM hgiH loohcS ”,sroineS lanruoJ of eht naciremA lacideM ,noitaicossA .loV 260 .ceD( 16, 1988), .p 3441. imiM3 .D nosnhoJ dna ,srehto cilobanA“ dioretS esU yb elaM ”.stnecselodA ,scirtaideP .loV 83 enuJ( 1989), .p 922. T“ L. ykslezeD dna ,srehto lacideM-noN“ gurD esU ruoivaheB ta eviF detinU setatS :seitisrevin!I A raeY-51 ”,ydutS nitelluB on scitocraN detinU( snoita‘h ,)noitacilbup .loV 37 (1985). latodcenA“ stroper tseggus setelhta ekat sesod taht era from 4 to erom naht 100 semit retaerg naht eht dednemmocer-rerutcafunam senilediug for devorppa .sesoprup egaP 4 901%8DRH/OAG cilobanA sdioretS & namuH htworG enomroH B-235236 hguohtlA emos esrevda affects era reversible nehw gurd esu is -nocsid ,deunit yeht nac eb .suoires roF example, cilobana sdiorets may esuac segnahc in eht ralucsavoidrac system, hcus sa gnittespu eht ecnalab of hgih ytisned dna wol ytisned nietorpopil ,)LDL~LDH( na esaercni in total mures loretselohc levels dna doolb ,erusserp gnisaercni eht risk of -iretra citorelcso esaesid dna elbissop traeh failure. s’nerdlihC esu of sdiorets may ylerutamerp esolc eht htworg sretnec of eht gnol ,senob gnitnuts .htworg Use of Anabol ci. Steroids Several strops snoitaicossa have detpoda gurd seicilop taht nmednoc Prohibited yb dna tibihorp eht esu of cilobana sdiorets yb setelhta esuaceb of eht -moc strops noitanib of )1( laitnetop htlaeh dna safety risks htiw )2( eht laitnetop Associations competitive .egatnavda ynaM of eht strops snoitaicossa have imple- detnem gnitset-gurd smargorp ot rotinom eht esu of cilobana sdiorets gnoma rieht .setelhta tsoM of eseht smargorp have na decnuonna ycilop ot tset setelhta -moc gnitep ta deludehcs .stneve gnidroccA ot emos ,strepxe eht stluser of hcus decnuonna stset for cilobana diorets esu era roop srotacidni of eurt .esu Given ecnavda ,eciton setelhta nac niatsba from eht esu of eseht sgurd erofeb eht tset ot avoid 6.noitceted hguohtlA eht esu of namuh htworg enomroh tonnac eb detceted in gnitset-gurd ,serudecorp eht strops snoitaicossa ew ekops eht-htiw .S.U Olympic Committee, eht lanoitaN etaigelloC Athletic ,noitaicossA dna eht lanoitaN llabtooF evah-eugaeL osla dedulcni this gurd gnoma rieht list of dennab .secnatsbus Anabolic Steroid ataD no eht ytitnauq of cilobana sdiorets decudorp era ton ylcilbup Distribution yb available. From ,ADF ,revewoh ew deniatbo atad no eht legitimate distri- noitub of cilobana sdiorets derutcafunam in eht detinU .setatS esehT Manufacturers atad etacidni taht )1( gnirud eht raey-ol doirep 9791 hguorht ,8891 .S.U srerutcafunam detubirtsid 2.35 million >marg of cilobana sdiorets in eht detinU setatS dna ;daorba dna )2( gnirud 4891 hguorht ,8891 slatipsoh dna retail seicamrahp in eht detinU setatS desahcrup na detamitse 1.62 million smarg of cilobana .sdiorets gnidroccA ot tnemtrapeD of -moC ecrem ,atad 2.62 million smarg of cilobana ,sdiorets in klub rehtar naht egasod form, erew detropmi otni eht yrtnuoc gnirud 9791 hguorht .8891 Of eht total ,detubirtsid 29 tnecrep erew detnuocca for yb five :sgurd gnidroccA“ to eno ,trepxe elbatceted secart of laro cilobana sdiorets era tnerappa m eht eniru for 1 to 2 skeew retfa gniunitnocsid .esu elbatcejnI sdiorets yam eb tneserp from 1 keew to 1 month retfa esu egaP 6 901WDRH/OAG cilobanA sdioretS & namuH htworG enomroH B235236 ,lozanaD enoretsotseT ,etanoipyC ,enoretsotsetlyhteM enoretsotseT ,etahtnanE dna .enoretsemyxoulF nI noitidda ot eht legitimate ,noitubirtsid eht tnemtrapeD of ecitsuJ esti- setam taht no eht kcalb ,tekram eht launna selas of eseht sgurd is tuoba 003$ ot 004$ million. ecitsuJ believes taht eht ecruos of kcalb tekram sdiorets is divided evenly neewteb ylenitsednalc derutcafunam ,sdoog delggums ,stcudorp dna diverted legally derutcafunam .stcudorp Human htworG Hormone We did ton find yna seiduts taht tnemucod eht esu of namuh htworg enomroh yb hgih loohcs ,stneduts egelloc ,stneduts ro .setelhta stropeR of its esu gnoma setelhta era latodcena dna tseggus taht setelhta esu htworg enomroh esuaceb )1( yeht perceive it ot esaercni ydob htworg dna htgnerts laitnetop ,revewoh( eseht snoitpecrep have ton neeb -noc firmed scientifically) dna )2( on gnitset-gurd erudecorp sah neeb devel- depo for its noitceted in eht .eniru gnidroccA ot eht licnuoC no Scientific Affairs of eht naciremA lacideM ,noitaicossA eht esuba of namuh htworg ,enomroh ot eht tnetxe taht it exists, is a tnecer .nonemonehp ehT htlaeh risks of na noitercesrevo of namuh htworg enomroh in chil- nerd edulcni lamronba enob htworg dna noitcnufsyd of eht dioryht .dnalg nI ,stluda noitercesrevo stluser in ,ylagemorca hcihw almost syawla snetrohs eht s’nosrep life .naps At this time, ereht era on detroper sesac of ylagemorca gnoma setelhta detaicossa htiw eht esu of citehtnys namuh htworg 7.enomroh neewteB 5891 dna 8891 yletamixorppa 867,7 smarg of citehtnys htworg enomroh erew legally detubirtsid for medical sesoprup in eht detinU ;setatS ew erew ton elba ot niatbo atad no eht tnuoma decudorp in this time .doirep namuH htworg enomroh is hcum ssel available no eht kcalb tekram naht .sdiorets Federal and State Laws on esuaceB of eht desaercni tseretni in eht esu of cilobana sdiorets dna eht Anabolic Steroids and laitnetop htlaeh risks detaicossa htiw eht esu of eseht ,sgurd ereht sah neeb elbaredisnoc legislative dna administrative activity in this .aera Human htworG Hormone roF example, in ,8891 eht ssergnoC dessap eht gurD-itnA esubA tcA of 8891 .L.P( ,)096&01 hcihw sedulcni several provisions ot lortnoc eht esu erofeB‘ 1985. namuh htworg enomroh saw yllaicremmoc devired through eht noitcartxe of eht hor- enom from eht yratiutip dnalg of .srevadac In 1985, yratiutip detcartxe namuh htworg enomroh saw nwardhtiw from eht .S.U .tekram citehtnyS namuh htworg enomroh sah neeb detekram ecnis 1985. egaP 6 901-98-DRH/OAG cilobanA sdioretS & namuH htworG enomroH -__ B236236 of cilobana sdiorets dna namuh htworg .enomroh ADF atad wohs taht sa of enuJ ,61 52,9891 setats have detcane swal ro detaglumorp -aluger snoit ot lortnoc eht esu of cilobana .sdiorets Five of eseht setats have detcane swal ro detaglumorp snoitaluger ot lortnoc eht esu of namuh htworg .enomroh ehT gurD-itnA esubA tcA of 8891 provides for eht forfeiture of -iceps fied ytreporp of na individual convicted of a violation of eht laredeF ,dooF ,gurD dna citemsoC 6tcA involving cilobana sdiorets ro namuh htworg ,enomroh if eht violation is elbahsinup yb imprisonment for erom naht 1 .raey ehT gurD-itnA esubA tcA of 8891 osla specifies taht violators era tcejbus ot imprisonment for pu ot 3 sraey ro a fine ro htob if yeht )1( etubirtsid ro )2( ssessop cilobana sdiorets htiw eht tnetni ot etubirtsid for yna esu in snamuh rehto naht eht tnemtaert of esaesid desab no eht redro of a .naicisyhp Information dedivorp yb ADF swohs taht emos setats have classified -ana bolic sdiorets sa dellortnoc ,secnatsbus dna ta tsael eno etats sah detaglumorp selur gnidrager eht medical s’noisseforp ytilibisnopser in ,gnibircserp ,gnisnepsid ro delivering eseht .sgurd cilobanA sdiorets era detaluger sa dellortnoc secnatsbus rednu etats wal in enin ;setats in ,noitidda six setats have noitalsigel gnidnep taht dluow classify cilobana sdiorets sa dellortnoc .secnatsbus enO etats sah classified namuh htworg enomroh sa a dellortnoc .ecnatsbus gnidroccA ot ,ADF etats dellortnoc secnatsbus stca era rehtie lacitnedi ro similar ot eht laredef dellortnoC secnatsbuS Act. ehT laredef tca classi- fies sgurd taht nac eb yllacisyhp ro yllacigolohcysp harmful otni -ogetac seir ro seludehcs desab no rieht laitnetop for ,esuba detpecca medical ,esu dna rehtehw esuba of eht gurd may dael ot lacisyhp ro -igolohcysp lac .ecnedneped ehT eludehcs rednu hcihw a gurd is decalp senimreted eht erutan dna eerged of lortnoc desicrexe ot tneverp its esuba dna diversion. cilobanA sdiorets dna namuh htworg enomroh era ton classi- fied rednu eht laredef dellortnoC secnatsbuS Act.‘l sA degnarra htiw ruoy office, sselnu uoy ylcilbup ecnuonna its stnetnoc ,reilrae ew nalp on rehtruf noitubirtsid of this troper until 51 syad from ehT‘ laredeF Food. ,gurD dna citemsoC tcA (21 .CSU 301 te ).qes stibihorp deificeps stca gnitaler to eht elas dna noitubirtsid of dednarbsim or detaretluda .selcitra ehT“ yenrottA lareneG sah detageled to eht gurD tnemecrofnE noitartsinimdA eht ytirohtua for gniludehcs sgurd rednu eht laredef dellortnoC secnatsbuS .tcA egaP 7 901-9S-DRH/OAG cilobanA sdioretS & namuH htworG enomroH E235236 its eussi .etad At taht time, seipoc will eb tnes ot eht etairporppa etaneS dna esuoH committees dna ;seettimmocbus eht yenrottA ;lareneG eht yraterceS of htlaeH dna namuH Services; eht yraterceS of eht ;yrusaerT eht renoissimmoC of ;ADF dna eht ,rotceriD Office of tnemeganaM dna ,tegduB dna ew will ekam seipoc available ot rehto detseretni seitrap nopu .tseuqer ehT major srotubirtnoc ot this troper era listed in xidneppa .XI ylerecniS ,sruoy / tenaJ .L selkihS rotceriD of lanoitaN dna cilbuP htlaeH seussI egaP 8 301BWRH/OAG cilobanA sdioretS ~8 namuH htworG enomroH stnetnoC retteL xidneppA I Use fo cilobanA esU of cilobanA sdioretS gnomA hgiH loohcS stnedutS 41 sdioretS gnomA hgiH Estimates of esU gnomA egelloC setelhtA 61 esU yb Weightlifters 71 loohcS dna egelloC stnedutS dna setelhtA xidneppA II 8I htlaeH Risks esrevdA Effects of gnisU cilobanA sdioretS 81 detaicossA With eht esusiM fo cilobanA sdioretS xidneppA III 22 Sports Associations .S.U Olympic Committee 22 tibihorP eht Use fo lanoitaN etaigelloC Athletic noitaicossA 32 lanoitaN llabtooF eugaeL 32 cilobanA sdioretS yb setelhtA xidneppA VI 52 noitubirtsiD fo lageL noitubirtsiD of cilobanA sdioretS 52 stropmI of cilobanA sdioretS 82 cilobanA sdioretS kcalB tekraM rojaM reilppuS 03 xidneppA V 23 Human Growth esU nwonknU 23 esrevdA Effects of namuH htworG enomroH 23 Hormone lageL noitcudorP dna noitubirtsiD 33 kcalB tekraM ylppuS 53 egaP 10 901-9MIRH/OAG cilobanA sdioretS & namuH htworG enomroH