[OA] Raising The Bar: Why The Anabolic Steroid Control Acts Should Be Repealed And Replaced
In 1990, against the advice of the American Medical Association, the Food and Drug Administration, the Drug Enforcement Administration, and the National Institute on Drug Abuse, Congress passed the Anabolic Steroid Control Act (ASCA) with the aim of putting an end to “cheating” in sports.
Far from eliminating “cheating,” use of anabolic-androgenic steroids (AAS) and performance-enhancing drugs (PED) has proliferated since the ASCA became law. Previously, about 50 percent of steroid users obtained the drugs through medical professionals, thereby ensuring the quality of the drugs administered.
As a consequence of prohibition, “virtually all current abusers obtain the substance from the black market.” Congress’s actions have detrimentally affected the health and well-being of people who, for recreational or professional purposes, make the choice to use these drugs but are left lacking legitimate options. Because this law and its successor, the Anabolic Steroid Control Act of 2004, have failed to meet their stated ends, they ought to be replaced with better legislation.
Unfortunately, informed public discussion of AAS and PED is hindered by widespread myths. “Meathead” stereotypes abound, and the small, isolated culture of physique and strength development has not sufficiently countered their common perception as grunting giants with little concern for more worldly pursuits. Conversely, AAS and PED remain taboo topics to society at large, and as athlete after athlete makes headlines for failing drug tests or confessing to use, many tend to regard that individual as a cheater.
Meanwhile, the medical community has continued to effectively debunk many myths regarding anabolic steroids, including the absence of evidence for “roid rage” and the extent of physical risk involved. Steroids do carry risk, but when administered properly, “androgens are safe.” Indeed, it is well accepted that these compounds have significant medical applications, and in addition to treating millions of men suffering from low testosterone, are used to treat some forms of anemia, some breast cancers, osteoporosis, endometriosis, and hereditary angiodema. However, research too often focuses exclusively on extreme AAS abuse and does not sufficiently denote the correlation between danger and dose.
Andreas Büttner and Detlef Thieme, in Side Effects of Anabolic- Androgenic Steroids: Pathological Findings and Structure-Activity Relationships, provide a comprehensive list of the possible adverse effects of abusing anabolic steroids. Lest errant conclusions be drawn, Büttner and Thieme also note that studies of these pathological effects contain several major methodological problems precluding general applicability. These problems primarily include “exorbitant dosages,” lack of reliable data from self-reporting, and difficulty identifying precise causation chains regarding more severe side effects. It is readily apparent that extreme use can be a cause of many of the purported medical risks.
Taken in the aggregate, however, these studies dispel many popular notions as to the intrinsic risks. For these reasons, only a small fraction of the purported risks of anabolic-androgenic steroids can be confirmed in lesser doses. A 1996 study of the effects of supraphysiologic doses of testosterone in forty-three normal men reached landmark conclusions about the safety of steroid use.
The subjects were given either 600 milligrams of testosterone enanthate or a placebo for ten weeks. This was the highest amount administered in any study of athletic performance at that time. “Stunn[ing] many in the medical community,” there was an absence of any systemic side effects associated with the androgenic steroids.
Bhasin’s team carefully limited the breadth of this study: it did not discount the “potentially serious adverse effects” of other steroids, of a potential synergistic effect when taking exogenous testosterone in conjunction with other drugs, or of continued administration for an extended period. A consensus has emerged, however, that many of the side effects associated with anabolic steroid abuse are reversible upon cessation.
As a Schedule III controlled substance, anabolic steroids are legally available only by prescription. However, relevant laws ensure that elective use is not a valid reason for a qualified professional to provide a prescription. When compared to the medical and other risks involved in activities permitted by law, this analysis raises the question of why American law at both the federal and state level effectively bans physicians from writing prescriptions for recreational or professional AAS and PED use. If past use patterns hold true today, many of these individuals would take advantage of the opportunity to use safer materials than provided by the black market. Therefore, Congress’s concern in passing the ASCAs could not have been public health and safety.
McGrew RJ. Raising the Bar: Why the Anabolic Steroid Controls Acts Should Be Repealed and Replaced. Hous. J. Health L. & Pol’y. 2015;15:233-52. https://www.law.uh.edu/hjhlp/volumes/Vol_15/McGrew.pdf
In 1990, against the advice of the American Medical Association, the Food and Drug Administration, the Drug Enforcement Administration, and the National Institute on Drug Abuse, Congress passed the Anabolic Steroid Control Act (ASCA) with the aim of putting an end to “cheating” in sports.
Far from eliminating “cheating,” use of anabolic-androgenic steroids (AAS) and performance-enhancing drugs (PED) has proliferated since the ASCA became law. Previously, about 50 percent of steroid users obtained the drugs through medical professionals, thereby ensuring the quality of the drugs administered.
As a consequence of prohibition, “virtually all current abusers obtain the substance from the black market.” Congress’s actions have detrimentally affected the health and well-being of people who, for recreational or professional purposes, make the choice to use these drugs but are left lacking legitimate options. Because this law and its successor, the Anabolic Steroid Control Act of 2004, have failed to meet their stated ends, they ought to be replaced with better legislation.
Unfortunately, informed public discussion of AAS and PED is hindered by widespread myths. “Meathead” stereotypes abound, and the small, isolated culture of physique and strength development has not sufficiently countered their common perception as grunting giants with little concern for more worldly pursuits. Conversely, AAS and PED remain taboo topics to society at large, and as athlete after athlete makes headlines for failing drug tests or confessing to use, many tend to regard that individual as a cheater.
Meanwhile, the medical community has continued to effectively debunk many myths regarding anabolic steroids, including the absence of evidence for “roid rage” and the extent of physical risk involved. Steroids do carry risk, but when administered properly, “androgens are safe.” Indeed, it is well accepted that these compounds have significant medical applications, and in addition to treating millions of men suffering from low testosterone, are used to treat some forms of anemia, some breast cancers, osteoporosis, endometriosis, and hereditary angiodema. However, research too often focuses exclusively on extreme AAS abuse and does not sufficiently denote the correlation between danger and dose.
Andreas Büttner and Detlef Thieme, in Side Effects of Anabolic- Androgenic Steroids: Pathological Findings and Structure-Activity Relationships, provide a comprehensive list of the possible adverse effects of abusing anabolic steroids. Lest errant conclusions be drawn, Büttner and Thieme also note that studies of these pathological effects contain several major methodological problems precluding general applicability. These problems primarily include “exorbitant dosages,” lack of reliable data from self-reporting, and difficulty identifying precise causation chains regarding more severe side effects. It is readily apparent that extreme use can be a cause of many of the purported medical risks.
Taken in the aggregate, however, these studies dispel many popular notions as to the intrinsic risks. For these reasons, only a small fraction of the purported risks of anabolic-androgenic steroids can be confirmed in lesser doses. A 1996 study of the effects of supraphysiologic doses of testosterone in forty-three normal men reached landmark conclusions about the safety of steroid use.
The subjects were given either 600 milligrams of testosterone enanthate or a placebo for ten weeks. This was the highest amount administered in any study of athletic performance at that time. “Stunn[ing] many in the medical community,” there was an absence of any systemic side effects associated with the androgenic steroids.
Bhasin’s team carefully limited the breadth of this study: it did not discount the “potentially serious adverse effects” of other steroids, of a potential synergistic effect when taking exogenous testosterone in conjunction with other drugs, or of continued administration for an extended period. A consensus has emerged, however, that many of the side effects associated with anabolic steroid abuse are reversible upon cessation.
As a Schedule III controlled substance, anabolic steroids are legally available only by prescription. However, relevant laws ensure that elective use is not a valid reason for a qualified professional to provide a prescription. When compared to the medical and other risks involved in activities permitted by law, this analysis raises the question of why American law at both the federal and state level effectively bans physicians from writing prescriptions for recreational or professional AAS and PED use. If past use patterns hold true today, many of these individuals would take advantage of the opportunity to use safer materials than provided by the black market. Therefore, Congress’s concern in passing the ASCAs could not have been public health and safety.
McGrew RJ. Raising the Bar: Why the Anabolic Steroid Controls Acts Should Be Repealed and Replaced. Hous. J. Health L. & Pol’y. 2015;15:233-52. https://www.law.uh.edu/hjhlp/volumes/Vol_15/McGrew.pdf
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~Ogh
