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Increased educational resources are available to at least certain age groups and are now reaching larger numbers of children. The percentage of pre-adolescent athletes who have heard of steroids has increased significantly from 78% in 1989 to 88% in the current survey (p<.05). In 1989, only 50% of respondents had had steroid side effects explained to them. This significantly increased to 64% in the current study (p<.05). Currently, 60% of respondents felt that steroids, even if used carefully, would still harm the athlete compared to 56% in 1989 (p<.05). Furthermore, 65% currently consider steroid use a drug problem compared to 57% in 1989 (p<.05).

Awareness and educational efforts are working to help prevent anabolic steroid abuse in schools and communities. The Adolescents Training and Learning to Avoid Steroids (ATLAS) and the Athletes Targeting Healthy Exercise and Nutrition Alternatives (ATHENA) programs, funded by the NIDA, and supported by the Oregon Health & Science University programs is teaching athletes that they do not need steroids to build powerful muscles and improve athletic performance. These programs provide weight-training and nutrition alternatives, increase healthy behaviors, less likelihood to try steroids, and less likelihood to engage in other dangerous behaviors such as drinking and driving, use of marijuana and alcohol , and and improved body image. Bother Congress and the Substance Abuse and Mental Health Services Administration endorsed these model prevention programs. 4

In addition to the mentioned side effects several others have been reported. In both males and females acne are frequently reported, as well as hypertrophy of sebaceous glands, increased tallow excretion, hair loss, and alopecia. There is some evidence that anabolic steroid abuse may affect the immune system, leading to a decreased effectiveness of the defense system. Steroid use decreases the glucose tolerance, while there is an increase in insulin resistance. These changes mimic Type II diabetes. These changes seem to be reversible after abstention from the drugs.

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