Journal of Pharmacy Practice

This article describes the professional services project for the Phi Delta Chi Professional Pharmacy Fraternity—Beta Gamma Chapter—preparation of an educational videotape on abuse of anabolic steroids. A short summary of the adverse effects of these steroids, a personal story involving steroid abuse, recovery, and motivation and stimulation of a group of pharmacy students to provide important educational services to teenagers (and older aspiring athletes) is presented.

Extracts of the testes of man and animal have been used for some time to enhance performance of a variety of sorts. Medical use of steroids dates back several decades, and recent intense athletic and fitness (bodybuilding) competition has driven some to use and abuse of testosterone and synthetic derivatives in the quest for that extra edge, despite a knowledge that anabolic steroids carry significant risk for liver, endocrine, and psychiatric toxicity, and also carry criminal penalties and disciplinary risks for athletes and health care workers who promote and traffic these substances outside their established medical uses.

Weight control and dieting is a subject of great interest to the American public. The use of pharmacologically active agents to help take weight off and keep it off has ranged from following the golden rules of moderation, not eating to excess, and following a regular plan of exercise. Many people are unable or unwilling to maintain these well-known practices and have sought out chemical means of assisting them is losing weight and keeping it off. The sympathomimetics have a powerfully effective appetite suppression, but also have a long list of serious and habituating adverse effects. Many diets have employed specific schedules and types of food to eat or avoid, but there is no diet employing drugs that is completely safe and effective. One new diet, Fen-Phen represents a new approach. Instead of using a single agent, a combination of two agents is used which affects the brain's neurotransmitters. The results have been impressive so far, but the adverse effects of these two agents and their use and possible interaction with other drugs remains a risk.

Vitamins, minerals, and nutritional supplements constitute materials which have been confused in the minds of consumers. They are promoted and sold by health care providers, including pharmacists, as well as by a wide variety of retail merchants. The relative safety and effectiveness of these substances in treatment of deficiency states has been extended to the notion that since the small recommended daily allowance ensures health or at least a non-deficient state, larger amounts will provide wellness or at least improve health. The proper use of diet, including vitamin and mineral supplements, has been supplanted by a form of unrestricted and unprofessional pharmacy practice. In large amounts, vitamins and minerals can have pharmacological effects including drug interaction and toxicity. The 1994 Dietary Supplements Health & Education Act has opened up the legal use by the general public of some pharmaceutically active ingredients unless they are demonstrated to be dangerous.

Ergogenic aids include prescription and OTC drugs. Many other substances are used for the purpose of enhancing performance. These include black market anabolic steroids, sympathomimetics, vitamins, and nutritional supplements. The effectiveness of these aids varies from potent to non-effective. There is no controversy about the adverse effects of prescription drugs in therapeutic doses. There is widespread confusion about what athletes really do to themselves when taking OTC drugs and dietary supplements containing drugs in large doses or black market drugs at doses and schedules that are user determined. To the extent that any athlete can enhance performance by taking ergogenics, they expose themselves to harm and put pressure on their competitors to join in or be defeated. It is essential to keep the population of competitive athletes informed by bridging the gap between “street knowledge” of ergogenics and the pharmacists' obligation to advise against harmful consequences.