1). The most recent results from this survey showed that in 2006,   2.7 percent of 12th graders said they had used anabolic steroids without a  prescription at least once. Some Federally Funded Efforts Are Designed to Focus on Preventing Teenage Steroid Abuse, While Other Efforts Designed to Address Substance Abuse in General May Include Teenagers

There are two categories of federally funded efforts that address teenage  abuse of anabolic steroids. Efforts are either designed to focus on  preventing the abuse of anabolic steroids among teenagers or are broader  and designed to prevent substance abuse in general—which can include  abuse of anabolic steroids among teenagers. Two programs that received  federal research funding for their development and testing, ATLAS and  ATHENA, are designed to focus on preventing or reducing teen abuse of  anabolic steroids. In addition, there are various research efforts and  education and outreach activities that focus on this issue. Two federal  grant programs—ONDCP’s Drug-Free Communities Support program and  Education’s School-Based Student Drug Testing program—are designed to  support state and local efforts to prevent substance abuse in general and  may include anabolic steroid abuse among teenagers as part of the  programs’ substance abuse prevention efforts. In 2007, about one-quarter of more than 700 grantees  reported that they were addressing steroid abuse as one of their program’s  objectives. Research Shows Teenage Anabolic Steroid Abuse Is Linked to Certain Risk Factors and That Prevention Programs May Have Some Short-term Effectiveness

Of the 16 studies we reviewed, nearly half focused on linking certain risk  factors and behaviors to teenagers’ abuse of anabolic steroids, including  the use of other drugs, risky sexual behaviors, and aggressive behaviors. Most of the other studies we reviewed were assessments of the ATLAS and  ATHENA prevention programs and in general suggested that the programs  may reduce abuse of anabolic steroids and other drugs among high school  athletes immediately following participation in the programs. Almost half of the studies we reviewed identified certain risk factors and  behaviors linked to the abuse of anabolic steroids among teenagers. Several studies found that the use of  alcohol and other drugs—such as tobacco, marijuana, and cocaine—is  associated with the abuse of anabolic steroids among teenagers, including  teenage athletes and non-athletes. Experts Find There Are Gaps in Research on the Sustained Effectiveness of Prevention Programs and on the Long-term Health Effects for Teenagers

Experts identified gaps in the research that addresses anabolic steroid  abuse among teenagers. Experts also identified gaps in the research on the long-term health effects  of initiating the abuse of anabolic steroids as teenagers. Experts  also report that the extent of the psychological effects of anabolic steroid  abuse and, in particular, of withdrawal from steroid abuse, is unclear due  to limited research. Appendix I: Selected Federally Funded Efforts That Address or Can Address Anabolic Steroid Abuse among Teenagers

Table 1 lists selected federally funded efforts—including programs,  research, and educational and outreach activities—that are designed to  focus on preventing or reducing the abuse of anabolic steroids by  teenagers (focused efforts), as well as other broader efforts that may  address teenage abuse of anabolic steroids as part of the programs’  general substance abuse prevention efforts. The list includes programs  funded by two departments and the Office of National Drug Control Policy  (ONDCP), in the Executive Office of the President. “Effects of a multidimensional anabolic  steroid prevention intervention: the Adolescents Training and Learning to  Avoid Steroids (ATLAS) program.” JAMA, vol.
Why GAO Did This Study

The abuse of anabolic steroids by teenagers--that is, their use without a prescription--is a health concern. Anabolic steroids are synthetic forms of the hormone testosterone that can be taken orally, injected, or rubbed on the skin. Although a 2006 survey funded by the National Institute on Drug Abuse (NIDA) found that less than 3 percent of 12th graders had abused anabolic steroids, it also found that about 40 percent of 12th graders described anabolic steroids as "fairly easy" or "very easy" to get. The abuse of anabolic steroids can cause serious health effects and behavioral changes in teenagers. GAO was asked to examine federally funded efforts to address the abuse of anabolic steroids among teenagers and to review available research on this issue. This report describes (1) federally funded efforts that address teenage abuse of anabolic steroids, (2) available research on teenage abuse of anabolic steroids, and (3) gaps or areas in need of improvement that federal officials and other experts identify in research that addresses teenage anabolic steroid abuse. To do this work, GAO reviewed federal agency materials and published studies identified through a literature review and interviewed federal officials and other experts.

What GAO Found

There are two categories of federally funded efforts that address teenage abuse of anabolic steroids. Efforts are either designed to focus on preventing the abuse of anabolic steroids among teenagers or are broader and designed to prevent substance abuse in general--which can include abuse of anabolic steroids among teenagers. Two programs that received federal funding during their development and testing, Athletes Training and Learning to Avoid Steroids (ATLAS) and Athletes Targeting Healthy Exercise & Nutrition Alternatives (ATHENA), are designed to focus on preventing or reducing teen abuse of anabolic steroids through use of gender-specific student-led curricula. In addition, there are various research efforts and education and outreach activities that focus on this issue. Two federal grant programs--the Office of National Drug Control Policy's Drug-Free Communities Support program and the Department of Education's School-Based Student Drug Testing program--are designed to support state and local efforts to prevent substance abuse in general and may include anabolic steroid abuse among teenagers as part of the programs' substance abuse prevention efforts. In 2007, about one-quarter of more than 700 Drug-Free Communities Support program grantees reported that they were addressing steroid abuse as one of their program's objectives. Almost half of the 16 studies GAO reviewed identified certain risk factors and behaviors linked to the abuse of anabolic steroids among teenagers. Several of these studies found connections between anabolic steroid abuse and risk factors such as use of other drugs, risky sexual behaviors, and aggressive behaviors. Most of the other studies were assessments of the ATLAS and ATHENA prevention programs and in general suggested that the programs may reduce abuse of anabolic steroids and other drugs among high school athletes immediately following participation in the programs. Experts identified gaps in the research addressing teenage abuse of anabolic steroids. Experts identified a lack of conclusive evidence of the sustained effectiveness over time of available prevention programs, for example at 1 year following participants' completion of the programs. Experts also identified gaps in the research on the long-term health effects of initiating anabolic steroid abuse as a teenager--including research on effects that may be particularly harmful in teens--and in research on psychological effects of anabolic steroid abuse.