Steroid Use in Canada

Steroid use in the western hemisphere is a growing problem, especially among teenage males. In Canada, the use of steroids by athletes and non-athletes alike has increased in frequency over the past twenty-five years, and now poses a serious health risk to Canadian athletes and students. As a response, organizations like the Canadian Centre for Ethics in Sport (CCES) have mounted a positive, proactive campaign to raise awareness about the problem, penalize use, and offer solutions. This essay discusses the history of steroid use in Canada, analyzes statistical and demographic data, profiles the CCES and its attempts to combat the use of dangerous drugs, and examines possible obstacles and objections to the success of the anti-doping campaign.

Steroid use among athletes became the topic of much discussion in Canada in the late eighties, when sprinter and national hero Ben Johnson was stripped of his Olympic gold medal and 100-meter world record, three days after the 1988 Summer Olympics in Seoul. Johnson’s urine was found to contain a banned anabolic steroid (AS), Stanozolol, which he later confessed to taking. Charlie Francis, Johnson’s coach, claimed in his book Speed Trap that all Olympic athletes were takings AS, and expressed frustration with the Olympic committee’s decision to rescind Johnson’s gold medal since the medal would simply be given to another steroid-using athlete (Francis, 1991). The revelation that professional competition was rife with illicit drug use opened the public eye to the problem, but also convinced many potential athletes of the effectiveness of AS.

In 1996 a national survey sent out a questionnaire to 16,119 random students in 107 schools throughout Canada. The purpose was to determine the frequency of AS use among young Canadians, to examine the methods by which the drugs were administered, and to explore reasons for their use. 2.8% of the sample group reported using steroids sometime in the year before the survey. This was extrapolated to show that more than 83,000 young Canadians nationwide had likely done the same (Melia, Pipe, & Greenberg, 1996, p. 1). The researchers were surprised by the frequency of steroid use in young Canadians but were even more troubled by the method of administration. 29.4% of users reported injecting the drug with a hypodermic needle, and 29.2% of that group admitted to sharing a needle at some point (Melia et al., 1996, p. 2). The risk of transmitting diseases such as HIV and Hepatitis adds greatly to the dangers of steroid use.

Since the 1996 survey, there are statistical indications that the frequency of use is on the rise. In a single needle exchange program in Halton Region, 49,000 steroid syringes were distributed just in 2010. 40% of that program’s total clients were reported to be steroid users (Young, 2011). Even more shocking are statistics from the Canada Border Service Agency (CBSA), which reported that, in 2012, there were 2,123 seizures of steroids at the Canadian border, worth just under two million dollars (Canadian). In six years, over $9.8 million worth of steroids were seized. “…performance-enhancing drugs, famous for costing sprinter Ben Johnson his Olympic medal, are seized six times more often than cocaine, nine times more often than hashish and 22 times more often than heroin” (Young, 2011, p. 3). The only drug seized more frequently than steroids was marijuana (Canada Drug Seizures, 2012, p. 1). In Quebec, steroids are the most frequently seized drug (Young, 2011, p. 2), while a study there showed that 70% of users were under the age of seventeen ("Steroids in Canada," 2013).

These numbers indicate an important fact about steroid use: a large percentage of users are not professional athletes. The 1996 study came to just this conclusion. “Anabolic-androgenic steroid use is often intended to alter body build as opposed to accentuating sport performance” (Melia et al., 1996, p. 5). Looking at steroid use as an avenue for aesthetic improvement and a boost in self-confidence helps to explain the growing use among students and teenagers. An American study concluded that “In males, steroid use was associated with poorer self-esteem and higher rates of depressed mood and attempted suicide, poorer knowledge and attitudes about health, greater participation in sports that emphasize weight and shape, greater parental concern about weight, and higher rates of disordered eating and substance use” (Irving, 2002, p. 7). It is clear from this data that steroid use is not solely a practical matter of performance enhancement. The Outreach Coordinator for the needle exchange mentioned above, Cecil McDougall, explains that steroid use “…can be a coping function, it can be a social function, it can be an emotional coping skill. Some of them it’s purely aesthetics with very specific goals… It’s not always the same for everybody.” The varied influences and motivations for teen steroid use make it difficult to profile, and hence, to treat. The emotional aspect of steroid use must be considered by any attempt to efficiently address the problem of growing abuse.

While trafficking or selling AS is illegal, possession of them does not carry a criminal penalty in Canada. However, as a banned substance, anabolic steroids can be seized by police. In contrast with the American approach, Canadian organizations seek to discourage steroid use, not with crippling legal penalties such as jail time, but with education and strict rules, penalties, and sanctions for athletes who violate anti-doping regulations. This information-based, educative approach is the backbone of the positive, proactive response to Canadian steroid abuse exemplified by the Canadian Centre for Ethics in Sport.

The Canadian Centre for Ethics in Sport (CCES) is committed to a values-based approach to sporting ethics and leads the fight against steroid use in Canada with its Canadian Anti-Doping Program (CADP). The CADP seeks to combat steroid use for two main reasons: fairness, and safety. “When athletes cheat by doping, they harm themselves, they harm their sport and they harm their fellow athletes who compete clean. And, they harm the individuals, communities and nation…” (http://www.cces.ca/en/doping). Competition in sport is meant to elevate and reward the top athletes, and like any other violation of the rules, steroid use gives an unfair advantage to athletes who participate in it. Furthermore, as the controversy with Ben Johnson in 1988 showed, steroid use can tarnish the national image, discourage the public and set an unhealthy example for young athletes.

Concern for the health and safety of users is the other motivation driving the concerted efforts of the CADP. Aside from the grave dangers of shared intravenous and intramuscular injections, steroids are associated with severe health risks in both the short and long term. While AS have diverse medical uses, people who abuse them tend to take doses ten to one hundred times greater than prescribed medical amounts (Drugfacts, 2012). This can lead to serious physical and mental problems. AS do not directly affect dopamine levels, and thus do not get the user ‘high’. However, long-term use has been shown to cause mood swings, from elation to violent aggression (Drugfacts, 2012). These symptoms, the latter of which is commonly known as ‘roid rage’, can lead to impaired judgment and reckless behavior.

The possible physical side effects of steroid abuse are numerous. Steroids affect the production of hormones, which leads to many other problems. For men, AS causes fluid retention, testicular shrinkage, gynecomastia (growth of breast tissue), and severe acne. Gynecomastia and testicular shrinkage are irreversible conditions. The risk of prostate cancer also rises, as well as chronically low testosterone after quitting the drug. For women, AS abuse causes masculinization, which can cause the growth of facial hair, male pattern-baldness, growth of the clitoris, and the disruption of menstrual cycles. Breast size is also reduced, the voice deepens, and the skin can take on rough texture (Drugfacts, 2012). In adolescents, AS abuse can cause stunted growth due to the acceleration of puberty. For all users, AS abuse is linked to increased risk of cardiovascular disease (CVD), stroke, liver failure, and kidney failure. The CADP includes all of these factors in its motivations to curtail the use of steroids.

The CADP works in conjunction with the Canadian True Sport movement, which emphasizes fairness and ethics in competition. Two of the seven principles guiding the True Sport movement are related to anti-doping campaigns. ‘Play Fair’ encourages athletes to follow all the rules of their given sport, while ‘Stay Healthy’ reminds competitors that success and victory are not more important than overall health. The True Sport movement discourages athletes from damaging their bodies for the sake of winning (http://www.cces.ca/en/doping). The CADP complies with the World Anti-Doping Code, an international organization funded by governments around the world as well as sporting organizations. The CADP employs a systematic approach toward the control of AS abuse in athletes. The five-tier system includes education, athlete services, test distribution planning, sample collection, and results management. Education involves informing athletes exactly what the rules are concerning steroid use. This ensures that competitors do not unintentionally break the rules.

Through athlete services, the CADP offers medical information and assistance. It is through this department that exemptions are made, and inquiries about substances are answered. The third tier of the CADP, test distribution planning, attempts to maximize deterrence by strategically organizing the frequency and locations of testing in such a way as to discourage athletes from breaking the rules.

Sample collection is carried out by officers trained to strictly follow the CCES protocol. Athletes are not required to be notified that they will be tested by the CCES, and can be approached at any location, including their homes, for testing. CCES testing is gaining momentum each year with 3,668 total tests in the fourth quarter of 2013, an increase of 365 tests from the same period in 2012 (http://www.cces.ca/en/doping). The CCES posts the names of violators, and their respective sports, on their website.

Finally, results management ensures that athletes who are found to violate anti-doping rules have access to information, the appeals process, and legal protection. Athletes found in violation of anti-doping rules are barred from participation in any role (including coaching) of organized competition, and from any organized sport of any kind (not limited to the sport the athlete played previously) (http://www.cces.ca/en/doping). As seen in America's Major League Baseball organization, sporting clubs or organizations then have the responsibility of removing violating athletes from their roster for the amount of time specified in the penalty. According to the CADP, first violations for presence, use, or possession of banned substances has a mandatory sanction period of two years. Second violations are punishable by eight years to life, and trafficking can result in sanctions lasting four years to life. (http://www.cces.ca/en/doping). The CCES will publicly announce any violators within twenty days of a positive test.

Despite the concentrated efforts of the CCES to reduce steroid abuse in athletes, there are many obstacles in the way of complete success. The most obvious problem is that the CCES only focuses on athletes. Compared to non-athletic abuse, AS abuse in athletes has a straightforward motivation- to improve performance. Abuse by non-athletes, however, points to more enigmatic motivations that are difficult to pin down. Cecil McDougall reports that “You’d find that there are probably as many different reasons for using as there are people” (Young, 2011, p. 2). AS abuse by non-athletes is so difficult to address because it cannot be boiled down to physical addiction or the desire to get high. In that way, steroids stand apart from other drugs of abuse, and abuse is more difficult to recognize and identify. This ambiguity and lack of understanding are reflected in the fact that there is no agency or organization currently operating in Canada to deter AS abuse in non-athletes. Clearly, there is a need for serious research to address the motivations and statistics behind non-athletic steroid abuse in Canada.

Another obstacle to the success of the CCES anti-doping program is a vocal minority of people who see anti-doping as a fruitless and ultimately irrational endeavor. One such argument equates steroid use with other nutritional supplementations, such as high-protein foods and shakes. This opinion is often supported by references to the performance-enhancing activities of athletes as far back as ancient Greece "The use of drugs to enhance performance in sports has certainly occurred since the time of the original Olympic Games [from 776 to 393 BC]. The origin of the word 'doping' is attributed to the Dutch word 'doop,' which is a viscous opium juice, the drug of choice of the ancient Greeks." (Bowers, 1998, p. 6). Interestingly, the same study that documented steroid use in Canadian schools found that many students reported using other methods of performance enhancement, such as: “caffeine, 27%; extra protein, 27%; alcohol, 8.6%; painkillers, 9%; stimulants, 3.1%; "doping methods," 2.3%; beta-blockers, 1%” (Melia et al., 1996, p. 5). The idea is that all forms of supplementation are forms of ‘doping’, many of them potentially dangerous, and AS should not be prohibited any more than caffeine or protein shakes.

Another obstacle in the quest to eliminate doping from sporting competition is the fact that only a certain number of AS users will ever be caught in the act. Methods for disguising the presence of banned substances are numerous and ever-growing in complexity and sophistication. Often, as in the case of Lance Armstrong, who used a sophisticated performance enhancement technique called ‘blood doping’, doping consists of drugs and treatments other than anabolic steroids. Many professional athletes claim that everyone in their sport is doping, and thus that the only way to maintain a competitive advantage is through AS use. Furthermore, those who are caught and penalized face public disgrace, while other users claim their prize and in that way are encouraged to continue using. Thus there is a contentious public debate about whether or not doping should even be prohibited at all. If doping were allowed, argue opponents of prohibition, athletes could openly seek medical advice on how to use the drugs safely and responsibly. The anti-doping debate mirrors the debate about drug prohibition in the sense that opponents of anti-doping measures believe that performance-enhancing drugs would be less harmful if their sale and use were regulated rather than prohibited.

In conclusion, steroid use in Canada has been a growing concern since the late twentieth century. Studies have shown that AS abuse is increasing over time, and data from border seizures show that steroids are one of the most widespread drugs in Canada. Further studies show that steroid abuse is more common among teenagers than previously believed. Steroid use has been linked to numerous health problems, and AS use during adolescence carries additional medical risks on top of those known to be a factor for adults. The CCES anti-doping program has made a concerted effort to discourage and penalize steroid use in athletic programs across the country, using a five-tier method. There are however serious obstacles to the success of such programs, such as the frequency of AS abuse by non-athletes, which is still poorly understood. Also, some believe the campaign against steroid use is flawed in its very foundation.

References

Bowers, L. D. (1998, Apr. 1). Athletic Drug Testing. Clinics in Sports Medicine.

Drugfacts: Anabolic Steroids. (2012). Retrieved from http://www.drugabuse.gov/publications/drugfacts/anabolic-steroids

Francis, C. (1991). Speed Trap. St. Martin’s Press.

Irving, L. M. (2002, April). Steroid use among adolescents: findings from Project EAT. Journal of Adolescent Health, 30, 243-252.

Melia, P., Pipe, A., & Greenberg, L. (1996). The use of anabolic-androgenic steroids by Canadian students. Clinical Journal of Sport Medicine, 6(1), 9-14.

National Statistics - January 1, 2012 to December 31, 2012. (2012). Retrieved from Canada Border Services Agency website: http://www.cbsa-asfc.gc.ca/agency-agence/stats/2012/2012-ann-eng.html

Steroids Addiction in Canada. (2013). Retrieved from http://www.drugrehab.ca/steroids-addiction.html

Young, L. (2011). Steroids: Big in Canada. Retrieved from http://globalnews.ca/news/191655/steroids-big-in-canada/7