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A half hour special from In the Mix, the award winning weekly PBS series
The abuse of anabolic steroids is no longer confined to a small group of professional athletes and bodybuilders. Today, teenagers girls as well as boys seeking shortcuts to athletic prowess or physical perfection are turning to these substances in increasing numbers. This In the Mix special, hosted by Hercules and Andromeda’s star Kevin Sorbo, explores the harsh realities of teen steroid use, including the health risks, emotional issues and legal consequences. Mixing the personal accounts of real teenagers with factual information from medical experts, the episode seeks to shed light on this rapidly growing problem and enable viewers to make informed decisions about steroid use. This program was funded by the National Institute on Drug Abuse.
How to Use this Program:
Studies conducted by RMC Research on previous In the Mix specials have shown that these programs engage the interest of teenagers, deliver information, catalyze discussion on critical issues, as well as promote analytical thinking and a greater sense of self-efficacy among teens. The aim is to encourage thought and allow teens to generate their own creative solutions.
In this guide, we have outlined specific questions based on the program’s content, with answers. These questions can be used to open up more analytical discussion about related concepts. Also included are in-class activities and longer-term projects that are presented in bold type. We suggest showing the entire program to the group and then running individual segments followed by discussion.
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In the Mix Awards
This guide to STEROIDS: THE HARD TRUTH contains five major sections which include questions, discussion topics, and activities, as well as a list of resources.
Teens and medical experts discuss the pressures faced by students who want to excel in athletics or measure up to high physical standards.

1. What specific effects or results might teens who use steroids be looking to achieve?
they want to become better, stronger athletes; they want to have more muscle and less fat, they want to have bodies similar to those seen in the media.
2. Where do teens say the pressure comes from?
the media, self, friends, team mates, coaches, parents
3. According to Dr. Linn Goldberg, director of Atlas, can steroids turn an average or poor athlete into an excellent athlete?
no; this is one of the prominent myths about steroid use.
Further Discussion:
Do you feel pressure to be stronger or better at sports? Where does this pressure come from? From what you've heard about steroids in the past, or what you've learned about peers who have used steroids, does it seem like a path to better athletic ability?
Further Discussion:
Is there such a thing as a "perfect body?" What do people consider the perfect male body and the perfect female body? Are these standards of perfection influenced by what we see in the media? Discuss famous people who embody these standards. Are these standards of fitness and beauty realistic for the average teen?
4. Has Kevin Sorbo ever used steroids?
No, and because of the damage they could do to his body, he never will.
Related Activity:
Have male students look through popular bodybuilding or men's fitness magazines, while the female students look at fashion magazines or women's fitness magazines. Within a chosen time limit, have the students count how many photographs feature what they would consider "realistic" or "typical" bodies, and how many feature "idealized" bodies. Discuss the results in terms of the media’s influence on teen body image and self-esteem.
Related Activity:
Choose a student to role-play the part of a teen who is considering using steroids, for reasons of low-self-esteem, peer pressure, the desire to excel in sports, etc. Choose a second student to play the part of a trusted friend that the first student confides in. After each scene, discuss how the characters dealt with the complex emotions and desires that can lead to teen steroid abuse.
Dr. Alan Leshner, Dr Linn Goldberg (Director, Atlas) and Dr. Diane Elliot (Director, Athena) describe the harmful effects that steroids can have on the body.
1. According to the medical experts, steroid use has different effects on males and females. What are some of the physical side effects specific to young women?
growth of facial hair, male-pattern baldness, changes in or cessation of the menstrual cycle, enlargement of the clitoris, deepened voice.
2. What are the side effects specific to young men?
shrinking of the testicles, reduced sperm count, infertility, baldness, development of breasts, increased risk for prostate cancer
3. What other serious side effects do steroid users of both genders risk?
heart disease, liver damage, high blood pressure, cessation of bone growth, and cancer. There is also a risk of HIV and hepatitis from shared needles.
4. Do the negative side effects of steroids go away once the user stops taking the drug?
not always; many of steroids’ harmful side effects are permanent. These include, but are not limited to: breast growth and withered testicles in males; lowered voice and increased facial/body hair in women; loss of scalp hair in both sexes
5. What about the desired effects of steroids, like increased muscle mass and decreased body fat? Are these permanent?
no; these effects go away once a user stops taking steroids.
Further Discussion:
Since informed decision-making requires a balance of pros and cons, discuss how the serious health risks of steroids balance against the perceived benefits.

Further Discussion:
According to the National Institute on Drug Abuse (NIDA), the perceived risk of steroids among teens actually decreased among teens for the year 1999. Discuss why teenagers might think that steroids aren't dangerous or harmful. Do the attitudes of peers effect these perceptions? What about messages from the media?
Related Activity:
Beauty and health are about more than just big muscles and lower body fat. Have students list characteristics of male and female health and appearance that are seen as desirable, and write these on one side of the blackboard under the headings "healthy man" and "healthy woman". Next, have students list the effects that steroids have on the health and appearance of men and women, and copy these on the other side of the board, under the headings "man on steroids" and "woman on steroids." Discuss the irony that steroids are used to increase attractiveness and health, but often lead to decreases in both.
Related Activity:
Divide the class into small groups and ask them to write proposals and scripts for radio or TV public service announcements that highlight one or many of the negative physical side effects of steroids. The groups may choose the tone and style of the PSA, and even include celebrities or famous athletes if they wish. Other formats to suggest are animated cartoons, songs, or parodies.
Matthew, who became psychologically addicted to steroid use and then started dealing, describes how his life began to spiral downwards after he began abusing the drug. Various experts and teens discuss "roid rage" and the emotional and psychological consequences of steroids.
1. Why did Mathew begin using steroids in the first place?
his girlfriend broke up with him and he thought it was because he was not good looking enough; he saw a buff body as way out of his depression
2. What were the actual, concrete effects that the drug had on Matthew’s life?
he became emotionally dependent on the steroids; he began spending time with other users even though he disliked them; he became distanced from his parents and friends; he lost interest in school; his grades dropped; he became edgy, aggressive and angry
Further Discussion:
Because people don’t take them to get high, steroids are rarely lumped in with other drugs. Discuss the similarities between Matthew’s story and the stories you may have heard about teens who have gotten involved with other types of drugs, like alcohol, pot, heroin, crack, speed or ecstasy.
3.According to sports trainer Ian and Dr. Linn Goldberg, what are the symptoms of "roid rage?"
mood swings; hair-trigger anger; uncontrolled aggression; paranoia

Further Discussion:
The teens in the episode talk about friends whose personalities have changed due to steroid use. Discuss how "roid rage" and the other emotional symptoms of steroid abuse can complicate friendships and relationships. Do you know any stories about teens whose personalities have been altered by steroids?
Further Discussion:
How do you feel when you are around people who cannot control their anger? How would it make you feel if you couldn’t control your own emotions? What kind of trouble could you get into if you became easily angered? Is there a difference between anger that comes from a specific reason, and anger that comes as a side effect of a drug?
4. According to Matthew and Dr. Linn Goldberg, are anabolic steroids addictive?
yes; users can become psychologically hooked on the drugs, and can experience withdrawal depression when they stop using them. Matthew had a difficult time getting over steroids, and felt their pull even months after he was arrested.
5. Arrests of steroid dealers rarely get the same press attention as arrests for other types of drugs. Does this mean that the police turn a blind eye towards steroid use?
no; dealers and users of illegal steroids can face felony charges, just like the dealers and users of other types of drugs
6. Steroid dealers often sell the drugs through the mail, frequently by advertising them on the internet, and do not meet their buyers face-to-face. Does this make the sale or purchase of steroids a less serious crime?
no; dealing steroids through the mail is just as serious as face-to-face dealing. Customs or postal officials can confiscate shipments and both dealers and buyers can face fines and/or imprisonment.
Related Activity:
Ask students to research the state and federal laws regarding the use and sales of illegal steroids, including the possible penalties. Have them include summaries of steroid arrest stories from newspapers and magazines. Ask for student volunteers to share their findings with the class.
Related Activity:
Through a local bodybuilding club, gym, or law enforcement organization, arrange for a teen or young person who has abused steroids to talk to the class about the social, emotional and legal consequences of using the drug.
The teens and doctors discuss other types of hormones and the thousands of athletic supplements available over the counter. We learn about programs like Atlas and Athena, which instruct teens on proper exercise and eating habits.

1. Not all hormones out there are true anabolic steroids. Are alternative male glandulars like Andros safer to take?
no; you can’t get around the side effects of steroids by taking the precursor drugs; these pro-hormones can be just as dangerous and destructive as the real thing
2. Should a supplement be considered safe just because it is available in stores or through the mail?
no; some supplements can contain the dangerous drug ephedra, which can cause seizures. Many have never been properly tested for their stated effects or side effects, so you never know exactly what is in them or if they are a waste of money.
Further Discussion:
Discuss the whole concept of the "quick fix." Is it realistic to think that a healthy, attractive and strong body can be achieved through short cuts like supplements? Why would some teens be tempted to turn to these products? Do people seek quick fixes and short cuts in other areas of life?
Related Activity:
From vitamin and supplement stores, bodybuilding magazines, or the internet, collect promotional pamphlets and advertisements for dietary supplements promoted as boosting athletic performance, muscle growth, or energy. Have students examine the imagery and wording of these materials and discuss what they see. Do the claims seem realistic? What about the models used in the photographs? Do the makers of these products suggest that are skirting the law by offering legal alternatives to steroids? Are these companies selling a product or an image?
3. Why did Ian, the young trainer, stop using nutritional supplements?
he forgot to take them for a couple of weeks and realized that he was gaining muscle just from working out; he felt they were a waste of money and he could get the same protein from real food, which tastes better.
4. According to Dr. Linn Goldberg, are the proteins in supplements the same as the proteins in food?
no. Food proteins are balanced proteins, while proteins found in supplements are often incomplete proteins.
Related Activity:
Divide the class into groups and assign each group a specific brand of dietary supplement or pill. Have the groups research the prices of the products, and add up the cost of taking them for a week, a month and a year. Then have them compare this to the cost of getting proteins, carbohydrates, and vitamins from a balanced diet.
Related Activity:
Break the class up into small groups. Using the pamphlets and advertisements for pills, powders and supplements as guides, have the groups design print advertisements that use the same sort of imagery and promotional wording to sell the effects of healthy foods and proper exercise. In viewing the students’ work, discuss how it is easy for companies to make a quick profit off of useless or potentially dangerous products, but very difficult for them to profit off of teens who eat right and have a reasonable exercise plan.
The Atlas (boys) and Athena (girls) programs teach teens to be peer educators about the dangers of steroids, as well as showing them how to build and strengthen their bodies through proper exercise and eating habits.
1. According to Melissa, an Athena trainer, is it healthy to eliminate fat from your diet?
no; you need fat in your diet to provide cushioning for your joints and allow your muscles to work properly; Dr. Elliot says that it’s normal for girls to gain 15-20 pounds of body fat during adolescence
2. What foods should teens eat if they are in training for a sport?
Teen athletes should eat foods rich in carbohydrates and proteins. Good sources of carbohydrates include starchy vegetables, pastas, rice, and whole grain breads, while good sources of proteins include milk, egg whites, chicken, fish and turkey. Male athletes should eat one gram of protein per pound of body weight and 26 times their weight in calories. For females, the amount is slightly less, but they should eat one-and-a-half times the RDA of protein while in training.

3. According to Dr. Kuehl, a nutritionist, what is a good non-training diet?
When not training for sports, teens should eat a diet high in carbohydrates with moderate amounts of proteins. A 130-pound teen should get about 100 grams of protein a day from sources like milk, egg whites, fish, chicken and turkey. An example of 100 grams of protein is one can of tuna, one chicken breast, and four cups of milk.
Further Discussion:
Melissa stresses that the key to success is moderation. Discuss the general concept of moderation with regards to diet, physical training, and the desire to be healthy, attractive and happy. How can straying from the path of moderation lead to danger or unhappiness? How does the desire for building the perfect body in the shortest possible time lead teens to make dangerous choices?
Related Activity:
Have students research their body’s nutritional needs for carbohydrates and protein, keeping in mind their age, gender and weight. Using the standard nutritional information label found on all foods, have the students deign diets or meals that meet their needs.
4. What is Kevin Sorbo’s exercise routine now?
Kevin works out three times a week, concentrating on a separate muscle group or activity each time he goes to the gym. This way, he allows his muscles time to recover between workouts and avoids over training
Related Activity:
Invite a coach, PE teacher or school dietician into the class to talk about nutrition and proper exercise as alternatives to steroid or supplement use. Local athletes or professional sports trainers are also good choices for in-class lecturers.
National Institute on Drug Abuse
Phone: (888) 644-6432
Infofax: (888) NIH-NIDA
Information on the abuse or steroids and other drugs, NIDA publications and communications, agency events, and links to other drug-related Internet sites.
Information from the National Institute on Drug Abuse about anabolic/androgenic steroid abuse.
The Atlas (Athletes Training and Learning to Avoid Steroids) Program
A drug prevention program designed for high school male athletes using a hands-on-approach with interactive activities.
The Athena (Athletes Targeting Healthy Exercise and Nutrition Alternatives) Program
A program for young women on school-sponsored athletic, dance & drill and rally teams. The program stresses sport nutrition and physical training as ways to improve athletic performance without resorting to unhealthy behaviors.
Covenant House Nineline
(800) 999-9999- available 24hrs/7 days a week
Provides assistance and referrals dealing with critical issues (for example: drug addiction, depression and suicide)
A comprehensive site on nutrition from the US government, including articles and guides writtenteenagers
US Food & Drug Administration: On the Teen Scene
A collection of articles on health and nutrition aimed at teenagers.
The White House's National Youth Anti-Drug Media Campaign has developed tools and resources for teens that want to maintain a drug-free lifestyle. They help young people understand the dangers of substance abuse and make responsible decisions with their lives. The site emphasizes that the majority of kids are not involved with drugs.

The American Council for Drug Education
Offers an extensive library of substance abuse education and prevention information for kids and adults, as well as a resource list of prevention materials and videos.
Join Together Online
A national resource center for communities working to reduce substance abuse and gun violence.
National Clearinghouse for Alcohol and Drug Information
Information on publications, calendars, and related Internet sites, as well as ‘For Kids Only" materials.
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2002 In the Mix.
STEROIDS: THE HARD TRUTH is a production of Castle Works Inc. In the Mix was created by WNYC Radio. This special was funded by the National Institute on Drug Abuse.