The days when performance-enhancing drugs were the stuff of East German Olympians and a few light-witted linebackers are over.
On high school football fields from Nebraska to California, students are turning themselves into pad-clad rockets by taking pills that give them an abnormal surge of strength and have been blamed for 80 deaths nationwide. Teenage linemen weighing 300 lbs., once unheard of, are now as common as helmets and cleats a trend many attribute, in part, to the rise of bodybuilding supplements.
Even at Big Spring Middle School in Pennsylvania, 3.6 percent of eighth-graders say they've used steroids a figure one point higher than the national average.
The use of such drugs among teens, scientists say, can cause long-term health problems. So, as more students look to supplements to give them the perfect body or a more powerful swing, an unprecedented number of states are moving to regulate an industry that has been left largely to its own devices.
None of the bills has yet become law, and most are still in the early stages. Yet the groundswell of concern is a sign that lawmakers and parents are beginning to subject performance-enhancing supplements to a new level of scrutiny, as abuse by teens becomes a widespread public-health problem.
The raft of state bills "is the biggest and most coordinated trend we've seen," says Bernard Griesemer, a scientist at the HealthTracks Center in Springfield, Mo., "and the reason is that we're now starting to see some of the adverse effects."
Among the legislation:
Proposed bills in California, Iowa, and New York would ban the sale to minors of certain types of dietary supplements deemed dangerous. Under one plan, Tennessee would ban the sale of one such supplement ephedra altogether.
Several states, including West Virginia and Washington, are considering limits on the amount of ephedra that can be sold legally.
New York has looked at making androstenedione [an-druh-steen-DY-own] a muscle-builder that is a chemical precursor of steroids available only with a prescription.
California also has a bill that would require all sporting organizations that wish to play in the state and have revenues of more than $1 billion to require drug testing. New York has a similar bill. Both target Major League Baseball, which is the only major team sport with no significant drug policy. Sponsors say baseball is setting an unhealthy example for young players.
If the drug-testing bills pass, baseball will have no one to blame but itself. Rarely has the issue of performance-enhancing substances been more central to the American conversation, and the cause can be traced directly to recent allegations by several former stars.
In quick succession, former Most Valuable Players Jose Canseco and Ken Caminiti admitted to steroid use during their careers. Perhaps more damaging, though, has been their estimate that between 50 and 85 percent of major league players use steroids.
Tellingly, their figures have been contested, but the substance of their statements has not. The furor has even reached Capitol Hill, where Congress last week held hearings on drugs in baseball.
It's a subject that infuriates Don Perata. "I know how professional players are icons today, the same way [Willie] Mays and [Stan] Musial were for me," says the California state senator from Oakland and sponsor of the drug-testing bill. But, he asks, what are these revelations telling today's children?
When Mark McGwire became the most beloved baseball player of his generation on his way to 70 home runs in 1998, he acknowledged that he was using "andro." Now, with stories of steroid use by some of the game's best players, he fears young people will see doping as a legitimate step toward beauty and athletic success.
Many already do. One million children ages 12 to 17 use supplements, according to a survey by Blue Cross Blue Shield.
Some 16 percent of boys take creatine, the most popular supplement, simply to look better and more muscular. Sales of androstenedione which is banned by the National Football League and the International Olympic Committee rose five-fold after McGwire's home-run binge, with demand high among teens.
Perhaps the supplement of greatest concern, though, is ephedra. Taken right before games, practices, or workouts, ephedra has become a kind of ecstasy for the athletic world. Just as the party drug ecstasy provides a rush of energy for dancers hopping from one nightclub to the next, ephedra provides a boost, raising players' heart rate and metabolism.
High schoolers call it "juicing," and in the heat of late-summer practices, it can have fatal consequences.
The health effects of androstenedione and creatine are less clear. Most scientists say andro which is one enzyme removed from being a steroid can produce the same undesirable side effects as its relative, including increased aggressiveness. They are more split on creatine, which can cause some weight gain through water retention, but has proven safe in many tests.
Almost universally, however, they say that ephedra and andro are not appropriate for teens, and creatine if taken at all should be taken under close adult supervision.
"It is a growing public-health crisis," says Iris Shaffer of Blue Cross Blue Shield's Healthy Competition Foundation in Chicago.
She and others point to the lack of federal regulation as a primary problem. A 1994 act of Congress gives the US Food and Drug Administration relatively little authority over supplement makers. For instance, supplements need not, like drugs, be tested for safety before going to market, and the FDA has so far been slow to establish minimum standards for quality.
Some problems have been as basic as false labeling. One study found that more than 40 percent of products included things that were not on their labels, didn't include things that were on their labels, or had the dosages wrong. (The industry acknowledges the problem, but puts the percentage much lower.)
More fundamentally, though, a growing body of data suggests that abuse can lead to serious medical problems. As teen use and abuse rises, states like California are seeing a lack of oversight and trying to fill it.
"California has taken a leading position on this," says Frank Uryasz of the National Center for Drug Free Sports in Kansas City, Mo. "We will begin to see more and more states address this because the federal government doesn't appear to be interested in stepping in."