Teen boys who want to excel on the pitch are putting their health at risk by using steroids and supplements to build muscle, says Helen O’Callaghan
WHEN it comes to schoolboy sport, clinical psychologist Dr Eddie Murphy has met two types of parent: The ones whose son is sport- obsessed but he’s not going to make it— it’s too competitive. They ask Murphy if he can pull their boy back, get him to have a broader life perspective.
And then there are other parents — who want to hire a sports psychologist for their “mad into the game” son, much as they’d get him a grind in maths. “They want to give him a mental health edge, a sporting edge,” says Murphy.
How far teen boys themselves will go to get that edge on the pitch can stray into dangerous territory. It’s a reality laid starkly bare at the inquest earlier this summer into the 2017 death of Leaving Cert student Luke O’Brien after he took muscle-building steroid Stanozolol. Luke was a skilled sportsman, playing rugby, football, hurling, and basketball.
While Sport Ireland (SI) doesn’t have jurisdiction over school sport and has “no statistics to say what happens in schools”, Dr Una May, head of its anti- doping programme, points to its Anti-Doping Annual Review 2016, which found 10% of athletes had inadvertently used banned substances while 6% had knowingly used them. In almost all cases the banned substance was a recreational drug. And over 40% of athletes reported they personally knew others who used banned substances. The athletes were just over 24 years old on average. The majority were male (67%) and played a team sport (71%).
Medics have reported unusual patterns of injury in young athletes, which have raised suspicions, says May.
“They’ve seen young athletes with unusual injuries to their tendons, ligaments, and overall musculature, which would lead to suspicions of substance abuse.”
Jim McVeigh, director of the Public Health Institute at Liverpool John Moores University, says his research has found the take-off point for the vast majority of steroid users is 16 or 17 years and much older. “We do hear of some individuals starting earlier,” he says.
The Prevalence of Drug Use and Gambling in Ireland 2014/15 report found lifetime prevalence for steroid use among 15-24-year-old males is 2.7%, which suggests overall teen use of steroids is low but it’s still a concern.
That there’s a deeply competitive culture among teens pushing themselves to play at adult level is undeniable. “There’s prestige associated with competing at adult level, whether it’s GAA, soccer, or rugby, so there’s a level of competition, of determination, for teens trying to make the transition as soon as possible,” says Tony McSweeney, vice-president of the Physical Education Association of Ireland (PEAI).
“You see 15- and 16-year-old boys really delighted to be invited up the age groups. There’s peer admiration — and teens today are very much about how they’re perceived.”
Anecdotally, there’s “definitely a strong competitive element” in school sport, says May. “We get people contacting us, concerned about the emphasis on competition.”
Dr Kate Kirby, head of psychology at Sport Ireland Institute, says if you take schools rugby as an example, there’s “an awful lot of pressure” on young boys, who dream about becoming professional rugby players, to perform in the school cup. “The vast majority of professional rugby players are recruited through schools rugby — so schools rugby is a great chance to showcase themselves to selectors in provincial academies.”
Kirby says experts point to transition periods in athletes’ career as risk times for taking performance-enhancing drugs. (The observation is made in Barry Houlihan’s book, Dying to Win, Doping in Sport and the Development of Anti-Doping Policy).
“The risk arises any time there’s change in a sporting career — moving from junior to senior, from national to international, from playing to retirement. When you look at the transition from junior underage to senior, the percentage who make it is relatively small. And the margin between those who do and don’t is also pretty small. The temptation to do something to gain that performance edge is greater when people know the margin’s very narrow.”
Figures from the Health Products Regulatory Authority (HPRA) show a dramatic rise in demand for steroids, with 449,411 dosage units of anabolic steroids detained in 2017, compared to 109,006 in 2016 and 38,049 in 2015.
Merchants Quay Ireland (MQI), a charity providing homeless and drug addiction services, in 2014 surveyed 89 clients of harm-reduction services who were users of performance and image-enhancing drugs (PIEDs). Almost all reported lifetime injecting use of anabolic-androgenic steroids. The main motivators for use were: To increase muscle mass (91%), increase strength (75.3%), look good (62.9%), and increase confidence (51.7%). Average age of initiation was 24, with 16 the youngest starting age reported.
“Most just wanted to look better — it was for body image, to have a more muscular appearance. People did mention sports but the main activity was going to the gym three, four, or five times a week,” says MQI head of recovery Mark Kennedy.
Body image is increasingly becoming a factor for boys and they’re turning to gyms to build muscle, says May. And therein lies a danger. “When you normalise gym use, there’s potential for normalising muscle building. A youngster playing sport comes in contact with people who’d consider taking supplements to build muscle. If sportspeople are in an environment where it’s OK to take supplements to build muscle, it can become more acceptable to take supplements to enhance sport.”
One secondary schoolteacher I spoke to, who prefered not to be mentioned, says he regularly sees boys in the classroom with protein shakes. “There’s this narrative around it, about building body mass. You hear 15- and 16-year-olds talking about it, ‘How much protein are you taking?’ ‘How did you get your abs so big?’”
From next year, the GAA will have anti-doping tutors in every county, offering courses to clubs, schools, and underage squads — a number of counties already have tutors in place. GAA policy doesn’t recommend supplement use for any player under 18. (Similarly, the IRFU has a ‘food first’ policy when it comes to U18s).
Dick Clerkin, chair of the GAA’s medical, scientific, and player welfare committee, says the organisation can’t be naive. “The reality is in every walk of life players will make choices. We want to educate them on the dangers of using substances, whether aggressive use of supplements or obviously illegal substances [such as steroids].”
Clerkin says the demographic playing GAA is much the same as that which is into the growing gym culture. “Just go into any gym and the supplement culture is rife. We can’t be so naive as to think that won’t spill over, that it will stop when it comes to our club door.”
The anti-doping tutor goal, says Clerkin, is to counter this growing body imaging/gym/supplement culture by educating about the alternative: Prioritising healthy diet and not taking shortcuts through substance use.
“You’re fighting an industry. I don’t think it’s a chronic problem [in GAA] but some players might be susceptible, so we have to be ahead of the game, which is where the anti-doping tutors come in.”
If a teen is over-committed to sport, Eddie Murphy encourages balance. “If the teenager can’t see that balance, then the coaches, club and school need to protect and support by introducing balance.”
McSweeney says no PE teacher has reported steroid use by schoolboys to the PEAI in the last 18 months.
“That’s not to say it’s not going on, but it’s not a commonplace problem.” He sees young players facing a two-fold danger, putting them at risk of supplement abuse.
The first danger is over-training. “One of the biggest problems is the amount of training 15-, 16-, and 17-year-olds are doing. On a Tuesday, they could be doing a training session with the school, another with the club, plus a gym session. And this happens two days a week — with a match on Saturday. Some schools have two games a week and a boy could be playing in both. Anyone with good talent will automatically be drafted up to the next age group and if they’re playing a couple of sports, they could be playing three or four games a week.”
This overtraining puts youngsters at massive risk of injury — cruciate injury has become more common, for example. “Someone used to getting the sports high, the peer adulation, and for nine months they can’t play — the withdrawal can affect mental health. The boy has gone from doing what he loves, and being admired for it, to having to all of a sudden sit down for six months,” says McSweeney, pointing out that in this scenario, recovery ASAP becomes the focus.
“Protein powders are the first port of call. Then they start asking about creatine and this is where they start asking, ‘What’s the best recovery supplement?’”
Several years ago, Dr Suzanne Guerin of UCD’s Department of Psychology led a study that reported 12% of a group of school-aged rugby, Gaelic, and soccer players had used creatine, a muscle-bulking compound that decreases recovery time, diminishes fatigue, and improves performance. Recognised adverse effects include gastrointestinal discomfort, muscle cramps and headaches. Experts believe high doses may potentially damage kidneys and liver
— two years ago, it was alleged creatine may have played a part in the death of All-Black legend Jonah Lomu.
McSweeney sees misinformation as the other danger besetting teens looking to recover fast. “They’re getting their information from anonymous forums written by random, uneducated people, from YouTube videos that anyone can post. These youngsters are in the gym environment, talking about nutrition; training and recovery — this is where misinformation can spread.”
Such misinformation can lead teens to make decisions with devastating consequences. Signs of anabolic steroid use include acne, premature halt in physical growth’ and roid rages characterised by short temper and aggressive behaviour, hallucinations, and sudden feelings of powerfulness paired with lack of empathy. Long-term side-effects include shrunken testicles, breast growth, and baldness, as well as liver damage, jaundice, fluid retention, trembling, bad breath, and aching joints. Life-threatening side-effects of steroid abuse span high blood pressure, heart attack, and liver cancer.
More immediately, artificial bulking up of muscles when tendons aren’t developing as quickly can lead to detached tendons — ending a potential career. “The body’s very fine-tuned. If you interfere and put unnatural development in one area, there’s going to be definite risk,” warns May.
McVeigh says young men’s systems don’t fully mature till they’re in their early 20s. Taking anabolic steroids — powerful hormones that mimic the action of testosterone — is a dangerous leap in the dark. “You don’t know what long-term changes or damage you could be doing to the body’s sensitive hormonal system — it’s a particular risk for youngsters.”
HPRA director of compliance John Lynch says it’s worrying that anybody would use potent prescription medicines without medical supervision. “There’s no guarantee these products contain the type/quantity of active ingredient stated on the label. In some cases, they can contain different substances altogether, which can have serious consequences for health of those using them.”
Youngsters, unfortunately, may very well trade potential adverse effects for short-term gains, says McVeigh. “They can have a very hedonistic attitude to life goals. In a sport where size and strength are at a premium, you can understand a youngster’s frustration, hearing feedback from peers and coaches about not being big enough. You can see how it would make an impression on someone for whom sport may be the most important thing in his life.”
As former Monaghan star Dick Clerkin points out, sport at elite levels is highly competitive. “It’s what makes it appealing. It’s not something we want to diminish. The challenge is to guard against the negatives — cheating, doping.”
There’s a responsibility too: To mind these young men so extremely focused and committed to their game, to protect them in their passionate dedication to a sport, so they see their role as part of a bigger team picture — and that their life is bigger than any game.”