Ellen Campbell -Grizzle - PHARMACY TODAY THE RECENT decoding of tetrahydrogestrinone (THG), a previously unidentified performance-enhancing steroid, has brought into sharp focus the difficulty of controlling drug abuse in sports.
The publicity has caused some patients to query the consequences of using the steroids (corticosteroids) prescribed for asthma. However, corticosteroids are different from anabolic steroids. Corticosteroids have been safely and effectively used, in low doses, to reduce inflammation of the lungs that underlies asthma and in the treatment of rheumatoid arthritis. Various brands of both are available on prescription in Jamaica.
Anabolic steroids are man-made substances related to male sex hormones. They are legally used to treat diseases that lower the amount of testosterone, to arrest body wasting that occurs with such conditions as AIDS and reverse some forms of anaemia. Some athletes abuse these drugs because they boost muscle size and/or reduce body fat, aid quick recovery from injury and strenuous workouts. Worldwide, bans have been imposed and various tests developed to detect these drugs. However, new substances designed for surreptitious use, elude identification.
It is well known that anabolic steroid abuse can lead to severe health problems, some irreversible. Doses taken by abusers are 10 to 100 times higher than doses for medical conditions. Usually more than one drug is mixed (stacking) and different dosage forms (oral, injectable and creams) are combined. The perceived benefits of achieving maximised effects from this mixing have not been proven. Instead, a wide range of adverse side effects have occurred. These include:-
Hormonal system -- men - infertility, breast development, shrinking testicles; women - enlargement of the clitoris, excessive growth of body hair; both sexes - male pattern baldness
Musculoskeletal system - short stature, tendon rupture
Cardiovascular system - heart attacks, enlargement of the heart's left ventricle
Liver - cancer, peliosis hepatitis (blood-filled cysts in the liver)
Skin - acne, cysts, oily scalp
Infection (needle use) - HIV/AIDS, hepatitis
Psychiatric effects - aggressiveness, mania, delusions
Steroid abusers are more prone to heart attacks, strokes and water retention with swelling especially around the neck and facial areas. When a child takes anabolic steroids, the resulting artificially high sex hormone levels can signal the bones to stop growing. Women display signs of masculinisation such as deepened voices and excessive growth of body hair at low doses.
Persons who have a behavioural syndrome in which they have a distorted view of their body image (muscle dysmorphia) may also abuse anabolic steroids. Typically, the men with this condition think they look weak and small and the women think they look fat and flabby. There is now concern in the United States that steroid abuse is increasing in the adolescent population who believe that these drugs will make them seem more attractive and intimidating. This appears to be part of a pattern of high-risk behaviour among some young people.
The risks of adverse health consequences associated with anabolic steroid abuse far outweigh temporary gains in athletic performance and physical appearance. Corticosteroids, prescribed by your doctor, are very effective in keeping asthma under control when used as intended. If you want to know more about the differences between steroids and safe and effective methods of use, ask your pharmacist, you have the right to know!
RESPONSE TO QUESTION
A young reader advises that our previous article on the abuse of antibiotics was timely as this topic is on the CAPE Biology syllabus this year. He asked for some guidance with the question. Antibiotics are generally classified as bacteriostatic or bacteriocidal. Within this broader classification there are various groups with different mechanisms of action. The type of bacteria to be treated is an important factor in determining the appropriate antibiotic to be used. Most general pharmacology texts give comprehensive treatment of this important topic. For information about new antibiotics, ask a pharmacist for drug information literature often inserted inside product packages.
Ellen Campbell-Grizzle, President of the Caribbean Association of Pharmacists (CAP) and Director, Information and Research, National Council on Drug Abuse (NCDA), Kingston, Jamaica.
