Steroids on the Job: An Emerging Problem

A major shift in steroid and performance-enhancing drug abuse is occurring, and the next place it emerges will be in the workplace.

ATHLETES and steroids have become a sad combination in modern Olympic and professional sports worldwide. It seems as if a day cannot go by without some reported scandal of an athlete abusing steroids or some other performance-enhancing compound to gain a competitive advantage. Photographs of bodybuilders from the 1950s bear no resemblance to modern bodybuilders, whose bloated muscles defy the image of what a well-exercised and -developed human body should look like.

Without a doubt, steroids are a major problem in modern sport--so much so that some experts suggest discarding all of the records in recent years until a fail-safe method of ensuring that all athletes are drug-free is fully implemented. This discussion is currently circling around Barry Bonds as he approaches breaking Hank Aaron's career record of home runs. Football players, soccer players, weightlifters, and even badminton players have been caught abusing steroids. But a major shift in steroid and performance-enhancing drug abuse is occurring, and the next place it emerges will be in the workplace.

Consider the two guys on the loading dock who work out almost daily together or the teenage interns working at your company this summer with the lean and sexy look pushed so hard by the media today. Could the guys be using steroids to gain strength (and the girls for cosmetic purposes) to gain that lean look? Unfortunately, the answer is yes. The abuse of performance-enhancing drugs that once were thought to be the exclusive province of elite athletes is now moving into all sectors of our society and, therefore, our workplaces.
What are the consequences if employees choose to abuse steroids on their own time for improved strength or body image? What impact does that have on the workplace? Presently, the answer to that question is unknown because steroids are not tested in the non-sports workplace, nor are there studies surveying workplace steroid abuse. However, experts in this area estimate there are between 1 million and 3 million former or current abusers of steroids in the United States. Also, there are compelling studies suggesting the abuse of steroids approaches 10 percent of high school males and females as young as 13 years old and that steroids are being abused by young adults who are not professional athletes. These studies were done a few years ago, which suggests those high-school steroid users who are not in professional sports are now in the workplace.

Big Changes from 1990 to 2006
The Steroids Working Group to the United States Sentencing Commission published its "2006 Steroids Report" in March of that year. The report discusses the legislative history of acts passed by Congress to crack down on steroid abuses, mainly in professional and amateur athletics. The commission had issued a 1990 report, and its members decided in April 2005 to conduct more research to update that document.

The 1990 report contained eight major findings. Among them were these items: Steroids were then thought to be not physically or psychologically addicting; penalties for steroid offenses had typically resulted in sentences of probation; and steroid offenses were not covered by the federal sentencing guidelines.

The 2006 report found two major differences had taken place since 1990: "First, steroids are now considered potentially addictive, with documented withdrawal symptoms. Second, steroids are primarily distributed through use of the Internet involving international sources." Also, the later report said one-third of illicitly used steroids in 1990 were diverted from legitimate sources in the United States, but "by 2005, illegal diversion represented a very small proportion of illegal steroid distribution."

The 2006 report cited the University of Michigan's Monitoring the Future Survey (MFS), which examines drug use in grades 8, 10, and 12. The 2005 MFS suggested steroid use was down in the higher grades from, but judging by several surveys' results, the working group concluded steroid use typically remains steady or rises with age. In 2005, 56.8 percent of 12th graders in the MFS sample said taking steroids is a "great risk," but this was below the peak level of 70.7 percent in 1992. And 39.7 percent of 12th graders in 2005 said it would be "fairly easy" or "very easy" to obtain steroids--down from the peak of 46.8 percent in 1992, and also the first time this response fell below 40 percent, according to the 2006 report.

Only 46 offenders were sentenced for steroid trafficking offenses under the drug trafficking guideline between 2001 and 2005, the report says. Twenty-six of the offenders received probation only.

The Price of Steroid Abuse
Steroids, or more accurately anabolic androgenic steroids, are male hormones like testosterone, its metabolites, or synthetic compounds. They do work in building muscle, aiding tissue repair, and decreasing fat and are medically appropriate for individuals who have hormone deficiencies or seek to build up muscle after surgery or in wasting diseases.
When abused, however, the dosage can be up 1,000 times the recommended amount and may continue for weeks. This can cause profound psychological effects, including depression, mood swings, aggressiveness, irritability, reckless behavior, impaired concentration, poor impulse control, and unpredictability; all are undesirable qualities in the workplace. These behaviors have become so well know that a new term as been coined for the syndrome: "roid rage."

Another significant finding is that individuals who abuse steroids are more likely to engage in other high-risk behaviors, such as substance abuse, smoking, violent behaviors, and binge drinking. Again, all of these are undesirable workplace behaviors. These high-risk behaviors are probably due to some underlying psychiatric disorder that is amplified by the abuse of steroids. In the extreme, these behaviors exacerbated by steroid abuse have been associated with at least 20 murders caused by "roid rage" in the United States alone.
One case involved a 23-year-old, mild-mannered construction worker who began using steroids as part of his bodybuilding program. He had been a social drinker and reported occasional cocaine use prior to abusing steroids. After starting to abuse steroids, he reported severe mood changes, including "incredibly shortened" temper and "challenging others for no apparent reason." He became manic, irritable, reckless, and suffered delusions of grandeur. ("I was the strongest person in the world, I was superhuman.") At one point during his abuse of steroids, the man stopped at a store, vandalized it, and later picked up a hitchhiker to "hassle a little." He drove the hitchhiker to a remote woodland spot and violently beat him to death.

The attacker was arrested and withdrawn from steroids while in jail; he reportedly returned to his previous mild-mannered personality. He was convicted of murder but not given the death penalty because the steroid abuse was considered in the sentencing phase of the trial, the judge stated.

Testing for Steroid Use
It has been documented that steroid abuse has a higher incidence in some industries, with private security, police, prison personnel, and law enforcement being the workplaces most at risk. However, the recent push for anti-aging medical treatment includes not only growth hormone but testosterone, as well. The concept of anti-aging is now part of an American culture that places high value on youthful appearance and seeks to maintain it at all costs. This makes steroid abuse a potential danger across all socioeconomic and age groups; entry of its negative affects into the workplace is only a matter of time.

Steroids have been problematic to measure since they were first discovered to be abused by Soviet athletes in the 1950s. Problems exist up to today, highlighted by the recent controversy over the quality of steroid testing by the French IOC accredited laboratory. The French lab reported that Floyd Landis, the 2006 Tour de France champion, was positive for testosterone, but significant questions exist as to the testing procedures and accuracy of results. Testosterone does exist in the body of men and women naturally, so the determination of abusing testosterone is complicated--and the interpretation of a positive result must be done by a Medical Review Officer (MRO) experienced with steroid testing. There are several commercial laboratories and one IOC-accredited laboratory in the United States currently testing for steroids. Testing can range from $80 to several hundred dollars, depending upon the number of steroids being tested.

Legally, testing for steroids is on sound footing in the athletic and security industries, but what about other workplaces? Steroids are now Schedule III controlled substances as a result of the passage of the 1990 Anabolic Steroid Control Act, and persons dealing or abusing them would face the same penalty as those who are dealing with cocaine, heroin, or methamphetamine. They are illegal to possess or use without a doctor's prescription and, as such, can be written into a company's substance abuse policy or fall into an "other illegal drugs" category if the policy is so written.

The cost and small number of laboratories performing steroid analysis limits the testing of steroids in the workplace at this point for pre-employment and random testing. But if reasonable suspicion exists based on the behaviors noted above, testing can be ordered for steroids on an individual, especially if "roid rage" is apparent. If found to be positive by a qualified MRO, appropriate disciplinary measures could be taken according to the company's substance abuse policy, up to and including termination.

In the future, when steroid testing is more available and less expensive, testing will be common. Not testing for steroids in such a situation will place other employees at risk of being harmed by another "roid rage" outbreak by the steroid-abusing employee, and the employer will be potentially liable for not identifying steroid abusers. Employers have the right to ensure their workplaces are safe and can take reasonable measure to ensure illegal drugs are not entering the workplace or being abused by employees.

In summary, steroid abusers are now an unknown part of the American workforce. Steroids are abused by not only professional athletes, but also anyone who wants to increase strength or gain a more youthful and lean look. Both males and females abuse steroids in ages as young as 13 and as old as the 70s for the anti-aging effects.

The consequences of the abuse of steroids are behaviors that range from depression to violent mood swings and "roid rage." Keep this in mind the next time you are faced with aggressive and unexplained behavior in the workplace. From the loading dock to the young female interns, steroids may have made their way into your workplace. [OHS endbug]

References
1. National Institute of Drug Abuse, NIH publication 06-3721, Research Report on Anabolic Steroids, revised August 2006.
2. Pope HG & Katz DL (1990) Homicide and near-homicide by anabolic steroid users, Journal of Clinical Psychiatry 51 (1) pp. 28-31.
3. Martin DM, Baron DA & Gold MS (2007) A review of performance-enhancing drugs in professional sport and their spread to amateur athletics, adolescents and other at risk populations, Journal of Addictive Disorders 25, supplement number 1, pp 5-15.

This article originally appeared in the August 2007 issue of Occupational Health & Safety.

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