Access and Availability

Steroids in North America are mostly sold on the black market. Because of the high demands, the prices remain high, although most materials are illegally manufactured. As well, the steroids are often impure and contaminated.

Dealers are often trainers or members in commercial gyms. Users are educated on how to use the drugs through an underground �bible� that circulates through many commercial gyms worldwide, as well as by word-of-mouth. The youth will gain easy access to the drug, as well as the dealers. The youth will also have a �teacher� about the drug, as the trainer or dealer often takes the youth under their wing, teaching them weight lifting and bulking techniques.

Casting Away our Biases -
Education and Health Promotion

Educating adolescents about the effects of steroids has shown to decrease the incidence of use among school sports teams and activities. During prevention, nurses will need to present a balanced picture of what steroids can do for them and to them. Most adolescents know that anabolic steroids build muscles and can increase athletic prowess. Research has shown that failure to acknowledge these potential benefits creates a credibility problem and can actually make youths more likely to experiment with the drugs.

Make use of the authority of coaches and the team ethos. In the most promising program currently under study, coaches and team leaders are trained to educate team members about the effects of anabolic steroid abuse, both desirable and adverse, in the general context of training. They also provide information about nutrition and, of course, exercise and other training techniques for improving performance and preventing injury without the steroid abuse. This has decreased the incidence of steroid abuse on these teams by as much as 50 percent. These programs also help reduce alcohol abuse among teammates.

To care for the youth who enters into nursing care already using, nurses must examine their own perceptions, values and beliefs, and biases about steroid use and abuse. How will nurses effectively care for a youth who is struggling with his self-identity, independence, and self-confidence, and the nurse doesn�t agree with his choices? Possibly healing from injury and overuse, support and encouragement will help to establish a healing and caring relationship between the youth and the nurse.

Honesty and authenticity will assist the nurse while interacting with the adolescent, who will be quick to pick up on incongruence. Allowing the adolescent to make his own decisions and choices about the direction of care and rehabilitation will help the youth feel that they have control over their situation.