'THE POUND IS STRONG, INFLATION IS UP'

A FUTURE MARKET FOR ANABOLIC STEROIDS?

Is the current rage for steroids destined to be just a footnote of drug history, asks Harry Shapiro, or does it herald an era of acceptable performance enhancement in society?

The rise in the non-medical use of anabolic steroids has constituted nothing less than agrowth industry for sport, the media and sectors of the drugs field itself. The Sports Council has a separate Doping Control Unit and recently hosted the 4th Permanent World Anti-Doping Conference in London; Merseyside boasts a Drugs and Sport Information Service with many other drugs agencies round the country producing a steady stream of information. Academic j ournals ofevery stripe have rehearsed the whole range of issues from the morality of performance enhancement and the ethics of drug testing to the debate over whether or not steroids 'work' and the reality of'roid rage'.

Meanwhile, since the breakthrough Ben Johnson scandal at the 1988 Seoul Olympics, the amount of newsprint devoted to further expos6s, comment and analysis, and reporting on the slew of national and international enquiries into doping (not to mention the weighty tomes themselves) would tax the strength of even the most 'ripped' muscle machine.

Most media attention focuses on steroid use at international level. Anxious to ensure that at least part of the Olympic ideal remains unsullied (even if the rest is seemingly sacrificed at the attar of rapacious commercialism) the sports bodies have taken on the 'drug cheats'with highly publicised punishment of high profile athletes such as Butch Reynolds (who successfully appealed the decision) and Katrina Krabbe. Even here cynics opine that keeping the sponsors happy carries equal (if not more) weight with preserving the porcelain frailty of fair and 'natural' competition in the almost gladiatorial environment of sport in the late twentieth century.

Conscious, too, of a chance possibly to win at least one skirmish in what appears an otherwise hopeless war against drugs, governments have weighed in with laws prohibiting non-medicat use of steroids and support for the banning of those caught out by testing procedures.

However, it is clear that in recent years steroid use has broken out not only from the world of 61ite sport, but also from top flight competitive bodybuilding where steroids have long been the unspoken, but nevertheless essential ingredient of success. Steroids now find a ready market among those whose use is not athletic, but either functional (bodyguards, doormen, construction workers, etc.) or simply cosmetic. Psychia, trist Dr Douglas Williamson is quoted as saying he believes, on the basis Of American high school studentstudies, thatsteroidsare one of the most popular recreational drugs of recent times. In the UK, as in the States, gripped by health fever, some 5% of the population engage in some form of fitness or strength training. Obviously by no means all body-builders and those who do fitness training are steroid users, but most workouts take place in the thousands of gymnasia across the country where steroids are potentially most easily obtained. This has been demonstrated by the surveys of steroid users conducted in Britain. Sample sizes have been small, but even so researchers appear to have had little difficulty in locating respondents Workia and Stimson, 1993). Furthermore in some areas injecting steroid users now account for upwards of a third of those coming forward to needle exchange schemes (Shapiro, 1992).

The body-building market in the UK is able to support several magazine titles including 'Flex', 'Bodypower Plus' and 'Muscle and Fitness' (a title with a claimed readership of six million worldwide) - all on the shelvesofWH Smith. Backstage at a rockconcert, the author noted a well-thumbed copy of 'lronmen' passing among the security guards.

Some of these magazines carry adverts for publications like the'Underground Steroid Handbook'and classified ads for companies whose addresses are well known to those requiring a shopping list of steroids to peruse. Others are resolute in eschewing steroids in favour of 'natural' body,building techniques (otherwise known as hard graft).

Yet irrespective of the magazine's stance on drugs all carry glossy, full colour photos of glistening musclebound bodies of women as well as men - although it is likely that as the vast majority of body,builders are men, the scantily clad women perform the pin,up role for men rather than genuine role models for women. Anybody who has seen the huge billboards advertising the new Volkswgen Vento car using a female body builder will get the picture.

The full page magazine shots shots stand in stark contrast to the eagerly submitted one inch polaroid readers' photos (akin to the'readers wives' photos found in most pornographic magazines) featuring Tony from Bolton, arms flexed in search of a muscle, posing next to his wardrobe.

Anyone wanting to be a well 'ripped' pin-up is looking at a long-term tough training schedule and strict diet control. But as one steroid user remarked: 'Why should I take a year and a half when I can look like that in three months'(Canadian Centre for Drugfree Sport, 1992).

The rise in purely cosmetic steroid use especially among adolescent mates appears to parallel changes over the last decade or so as to what cons t itutes 'looking good'. Historically for young men this has meant being slim, but perhaps even more important it has meant wearing the right clothes: teddy boy rock'n roll gear, biker chic; mod styles inspired by Italian haute couture, hippy regalia; the seventies Brian Ferry lounge lizard look juxtaposed with stack heels and flares of'glam'; punk's disposable anti-fashion; fey new romanticism, grunge and so on. Obviously clothes fashion is still with us, but to some extent the drapes have overshadowed the skin and bones underneath the body itself is now the fashion.

We can follow two lines of development here: one from advertising, the other from entertainment. The cult of the male body in advertising probably derived initially from the 1980s concept of the'New Man'which in advertising terms meant a half-naked welldeveloped hunk holding a baby or walking along a country path with a toddler into the setting sun. The baby was soon ditched in favour of the hunk dominating, for example, theCalvin Klein cosmetic advertisements and any number of rock videos. Enter stage left from the world of'showbiz','Rambo Man'with power over life and death and, even more importantly for the star-struck acned youth of the world, over women. Arnold Swarzenegger, Sylvester Stallone, JeanClaude Van Damme, the TV Gladiators, the Chippendales and the phenomenally successful stars of the World Wrestling Federation all spoke the same message - muscles maketh the man. And with Arnie and various Chippendales admitting steroid use, the message was even clearer.

As a rule one must be careful about attributing too much influence to role models as far as drug use is con, cerned, especially when discussing remote (albeit high profile) figures from the world of entertainment. It is commonplace to burden rock stars with the responsibility ofsetting a good example to the youth of the nation - a point few judges can resist making when a musician stands before them on a drug charge. Yet despite some notable exceptions, few rock musicians readily admit to current drug use and most fans wouldn't even know who was using what unless said hero found himself under arrest or otherwise exposed by the media. The author has found only one example in the literature of predictors of drug use when a musician was actually cited as influencing a decision to use drugs - in this case it was Bob Marley mentioned by a group of West African youngsters in discussing cannabis - and Marley hardly made a secret of his recreational and sacramental use of the drug.

With steroids the situation is somewhat different. You don't have to know for sure that a certain wrestler has taken the drug; all you need to know is that you waritto looklikehim andyouwant all the prestige and success that appears to come with the muscles. This steroid user was in no doubt of the value of a short cut to status: 'Stop being skinny and one of the crowd. Have you ever wanted to walk into a club and be worshipped by the masses and to take your pick of sexual partners?Then join us for this is the reality fort'ne and some of my friends. Join us' (Korkia and Stimson, 1993).

Quite simply large numbers of young men will do just about anything to took good without a shirt on. It might be the seven stone weakling; it might be the unemployedyouth trying to take control over that one bit of his life he feels he can control - his body; it mightbe the shy teenager anxious to build self-esteem, it might be somebody who is all of these or none of them. Eating disorders are apparently on the increase among the male population as those among certain groups are faced with pressure to conform to a body type. It may well be that currently at any rate, the politics of image and appearance are not the sole provenance ofthe feminist dialectic. Some even believe that the topical premium on muscle is a form of reaction against loss of masculine identity in the face of greater assertion on the part of women. However, it is unlikely that how a man is judged in society will ever depend on his physical appearance to the extent that women have to face. Being overweight and unattractive has never been a barrier to success for men as a glance around most industry boardrooms would confirm.

Those keen to dissuade young people from taking steroids face assaults on two fronts, both from the (win- at all- costs' mentality which prevails in sport at all levels and the gender- based cultural phenomenon outlined above.

In any case the notion of sport as the central plank of a cleanAiving ethos is something of a myth in itself - if clean living is synonymous with chemical abstinence. Sport is often cited as an antidote to a range of unhealthy and antisocial behaviours including drug taking. But in one study of American high school students who engaged in regular sport, 50% drank alcohol while 42% smoked cannabis (Rooney, 1984). As one student interviewed for another survey remarked, 'I'm as athleticas hell, but 1 like to party' (Stuck, 1990). Steroids render the playing field even less level. In research conducted for the Miller Lite Beer company, many respondents took drugs in athletic competition while at the same time saying they believed in the association between sport and clean living. In other words, for these competitors at least, taking drugs to enhance performance did nothing to undermine the lofty aspirations of sport. This may presage a change of attitude in what is deemed acceptable as 'natural' in society and it's a point we will return to later.

Studies conducted to ascertain the efficacy of mass media anti-drug campaigns have come to the general conclusion that they fail to change drug behaviour. However, they do appear to re-affirm in the minds of the target audience (mainly young people) that drugs such as heroin and cocaine are best avoided. Through television adverts and billboards the negative images of drug use are vividly portrayed. Although anecdotally, some young people may have found the 'wasted' vision of drug use appealing, the majority would not wish to end up looking like the models featured in the 'Heroin Screws You Up'UKgovernment campaign of themid-1980s.

Within sport itself bodies like the Sports Council nowadays take a more considered view of prevention and acknowledge the limited value of sensational anti-steroid materials. Nevertheless, the national and international sports organisations are in a position to deny athletes the chance to compete if they are tested positive for drugs. However, few are caught and the legal challenges to banning notwithstanding, the ultimate sanction exists and risk is there for all.

Outside organised sport prevention becomes far more problematic. First there is no coercive element; laws against possession appear to offer little in the way of deterrence to those who are determined to use drugs. Second, if one thinks of the muscle magazines, the pictorial possibilities are anything but negative. And third, even from a health point of view, the various exhortations not to use because of the risks may be falling on deaf ears especially when one considers that 'there are relatively few significant side effects from the low dose, intermittent use patterns typical of ado, lescent athletes and nonathletes'(Rogol and Yesalis, 1992). If young people see those around them using steroids, achieving the desired results in terms of bulk and its attendant status but with few if any of the much publicised side effects, then attempts at discouraging use will run into problems.

Up to now we have considered the current chatlenge to health education in trying to persuade young people against the use of anabolic steroids. But asstiffas that challenge might be, there is at least one scenario which could render any sort of campaign redundant.

At present any moves to restrict the use of steroids are conducted in a climate of approbrium about nonmedical drug use in general and drug- induced performance enhancement in particular as an activity which is 'cheating' and, within the healthy living ethos of our times, not 'natural'. But 'naturalness' is not a universal and timeless construct, but one built on shifting sands, simply a product of a specific era and its particular prejudices. At one time it was not considered 'natural' to give women pain relief in childbirth. Currentlythere is a debate over whether women in their fifties or even older should be given the chance to bear children. This is criticised by many as not being 'natural'. Significantly, no such questions are asked of actor Anthony Quinn being a father at 78 years of age. Taking the question deeper, it is not 'natural' that human beings fight infection with antibiotics; in the natural world we would simply die. These are but a few of the many examples one could cite. In fact, there would be a strong argument for the position that whatever humans can achieve by way of scientific developments is'natural'; it is part of our psychological makeup to want to push our achievements to their farthest point. Thus the argument becomes not what is'naturat', but what is'acceptable'.

As the Miller Lite research suggested, for some young people using drugs to enhance performance does not appear to be necessarily inconsistent with an otherwise'clean,living'outlook on life. Already there are people trying to enhance their mental perfor, mance through the use of so,called smart drugs - will anybody try to drug test young people before they sit their exams in case they have chemically'cheated'?

One of Britain's foremost geneticists, Professor Steve Jones, has suggested that because a number of mutative forces in our environment no longer exert the power they once did to change us, human evolu, tion has come to an end. This is as good as it gets; the implication of that is if we want to change any more, we are going to have to do it ourselves through that most controversial of scientific endeavours, genetic engineering -7he danger that specific body-types will be developed for specific sport disciplines is no longer a matter for science fiction; for this reason we can already see on the horizon the danger that specific athletic types will be bred by means ofniore or less concealed chemical or even genetic manipulation' (Hoberman, 1988). But taking a step back from a Jurassic Park vision for sport, isthesteeprise in the use of anabolic steroids simply the latest development in the history of male narcissism? Or do they presage a change in outlook where, in an increasingly competitive, aggressive and unstable world, any mechanism for performing better becomes acceptable?

Harry Shapiro, Institute for the Study of Drug Dependence, Waterbridge House, 32-36 Loman Street, London SE1 OEE, UK

REFERENCES

Canadian Centre for Drug-free Sport (1992). The body image study: a qualitative study of the use of performanceenhancing drugs by non-athletes. Ontario.

Hoberman, J.M. (1988). Sport and the technological image of man. In Morgan, W.J. et al. (Eds), Philosophic Inquiry into Sport. Champaign, IL: Human Kinetics.

Korkia, P. and Stimson, G.V. (1993). Anabolic Steroid Use in Great Britain: An Exploratory Investigation. London: The Centre for Research on Drugs and Health Behaviour.