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July 13, 2004

The Abuse of Anabolic Steroids and Their Precursors by Adolescent and Amateur Athletes

Terry Madden
United States Anti-Doping Agency

Mr. Chairman, Senators.

Mr. Chairman, members of the committee, good morning, my name is Terry Madden. Thank you for the opportunity to testify. Today I come to you as the CEO of the United States Anti-Doping Agency, which has been recognized by Congress as the independent, national anti-doping agency for Olympic and Paralympic sport in the United States. Our mission is to protect and preserve the health of athletes, the integrity of competition, and the well-being of sport through the elimination of doping. Over the last year, we conducted more than 7,000 tests for steroids and other prohibited doping substances.

I am here today to speak to you about the increasing number of products sold over-the-counter in the United States that contain anabolic steroid precursors. These products, marketed and sold as dietary supplements, contain substances, such as androstenedione and norandrostenedione. These substances are one chemical step away from anabolic steroids. Once ingested these products are converted within the body into anabolic steroids. While this is a problem that affects athletes, it is, in truth, a significant public health issue that transcends sport and places American consumers at risk.

The perils of anabolic steroid use are well known. In Olympic sport, the most notable, systematic state-supported program of doping with anabolic steroids was conducted by the East Germans from 1974 until the Berlin Wall fell. The results of this program have since been substantiated through the testimony of many of the athletes themselves, their coaches and doctors during the East German doping trials. One of the anabolic substances developed by the East Germans as part of their doping program was androstenedione. In the body, androstenedione metabolizes into the anabolic steroid, testosterone, and other steroids.

The documented side effects of steroids and steroid precursors among these East German athletes, particularly women athletes, are severe and include effects on the liver and reproductive system, susceptibility to cancers, and permanent masculinization of women. Other side effects include growth arrest in adolescents, and shrinking of testicles and impotence in men.

Today, American consumers can walk into their corner nutrition store and buy products containing androstenedione. After professional athletes acknowledged that they used androstenedione, sales of these supplements in the United States dramatically increased. This phenomenal demand, particularly among teenagers, led to the mass marketing of other steroid precursors like 19-norandrostenedione, which metabolizes in the body into the steroid nandrolone, another controlled substance. Now the nutrition store shelves, and the internet, are flooded with products containing these steroid precursors. Further, the manufacturers of these substances attempt to take advantage of DSHEA by touting these substances as "natural," and implying in their advertising that "natural" equals safe.

Under the current regulatory scheme, a manufacturer is not required to test its steroid precursor product for either side effects or purity prior to putting it on the shelf. This is of particular concern when women and adolescents are considered. Instead, the burden rests on the government agencies to prove that a particular product is harmful. However, by the time action is taken against a specific product, an unscrupulous manufacturer could simply make a minor chemical change and reintroduce the product.

The marketers of these products glorify the muscle-building qualities of these substances and do everything possible to reinforce the association between these products and controlled anabolic steroids. These products are marketed under names that reinforce their connection to anabolic steroids, including "Cycloroid," "Masterbolan," "Anabol-X," "Paradrol," and "Animal Stak." These products are advertised as equal to or better than the "real steroids" and promise the user huge gains in muscle mass. The advertising also stresses that these products are "legal" in order to raise the implication that they must be safe.

In a society where high school athletes can sign multi-million dollar endorsement contracts, we cannot expect teenagers to ignore advertisements claiming that these products are "safe alternatives" to steroids and will make them "ripped," "huge," improve their athletic performance and give them the body of their dreams.

For Olympic athletes, who know to avoid these products, there remains another concern. In increasing numbers, athletes are failing doping tests after taking mis-labeled dietary supplements. Studies have shown that an alarmingly high percentage of dietary supplements contain doping substances that are not disclosed on the label. For example, a recent study of 624 dietary supplements by the International Olympic Committee found that 41% of the products from American companies contained a steroid precursor or banned substance not disclosed on the label.

USADA believes that the current effectively unregulated availability of products containing steroid precursors in the United States is a health crisis that affects not just Olympic athletes, but every American teenager who dreams of becoming a professional or Olympic athlete, and every consumer who takes one of these products without being informed of the risks. Additionally, because of the risk of contamination, American consumers may unknowingly be ingesting steroid precursors.

USADA feels strongly that research and education of athletes regarding the medical and ethical issues with taking performance-enhancing substances are an important part of the drug deterrence strategy. Members of USADA staff have made more than 100 presentations before more than 4600 athletes, coaches and parents in 2003-2004 to discuss drug testing and the dangers of performance –enhancing drugs. USADA has also been part of a pilot program entitled "100% Me" with Scholastic which guides 5th grade students to make good ethical and healthy life-style choices – including not using drugs. Our intent is to educate the next generation of citizens and athletes about the benefits of doing things right. Finally, USADA has invested $3.7 million in the past two years and committed $1.4 million for the next two years to develop new tests and testing strategies. New tests are now beginning to appear as a result of this investment. In addition, a research project on the ethical aspects of performance enhancing drugs in sport is coming fruition.

On behalf of the Coalition for Anabolic Steroid Precursor and Ephedra Regulation (CASPER), I would like to thank Senator Biden, Senator Hatch, Senator Grassley and Senator Harkin for their attention to this matter and commend their introduction of The Anabolic Steroid Control Act of 2004. This important bill amends the Controlled Substances Act by scheduling the substances I have discussed here today and making it easier to schedule any anabolic steroid precursors introduced by manufacturers in the future. USADA believes that this bill is an appropriate solution to the steroid precursors problem. Similarly, I would like to thank Congressman Sweeney, Congressman Osborne, and Congressman Sensenbrenner for their leadership on this issue and the passage of Anabolic Steroid Control Act of 2004 in the House of Representatives. Finally, I would like to thank this Committee for its time and its interest in this important public health issue.

Thank you.