Primary prevention
Primary prevention is focused on professional athletes. Social factors and motivations that precipitate non-sporting, image-oriented anabolic-androgenic steroid (AAS) use remain vague; a different prevention and diversion focus is required.[19]
Research suggests that athletes in high school years are less likely to use AASs if their parents and peers disapprove.[33] Presenting both the risks and benefits of AASs more effectively discourages use than teaching about adverse effects alone.[33]
In the US, National Institute on Drug Abuse (NIDA)-funded educational prevention programmes have been shown to help reduce abuse in US high schools. Adolescents Training and Learning to Avoid Steroids (ATLAS), a school-based drug and alcohol prevention programme for male high school athletes (13-19 years of age), is designed to reduce or stop adolescent male athletes' use of AASs, sport supplements, alcohol, and illegal drugs, while improving healthy nutrition and exercise practices.[34][35] Athletes Targeting Healthy Exercise and Nutrition Alternatives (ATHENA) is a programme for female athletes that addresses the connection between young women in sports, disordered eating behaviours, and body-shaping drug use.[33][36]
Secondary prevention
Early identification of relapse is important so that encouragement and supportive counselling, without prescribing an AAS or routine medical monitoring (in the absence of medical problems), is provided.[11][19]
National Institute on Drug Abuse (NIDA)-funded educational prevention programmes have been shown to help reduce AAS use in US high schools. Adolescents Training and Learning to Avoid Steroids (ATLAS) and Athletes Targeting Healthy Exercise and Nutrition Alternatives (ATHENA) can help with secondary, as well as primary, prevention.[33]
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