Earlier this month, the Drug Enforcement Administration (DEA) announced the shutdown of 16 underground anabolic steroid labs and 90 arrests - the result of a series of more than 30 investigations in 20 states. "Operation Cyber Juice" made headlines with accounts of its nationwide enforcement action and seizure of "homebrew" steroid labs across the country. This steroid takedown operation -- which follows past DEA-led investigations such as "Operation Raw Deal" in 2007 and 2005's "Operation Gear Grinder" - once again brings the subject of anabolic steroid use to center stage. And, now with both the U.S. Anti-Doping Agency (USADA) and the World Anti-Doping Agency (WADA) announcing their involvement in this multi-agency collaboration, the connection between non-medical steroid use and competitive athletics is highlighted.
When mainstream media sources cover steroid use, high-profile athletes like Barry Bonds or Lance Armstrong are usually the focus. Certainly, the unauthorized use of banned substances in competitive sports at all levels raises serious ethical questions about unfair advantages and a tilted sports playing field. USADA and WADA are tasked with policing this territory. However, despite the inferences suggested by the active involvement of USADA and WADA in Operation Cyber Juice, it's important to note that most non-medical steroid users aren't competitive athletes looking to gain an edge -- they are mature adult males primarily seeking to improve their appearance.
When my co-researchers and I looked at the demographics, motivations and use patterns of a population of 1,955 male non-medical steroid users, we found that the typical user is about 30 years old, well-educated, earns an above-average income in a white-collar occupation, and is not active in organized sports. The study, "A League of Their Own: Demographics, motivations and patterns of use of 1,955 male adult non-medical anabolic steroid users in the United States," published in 2007 in the Journal of the International Society of Sports Nutrition, suggests that personal physical self-improvement motivates the unrecognized majority of non-medical steroid users who particularly want to increase muscle mass, strength, and physical attractiveness. Other significant but less highly ranked factors included increased confidence, decreased fat, improved mood and attraction of sexual partners. For about 80% of the steroid users in this survey, competitive sports were completely unrelated to either current or past steroid use - a finding backed up by other researchers, my anecdotal experience having personally interviewed many hundreds of non-medical users, and the observations of others who've looked deeply into the steroid market.
From a purely motivational standpoint, the non-medical use of anabolic steroids to improve aesthetic appearance through enhanced muscle size and better body composition is less analogous to sports cheating (i.e., "doping") than to cosmetic modalities like breast augmentation, liposuction, rhinoplasty, lip fillers, Botox and the like. We live in an appearance-obsessed society where the latest medical technology is widely acceptable solely to improve personal self-image. Everyone wants to look better naked. Every guy wants a killer set of abs, as do more and more women. In a society such as ours that is increasingly driven by vanity is it really so surprising that drugs that can help add muscle and shed some fat have become so popular? As they are most commonly used, "performance-enhancing drugs" are more accurately called "image-enhancing drugs" - a term already seeping its way into the professional literature.
The distinction can be made that the various medical procedures referenced above are allowed by law to be performed by physicians. But the distinction exists only because politicians have passed laws to classify anabolic steroids as controlled substances, thereby limiting their application only to medical uses, not cosmetic ones. Ironically, the laws intended to suppress non-medical steroid use by banning physicians from prescribing steroids for aesthetic reasons are the very basis upon which the black market steroid network has flourished. The underground labs targeted by Operation Cyber Juice largely exist because anti-steroid laws have subtracted physicians and pharmacists from the equation, cutting off the controlled source of legitimate supply. Any college freshman knows from Economics 101, if there's a demand, there will be a supply. With doctors forbidden to prescribe and pharmacists unable to dispense FDA-approved steroid products for aesthetic reasons, the demand has been filled by kitchen table labs in which raw powders from China are homebrewed into injectable steroid oils or tablets of variable potency and purity. We have forgotten all too soon the lessons about moonshine and bathtub gin that the Prohibition of alcohol should have taught us. As is the case with the Drug War against cocaine, heroin and marijuana, legislation and enforcement can have consequences that may exacerbate the problems and even create new dangers.
It's clear that effective policies and interventions are necessary to deal with the current problems associated with underground steroid labs. But the involvement of WADA and USADA may divert the discussion to tangential issues. The vast majority of underground lab customers fall far outside the jurisdiction of USADA and WADA. Sports cheating should be viewed as a separate problem. Allowing the anti-doping movement too much attention in headlines about the steroid black market mislead the public about who's using steroids and why. Conflating two different problems can only hinder the quest for solutions to either. Giving the anti-doping agencies too loud a voice in the interdiction efforts toward underground labs, or in setting policy about non-medical steroid use in general, may divert our focus, and our resources, in the wrong direction.