The Mitchell Report on the use of performance-enhancing drugs by professional baseball players followed on the heels of Olympic-winning sprinter Marion Jones's losing her medals for using anabolic steroids. The cheating described in the Mitchell Report has angered many baseball fans like me and my family. But what should be of much greater concern to parents is the use of anabolic steroids by aspiring high school athletes.

My first professional experience with anabolic steroids was when I saw a weight trainer and "body builder" in his late 20s. He had been referred to me because, despite his youth, he had elevated blood triglycerides and very low levels of protective HDL cholesterol. Both abnormalities quickly returned to normal when he stopped taking anabolic steroids.

Several years later, a long-time friend told me that his 16-year-old son was considering anabolic steroids to better his chances of becoming a starter on his high school football team. My friend had called to ask if I'd add to his warnings about anabolic steroids.

Anabolic steroid use by teenagers is not rare or new. Studies estimate that 1 in 20 high school students is taking or has taken these products. The American College of Sports Medicine issued a statement on this problem 30 years ago, and the American Academy of Pediatrics soon followed with their policy statement.

In addition to their tendency to push cholesterol and triglyceride levels out of kilter, anabolic steroids are associated with a long list of other potential adverse effects.

In males:

• decreased production of testosterone and sperm
• shrinking of the testes
• impotence
• prostatic overgrowth (benign prostatic hypertrophy) and possibly prostate cancer

In females:

• increased hairiness
• acne
• loss of menstrual periods

In all users:

• liver damage
• increased frequency of muscle strains and ruptures
• mental and psychological changes (irritability, aggressiveness, "roid rage")
• mood swings, from euphoria to depression
• altered libido
• psychosis

Although some of these side effects raise the threat of premature heart attacks and strokes, that possibility remains unproven. Of special concern to teenagers is premature closure of the rounded ends of the long bones in the body that may stunt their growth and lead to shorter stature as adults.
 
The Mitchell report and newspaper articles also questioned the fairness and authenticity of the new records set by steroid-using major league baseball players, and proposed more intensive drug testing for the players.

But these concerns don't just apply to professional athletes; parents and high school personnel must now realize that similar ethical issues apply and possibly that drug testing regimens should be considered for high school athletes. At present, only high school athletes in New Jersey and Texas undergo drug testing.

So parents, beware: If one of your teenagers suddenly develops the musculature of a body builder, consider the possibility that he or she is using anabolic steroids.