Steroid Use a Widening Addiction, Doctor Says

The Seoul Olympics focused a spotlight on steroid use, but the expulsion of several gold-medal winners for using performance-enhancing drugs came as no surprise to doctors who say steroid use is reaching epidemic proportions, even in the general populace.

Dr. Jack Freinhar, a psychiatrist who treats substance abuse patients, including steroid users at Del Amo Hospital in Torrance, says there is increasing steroid use by youths as young as 14, and that the revelation of Olympic sprint star Ben Johnson’s steroid use “just brings to light how many millions (of people) are into sports, and for those who want it this stuff is available. . . . The obsession with weightlifting and steroid use is growing in epidemic proportions, especially among teen-agers.”

Freinhar contends that steroid use can be as compulsive and unstoppable--and users display the same symptoms--as an addiction. In fact, most of the patients Freinhar sees for steroid use are not competitive athletes, but people with self-image problems who fill their needs by pumping up their bodies, aided by steroids.

Freinhar calls it “reverse anorexia.”

“With anorexia, it’s the idea they’re never thin enough,” he explained. For adolescent males, he said, “There’s this media push to be muscular. Most of the kids I treat have had a very depriving childhood. They have holes in the self . . . the self becomes very fragile and flimsy. So he looks outside for affirmation, a need for acceptance. One way to do that is to look good. So they start pumping (iron) and they’re getting bigger. But not fast enough. As they’re looking in the mirror, they’re always too small. They decide to try steroids.”

Freinhar said he can empathize with athletes and body builders who use steroids to stay competitive. “As everyone is condemning Ben Johnson, no one is trying to understand why he did this--if he did,” Freinhar said. “In body building you can’t compete (without steroid use). In the Olympics it’s impossible to compete with some of these guys without using steroids.”

But for many users, he said, taking steroids is compulsive behavior.

“A lot of body builders, if you asked them, they couldn’t get off them,” he said. “I’ve heard at certain gyms in L.A. steroid use is 80%. And most of these guys aren’t competing. So they’re taking serious medical risks for little reason, or for a personal reason. People who use steroids are addicts in the true sense. I have friends who use them who deny it. I take the same approach (for treatment) I take with drug addicts and alcoholics.”

As Freinhar spoke, a patient nodded in understanding. Tina Plakinger, a former champion body builder, used steroids for five years while competing. She now trains other body builders and is an official in the International Federation of Body Builders.

“I liked lifting right away. It made me feel good. After two years I joined a men’s gym,” she said. “My first contest I went in clean. After that I started using drugs. I created a world-champion physique, but it turned out I was an emotional basket case.” Pumped up to 150 pounds and using as many as four different steroids, she didn’t like what she saw in the mirror and retired from competition at 28.

“My voice was so low that on the phone people would call me ‘sir.’ The last year I competed I was worried more about how to hide it than anything else. I hit bottom,” she recalled. “I injured my knees after winning the world mixed title in 1985. I couldn’t compete, but I realized I was still sticking (injecting) myself. I couldn’t stop. I thought, ‘My God.’ I had to get into a program. When you ask me are (steroids) addicting--absolutely.”

Anabolic steroids--synthetic versions of the male hormone testosterone--have been around since the 1930s, used originally to treat metabolic problems, burn victims and surgery patients. The medical profession has not used them widely since the 1960s, but steroids have been ingested for several decades by athletes, weightlifters and body builders for their ability to increase muscle mass and heal injuries rapidly. Taken orally or by injection, steroids also have an antidepressant quality that may appeal to some users.

Steroids are not illegal, controlled substances, but require a monitored prescription. For muscle building they are generally obtained from personal physicians or from the black market. Most doctors, Frenhar said, will no longer prescribe them.

Steroids have several known harmful qualities: possible liver damage, impotence, atherosclerosis and acne. In men, there can be side effects of decreased hormone levels and prostate enlargement; in women, arrested menstruation, shrunken breasts and uterus, hair loss and deepened voice. Steroid use can also manifest itself in what Freinhar calls “pseudo Alzheimer’s type dementia” and increased aggressiveness that can lead to spontaneous violence.

By medical definition, Freinhar said the steroid use he sees is classic addiction. “Absolutely,” he said emphatically. “Have you built up tolerance? Is there withdrawal? Definitely psychologically, and sometimes physically.”

Freinhar said his treatment program is 2-pronged:

-- Educating the user to the medical problems: “Invaluable, but useless by itself;”

-- Self-psychology: “We explore the reason they need this drug. Then we explore the past, what caused this hole. We close the hole. (Usage) falls off spontaneously.”

Freinhar is working on a book on self-psychology. Meanwhile, as an active weightlifter himself, Freinhar continues to see--and be frightened by--increased steroid use as a means to fill a personal need not being met by family or friends.

For many steroid users, he fears that without professional counseling, “it’s uncontrollable. They can’t get off the steroids.”