Professional athletes may be stealing the headlines when it comes to the use of performance-enhancing drugs, but those headlines represent merely the tip of an iceberg.

Three percent of high school seniors admit to using anabolic steroids, with 40 percent of their classmates reporting how easy they are to obtain. The use of performance-enhancing drugs is a national problem, with maturing adults eager to look young and many teens who don't participate in sports eager to look more mature.

Whether they are athletes or not, adults and teens are taking performance-enhancing drugs to gain a fitness edge and improve performance. In some cases, medication prescribed for a legitimate purpose is being used for other reasons. Laxatives and stimulant medications that cause rapid weight loss enable wrestlers to compete in lower weight classes. Asthmatic bronchodilators can improve exercise tolerance. Athletes also use erythropoietin, a drug used to treat severe anemia, to improve endurance.

The use of anabolic steroids, which are synthetic forms of the male hormone testosterone, is of particular concern. While these hormones do enhance performance in certain athletic arenas, the health consequences can be severe and may be irreversible. Adolescent growth and physical development may be prematurely halted. Kidney damage and liver failure are other potentially fatal side effects of steroid use. Males may develop larger breasts, a diminished sperm count and even testicular atrophy. Women may develop male-pattern baldness and a significant deepening of the voice. Behavior changes can be quite severe, including mood swings, paranoia, aggressiveness and depression.

As weight-lifters discovered when they tried these drugs more than 50 years ago, as muscle strength increases, so does muscle size. Teens, competing to "win at all cost," are eager to look buff and excel in athletics, making steroid use a compelling option in spite of the dangers.

Many kids take cocaine, heroin and marijuana to get high. These, and other illicit drugs, provide a sense of euphoria. In much the same way, adolescents who use steroids overlook the potential dangers because the drugs boost a teen's self-confidence, improve self-image, and, in many cases, heighten athletic prowess.

Steroid use in teens can be very difficult to detect and differentiate from normal growth and physical changes. If a teen's appearance seems to change too rapidly, parents and caregivers should be suspicious. Look for sudden increases in weight, muscle size and definition. Check to see whether academic performance suffers as athletic skills skyrocket. Escalating mood swings, erratic behaviors and increased aggression are frequent indicators of steroid use, as are sudden severe acne eruptions and exceptional vocal changes.

Do not overlook these signs, or knowingly tolerate the use of performance-enhancing drugs, even if your son or daughter is a star athlete. While many view athletics as far more than healthy activities that lead to skill development and good sportsmanship, the risks of steroid use are too great to take. Enhancing skills by injecting harmful drugs and exposing children to hepatitis and HIV risks are senseless. In addition, there is strong evidence that the use of performance-enhancing drugs is strongly associated with the use of cocaine, alcohol, marijuana and needle sharing.

If you suspect that your child is using or at risk of using any of these substances, talk openly and honestly with him or her. Control your emotions and share information about the risks. Acknowledge that, although these drugs may improve performance, their use is not just bad sportsmanship, it is dangerous. Then, make an appointment with your pediatrician for counseling and professional observation of telltale signs, including hypertension, high cholesterol and liver abnormalities.