The first time professional cyclist Matt DeCanio took steroids, he felt an immediate difference.
His body tingled with a burst of energy that allowed him to perform at levels he'd previously only imagined. Instead of getting tired after a workout, the steroids allowed him to quickly recover and proceed to the next challenge.
"What people need to understand is how powerful the drugs are," said DeCanio, who no longer dopes and is one of the nation's most outspoken doping critics. "We're not talking about a steroid; we're talking about something that can turn you into a super human."
Anabolic steroids, the class of steroids used to boost athletic performance, are a type of hormone that alters the body at a cellular level to increase muscle mass and strength. Its main building block is testosterone.
They enter the body and bind to specific receptors that trigger the way cells grow or multiply, said Matt Fedoruk, science director at the U.S. Anti-Doping Agency.
When they bind to receptors on the muscles, the muscles grow.
But "you're introducing a hormone into your body that's not only not supposed to be there, it's also competing with hormones already in your body," Fedoruk said. "So things that are supposed to happen may not be because of the hormone in your body."
Likewise, things that aren't supposed to happen, in fact, do.
It's especially visible in women, who don't normally produce much natural testosterone. Besides bigger muscles, steroids can enlarge the larynx and deepen the voice. It also can trigger hair growth on areas like the face and chest as well as male pattern baldness.
Other short-term side effects include high blood pressure, liver damage, acne, menstrual irregularities, mood disorders, increased sex drive, shrunken testes and enlarged clitoris.
Long-term effects are less understood, but, according to the Association Against Steroid Abuse, can include liver failure, cardiovascular problems, ligament and joint injury and neurological issues.
The world's professional sporting authorities have banned steroids and other performance-enhancing drugs in and out of competition.
In America, the U.S. Anti-Doping Agency polices and enforces that rule.
USADA has reported more than 350 doping violations since its inception in 2000. It has issued more than 270 suspensions, more than 40 warnings and exactly 15 lifetime bans - including those of Tour de France champion Lance Armstrong and former sprint cyclist Tammy Thomas of Yazoo City.
Some athletes know the risks, yet they do it anyway.
"They realize if they dope, they can get to the big race," DeCanio said.
"I can make half a million dollars as opposed to $20,000. It's easy to justify it in your own mind why it's not wrong."
Other athletes, though, say they had no idea the damage they were doing.
"I couldn't comprehend what harm it was going to do later," said Thomas, who doped for years and now suffers a host of problems.
Athletes continue to find ways around the system. Fedoruk said he sees increasingly more difficult-to-detect substances, forcing the agency to evolve its testing procedures to keep up.
One thing that hasn't evolved, though, is the agency's role in rehabilitating athletes. It just doesn't do it, Fedoruk said.
Thomas and DeCanio think it should.
"Until the U.S. Anti-Doping Agency views doping as a sickness, they're totally off track," he said. "You can't just kick these people to the side. They need help, they need therapy. People develop mental disorders. They become very delicate. When their careers end, they usually don't end well."
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