About this book: About the Project

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2 About the Project The South Carolina Area Health Education Consortium partnered with the U.S. National Library of Medicine and high schools in South Carolina for a health information literacy project. Students were charged with researching public health areas and creating educational comic books about their topics so that middle school students could also learn more about important health issues. In the process, students learned about helpful resources from the U.S. National Library of Medicine and valuable communication, research, and creative skills, as well as increase their knowledge about health careers and health literacy. For More Information about Substances of Abuse and other health topics check out: About this book: Students participating in a Medical Terminology Course from Lowcountry Leadership Charter School created this book about substance abuse. Project Manager - Brewer Savage Software Supervisor - Thomas Tanner Research Specialists - Antoinette Gibbs, Tide Elliott, and Cooper Weeks Other Contributors - Hunter Boykin, Anna Gavin, and Walker Butler Artist: Renwick Lateef Allen-McDowell School Liaisons: Ms, Olivia Isgett-Rubin, LLCS Ms. Melody Keller, LLCS Ms. Paula Jones, SC AHEC Medical University of SC Library Liaisons: Ms. Monique Hill Dr. Shannon Jones Join Vanessa, Brian and me, Rx (pronounced Rex), for other adventures. PubMed MedlinePlus The Centers for Disease Control and Prevention World Health Organization Available titles in this series: Choosing the Way The 1st 72 Hours: Earthquake The Expert Investigator Series 1, Volume 2 If interested in obtaining copies of this book contact: Published April 2015 South Carolina AHEC online ( or call

3 Last week, Channel 48 reported the story of a tragic car accident resulting in the death of a teen driver. It has been confirmed that the driver from last week s car accident was under the influence of anabolic steroids. With this tragic accident affecting our community, Channel 48 wanted to focus this week's Health Watch on this danger. Our Health Consultant, Leslie Savage, is here with our Tuesday Health Watch. Thank you, George. This young driver was a local high school student. While studies have shown that anabolic steroid use in high schools is declining, the fact that any high schoolers are illegally using steroids is troubling. Many people abuse anabolic steroids to try and enhance performance or improve their physical appearance. There are still many serious side effects of steroid abuse, even to adults. This should not be ignored. Anabolic steroid abuse may affect a part of the brain called the limbic system, which controls your mood. Some of the most easily recognized side effects of steroid abuse are roid rage, skin discoloration, and severe acne. Continued use could lead to complications such as liver cancer...

4 That day at school... Hi Vanessa! Hi, Connor! Did you see the NEWS this morning? That stuff seems really scary. So what, Brian? I don't see what the big deal is! Well, it is a big deal. Steroids are horrible. I don't understand how anyone could risk hurting their body like that. It's awful. For starters, your hair can fall out. Girls can grow facial and chest hair. Guys can develop breasts. I'm scared!! My doctor has given me steroids when I've had an allergic reaction before. Brian, really?!? The term for breast development in males is gynecomastia. The swollen male breast tissue is caused by a hormone imbalance. Well... Steroids can't be that bad if doctors use them.

5 There are different types of steroids. Brian, it's fine if your doctor prescribed steroids to you and you are using them the right way. Connor becomes very angry after hearing Vanessa and Brian s comments. He walks away. But the types of steroids that people use illegally can really hurt your body! Connor begins to cry. *sniff* *sniff* Grrrrrr... Coach Dwayne runs into the locker room and sees Connor. Connor! In my Office, now! Connor is suddenly overcome by his anger and begins to throw things around.

6 Coach Dwayne's office... Connor, you have been acting differently. Is there something you would like to talk about? If I tell you this, please promise me you will not be mad at me? Connor. I m here to help. A friend of mine has been selling me anabolic steroids. He said that they will help me perform better on the field. I m sorry, coach. I didn t want you to find out. People have suffered serious consequences because of steroids. Lance Armstrong is a testicular cancer survivor who used steroids during his cycling career..., and it destroyed his reputation.

7 I know someone we can call who can help I would like her to come and speak with you if that is okay. Whatever. Do what you want. Hi Connor, I m Leslie Savage, I'm a personal trainer and nutritionist. Coach Dwayne asked if I would come and talk with you about your steroid usage. Maybe around a year now. How long would you say you have been using anabolic steroids? A NUTRITIONIST is an expert who gives people advice on what to eat and what to put into their bodies in order to be healthy. Well, right now you may only have a few symptoms because you have only been using them for a year. I don t see what the problem is. I don t see any symptoms at all.

8 One of the most common side effects of steroid abuse is aggressive behavior. Maybe, but I am just going through a rough time. Don't you think that you ve been acting a little differently? Even a little irritable? I mean, your coach and friends have noticed. It's why he called me here today. I guess that my behavior has been a little off,... but that doesn t mean that it is from the steroids. According to your coach and teammates, you have never used to react this badly even on your worst days.

9 We are just here to help you Connor. We want you to make the right decisions. It really is not worth it. Everyday teenagers and young adults are caught illegally using anabolic steroids. I just wanted to play my best. I wanted quick results. I thought I was making the right choice by using the steroids. You don t need steroids to play your best. With just practice and dedication, you can do anything you set your mind to. I never thought about it that way. Oh, and please take some time to go to your doctor. If you quit taking steroids really fast, new symptoms from drug withdrawal will usually follow. Don't be afraid to tell your doctor what has been going on. The extra support will help you succeed!

10 There are so many bad effects that last a long time. People don't think about these before taking steroids. The steroids could be causing you to act the way you do. Side effects from continued use are mood swings, changes in the way you act, and... Okay, but I really don t think that I would end up having these side effects. I take care of my body and I wasn't...well, did you know that if you take them before you reach your full height, they can STOP your leg bones from growing longer! That is not a reversible side effect! So, that s just it. Even those who have taken excellent care of their bodies can end up having the side effects. Not to mention that it s illegal....

11 Thank you, but do you really think that it will help? I think I can do it without help from a doctor. Drug withdrawals are a group of symptoms that occur right after discontinuation or decrease in intake of medications or drugs. I m sure that you could, but some withdrawals can be much more severe than others. It can really put your health in danger. How are you doing today, Connor? It s been a while. What seems to be the problem? I'm okay, but I would like to talk with you about something...

12 The longer you use them the more at risk you put yourself. I have being using steroids for about a year now. I have decided that I should quit for good! I talked to my baseball coach and a personal trainer. They think that I should speak to you for extra help.something about "withdrawal" causing serious health issues. They re absolutely right. The longer you use them the more at risk you become. Steroids can cause many health problems in the future and it becomes harder to quit. When you quit, you will crave the steroids and your mood swings may get worse for a while. You may feel tired or restless. You may not eat or have insomnia. One of the scariest withdrawal symptoms is depression. Even suicide. Okay, I will try to go through with this. I will set up an appointment for next week. It is hard to quit by yourself. I want you to visit me weekly so we can talk. Also, physical activity can help you cope. I know Coach Dwayne can help with this!

13 Connor has come such a long way. He has even been offered a scholarship for baseball! He really does owe a lot to his "team". He had Coach, the nutritionist and his doctor on pulling for him. I knew that he would be able to do it. I m so proud of him! Me too! You don t need steroids to play your best. All it takes is hard work and dedication.

14 Here are some terms to know! Anabolic steroids are man-made substances that resemble a natural hormone in men (testosterone). They promote the growth of muscle. Doctors use them to treat some types of hormone imbalances in men and to improve muscle loss from certain diseases in some patients. Bodybuilders and athletes have used them to build muscles and improve athletic performance, often taking them in very high doses. This is not legal nor safe. Abuse of anabolic steroids causes many health problems, such as, breast growth and shrinking of testicles in men, voice deepening and growth of facial hair in women, high blood pressure, heart problems, liver disease, kidney damage, and aggressive behavior. Corticosteroids are different from anabolic steroids. Corticosteroids are commonly used to treat a variety of problems, such as asthma and allergies. These steroids are similar to hormones that your adrenal glands make to fight stress associated with illnesses and injuries. They reduce inflammation and affect the immune system. Depression is a serious medical illness that involves the brain. There are a variety of causes, including genetic, environmental, psychological, and biochemical factors, such as anabolic steroids. It's more than just a feeling of being "down in the dumps" or "blue" for a few days. Symptoms can include sadness, loss of interest or pleasure in activities you used to enjoy, change in weight, difficulty sleeping or oversleeping, energy loss, feelings of worthlessness, and thoughts of death or suicide. Gynecomastia is the swelling of breasts in boys or men, usually due to hormone imbalance or hormone therapy. Hirsutism is growth of excess hair or hair in an unusual place. Anabolic steroids can cause hirsutism in women. Women with hirsutism can have dark, thick hair on their face, chest, abdomen and back. This thick, dark hair is different from the hair that some women have on their upper lip, chin, breasts or stomach, or the fine "baby" hair all over their body. Hormones are your body's chemical messengers. They travel in your bloodstream to tissues or organs. They work slowly, over time, and affect many different processes, including growth and development, metabolism (how your body gets energy from the foods you eat), sexual function, reproduction, and mood. Insomnia means the inability to obtain enough sleep, especially when sleeplessness is a chronic problem. It can also mean trouble falling or staying asleep. The limbic system of the brain is a group of structures that govern emotions and behavior. The limbic system, and in particular the hippocampus and amygdala, is involved in the formation of long-term memory, and is closely associated with the parts of the body that have to do with the sense of smell. Nutritionists and Dietitians are experts in food and nutrition. They advise people on what to eat in order to lead a healthy lifestyle or achieve a specific health-related goal. Personal trainers and Fitness trainers lead, instruct, and motivate individuals or groups in exercise activities, including cardiovascular exercise (exercises for the heart and blood system), strength training, and stretching. Roid rage is a slang term to describe the episodes of outright aggression and/or violent feelings and actions caused by anabolic steroid. Skin discoloration (changes in skin color) occurs when special cells made in the skin, call melanocytes, get damaged or become unhealthy. Melanocytes make melanin, which creates skin color or skin pigmentation. The darker the skin, the more melanin the skin makes.

15 Signs and Symptoms: A symptom is a change in the way you feel, like feeling chest pain or feeling like it is hard to breath. A sign is something that can be measured or seen by someone else, like an elevated blood pressure or a value on a lab test. Knowing how your body is reacting to a disease is an important part of figuring out what is wrong. Suicide means taking your own life. A suicide attempt means that someone tried to take their own life, but they did not die. It is the tenth most common cause of death in the United States. People may consider suicide when they are hopeless and can't see any other solution to their problems. Often it's related to serious depression, alcohol or substance abuse, or a major stressful event. Sources: MedlinePlus Encyclopedia ( MedlinePlus Medical Dictionary ( Acknowledgements This book would not be possible without the time and expertise of professionals who volunteered their time. A special thanks to: Michael G. Schmidt, PhD Director, Office of Special Programs Professor and Vice Chair, Department of Microbiology and Immunology Medical University of South Carolina Leslie Savage Personal Trainer and Physical Therapy Assistant Chucktown Fitness Gary McDonald Athletic Director, Lowcountry Leadership Charter School Founder of MidAtlantic Baseball Academy Melody Keller, LPN School Nurse Lowcountry Leadership Charter School Ms.Olivia Isgett-Rubin, BA English Creative Writing Teacher and Coach Lowcountry Leadership Charter School Mache Larkin, M.Ed. School Leader Lowcountry Leadership Charter School Julianne Lang, M.Ed. Leader of Student Interaction Lowcountry Leadership Charter School Erica Carson, BA Comic Life Consultant Jennifer O'Steen Teaching Assistant Lowcountry Leadership Charter School

16 Interested in a career in HEALTH CARE? The South Carolina AHEC Health Careers Program works to increase the number of students entering the health professions in South Carolina. Emphasis is placed on underrepresented minority and disadvantaged students in order to address disparities in the health professions workforce. The Health Careers Program (HCP) is designed to develop academically proficient and self-confident future health care professionals. For more information visit: Follow us on Facebook: South Carolina AHEC CENTERS Regional AHEC Centers provide services to healthcare providers and students in all counties of South Carolina. The nature of the service and its delivery may vary among Centers. Please call or visit their web sites for specific information. AHEC Project Coordinators Deborah Stier Carson, Pharm d Associate Program Director for Education Angelica E. Christie, M Ed Director of Health Careers Program Paula M. Jones, BHS, MBA Health Careers Program Coordinator Alicia McMenamin, MA Program Coordinator David R. Garr, MD Executive Director, SC AHEC Lowcountry AHEC (843) Mid-Carolina AHEC (803) Pee Dee AHEC (843) Upstate AHEC (864)