Awareness and educational efforts are working to help prevent anabolic steroid abuse in schools and communities. The Adolescents Training and Learning to Avoid Steroids (ATLAS) and the Athletes Targeting Healthy Exercise and Nutrition Alternatives (ATHENA) programs, funded by the NIDA, and supported by the Oregon Health & Science University programs is teaching athletes that they do not need steroids to build powerful muscles and improve athletic performance. These programs provide weight-training and nutrition alternatives, increase healthy behaviors, less likelihood to try steroids, and less likelihood to engage in other dangerous behaviors such as drinking and driving, use of marijuana and alcohol , and and improved body image. Bother Congress and the Substance Abuse and Mental Health Services Administration endorsed these model prevention programs. 4
Second, in addition to estimating illicit drug use, wastewater-based epidemiology has been successfully applied in recent years to providing detailed information on the use and misuse of alcohol (Boogaerts et al., 2016; Mastroianni et al., 2017; Rodríguez-Álvarez et al., 2015), tobacco (Senta et al., 2015; van Wel et al., 2016b) and medicines in a specific population (Baz-Lomba et al., 2016, 2017; Been et al., 2015; Krizman-Matasic et al., 2018; Salvatore et al., 2016,). Furthermore, wastewater analysis can potentially provide information on health and illness indicators within a community (Kasprzyk-Hordern et al., 2014; Thomaidis et al., 2016; Yang et al., 2015).
The abuse of anabolic steroids by high school, college and other amateur athletes is a dangerous practice. Participants in amateur sports must be made aware of the physical and emotional dangers associated with steroid abuse. The "win at any cost " attitude embraced by some athletes must be redirected and replaced by personal dedication to the sport; a thorough knowledge of the sport's physical demands and requirements; maintenance of a healthy lifestyle; and, an appreciation of the satisfaction that comes from participation.