But drug testing with stiff penalties isn't likely to work, the group says in a new policy statement. Instead, schools and coaches should promote fair competition.
"We're creating a society of kids who just take a pill to improve performance and to gain an unfair advantage," said Dr. Eric Small, chairman of the AAP committee that wrote the statement.
Little is known about the safety of the substances in adolescents, Small said, and their use diminishes the value of good nutrition, training and coaching.
Seven percent of ninth-graders say they've taken steroids without a doctor's prescription, according to a U.S. Centers for Disease Control and Prevention 2003 survey.
Use of creatine, a nutritional supplement, may be more widespread. A study of suburban New York students, co-authored by Small, found that 44 percent of 12th-grade athletes admitted using creatine.
The timing of the policy statement, issued in the midst of baseball's steroids scandal, is coincidental, Small said. The statement took five years to develop.
When talking to kids, doctors shouldn't question the effectiveness of the products, the statement says. Saying the products don't work will damage a doctor's credibility.
Small, who practices sports medicine in New York City and in Westchester County, N.Y., said he often talks to young athletes who feel pressured to beef up.
Recently, an eighth-grade boy told the doctor he wants to play basketball next year.
"The coach told him he needs to put on 30 pounds this summer to make the team," Small said.
Small helped the boy develop a weight-training program and start thinking about how to add more calories to his diet.
By Carla K. Johnson