Does steroid abuse have a direct link to cancers such as Alzado's T-cell lymphoma, and to heart conditions such as Courson's cardiomyopathy? The answer, doctors say, is: maybe.
Medical science lacks proof, Howard says, because large-dose use of steroids and human growth hormone has become common only in the last 10 to 15 years.
xTC "But the time is getting close, and we're going to start getting answers to these questions in the next five-10 years," he says. "I bet you it's not going to be a pretty sight."
In Joe's opinion, many steroid abusers know there are risks but cannot quit because they crave the chemically induced feelings of assertiveness. "The only way to make them stop is if they can't get them," he says.
New state and federal laws that crack down on the non-prescription use and distribution of steroids went into effect this year.
Courson says steroids were startlingly easy to obtain when he was in college. He started using them in the off-season before his sophomore year at the University of South Carolina. At the time, steroids were not a banned substance.
He says he continued to use them throughout his seven-year professional career with the Pittsburgh Steelers and Tampa Bay Buccaneers. Courson says he had no choice because he had to compete against younger, stronger linemen who had pumped up their bodies through chemistry.
In his playing days as a 302-pound offensive guard, Courson earned the nickname "Captain Caveman." Alzado, too, was known for furious play. A 265-pound defensive end, he made All-Pro and had a 14-year career, with the Cleveland Browns, Denver Broncos and Los Angeles Raiders.
In 1985, Courson wound up his professional career and, in a first-person story in Sports Illustrated, went public with his steroid abuse.
Reading his words today is a haunting experience.
"In order to compete at this business, you absolutely have to know the pluses and minuses that come along with using steroids. Maybe kidney and liver disease when you're older. But you do what you have to do, otherwise you don't have your job," Courson wrote.
Then he described the potential risk: "Right now, there's an 'X' factor. You don't know what that X factor is, but you know that you're reaping benefits."
Today, the heart disease that threatens his life might be Courson's "X factor."
"The number one associated factor with this disease is heavy drinking, and I was a heavy drinker," he says. "I believe that steroids were a contributing factor, and not a cause."
His cardiomyopathy was diagnosed on the day before Thanksgiving, 1988. His only previous heart condition was an accelerated heartbeat discovered in 1985, a condition that may or may not have been caused by steroids.
In 1985, Courson had said, "I take this attitude toward drugs: They give me an edge in my business. I don't regret anything I've done so far as pharmaceutical use is concerned."
Today, his attitude has changed.
"I didn't like that I had to take steroids, but I was an athlete in the center of a chemical war. And if I had to suit up today I would feel pressure to use them."
"As far as using drugs, the biggest thing that I regret is not the heath condition," says Courson. "It's the fact that you dehumanize yourself to become something you're not."