Pursuant to a congressional request, GAO provided information on the use, distribution, production, and health risks of anabolic steroids and human growth hormone, focusing on the estimated use of anabolic steroids among high school and college students and the adult population. GAO found that: (1) most of the studies that addressed the prevalence of anabolic steroids indicated that high school, college and professional athletes were the primary misusers, while others participating in sports used them to a lesser extent; (2) most of the misusers were male; (3) as many as 6.6 percent of 12th grade males, mostly athletes, and 15 to 20 percent of college athletes used steroids; (4) although a high percentage of weightlifters used steroids, there was little information on the use of steroids outside of high schools and colleges; (5) studies showed that steroids could increase the risk of heart disease, produce liver toxicities, affect sex characteristics and reproductive capacity, cause possible psychological disorders and tendon and ligament injuries, and result in stunted growth in children; (6) although several sports associations prohibited the use of steroids and implemented drug-testing programs to monitor steroid use among their athletes, athletes could abstain from the use of the drugs before the tests to avoid detection; (7) from 1979 through 1988, U.S. manufacturers’ anabolic steroid distribution totalled 53.2 million grams, while imports totalled 26.2 million grams; (8) between 1984 and 1988, hospitals and retail pharmacies purchased 26.1 million grams of anabolic steroids; (9) sales of steroids on the black market totalled $300 to $400 million annually; (10) there was little information on the use of human growth hormone abuses because that was a recent phenomenon; and (11) the increased interest in and potential health risks associated with the use of anabolic steroids prompted considerable legislative and administrative activities.