It's a promise difficult to ignore for those looking for a quick fix to get bigger and stronger: "Perfect for inhuman strength and massive muscle growth!"

The proclamation is from an Internet site, one peddling steroids with no apologies. For $119, you can have 90 tablets discreetly delivered to your door, without medical clearances or real proof you are at least 18 years old.

Steroid use among high-profile athletes is hardly breaking news. From the NFL to major-league baseball to the Olympics, numerous athletes turn to "juice" —— a slang word for the substance —— to squeeze out better performances. We hear or read about it seemingly every day. Some admit to using. Many more get caught. Innuendo haunts countless others.

The BALCO case, a federal investigation into the Bay Area Laboratory Cooperative, has put well-known professional athletes under the steroid microscope. And major-league baseball recently was paraded before Congress to address its steroids problem. MLB recently broke ground by initiating its first testing policy for steroids.

But what about steroids in the community, especially in regard to teenagers?

"What I'm hearing is that because there has been steroids in baseball, it has trickled down to colleges and high schools," Padres second baseman Mark Loretta said following the congressional hearings. "I don't think that's accurate. This is not unique to baseball; it's not even unique to sports. This is a societal problem."

According to Dr. Ken Fujioka, the Scripps Clinic's director of nutrition and metabolic research, performance-enhancing drugs have indeed invaded the culture of communities throughout the country. North County is no different. There are teens eager to take steroids to get more muscles to make them better in sports and to increase their chances of landing a college scholarship. And there are adults in their 20s, 30s and 40s using them to achieve better-looking bodies, mostly for self-esteem purposes.

"I would say it's still on the uprise," Fujioka said.

Added Escondido baseball coach Steve Afenir: "It's definitely out there."

Fujioka recalls a 17-year-old filling his Del Mar office doorway. Or, better put, how he didn't fill it. The aspiring football player was 6-foot-2, 175 pounds, which wasn't enough to suit his gung-ho father.

"He wanted his son to get a little bigger for college," Fujioka said. "They came to me and asked me this, this and this."

The road they were trying to lead Fujioka down was one ending with a prescription for steroids. But that was a dead end.

"I said no," Fujioka said.

Some say yes. And that's particularly disheartening to Fujioka, because he said mixing the teenage years with steroids is a recipe for medical disaster. The body, Fujioka said, is transforming a youth into an adult and the ingestion of steroids confuses that process.

"You really mess with that when you start to take steroids," Fujioka said.

A 2003 report by the National Institute on Drug Abuse estimates more than a half-million eighth- and 10th-graders are using anabolic steroids, either through injections or digesting them through pills and powder.

A 2004 survey by the San Diego Unified School District revealed about 4.5 percent of high school-age students have experimented with steroids.

Dennis Ackerman, the California Interscholastic Federation San Diego Section commissioner, speculated the use of steroids in North County likely mirrors the San Diego school district's numbers.

"It's a concern," he said. "And it's our job to help educate."

The CIF did that last fall, holding a workshop for high school coaches and administrators in which steroid use was among the topics.

Close to home

Are there people on your block using steroids? Are impressionable youngsters turning to medicine instead of hours in the weight room?

Absolutely, Fujioka says.

Fujioka said youths look to steroids while chasing the dream of a rich contract or scholarship. And his elder patients —— who Fujioka said should know better —— also are experimenting. Fujioka, an Encinitas resident, can decipher with a high degree of certainty when adults are abusing steroids —— and they have challenged his bedside manner in telling him otherwise.

"It's really kind of funny because they will be so defiant and say, 'No way,' " Fujioka said. "They will say, 'The lab results are wrong.' They have this facade that they are staying healthy, but they are not."

Teenagers —— especially those just starting to use steroids —— often can be more difficult to pin down through lab tests, Fujioka said. It's because their short-term exposure doesn't lend itself to as many warning signs. That makes it critical for parents, coaches and friends to watch for red flags indicating possible steroid use.

Some warnings don't come from a survey, but an actual sign. There's one in the Oceanside High weight room, detailing the shortcomings of taking a shortcut with steroids. The school's physical education instructors also lecture students to investigate the effects of steroids before turning to them.

A 2002 survey conducted by the University of Michigan showed that 4 percent of high school seniors said they had used steroids. Other surveys show 3 percent to 11 percent of high school students have experimented with steroids.

According to doctors and trainers, here are warnings of steroid use:

- Signs of aggressive behavior.

- Rapid weight and muscle mass gain.

- Increased irritability.

- Acne on the back.

- Possible thinning of hair.

Chargers trainer James Collins said the body often can't handle the load bigger muscles put on its frame.

"In addition to mood swings, you are putting additional pressure on your tendons and ligaments because the muscle in your bones is not going to grow a lot more than they are supposed to," Collins said. "You're putting undue stress on your body parts, not to mention the increased pressure on your heart.

"And your liver is affected. Anything you put in your body has to filter through your liver and kidney; it has to go through your system."

Fujioka agreed. And while steroid use can lead to such problems as shriveled testicles, lack of sperm, loss of scalp hair and growth of breast tissue in males, the real danger is under the surface.

"The problem is the stuff you can't see," Fujioka said. "You're driving up your insulin and glucose, and you're making yourself an old man real quick. You are not only growing bigger, but heart disease and cancer cells are growing faster."

Fujioka uses the nearby Interstate 5 traffic outside his office to illustrate his point.

"Cars are a good example," he said. "You could run a car and cruise it around mellow and have 50,000 miles on it and it's like a new car. But if you take a car and drive it into the ground, it's done and you have to get rid of it. That's just like using steroids.

"That is what these drugs do to you. You are dealing with the devil when you say I'm going to get this super athletic performance, then you die from it later."

Late baseball star Ken Caminiti admitted using steroids in 1996, the year he was the National League Most Valuable Player while leading the Padres to the playoffs. He died last year of a cocaine overdose. He was 41 years old.

Caminiti's demise could be a wake-up call, at least locally given his popularity here and the media attention given to his death.

Fujioka says he has noticed a growing concern among steroid users.

"Guys come in and they're in their 40s and they say, 'Ken, this is what I'm doing and I'm kind of worried now,"' Fujioka said. "They've been doing steroids for five years and they're big and they look cut, look buffed. But now they're really scared. They are starting to realize, hey, I had a friend who died of cancer and they're thinking, 'You know, maybe I'm pushing the envelope there.' And I say, 'Yeah, your liver is off and your cholesterol is off.' "

Reaching out to teens

The trauma to one's body isn't restricted to physical woes. In 2003, a star pitcher at Plano (Texas) West Senior High committed suicide. His parents were certain Taylor Hooton's death was because of depression he experienced after ending his steroid use, according to an article in Sports Illustrated.

"It was a pretty strong case that he was withdrawing from steroids and his suicide was directly related to that," Dr. Larry W. Gibbons, medical director of the Dallas-based Cooper Aerobics Center, said soon after Hooton's death.

There's another high school death thought to be linked to the psychological fallout from steroids. Eric Elofson of Bakersfield hung himself in 1989, a month after stopping his intake of steroids, according to what his parents wrote in The Physician and Sports Medicine Journal.

"While we focus on the elite athletes that are headline grabbers, the underbelly of all this is a much more serious problem," Dr. Gary I. Walder, a New York University professor of medicine, said in the wake of Hooton's death.

Local high schools have tried cutting off at an early stage the temptation of steroid use. Through educating their players of the drug's dangers, coaches are at the forefront of getting the word out.

"I'm hoping I'm not ignorant, I'm hoping I don't have my head in the clouds," Oceanside High football coach John Carroll said. "But in having a pulse on our kids —— at least our football players —— I don't believe it's a problem."

But what if it is?

Escondido High football coach and athletic director Paul Gomes, when coaching in the Thousand Oaks area several years ago, remembers a particular evening when a player was tearing up and down the field like a Tasmanian devil.

"I said, 'What happened to you?' " Gomes said. " 'You went from a mild, meek-mannered good kid into this wild and crazy kid on the field. What happened from June to August?' "

It wasn't the summer winds that flipped this player. It was steroids. And it was a transformation Gomes can't forget. That's why he's active in spreading the word —— throughout the school's entire athletic program —— that steroids are incredibly harmful. His antenna remains high to spot those using them.

"Any time there is a mood change, that is one of the red flags," said Gomes, who estimated he has seen 10 steroid cases in 25 years of coaching. "And if they go up 40 pounds in a few months and have huge strength gains, right away a red flag will go up."

Afenir, the school's baseball coach, is certain his players aren't users.

"At our school, we stress work," Afenir said. "We say if you want dividends, trade work. But no one would accuse any of our players of using steroids. You have to poke around to find their muscles."

But the strength of Afenir's eyes are fine. And he said in looking at some of his opponents, it raises his eyebrows.

"I see it, and I hear about it secondhand," he said. "But I don't have firsthand knowledge of kids doing it. But we all have our suspicions. We know certain kids most likely are doing it. A lot of our guys lift three or four times a week, and it's really frustrating for them when they see other kids not doing the same programs and they are getting more physical results."

Among the hardest things Afenir said he has to do is explain to a teenager that instant gratification —— fueled by steroids —— isn't all it's cracked up to be.

"I do address it with my guys," Afenir said. "And I keep a real close eye on them and watch their attitude changes. When you are around kids as much as we are, it's the emotional side effects which are much easier to spot than the physical ones."

Carroll admits some shirt-popping players require a second-glance. But without knowing their work ethic and family makeup, it's hard to accuse someone of cutting corners for a cut body.

"You see a kid who is 17, 18, and is physically well beyond his peers," Carroll said. "Now, is it genetics? Is it hard work? Or is it chemicals? You don't know. Now we have many big kids. But I have not seen any that are what I would say are suspect in their genetics. Although I'm sure, probably like I do other players, other coaches look at my kids and wonder.

"But not knowing the kid from another school, or being privy to his family background, I don't think it is fair to guess."

Added Gomes: "For us, it's hard to say what is a problem and what isn't a problem."

Escondido High tight end Kevin Small knows people may look at his 6-foot-4, 225-pound frame and wonder how he did it. But he swears he's big on being natural and thinks so, too, are his teammates.

"Honestly, I don't think any of our guys use steroids," Small said. "We're a pretty tight group. We all lift weights together, and the coaches monitor things pretty close. We lift hard, and everyone is getting bigger. But they'd notice if anyone gained so much weight or strength that it was out of line."

Afenir's son, Buck, is a top-notch prep catcher headed to Stanford University on a scholarship. That scholarship, though, comes with a requirement: testing for steroids. It's a stipulation that doesn't concern Buck.

"I guess I've got too much self-respect to mess with that kind of stuff," he said. "We're always talking about (steroids) in our athletic training and health class. They make you read articles to learn about steroids, and I would tell someone who's considering doing it, not to do it. It's just not worth it."

Ackerman, the CIF commissioner, says he is of the belief that high school athletics, while hardly free from problems, remain a relatively wholesome activity.

"That's why a lot of people like high school sports, because it's sort of still pure, versus college and the pros," Ackerman said. "They're tired of watching athletes taking this drug and making all this money. But with high school football on Friday night? You would hope to God that everything is OK."

Tim Reichardt is hopeful, too. The Encinitas YMCA health and fitness director said problems regarding steroids don't arise often. But there was an incident when a young adult was asked to exit the weight room because of suspected steroid use.

"The staff was certain he was on steroids," Reichardt said. "He was belligerent, and we told him he needed to leave."

Reichardt first tries to reason with anyone considering steroids. He isn't shy using his "scared straight" approach.

"If I ever do have to share information, I first start with the ramifications of taking steroids," he said. "The side effects, of course, of what they can do to people. In extreme cases, they cause cancer and death —— that's what happened to (former Raiders football player) Lyle Alzado. I stress all the negative side effects to steroids and try to scare them straight. No question about that."

Another personal trainer, who requested anonymity, has been approached at his company's fitness center about providing steroids.

"Usually it's somebody you see in the gym over a period of time and they sort of get to know you a little bit," he said. "Then they ask you if you know anyone who does it, or if you do it."

Like most drugs, steroids offer tempting benefits. From increased production on the athletic field to enhancing one's appearance, steroids can boost a teenager's self-esteem. But, clearly, at an incredibly high cost.

That's why parents have to be cognizant.

"The keys are education and communication," said Phillip Hubbs, a 28-year veteran of the San Diego Police Department. Hubbs is the executive director of Proactive Network Against Substance Abuse, a nonprofit drug awareness and education organization. He crisscrosses San Diego County giving seminars about drug abuse. He talks about cocaine, heroin and all the new fancy designer drugs. He said with more frequency, questions about steroids arise from parents in the crowd.

"You have to talk to your kids about steroids and be honest with them," Hubbs said he tells mothers and fathers. "Because, honestly, the kids are playing a game in which there are few winners."

And a considerable number of losers.

"They think it won't happen to them," Fujioka said. "And the problem is for them to see 20 years in the future. And it's so hard to get kids to understand that because they think they are totally indestructible.

"But if you use steroids, I think you are fooling yourself."

Contact staff writer Jay Paris at jparis8@aol.com.