Lance Armstrong has a lot to answer for. The man who made a profession of cheating in cycling was also an international role model to people of all ages for winning seven straight Tour de France titles. In an age where we have built up the stature and achievements of athletes who are ultimately found to be drug cheats, serious legal and ethical questions need to be asked about our sports' culture. This issue has become important for schools to consider from educational and risk management perspectives since the release of a study showing that children as young as twelve are using performance and image enhancing drugs.

The joint study was undertaken by Griffith University and the University of Canberra.  Sydney Morning Herald reported that the study interviewed more than 900 athletes between the ages of twelve and seventeen and found about four per cent of elite junior athletes were using performance (enhance muscle) or image (reduce body fat) enhancing drugs.  The study was presented at the University of Canberra yesterday but has not yet been publicly released.

One of the authors of the study, Associate Professor Stephen Moston, is quoted as saying 'we don't do much testing of young children and they're very much aware of that. They're growing up in a culture where they think elite athletes are using drugs, they think it's really common and young athletes think they have to take drugs to be like the elite athletes they see on TV'.

Worryingly, Dr Moston believes that young athletes 'expect drugs, and even, supplements to have this magical effect to turn them from an average athlete into a super athlete'. When lucrative opportunities such as scholarships are on the line, it is not completely surprising that children (and perhaps parents) respond to the pressure to achieve by using performance enhancing drugs. These pressures can be particularly acute for the children of families who cannot afford the often expensive fees at some private schools.

Questions remain about how those children who participated in the study obtained the drugs they admitted to using. Given that they are underage, the source is unlikely to be a reputable doctor who, as part of prescribing such drugs, outlines the risks of taking them. It's more likely that these children are receiving drugs from sports coaches and ambitious parents, meaning that they may be in the dark about the negative side affects of taking them.

Schools are specially placed to detect the positive and negative effects of the use of performance enhancing drugs, especially in a student's performance in school sport, and their pattern of behaviour. Unusual behaviour, which might indicate performance-enhancing drug use includes aggressive behaviours, rage or violence as well as mood swings. For some drugs such as steroids, the negative side effects noticed in adults (such as increased body hair and deepening voice in females or breast growth in males) may not be as prominent in pubescent adolescents.

Schools also need to be conscious of drugs being brought onto school grounds and worse, being sold to other students. The possession and distribution of such drugs could be a criminal offence. Not only will taking the drugs potentially increase the risk of injury amongst the athletes, they may also expose other 'clean' students to injury as a result of the affected athletes altered behaviours and potential criminal activity.

Schools should have an illicit drugs policy in place, which should address the issue of performance enhancing drugs. Such a policy should include appropriate penalties for students who breach the policy. Schools should also consider making public their expectations about the use of performance enhancing drugs. In accordance with the anti-doping principles espoused by organisations such as ASADA, schools should make it clear that they do not tolerate such behaviour. The release this week of a Sports Supplement Framework by the Australian Institute of Sport will also provide schools with useful information about best-practice use of sports foods and legal supplements which they can then use to educate students.

Do you think the pressure to perform is driving children to use performance enhancing drugs? Is there a culture condoning the use of performance enhancing drugs in schools?