For the unversed, a primer: Testosterone is an anabolic steroid primarily secreted by the testicles. It’s the principal male sex hormone and plays a key role in general health and well-being. Specifically, it helps the body maintain sex drive, sperm production, mental and physical energy levels, bone density, and, yes, muscle mass and strength.

Generally, after the age of 30, a man’s testosterone levels begin to decline, and with them, all of the aforementioned benefits. Hence, the reason a 40-year-old sags and bloats, and loses the definition of his muscles, is due to a lower level of testosterone. If he takes anabolic steroids exogenously, that is, originating from outside the body, his testosterone level will increase. Thus, a 40-, 50-, or even 60-year-old man can dial back the clock to the hearty physiology of a 30-year-old. Some might argue that, taken out of the context of professional sports, using steroids is akin to taking a pill to combat high cholesterol or high blood pressure—you’re merely refusing to give in to old age.

Where people get into trouble is when they surpass an optimal physiologic range of testosterone—which can easily be established with a blood test—and move into the superphysiologic. Think the difference between the svelte and powerful body of Ben Johnson, the disgraced Canadian track star of the 1988 Olympics, and the overgrown physique of Hulk Hogan.

“It’s a drug like any other,” says Clapp. “There’s use, and then there’s overuse. It’s like if you get a prescription from your doctor that says take X. Well, the people who get into trouble take X + X + X; it’s the fool’s logic of more chocolate ice cream must be better.”

Of the negative effects that can result from overuse, there’s acne, high blood pressure, lower sperm count, and the potential for gynecomastia, known in the gym as “bitch tits”—none of them fatal, and none of them irreversible. But what we hear in the public outcry against steroids is much more alarming: There’s the nightmare story of Chris Benoit, whose so-called “roid rage” led the pro wrestler to murder his wife and son before committing suicide; the fatal heart attack at age 40 of one-time Major League Baseball MVP Ken Caminiti; the teenage suicide of high school athlete Taylor Hooton; and the deadly brain tumor of NFL legend Lyle Alzado. To be sure, all tragedies in their own right, but there’s no medical evidence linking any of these deaths to anabolic steroid use.

If you scratch beneath the surface of the sensational headlines, what’s plain is the absence of the authoritative voice of a doctor. That’s probably because the voice of reason from the medical community often turns up on the unpopular side of the issue. Take Norm Fost, M.D., who served on President Clinton’s Health Care Task Force and is currently director of the bioethics program at the University of Wisconsin. At a Bob Costas–moderated debate on performance-enhancing drugs in sport held last year in New York, by a forum called Intelligence Squared U.S., Fost had this to say: “Lyle Alzado died of a brain tumor. Then the New York Times and Sports Illustrated told us that this was due to steroids, without a single quote from an informed physician or a single source showing any association with steroids … because there is none!”

“It’s all anecdotal,” says Mauro DiPasquale, M.D., a widely renowned expert on ergogenic aids, of the so-called evidence linking steroids to various health issues. “The studies that blame steroids for certain heart problems, for sudden death, etc., are not the kinds of things that make up evidence-based medicine. In other words, they don’t really mean all that much. Bottom line: the adverse effects of steroids have been wildly overstated.”

When it comes to the non-medical use of steroids, the fact of the matter is that conclusive long-term studies have yet to be done. Because of the stigma attached to steroids, many researchers and doctors would rather not get near the subject. And while Dr. DiPasquale won’t say that steroids are innocuous, he does allow that, under the right conditions, he’d give the green light to a healthy adult male wanting to use them.

“If it was legal, and no one had any moral or ethical objection,” he offers, “I’d say ‘Go for it.’ Why not? They’re drugs. They can be misused, but they can be used properly, too. Let’s face it, if all the objections were removed, there would be very little difference between prescribing steroids to an adult male and prescribing birth control pills to a woman. What an anabolic steroid user has to do is weigh the possibility of an increased risk of prostate cancer—which we don’t know yet—against the fact that they look and feel great, have a decrease in depression, an increase in sexual activity, and decrease in fatigue. It will give you better quality of life, there’s no doubt about it.”

Over the past century, the medical community has made great strides in technology and pharmaceuticals that have directly resulted in people enjoying longer and better quality of life than their ancestors. So one might ask, why draw the line at anabolic steroids? If it’s good for treating muscle wasting in those suffering from cancer and AIDS, then why not for augmenting the general health and well-being of the average Joe?

The resistance goes all the way up to the congressional level.  In 1990, the U.S. Congress passed the Anabolic Steroid Control Act, which classified these substances as Schedule III drugs, making them illegal to possess without a legitimate medical reason and a prescription from a licensed physician—despite the fact that expert witnesses from the Drug Enforcement Administration (DEA), the Federal Drug Administration (FDA), and the American Medical Association (AMA) all testified and were unanimously opposed to any such criminalization.

The events that led up to congressional action might help explain the reasoning behind it. In 1988, just two years prior to Congress taking up the issue, steroids became front-page news when aforementioned track star Ben Johnson was stripped of his Olympic gold medal over the revelation that he’d enhanced his performance with anabolic steroids. Although the original clamor was about maintaining a level playing field in professional sports, the policy and media debates that led to criminalization focused not only on cheating elite-level athletes, but on the at-risk youth who look up to them. Any rational debate on the subject was quickly muffled by the emotional outcry, “Think of the children!”