Girls who use steroids tend to fall into two categories, Goldberg said. Many, like Passacantando, tend to be overachievers, more concerned with their looks and social status, than with their performance on the lacrosse field, said Goldberg. In fact, according to Goldberg's study, female steroid users are less likely than their peers to participate in team sports.
"It's very different than the use of another drug. It's really a pro-social drug," he said. "You will look better, you may perform better, and so, it's not one to drop out or get high, or do anything like that. It's to look better and achieve more."
Other female steroid users have already shown other kinds of high risk behavior, such using alcohol and drugs, and having sex early, according to Goldberg's study.
Dr. Harrison Pope, director of McLean Hospital's biological psychiatry laboratory, which specializes in steroid abuse research, said the CDC's statistics overestimate the number of girls using steroids. Pope co-authored a study, published last year, that said girls surveyed by the CDC probably confused illegal steroids with other types of legal drugs.
Pope called steroid use among girls an "illusory" problem.
But, for Passacantando, the problem was real. She said she had no idea about the dangers of steroid abuse. "The only thing that I had ever heard was that steroids could cause 'roid rage," she said.
But, after five weeks of injecting herself with the drugs, she became short-tempered and angry. She gained 8 pounds of muscle, fought with her family, and felt unable to cope with everyday stresses. "I didn't feel like myself," she said.
After one fight, she ran to the bathroom and swallowed a handful of over the counter medicine. "I was angry and ... just kind of towards a breaking point," she said.
A few days later, she drank too much and had a public "meltdown" in front of her friends. "I lost all control," she said. "I was about to hit rock bottom."
She drove herself to the hospital where she confessed her drug use.
Passacantando now says she believes that she was able to take the drugs undetected because most people don't think of steroids as a problem of teenage girls. "I don't think a lot of people had really heard of girls using it, especially for cosmetic reasons," she said.
Goldberg said girls tend to be more secretive than boys about their drug use. "That's the difference between girls and boys, and how they use drugs, so it wouldn't be odd for a young woman to be using anabolic steroids and be very secretive," he said.
Passacantando said she wants other teens to understand the side effects of the drugs. "If someone would have said, 'there's really a good chance you could become unbelievably depressed,'" she said, "maybe I would have thought twice about it."