As with all non-inert substances there is a very big difference between use and abuse. Put simply, I feel it's possible for many (not all) PED's to be used in a reasonably safe manner, and that much of society's fundamental opposition to what they lump together as "steroids" is driven by ignorance.
You are right that there are some studies (very few have been conducted, however) which point to health complications with the heart. It's very difficult to apply these studies to either the general populace or non strength sport athletes, due to the studies primarily being done on bodybuilders, powerlifters and weightlifters - who all compete in sports which you couldn't really describe as being "heart friendly" in the first place. It does not surprise me that the study on powerlifters found that 3 of the 60 odd subjects had died of a heart attack within 12 years, since I know what powerlifting training, and more importantly powerlifting "nutrition" looks like (more often than not it involves enough Maccy D's to feed about 5 regular people).
The mental state thing... I assume you are reffering to "roid rage"?! I hope not, because it's ********. It's not founded in science, it's mainly founded on things like Chris Benoit's murder/suicide and this wonderful dramatisation starring a young Ben Affleck:
https://www.youtube.com/watch?v=3FvlIwuQBO8
By all accounts, taking AAS will pronounce certain personality characteristics that are effected by test - basically, if you're a short tempered ****, you'll probably be a bit more of a **** when you have increased test levels.
Testosterone absolutely effects the mental state of a person - see the difference between young men and old men, and men/women. The idea that it's something to be seriously concerned about is silly.
Anyway - this isn't a medical board...
I'll try to sum up my feelings on the matter as succinctly as I can, but you should know that I'm not too enthusiastic about engaging in a lengthy debate about it. And to be clear, I'm referring to PED's more widely, not AAS specifically.
- Are some PED's dangerous? Yes,
potentially, some extremely so.
- Does that mean all PED's are impossible to use safely? No.
Bodybuilding is quite a good case study for this for a number of reasons - AAS use has been prolific since the 60s and has been quite extreme compared with, for example, athletics.
The difference in physique between the "golden era" bodybuilders and the "mass monsters" that started to appear in the 90's is stark, and indicative mainly of the transition from AAS use to the addition of HGH and Insulin.
You add in that the sheer volume of tissue and training that the heart needs to work for and you basically have proverbial PED canaries... giant, tanned, vascular canaries...
The vast, vast majority of top bodybuilders from the 60's and 70's are either still alive (and notably healthy compared with others their age in most cases) or died well into their 70's or 80's - very good innings by most people's standards.
The same cannot be said for those from the 90's onwards - this era of bodybuilding is the embodiment of PED
abuse, lots of guys dying very, very young and lots of guys living with very serious illness. Google "Palumboism" for more info.
- Could you negate some of the advantage that cheaters hold by establishing regulated tolerable doses of certain substances? Yes
The performance benefits of many drugs do not scale in a linear fashion, they have diminishing returns.
For example - let's say that WADA allowed sprinters to run a 6 week cycle of testosterone in the off-season, let's give the allowed daily dose an arbitrary value of 1. If an athlete decided to cheat and doubled the allowed dose and took 2 every day - the cheater would not gain twice the benefit. This would directly attack the advantage the cheaters have, and reduce the incentive to take potentially harmful doses of drugs or fundamentally dangerous drugs at all.
In many cases the sorts of doses that would likely be considered "safe" are also the most effective doses in regards to athletic performance.
- I do not consider anything other than the direct health implications of PED's to be relevant in determining whether or not they should be legal (this includes virilisation effects in women).
- Rightly people are cautious with regards to any drugs, but much of the media coverage of PED's is (to me, at least) reminiscent of their coverage of Cannabis and Video Games.