The use of anabolic steroids and performance-enhancing drugs in American football is officially prohibited by virtually every sanctioning body.

The National Football League (NFL) began to test players for steroid use during the 1987 season, and started to issue suspensions to players during the 1989 season. The NFL has issued as many as six random drug tests to players, with each player receiving at least one drug test per season. One notable incident occurred in 1992, when defensive end Lyle Alzado died from brain cancer, which was attributed to the use of anabolic steroids; however, Alzado's doctors stated that anabolic steroids did not contribute to his death.

The use of performance-enhancing drugs has also been found in other levels of football, including college level, and high school. The most recent figures from the National Collegiate Athletic Association (NCAA) football drug tests (see NCAA drug testing) show that one percent of all NCAA football players failed drug tests taken at bowl games, and three percent have admitted to using steroids overall. In the NCAA, players are subject to random testing with 48 hours notice, and are also randomly tested throughout the annual bowl games. The NCAA will usually take approximately 20 percent of the players on a football team to test on a specific day.

Anabolic steroids and other performance-enhancing drugs are also used throughout high school football. Steroid use at this level of play doubled from 1991 to 2003, with results of a survey showing that about 6 percent of players out of the 15,000 surveyed had admitted to using some type of anabolic steroid or performance-enhancing drug at one point in their playing time. Other data shows that only 4 percent of high schools have some form of drug testing program in place for their football teams.

Use in the NFL

The use of performance-enhancing drugs and anabolic steroids dates back to the late 1960s in the National Football League (NFL). The case of Denver Broncos defensive lineman Lyle Alzado notably exposed early use among NFL players. In the last years of his life, as he battled against the brain tumor that eventually caused his death at the age of 43, Alzado asserted that his steroid abuse directly led to his fatal illness, but his physician stated it could not possibly be true. Alzado recounted his steroid abuse in an article in Sports Illustrated. He said:

Former player and NFL coach Jim Haslett said in 2005 that during the 1980s, half of the players in the league used some type of performance-enhancing drug or steroid and all of the defensive lineman used them. One of the players from the Super Bowl winning 1979 Pittsburgh Steelers team who had earlier confessed to using steroids (in a 1985 Sports Illustrated article) was offensive lineman Steve Courson. Courson blamed a heart condition that he developed on steroids. However, Courson also said that some of his teammates, such as Jack Ham and Jack Lambert, refused to use any kind of performance-enhancing drug.

The BALCO Scandal in 2003 also revealed many users of steroids in the NFL. The scandal followed a US Federal government investigation of the Bay Area Laboratory Co-operative (BALCO) into accusations of its supplying anabolic steroids to professional athletes.Fainaru-Wada, Mark, and Lance Williams. Game Of Shadows. 2006. U.S. sprint coach Trevor Graham had given an anonymous phone call to the U.S. Anti-Doping Agency (USADA) in June 2003 accusing a number of athletes being involved in doping with a steroid that was not detectable at the time. He named BALCO owner Victor Conte as the source of the steroid. As evidence, Graham delivered a syringe containing traces of a substance nicknamed The Clear.

Shortly after, then-director of the UCLA Olympic Analytical Laboratory Don Catlin, developed a testing process for The Clear (tetrahydrogestrinone (THG)). With the ability to detect THG, the USADA retested 550 existing urine samples from athletes, of which several proved to be positive for THG.

A number of players from the Oakland Raiders were implicated in this scandal, including Bill Romanowski, Tyrone Wheatley, Barret Robbins, Chris Cooper and Dana Stubblefield. Recently, many players have confessed to steroid use. One of these players was former Oakland Raiders player Bill Romanowski. Romanowski confessed on 60 Minutes to using steroids for a two-year period beginning in 2001. He stated that these were supplied by former NFL player and former head of BALCO Victor Conte, saying:

A notable occurrence happened in 2006. During the season, San Diego Chargers linebacker Shawne Merriman failed a drug test and was suspended for four games when his primary "A" sample and backup "B" sample both tested positive for a banned substance. Merriman was named NFL Defensive Rookie of the Year in 2005, with 54 tackles and 10 sacks. He also had a total of five passes defended and two forced fumbles. He was a starting player in the 2005 Pro Bowl, and was a leader on his team in sacks in the 2006 season. The incident led to the passage of a rule that forbids a player who tests positive steroids from being selected to the Pro Bowl in the year in which they tested positive. The rule is commonly referred to as the "Merriman Rule". However, NFL Commissioner Roger Goodell has tried to distance the policy from being associated with the player, stating that Merriman tested clean on 19 of 20 random tests for performance-enhancing drugs since entering the league.

The NFL drug testing season commences on 4/20 of each year. The NFL is known to take drug tests seriously. When an athlete is selected for a drug test, they must have it completed within 4 hours of notice, or else the league will start to impose fines and suspensions for not complying. If athletes fail to complete the test in the 4-hour window, the NFLPA will still treat it as if they tested positive, even if no drugs were found. The NFL has drastically increased the frequency of testing athletes. In the past 10 years, the NFL has begun to crack down heavily on athlete's use of performance-enhancing drugs and has further improved their testing methods each year since. The drug testing season closes at the end of the season; up until Super Bowl week, players may be subject to random drug tests.

Players are notified usually after practice via a note on their chair next to their locker that they are required to complete a drug test. Any failure or refusal to complete the test will be treated as a positive result, and the athlete will be given the full punishment as if they were tested positive. The athletes then have limited time to complete the test to be eligible to play the next week and so forth. The athlete will then urinate into a cup and that will be sent to an official testing facility to deem if the athlete is clean or is tested positive for an illegal substance. After all testing is completed, the athlete and club manager are notified of the results. If the test indicates that the athlete has taken performance-enhancing drugs, both individuals are notified of the imposed sanctions. Players can be tested either at a team facility or if the team is away they can be tested at the nearest NFL testing station.

Appeals process If an athlete is deemed positive for PEDS, every player has the option to appeal the result. The most noticeable appeal that has been won in recent years was Richard Sherman, who in 2012 avoided a 4-game suspension because of wrongful practices when he was being tested. The likelihood of an appeal going the player's way is low. Very few players that are tested positive end up winning the appeal, and only a few have won the appeal in recent years.

NFL banned substances policy

The NFL banned substances policy has been acclaimed by some and criticized by others. Critics argue that the NFL's policy on performance-enhancing drugs, set by the NFL and by the players' union (National Football League Players Association) instead of an independent agency like USADA, bans a specific list of stimulants rather than a "catchall" approach like the World Anti-Doping Agency, and uses random testing instead of the globally accepted intelligence-driven testing. The policy is one of the longest running in professional sports, beginning in 1987. Since the NFL started random, year-round tests and suspending players for banned substances, many more players have been found to be in violation of the policy. By April 2005, 111 NFL players had tested positive for banned substances, and of those 111, the NFL suspended 54.

Though the policy involves all players getting tested times throughout the regular season, the playoffs, and during the off-season, Dr. Forest Tennant, the former drug adviser to the National Football League, stated that “its current policy, based on random testing, has not eliminated the problem.” The policy was different in the 1990s than it is today, due to heavy criticism from the United States Government. Originally, there were specific guidelines for when the player was caught using a steroid or other performance-enhancing drug. If a player was caught using steroids during training camp or some other off-season workout, they were suspended for 30 days for a first-time offense. Typically, this would mean missing four games, three in the pre-season and one in the regular season. Players would then be tested throughout the year for performance-enhancing drugs and steroids. A player who tested positively during a previous test might or might not be included in the next random sampling. A player who tested positive again would be suspended for one year, and a suspension for a third offense was never specified, because it never happened. In later years when many players ignored the policy, NFLPA director Gene Upshaw sent out a letter to all NFL players that stated:

The current policy includes having 20% of each team’s players blood-tested at random each year in training camp, and the offseason, 10% are blood-tested. The NFL employs isoform blood tests for Human Growth Hormone instead of the more precise biomarker test, which only has a detection window of 24 to 48 hours, and when notified at home, a player may take up to 24 hours to submit a sample.

Use in college football Steroids and performance-enhancing drugs have been reportedly used by many college football players in the NCAA. According to a recent drug test and survey, about one percent of all NCAA football players have tested positive for a performance-enhancing drug or steroid, and about three percent have admitted to using one sometime during their college football career. Controversy arose in 2005, when former Brigham Young University player Jason Scukanec, although never admitting to using steroids himself, stated that steroids were used in many notable Division I programs.

Scukanec, who is the co-host of a sports talk radio show "Primetime With Isaac and Big Suke" on KFXX-AM (AM 1080 "The Fan") in Portland, Oregon, made these statements:

Portland State University coach Tim Walsh commented on the situation, declining the remarks:

The number of players who have admitted using steroids in a confidential survey conducted by the NCAA since the 1980s has dropped from 9.7 percent in 1989 to 3.0 percent in 2003. During the 2003 season, there were over 7,000 drug tests, with just 77 turning up as positive test results. Scukanec claims that methods were used to get around the drug testing, whether it be avoiding the tests by using the drugs during the off-season, or flushing the drugs out of your system. This was used with a liquid he referred to as the "pink." He stated:

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