He came up with it after years of studying steroid users in Boston-area gyms and comparing them not just to non-steroid users in the same gyms, but also to bodybuilders from different eras. For a 1995 study, Pope and his coauthors estimated the FFMIs of Mr. America winners from 1939 to 1959, before steroids were readily available. The group includes future B-movie star Steve Reeves, whose physique was so iconic that he was name-checked in The Rocky Horror Picture Show . The average FFMI was . (One of the highest was George Eiferman, Mr. America 1948, with a FFMI. His upper body was later the model for George of the Jungle, a 1960s cartoon character.) Even today, with all we’ve learned about training and nutrition, an FFMI in the mid 20s is still considered the ceiling for natural bodybuilders. Anything above 26 or 27 is suspect.
Steroid-induced osteoporosis (SIOP) is osteoporosis arising due to use of glucocorticoids (steroid hormones) - analogous to Cushing's syndrome and involving mainly the axial skeleton. The synthetic glucocorticoid prescription drug prednisone is a main candidate after prolonged intake. Bisphosphonates are beneficial in reducing the risk of vertebral fractures.  Some professional guidelines recommend prophylactic calcium and vitamin D supplementation in patients who take the equivalent of more than 30 mg hydrocortisone ( mg of prednisolone), especially when this is in excess of three months.   The use of thiazide diuretics, and gonadal hormone replacement has also been recommended, with the use of calcitonin, bisphosphonates, sodium fluoride or anabolic steroids also suggested in refractory cases.  Alternate day use may not prevent this complication. 
Laws and Penalties: Concerns over growing illegal AAS abuse by teenagers, and many of the just discussed long-term effects, led Congress in 1991 to place the whole AAS class of drugs into Schedule III of the Controlled Substances Act (CSA). Under this legislation, AAS are defined as any drug or hormonal substance, chemically and pharmacologically related to T (other than estrogens, progestins, and corticosteroids) that promotes muscle growth. The possession or sale of AAS without a valid prescription is illegal. Since 1991, simple possession of illegally obtained AAS carry a maximum penalty of one year in prison and a minimum $1,000 fine if this is an individual’s first drug offense. The maximum penalty for trafficking (selling or possessing enough to be suspected of selling) is five years in prison and a fine of $250,000 if this is the individual’s first felony drug offense. If this is the second felony drug offense, the maximum period of imprisonment and the maximum fine both double. While the above listed penalties are for federal offenses, individual states have also implemented fines and penalties for illegal use of AAS. State executive offices have also recognized the seriousness of AAS abuse and other drugs of abuse in schools. For example, the State of Virginia enacted a law that will allow student drug testing as a legitimate school drug prevention program (48, 49).