Healthy pursuits such as running, cycling and visiting the gym are now well and truly part of the mainstream, no longer minority interests. But as people become more focused on their body image, a worrying new trend has emerged.
Sheffield’s Arundel Street Project sees seven new clients each week who are regular users of steroids or performance-enhancing drugs, used to build up muscle mass, smoothen skin or even give the appearance of a golden tan.
The new clients are from all walks of life - from office workers to teenagers and emergency services staff.
According to health experts, many of these users do not see themselves as having a problem.
Instead they view themselves as ‘fit and healthy’ - despite the fact that people who inject any type of drug are at risk of HIV and hepatitis.
The Arundel Street Project has run a weekly drop-in clinic for steroid users for 18 months, providing people with clean needles, advice and support.
Meanwhile new guidance from the National Institute of Health and Care Excellence has made it clear for the first time that steroid users should be provided with equipment and get tested for blood-borne diseases.
David Rourke, Arundel Street’s harm reduction lead, said the trend has proved surprising.
“We don’t really talk about it that much and some places don’t even have services geared up specifically for steroid users,” he said.
While steroids themselves are generally used to build muscle, today’s preferred term of IPEDs - image and performance enhancing drugs - takes in a wider range of substances.
These include weight loss drug Clenbuterol, tanning agent Melanotan and Botox.
David said the rise in steroid use is a symptom of people focusing more on ‘how they look and wanting to feel healthy’.
“You see it in Sheffield - with us having a lot of parks, you’re guaranteed to see a runner and quite often you’ll see people doing circuits in the morning.
“People want to feel healthy and when you’re in a gym, training every day and not getting any bigger, and the guy next to you is getting twice the size every week, people want that to happen to them. So then they fall into the trap and that’s how people start to use.”
He added: “They’re not addicted in the same way as heroin or crack, where you suffer from physical withdrawals, but people do get obsessed with the way they look.
“I’ve spoken to people who look like they’re 18 or 19 stone of muscle and they believe they look small.
“They’re the problematic ones.”
Steroids are often bought online, or shared on a word-of-mouth basis.
“It’s very undercover, and about knowing the right people,” David said.
The risk of HIV and hepatitis comes from sharing needles, the injection process itself and risky sexual behaviour, particularly among younger users.
“We have people who are using to look good on a Friday night or to go on holiday and get a ‘beach body’, but then they’re going out drinking - then you get the risky sexual practices,” said David.
Other side-effects of steroids include ‘shut-down’, where the body stops producing testosterone, baldness and acne.
Hormone imbalance can lead to gynaecomastia - development of breast tissue in males.
More severe effects such as heart failure, liver and kidney problems can follow too.
“Just because someone is using a different drug, doesn’t mean the risk isn’t exactly the same,” said David.
“It’s not our job to say ‘You can’t use that substance’. That’s where the improvement in drug services has come from over the last 20 years - reducing harm, reducing the cost to the public and getting people on the right track.”
Tens of thousands using steroids
The use of steroids and other performance-enhancing drugs is ‘rapidly increasing’, the National Institute of Health and Care Excellence has said.
Around 59,000 people aged 16 to 59 are thought to have used anabolic steroids in England and Wales last year, but NICE said these estimates are ‘conservative’.
Prof Mike Kelly, director of NICE’s centre for public health, said: “Needle and syringe programmes have been a huge success story in the UK, credited with helping stem the Aids epidemic in the 1980s and 1990s. However, we are now seeing a completely different group of people injecting drugs.
“They do not see themselves as ‘drug addicts’ - they consider themselves fit and healthy people who take pride in their appearance.”
David Rourke said: “We have people coming through the door on a daily basis, with at least seven new clients every week. We know there are many more people out there not using needle and syringe programmes.”
Visit http://cri.org.uk/arundel_streetproject for more details.