Think of the word steroid and a barrage of negative connotations spring to mind: Ben Johnson's Pyrrhic victory at the 1988 Seoul Olympics, Lance Armstrong's unrelenting ascent up France's highest peaks, even Raoul Moat's murderous final days on the run in Newcastle. We tend to consider steroids as an unknown evil, the refuge of cheats and madmen. It's easy to forget that GPs prescribe them to patients on a regular basis.
Anabolic steroids are an artificial substance, made in laboratories, that behave like natural hormones in the body. Usually, they fulfil the role of testosterone at a muscular level by helping to repair minor damage in muscle fibres. The steroids work much faster than natural testosterone, offering help to people with late onset puberty or muscle loss from cancer.
In terms of non-medical use, steroids are classified as a Class C drug, which means you can possess them as long as they are for personal use (supply or intent to supply is a crime punishable by up to 14 years in prison): "No one's committing a criminal act by injecting themselves with anabolic steroids, " says McVeigh.
That isn't to say there aren't dangers involved. While the pharmacological substances aren't a threat "to the majority of the population, to anyone with an underlying sensitivity they can be dangerous", explains McVeigh. Just as with all other drugs, individuals can react badly to steroids. Crosland says one of his friends "suffered two heart attacks and has permanently screwed up his testosterone cycle from a starter’s course. It can happen, you just have to be careful."
Another worry is what's in the substance. Steroids can be bought legally abroad or online, but Crosland says users often turn to the illicit market. "Generally, most people will buy it from a supplier – a dealer, as such. A lot of it is done by word of mouth and post. The steroids are from underground laboratories (UGLs). Some UGLs are slick operations run professionally, hygienic, with high standards. But some of them are 17-year-old spotty nerds in their kitchen sink. The thing is, you don’t know."
By buying steroids from a UGL, users relinquish all certainty they have in the substance they're using. "Nobody knows the exact drug, the strength, or whether they’re being adulterated, " says McVeigh. "On top of that, they’re being injected straight into the body, so any contamination or adulteration is going directly into the system. It’s not like you’re going to have your liver or your bowels sort it out. And then you have to add in the potential for contaminating injecting equipment and the possibility of exposure to HIV."
Feeding the man in the mirror
"I get everything I want from a needle, " 23-year-old steroid user Oli Smith told The Sun last week. "Apart from the side-effects you feel fantastic. In a club you feel like the biggest, strongest, best-looking, most powerful man in the world."
Knowingly or not, Smith speaks for a new breed of steroid user: young men who juice their bodies from an early age simply to look good. Unlike bodybuilders, the only competition on the mind of these men is the melee of the dance floor.
The transformation in the age and motivation of steroid users is due in part to simple economics. The drugs are now a tenth of the price that they were 15 years ago, and thanks to the advent of the internet, they're much easier to purchase. Today, young men with only a little disposable income can readily buy anabolic steroids.
Both McVeigh and Crosland think a deeper, cultural issue is also to blame. "Males are exposed to more pressures to conform to a stylised body image now than they ever have in the past, " says McVeigh. "20-30 years ago, there wasn’t the same extent of mags portraying stylised men; every man without a shirt on in TV ads didn't have what, for many people, is a totally unachievable physique. It’s that drip drip feeding of what a male body should look like."
The uptake of steroid use among young men for aesthetic reasons adds another issue into the mixing pot: they often have a poor level of knowledge about how to train their bodies. Bodybuilders tend to begin a course of steroids after years of training, but teenagers or young adults simply don't have that level of understanding. An escalating boom-and-bust cycle of steroid use can ensue. Start taking these drugs and your muscles grow rapidly within a couple of weeks – not due to an increase in functional strength per se, but because they start to retain extra water. They bloat, in other words. Then, when the course of steroids is over, the muscles shrink equally fast, often prompting the user to panic and restart injecting with a higher dosage.
Crosland explains that while the substances aren't physically addictive, "psychologically, they can be difficult to walk away from". He blames a lazy social attitude for the boom among young men. "Everybody wants a magic pill. People don’t want to work hard, they want to take something that will fulfil their dreams. Steroids will give the results that are wanted if all other fitness considerations are in place, but the problem with this group is that everything else isn’t in place. The onus is on the drug use, not the training or the diet."
"It doesn’t matter how many cement mixers you’ve got, if you don’t have bricks you aren't going to build a house."
A matter of education
If more young men are leaving themselves vulnerable to physical side-effects and blood-borne viruses, should anabolic steroids be reclassified as a Class B drug – or higher?
Neither McVeigh or Crosland think so. Instead, they want to see more efforts to educate and protect users.
The idea of "harm reduction" is key. "People’s lives are scattered with risks, " says McVeigh. "It’s about minimising those risks. Steroid use tends to be transient, so the main thing we should be doing is making sure they travel through this period in their lives without any permanent damage."
One step would be to follow NICE's call for needle exchanges operated within gyms, allowing users easy access to sterilised injecting equipment. Another would be to ensure health professionals are on hand to talk to potential steroid users. "At the moment, " says Crosland, "the NHS haven't a clue. They have no experience in the area."
Crosland imparts his experience of steroid use as a Performance and Image Enhancing Drugs Counsellor, helping people to understand the life pressures and physical effects associated with drugs that change the way you look. He says his first action with any potential user is to talk them through the ramifications of steroid use and stress the importance of a thorough training regime and diet. If the person hasn't already undergone an extensive period of training, he tells them to wait.