Steroids and image enhancing drugs
Over recent years, there has been a significant increase in the use of steroids and other image enhancing drugs (SIEDs) – particularly amongst young people. The range of substances used has expanded and includes peptide hormones which are still at the early stages of development. Most drugs are illicitly manufactured and sourced, although legal to possess for personal use. They are of highly variable quality and stability and pose significant health risks.
A growing number of SIED users also tend to use cocaine and cannabis in particular. The main risks from SIED use come from the fact that most people inject the drugs, with HIV prevalence in England and Wales at a similar level to those who inject heroin and/or crack cocaine. There are also a number of specific health risks; anabolic steroids alone have been linked with a number of side effects (acne, accelerated balding, gynaecomastia, sexual dysfunction as well as mood and psychological effects) and, even more worryingly, chronic heart conditions.
A new survey , conducted by the Centre for Public Health at John Moores University, published in July 2015, provides us with more information.
A total of 108 people from the UK took part in the online survey, 93% of them men. Participants describe their primary purpose and other motivations for using SIEDS with gaining muscle and strength, together with losing fat the most common reasons:
Although the number of SIED users completing the survey is very low (the Crime Survey for England and Wales suggests there are between 43,000 and 89,000 active steroid users), it is notable that a third of respondents started using orally when they were aged 21 years or younger and 27% started injecting SIEDs at the same age.
That using SIEDs is risky is something that many users are aware of; the survey respondents reported a worrying number of injuries and side-effects:
The most worrying aspect of SIED use, alongside its increased popularity, is that very few users engage with drug treatment agencies or other health services, with the exception of using needle and syringe exchange programmes. The survey’s authors, Jim McVeigh, Geoff Bates and Martin Chandler, recommend that we need to understand the needs of SIED users much better – practices and preferences are changing rapidly as are the associated health risks.
The priority for public health departments must be to try to reach SIED users with targeted information and encourage them to seek advice and support from local services.