Four years ago Rob Dawson, a British GP (general practitioner, or family doctor), came across a startling set of figures from a local needle exchange programme: the largest single group of drug users visiting the exchange -- 60 percent -- were not heroin addicts, but intramuscular steroid injectors.
Dawson's discovery prompted him to establish a specialist clinic that today treats around 600 anabolic steroid users a year and has established him as the leading medical expert on the scale of steroid use in the UK.
Dawson has witnessed an explosion in the use of steroids and, more worryingly, a change in the profile of users. Where once steroids were the preserve of elite athletes and the body building clientele of "hardcore" muscle gyms, the doctor is seeing increasing numbers of young men, even adolescents, turning to steroids for no other reason than Friday night vanity.
"The youngest person I have treated is 15. We have realized that this isn't a small, isolated problem. It's an international problem for the youth of today," he said. "There will be people out tonight in Newcastle [northern England] who are using steroids, not because they want to run faster or jump further, but just because they want to look good."
Despite the boom in steroid use and the potential dangers involved, less is known about the scale of the problem than with any other controlled drugs. While steroids are banned under the same Misuse of Drugs act that controls the supply of cannabis and cocaine, users do not consider themselves standard drug takers because of the association with fitness and nutrition.
Experts say a mythology has grown up around anabolic steroids, a myth fed by the importance that sports' governing bodies attach to testing for them. In evidence they cite the increased sales of steroids and supplements that usually follow the exposure of high-profile athletes who test positive for drugs, such as the British sprinter Dwain Chambers.
The phenomenon was most obvious when elite athletes began testing positive for nandrolone, a substance that boosts endurance.
"The stuff literally flies off the shelves [after a positive test]" said a warehouseman at one leading nutritional product manufacturer. "The public seems to believe that if it's good enough for the stars, then it's good enough for them."
Certainly there is nothing good about testicular atrophy, baldness and breast growth -- some of the side-effects commonly associated with steroid use.
Neither are blood disorders or abscesses caused by dirty needles and drugs manufactured in unhygienic environments, yet the rise in steroid use is undeniable.
No nationwide study of drug use has been undertaken but the London-based Guardian newspaper has found a growing body of evidence that points to a burgeoning market for illegal anabolic steroids in the UK, and a disturbing shift in the demographic spread of the people taking them.
A study by the University of Glamorgan, Wales, has identified steroid use by children as young as 14 in south Wales, and found that use of the drugs spanned a wide social spectrum including teachers, police officers and office workers.
Britain's Home Office estimates that as many as 42,000 people used the drugs in 2001 to 2002. Police and customs seized more than 70kg of anabolic steroids during the same period.
The growth in steroid use in the UK is mirrored in the US and Canada, where use among high school athletes is at an all-time high as students strive to become bigger, faster and stronger. More than 500,000 American children are estimated to have used the drugs, and use by teenage girls has doubled during the 1990s.
The Glamorgan study found that 58 percent of people questioned at three gyms in the mid-Glamorgan area admitted using steroids, some of them as young as 15.
Julian Baker, one of the researchers, said: "We did not go looking for steroid use. We just took a cross-section of the gyms in the area and this is what we found. One of the most worrying aspects is the increasing number of teenagers who are getting involved. Once the pits and the mines closed down men had to redefine themselves and one way of doing this was to get into body building -- and often that can lead to steroids."
The Guardian has discovered that the use of steroids is spreading from the gym to the playground. At Porth county school in Rhondda Cynon Taf, south Wales, staff have caught young teenagers using steroids and, on one occasion, found steroids on the school premises.
Steve Bowden, the headteacher, said: "It is becoming more apparent now. It seems to come from a macho gym culture. The boys who are taking the drugs are not top sportsmen, they are just looking for respect in their communities."
Robert, a body builder from mid-Glamorgan who has been using steroids for a decade, agreed that the users were getting younger.
"There are a lot of younger lads getting involved with steroids at the gyms round here now," he said. "They come in and train for a few weeks then start using and it is no good for them because they haven't got the core strength to start with."
The users may have changed but gyms remain central to the use and supply of steroids. Visit any hardcore gym and you will find a room echoing to the clank of heavy weights and the grunts of effort from the men who lift them.
The culture of such gyms, where bicep curls with 25kg weights are routine and being able to lift your own bodyweight above your head unremarkable, is macho, intimidating, and highly competitive. Fed by vanity and competition, the desire for ever greater muscle mass and definition can be met by steroids.
Many gyms operate a strict no-drugs policy, but there are others where steroids are available over the counter at prices ranging from US$130 to US$400 for an eight-week course.
One source with knowledge of such gyms said: "You walk in and you wonder whether you will be walking out again. It can get pretty hairy, particularly with big guys around."
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