Rise in UK Steroid Use Brings Severe Health Risks

performance enhancing drugs

Steroid misuse is thought to be rising in the UK, increasing concerns over the spread of blood-borne viruses among this emerging population of injecting users.

In a recent interview with the BBC, Open Road, an Essex-based charity providing support for drug users, claimed that almost two thirds of visits to needle and syringe exchange programs in the past year were to help steroid users.

What's more, according to Open Road, “33% of visits for steroid problems last year were from new users, compared to 11% for heroin,” further suggesting the scale of the problem may be outstripping that of more “traditional” illegal drugs in the area.

Anabolic steroids are a Class C drug in the UK: it is legal to possess or import them for personal use, but it is illegal to sell them to others.

The use of Performance and Image Enhancing Drugs (PIEDs), a category encompassing a wide range of drugs such as anabolic steroids, androstenedione, human growth hormone, erythropoietin, diuretics, and stimulants is thought to be increasing in the UK. A recent investigation by Sky News concluded that up to one million people in the country could be using steroids illicitly, with seizures of PIEDs increasing 35 percent in 2014 compared to the previous year.

A 2013 report released by the Centre for Public Health (CPH) at Liverpool John Moores University highlighted that more people were presenting to needle exchange programs around the country for steroid use, and that between 2012 and 2013, 271,000 people were found to have used anabolic steroids at least once in their lifetime.

Public knowledge of PIEDs such as steroids typically extends to sports scandals, with very little coverage of their misuse among the general population. Drug workers told Sky News that the rise in use is partly attributed to the pressure to "conform to a highly-defined body type," indicating the phenomenon's links to body dysmorphia. 

Most worrying within all of this is the injecting of steroids and associated risks that come with this type of drug administration. With the number of users at risk of blood-borne viruses and bacterial infections increasing -- one in 10 PIEDs were found to have been exposed to HIV, hepatitis C, or hepatitis B the CPH found -- the problem has worked its way to the forefront for harm reduction providers.

In April 2014, the National Institute for Health and Care Excellence (NICE) updated its guidelines regarding needle and syringe exchange programs with new recommendations about services for people using PIEDs. As explained by David Rourke, working for the Arundel Street Project in Sheffield:

“We run a weekly clinic for steroid users but we have people coming through the door on a daily basis, with at least seven new clients a week. We know there are many more people out there who are not using needle and syringe programmes because this group of users do not see themselves as drug users. Traditionally they are more sexually active than users of heroin or crack, so there is more potential for the spread of infections through sex.”

Steroid misuse may have become common, but many users seems to believe that neither HIV nor hepatitis will ever be their problem. NICE recommends providing outreach or detached services in gyms: workers and experts available who can discuss the effects of these drugs, or can give advice on nutrition and physical training that can be suggested as an alternative to steroids. Though some gyms are providing safety disposal bins for syringes, very few -- if any -- provide clean syringes, according to one news investigation last year.

Following a recent tightening on the law on importing steroids, another problem is emerging: the proliferation of underground labs that illegally manufacture steroids that might be “five times stronger than the regular stuff," one anonymous amateur sportsmen told the BBC.

PIEDs, especially in the form of anabolic steroids that are injected represent an evolving challenge for harm reduction services in the UK. The latest data, along with a greater attention paid by drug workers and health providers, could provide a much needed wake up call for users.