The health risks are well known, so why do almost a million people continue to misuse steroids?

11 May 2019

The website Paul uses to purchase steroids. Photograph: Craig Quirie

Steroid usage is on the rise in Britain. One user tells his story.

It is believed that up to one million people in Britain use steroids for body-image purposes, according to public health leaders.

Paul (not his real name) is a user of steroids, and says that, in actuality, the number of users likely towers over the figure released and that some dealers will rake in £80,000 per month from sales.

Paul says: “It was mainly curiosity that lead to me taking steroids… I had been training for ten years without steroids, but I knew a lot about them. I decided to take them to see what would happen in terms of my physique and weight of lifts.”

Within four weeks of taking steroids, Paul’s personal best bench-press went up by 15kg to 162.5kg – no mean feat, considering it had taken him a decade to get to his original (pre-steroids) personal best of 147.5kg.

He was able to source the drug through an acquaintance in the gym. He says it is common practice for ice to be broken between the heaviest lifters in the gym, by asking each other to stand watch in case an intervention is needed whilst attempting heavy compound lifts.

These interactions eventually led to Paul being offered steroids, then later given the contact details and website of a dealer. He now spends £55 every second month ordering steroids from a professional looking website, or from an email catalogue system. He has no idea who the actual dealer is, but says the service is fast and efficient. The packaging of the steroids even includes a verification QR code, which cuts the dealer out and takes the user directly to the steroid company website which then gives confirmation of quality and an expiry date of the drug.

The steroid verification system. Image: Paul

Although using steroids is legal in the UK, they can only legally be acquired through a pharmacist, with a prescription, meaning Paul’s dealer is breaking the law. NHS Scotland say: “It’s illegal to possess, import or export anabolic steroids if it’s believed you’re supplying or selling them.” The penalty for providing steroids outwith the law is an unlimited fine and up to 14 years in prison.

Despite spending £330 per-annum on steroids, Paul says he has no qualms over the hefty fee – saying that the advantages gained from the drug go beyond just physical appearance.

“The benefits of taking steroids were not just in my gym performance, but my mental state, which improved tenfold,” he said. “As my lifts went up, so did my confidence – I felt better about myself not just in physique or gym performance, but life in general.”

There has been much debate on the implications steroids have on a user’s mental state, with many studies finding that there is a link between the increased testosterone steroids bring and aggression.

Although Paul champions the use of steroids, Niall McFarlane, Professor in Physiology and Sports Science at the University of Glasgow, has cast doubts over Paul’s belief that steroids enhance his mental state long-term:

“There is no mental benefit at all [in taking steroids] – the person [experiencing immediate improved mental health] is describing a common side effect of taking anabolic steroid (AS) or androgenic-anabolic steroids (AAS). This side effect is an action of the steroids in the central neuron system, it involves dopaminergic neurotransmission and produces amphetamine-like activity. So they produce a sensation of euphoria – but which may also result in increased aggressiveness.”

Paul said: “In my own experiences, and those of other steroid-users I know, steroids only exemplify personal traits that are already there prior to taking steroids; so if you’re cocky, you get more cocky; if you’re aggressive, you get more aggressive – I don’t think steroids can create a new personality.”

The steroids Paul uses. Photograph: Paul

The improvements he has experienced since taking the class C drugs has led him to question why there is a trend, particularly online, of outing steroid-users. Paul takes the steroid hormone testosterone enanthate. This is the same hormone that a female-to-male transgender person would take during hormonal transition (in much smaller doses). Paul thinks this is something that should be considered when steroids are spoken about as a “magic but shady, backwater drug.”

“If a female visits their doctor and tells them that they are unhappy in their gender, and wish to be male – they are prescribed with testosterone. If a 21-year-old male tells their doctor that they want to take testosterone because they are unhappy in their body and the way they look, they would be asked to leave.”

Paul uses the needle exchange system offered by high street retailer, Boots. This allows him to get, and dispose of, needles and syringes free of charge. He simply has to ask for a sports kit, then gives his initials and date of birth. The needle exchange system is one he appreciates, saying it gives him peace of mind knowing he is disposing of needles safely. In addition to this, it also saves him money – without it he says he’d have to pay for more expensive steroid gels which are applied to the skin.

It may come as a surprise to many that a major retailer provides the equipment needed to take the drug – especially given some of the side effects they are believed to cause. Despite this, Paul insists that he has no fears about adverse effects.

The side effects of misusing steroids are listed on the NHS website and are as follows:

Physiologically, in men there are chances of users encountering:

  • Reduced sperm count.
  • Ifertility.
  • Shrunken testicles.
  • Erectile dysfunction.
  • Breast development.
  • Baldness.
  • Increased risk of prostate cancer.
  • Severe acne.
  • Stomach pain.

And in women:

  • Facial hair growth and body hair.
  • Loss of breasts.
  • Swelling of the clitoris.
  • A deepened voice.
  • An increased sex drive.
  • Problems with periods.
  • Hair loss.
  • Severe acne.

Medical conditions that could occur in both men and women:

  • Heart attack or stroke.
  • Liver or kidney problems or failure.
  • High blood pressure.
  • Blood clots.
  • Fluid retention.
  • High cholesterol.

Physiological effects:

  • Aggressive behaviour.
  • Mood swings.
  • Paranoia.
  • Manic behaviour.
  • Hallucinations and delusions.

Paul says: “I do not plan on taking steroids long term so [I’m not worried about long term effects] not really. But as long as you are smart about dosages and do not abuse them long term, then effects are minimal.” he says, continuing, “I’ve experienced night sweats, acne and hunger pangs – but are they that bad? Certainly not as bad as the the typical heart failure, kidney failure, strokes and cancer that most people, for whatever reason, associate with steroids.”

McFarlane adds: “Sometimes, AAS abuse may lead to withdrawal syndrome, like alcohol or other drug abuse and in a study conducted on 160 athletes including 88 AAS users and 68 control athletes, the prime difference between the two groups was the incidence of psychiatric ill effect; with 23% of steroid users showing maniacal symptoms, hypomania and depression. So, the initial high – does not lead to a beneficial effect.”

Paul, however, says he felt little withdrawal symptoms when, due to personal circumstances, he decided to cycle off steroids. “I would have undoubtedly craved the peak gym performances and physique I experienced and exhibited whilst on steroids, had I come off expecting to continue at the performance levels I was showing whilst on steroids.

“However, I had realistic expectations before cycling off steroids, and prepared myself mentally for a drop in what weights I could lift and how I’d look. And I also knew how easy it’d be to regain those performances, but there was no nagging desire to have it immediately.”

Infographic on anabolic steroids. Infographic: Craig Quirie

Paul says that once he had come off steroids his strength levels simply reverted back to the point they were at prior to taking them. This naturally gained strength level is what he uses to justify taking steroids whilst training in combat, saying that his 10 years of consistent weight lifting ensured he was already one of the strongest in the room anyway, and that steroids never gave him any sort of aerobic, speed or technique advantages.

On whether he believes the average person takes steroids for sport performance or image purposes, McFarlane said: “No – I don’t think that there is really a basis in performance but rather in trying to control body image. Any performance benefit from steroid use is commonly associated with stacking [concurrent use of 2 or more steroids at high dose].  This approach assumes each steroid has a different physiological action and involves the gradual increase in dose; the user, begins with low-doses, reaches a peak and then slowly decrease the dose for a period of time which can range from 4-18 weeks.

“This ‘pyramid’ protocol consists in alternating steroid with periods of suspension, a process known as ‘cycling’. The doses used in these procedure are up to 200 times higher than the recommended dosage employed for therapeutic reasons. So most people can’t afford to use a protocol that will lead to performance gains.”

The NHS say: “There is no evidence that any of these methods actually reduce side effects from taking anabolic steroids.”

Paul plans to continue using anabolic steroids, saying that continuous strength gains mean a constant challenge in the gym – something he has longed for, as his progress naturally stalled after 10 years. He won’t use them competitively, merely to continue his hobby.

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