Steroid use in Britain is on the rise. Up to 1 million people illicitly use steroids in the UK, and in certain areas needle exchanges have seen a 600 percent increase in steroid users in the last decade. But while we're all familiar with the stereotypes of steroid users—roid rage, shrunken testicles, exploding biceps—we're much less familiar with the concrete physical and psychological consequences of steroid abuse.
Anabolic steroids mimic the effects of testosterone, stimulating muscle growth and therefore enabling you to train harder and faster. However, they can also have serious side effects. These include everything from high blood pressure to heart problems, testicle shrinkage, erectile dysfunction, sterility, low libido, and aggression. Moreover, if you're young, steroids can irreversibly muck up body development and stunt growth.
But what is driving this rise in steroid use? The reasons are numerous, but some argue that certain cases are linked to muscle dysmorphia—or "bigorexia", as it has become routinely referred to in headlines—the fear of being too small and seeing oneself as weak, when in reality you are large and muscular. Hyper-vigilant to the smallest deviation from the perceived ideal, one is preoccupied with appearance and perceived defects.
According to the Body Dysmorphic Disorder Foundation, the condition affects one in ten men who go to the gym in the UK.
Steroid specialist Dave Crossland argues that steroid use can go hand in hand with muscle dysmorphia. "Steroid usage can increase body image problems," he says. "If you improve the way you look and you've used chemical enhancements to do that, it's then difficult to go back to a physique that you're not happy with."
Crossland, 44, has first-hand experience of the dangers of steroids. "I was 19 when I first took them. I'd gone as far as I felt I could naturally. Before that I was actually quite anti-steroid," he tells me. "At 24 I completely detached my left chest muscle and I drifted away from training. But when I was 38 I started taking steroids again, and it was then that I saw how poorly educated people were and how widespread use was."
Although Crossland is not currently taking steroids, he has taken them for much of his life, and just six months ago he took a low-dose steroid cycle. "I'm 28.5 stone [400 pounds]. I'm effectively 14.5 stone [200 pounds] over my ideal weight. I am probably one of the biggest guys in Britain and possibly further afield. Now, that doesn't mean I have the same quality of muscle as a pro builder, but I definitely have the physical dimensions," he explains. "I have a 25-and-a-half-inch arm. I eat seven to eight meals a day. It's the only way I can maintain my mass. The last two meals of my day I force-feed, physically taking a mouthful and swallowing it down with water because it's the only way I can get it in."
Crossland says living life at his size isn't easy. "It controls everything I do. I can't get up in the morning and think, 'You know what? I can't be bothered.' I have to get up at six o'clock every day to eat," he tells me. "When I do a blood test, my sodium levels are OK for a normal person, but I need three or four times as much as that, and that's with everything I do."
At his size, Crossland says normal rules don't apply. "I don't fit in cars. I don't fit in buses. I don't fit in planes. I don't fit in toilet cubicles. I have to use disabled ones," he reflects. "I've had 'roidhead' and all sorts shouted at me in the street. People tend to view you as a bit of public property; they'll come up and start poking and squeezing your arms. You become a bit of a circus freak. People will literally stand next to me and take photos while I'm trying to eat out of my Tupperware because they think it's really weird."
A Sky News investigation found that there could be up 1 million people illicitly using steroids in Britain, but Crossland reckons the number is far higher: "I'd say it's more like 2 million. Most of the official stats come from needle exchanges, but only about 30 or 40 percent of steroid users use those services."
After all, steroids are Class C drugs and are only legal if taken with a doctor's prescription. "I know one case where a steroid dealer went to prison for two years. You can't just walk into any gym and buy steroids," explains Crossland. In turn, he says, many users end up buying online. But it's not just specialist websites peddling steroids—a large proportion of dealers now operate on Facebook. "It's not hard to find when dealers have got a picture of steroids as their profile pic. There are also private groups on Facebook where you can request drugs," he tells me.
The growing ubiquity of the drug means the spectrum of growth is much broader than most would imagine. "An area of growth that people don't consider is affluent, well-established 40-something males who might not even go to the gym. They're getting old and their natural testosterone's dropping, so they're going online," says Crossland. "You come across a lot of people whose partners don't know they use, and they're trying to make excuses to the partner about why they're not performing in bed."
Crossland believes media representation has a large part to play in the rapid increase of steroid use in the UK. "There's a massive social pressure to look a certain way. I think males are struggling with it harder because it's new for them. Add that to a society that looks for a pill for every ill, and you can understand why people are turning to steroids," he argues. "But why have we got to the point where 17 or 18-year-olds are willing to take massive risks just to look good in a t-shirt? This isn't to achieve a world record. This isn't to be number one in their sport. This is just an average kid who wants social acceptance."
With anecdotal reports of boys as young as 13 turning to steroids, it is clear usage is no longer the domain of top-class athletes and body-builders. Public Health England admits steroid use is a growing problem and is urging local authorities to offer needle exchange services and health testing. After all, the HIV infection rate of steroid users (1.5 percent) is as high as it is for heroin users. What's more, steroid users are not just taking increasingly high doses; they are taking them for longer and longer periods of time. While it used to be common to do cycles of six to eight weeks, it is now more and more common to stay on them all the time.
Nevertheless, Gary Beeny, who works in a steroid clinic in Ancoats, Manchester, argues that most steroid users wouldn't dream of setting foot inside a clinic. "For every one person I see, there are plenty of other guys who would never come near because of the stigma," he explains. "They feel uncomfortable about being around heroin users and are wary of the legality of their use."
That said, the number of steroid users accessing clinics has grown hugely over the past couple of decades. "In the 90s, 5 percent of our users took steroids, but now it's roughly 50 percent of our client group. It's the same nationally," Beeny tells me. "We have two types of users—there are the body-builders, and then you have aesthetic users who train during the week and go out during the weekend. One of the workers I met at a conference described them as 'weekend warriors.' We're more concerned about them because they'll obviously drink alcohol and maybe use cocaine."
Like Crossland, Beeny argues that muscle dysmorphia has a role to play in the rise of steroid use. "I'll say to someone, 'You've got massive arms,' but they'll say, 'No, they're not big enough—I need to work out more.' That is the fundamental description of muscle dysmorphia," he explains. "If you're on the track of trying to get bigger, there's no end to it."
As well as distorted body image, the symptoms of muscle dysmorphia include working out obsessively, prioritising exercise over family and friends, disordered eating, compulsive checking of one's physique in the mirror and steroid use. The combination of the aesthetic fixation and excessive perfectionism, which characterises the disorder, can cause depression and anxiety. Although relatively little is known about the condition yet, the NHS believes the disorder could be genetic, or caused by a chemical imbalance in the brain and might be more common in people who were bullied or abused while they were young.
Given a YouGov survey found that 31 percent of British men aren't happy with their body image, it's perhaps unsurprising that some turn to substances that can help them fast-track their goals.
Nevertheless, it goes without saying that the reasons behind steroid consumption are myriad, and as with anything, causation is complex. However, what's evident is that the increasing accessibility of steroids and the intensified cultural pressures around body image mean what was once an open secret within a close-knit body-building community has become a lifestyle choice for people from all walks of life.
Follow Maya on Twitter.