‘Natty or not?’: how steroids got big

🌈 Abstract

The article discusses the growing prevalence of steroid use among office workers and the general public, beyond the traditional bodybuilding and powerlifting subcultures. It explores the reasons behind this trend, the availability and accessibility of steroids, the health risks and long-term consequences, as well as the challenges in addressing this issue from a public health perspective.

🙋 Q&A

[01] The Rise of Steroid Use Among Office Workers

1. What are the key factors contributing to the increased steroid use among office workers and the general public?

• The article highlights several factors:
  • The availability and ease of access to steroids, with online sales and underground labs making them more widely accessible
  • The influence of social media and fitness influencers, who have helped normalize and even glorify the use of steroids
  • The desire among young men to achieve a muscular, "ideal" physique that is often portrayed in media and social platforms
  • The perception that steroids can help them achieve their fitness goals faster and more effectively

2. How has the profile of steroid users changed over time?

• The article notes a shift in the typical steroid user, from committed bodybuilders and powerlifters to younger, more naive individuals who may not be as dedicated to the lifestyle and monitoring their health.
• Outreach workers have observed that the "average steroid user is now younger - in their 20s or even teens - and more naive, not a bodybuilder who is monitoring his bloodwork and taking care, but a kid who might barely even work out."

3. What are the potential long-term health consequences of widespread steroid use?

• The article cites research indicating that long-term steroid use can lead to a range of health problems, including:
  • Increased risk of heart attack (tripling the risk compared to non-users)
  • Cognitive impairments and reduced brain volume
  • Testicular atrophy and potential infertility
  • Liver damage and other organ-related issues

[02] Harm Reduction Approaches

1. How are some countries and organizations addressing the growing steroid use problem?

• The article discusses two contrasting approaches:
  • The "hardline" approach taken by countries like Denmark and Sweden, which involved police raids on gyms and "muscle-profiling" of individuals, with little effect on overall steroid use.
  • The harm reduction approach in the UK, exemplified by clinics like the Juice Clinic in Sheffield, which focus on providing a safe space for users to get blood tests, discuss their usage, and receive guidance on safer practices, rather than confrontation.

2. What are the challenges in implementing effective harm reduction services for steroid users?

• The article notes that there are only a handful of such harm reduction services across the UK, and their continued operation is often dependent on ephemeral public health funding.
• Experts highlight the need for more comprehensive services that offer not just blood testing, but also psychological support and other resources, which would require significant time and financial investment.

3. What are the barriers that prevent steroid users from seeking help from mainstream healthcare providers?

• The article suggests that many steroid users are reluctant to discuss their usage with doctors, as they fear being met with moralizing lectures and having a note on their medical record.
• The lack of specialized knowledge about steroids among healthcare professionals is also cited as a barrier, leading users to seek out more understanding and supportive services like the Juice Clinic.