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The vast majority are male and in work or fulltime studies. More than half say they want to change their body shape for image or cosmetic reasons. Some take them to increase chances in bodybuilding competitions, as hormone replacement therapy, to retain youthfulness or increase confidence.
Testicular atrophy, change in sex drive, sleep difficulties, aggression, mood swings, acne, injection site pain, depression, hair loss. Long-term effects may include disease and dysfunction of the liver and both acute and chronic cardiovascular pathologies. Users are not believed to become physically dependent, but may become hooked on the way the drugs make them look and feel.
John, 30, is one of a new breed. He is a quietly spoken engineer on a good wage and devoted to his career. In his spare time he works hard, not only on pumping iron but on understanding what each of the IPEDs he uses does. Doctors and nurses carry out blood and ECG tests on users and give them non-judgmental advice about the substances they use. John takes part in bodybuilding competitions and does not have much time for those who are more concerned about using anabolic steroids simply to look good when they are out socialising or on holiday.
That gives us a bad name. Following John into the clinic was Paul, a year-old security worker. He has been training since he was 13 and began taking IPEDs after seeing so many other people doing it. All my mates are training. Paul does not take a cocktail of substances. You hear about the big boys going up to 1. He envisages himself taking steroids for the rest of his life.
The medics who work here — all as volunteers — see some worrying cases. When the Guardian visited, one young man was found to have a resting heartbeat of more than double the normal. He did not drink or smoke, had a well-balanced diet and exercised every day. But he did take steroids and caffeinated drinks.
They also speak to young men who inject directly into the muscles in the areas of the body they want to enhance — such as the pectorals — though this is considered dangerous.
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