Warning: This article contains references to eating disorders which may be distressing for some readers.
The increasing use of illegal anabolic steroids will be a key focus of this year’s Global Drug Survey, the world’s largest study on drug use.
Performance and image-enhancing drugs, consisting of hormones and anabolic agents such as synthetic testosterone, have overtaken methamphetamine as the most recently used substance among new users of injectable drugs, the latest Australian Needle Syringe Program National Data Report showed.
More people are turning to drugs as a shortcut to building muscle.Credit: Getty Images
They were also the third most commonly reported drug last injected overall, with the proportion of people nationally who reported performance and image-enhancing drugs as the drug they had most recently injected increasing from 4 per cent in 2018 to 7 per cent in 2022.
Anabolic steroids can be used to treat hormonal problems, such as delayed puberty or disease-induced muscle loss, but they are also popular to build muscle mass quickly to create a defined physique. However, they can have negative health impacts and are illegal to use or distribute in Australia without a valid prescription.
Australian survey lead Dr Cheneal Puljevic, from the University of Queensland’s School of Public Health, said researchers wanted a better idea of which performance-enhancing drugs people were using, and whether they had any health-related concerns around them.
“There’s quite a large online black market for steroids … which come with a lot of risks. That’s true for any drug, but especially true when people don’t understand the risks of using steroids [generally],” she said.
The Australian Criminal Intelligence Commission found the number of steroids detected at the border increased by 64 per cent between 2019-20 and 2020-21.
The most recent Australian National Drug Strategy Household Survey found nonmedical anabolic steroid use almost tripled in the 18 years between 2001 and 2019, with men in their mid to late 30s the most common users.
Senior clinical psychologist and head of Monash University Body Image and Eating Disorders Research Associate Professor Gemma Sharp described the increase as concerning, especially among young people with muscle dysmorphia – a body-image disorder that often coincides with an eating disorder.
“Unfortunately, many users don’t see it as problematic or linked to an eating disorder – even if the person is eating a very limited range of food. With wider usage, there’s a bit of normalisation seemingly as with [weight loss injectable drug] Ozempic too,” she said.
She said seeing other men with highly defined or “ripped” muscles in real life, in action movies, and on social media created a false sense of comparison about normal muscle mass, which can lead to body dysmorphia and steroid abuse.
“There’s the idea that, ‘all my friends are doing it, and I just want to get ripped’,” she said.
Eating disorder charity Butterfly Foundation’s most recent youth survey found more than 90 per cent of 12 to 18-year-olds reported some level of body-image concern, with two-thirds of men and women reporting they wanted to be more muscular.
Royal Australian College of General Practitioners Addiction Special Interest Group chair Dr Hester Wilson said there was a lack of information about anabolic steroid users, as they were not likely to see their use as problematic or seek medical help.
Users were also likely to source the drugs from the gym, personal trainers or friends, meaning they were unlikely to interact with the healthcare system.
“There’s a need for GPs to be upskilled so they can approach it and ask about use in a non-judgmental way,” she said.
New data on how people use anabolic steroids would be useful, she said, for GPs to research the drug details and provide evidence-based advice on the risks, and how to use them most safely.
“From there, we can have a conversation about why someone is using it and what they’re looking for,” she said.
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