I have hesitated to talk in terms of ‘epidemics’ and ‘timebombs’ when writing about anabolic steroid abuse – but maybe I’ve been too cautious.
In avoiding emotive language, I’ve been mindful that – although NHS Choices warns steroid users they risk high blood pressure, heart attacks and strokes – the Government’s Advisory Council on the Misuse of Drugs acknowledges more research is needed to establish the link conclusively.
But how much longer can we wait? There comes a point when the anecdotal evidence is so overwhelming that it would be wrong not to use much starker language.
The latest examples of the seriousness of the situation came in a piece recently by Guardian journalist Peter Walker, who quoted people working with steroid abusers in Bradford, Manchester and Sheffield talking plainly of an epidemic and warning it is indeed a health timebomb.
In researching for my novel, Over The Line, I spoke to bereaved parents, young people and doctors who similarly left me in no doubt we are heading for disaster.
One GP told me he is already encountering a disproportionate number of cases of heart trouble among former rugby players. So what will happen when that sport’s current generation reach their thirties and forties?
And what health problems will the tens of thousands of teenage boys now using steroids to build ‘perfect’ muscle-toned bodies suffer in middle age?
In Over The Line, Olympic poster girl Megan Tomos is caught up in a drugs controversy when the police reopen their investigation into the steroid-related death of her old school friend, Matt Davies.
Matt’s story is fictional, but it draws from tragic real-life cases. I’m not giving the plot away by saying he was a teenager with low self-esteem who turned to steroid-fuelled body-building to feel better about himself.
At one point, Matt’s father tells Megan: “I couldn’t talk to him. Every time I tried to, it went wrong, and anyway, he needed professional help. It’s like anorexia, you know. Anorexia for boys – that’s what they say.”
In the United States, it is often called Bigorexia and is treated as a body image disorder that makes teenagers feel unable to measure up to their own inflated expectations.
The US campaign to build awareness of the dangers of what they dub APEDs – Appearance and Performance Enhancing Drugs – is led by the Taylor Hooton Foundation (THF), named in memory of a 17-year-old boy who took his own life in 2003 after using anabolic steroids.
THF’s educational programme has so far been presented directly to almost a million young people, coaches, parents and other adult influencers at high schools and universities. Donate $25 and you get an All Me PED Free T shirt.
In Britain, however, there has tended to be much more focus on the issue of steroids as a form of cheating in sport. The coverage of the current controversy surrounding Mo Farah and his coach Alberto Salazar has hardly touched on the question of the health risks.
And some would say why should we care about the well-being of people who use steroids to pursue the glory and wealth that goes with sporting success? If they want to take that risk, let them.
But what about the message these roles models are sending to young people? And what about the way it adds to the pressure to have an unachievable physique?
The head of the UK anti-doping agency warned recently that the glamour of the Rugby World Cup this autumn could tempt some youngsters to take banned substances in a desperate attempt to emulate their heroes by becoming bigger, stronger and faster. And that applies whatever the sport.
It’s time for this issue to be taken much more seriously. Anabolic steroid abuse is one of the big public health issues of our time, and tackling it needs an equally big investment in research, awareness-raising and counselling.
And, yes, let’s say it: the timebomb is definitely ticking.