Abstract
Aim: The aim of the paper was to identify changes in the extent and patterns of anabolic steroid use in the United Kingdom to better understand the public health implications within the context of the current health-related evidence base. Methods: Using the two time points between 1995 (prior to legislation changes in the United Kingdom) and 2015, a review of the evidence related to health harms was conducted, in conjunction with needle and syringe programme (NSP) data in Cheshire & Merseyside (UK) relating to anabolic steroid users. Findings: Dramatic increase in the number of anabolic steroid users accessing NSPs, 553 in 1995 to 2446 in 2015, now accounting for 54.9% of clients. With the inclusion of pharmacy NSPs, this rose to 5336 individual anabolic steroid users. Conclusions: Key changes in our knowledge during the 20 years, in particular, in relation to HIV prevalence, changes in the market and patterns of use make anabolic steroid use a public health concern. In the context of increasing numbers of injectors, there is a need for comprehensive interventions.
Acknowledgements
We thank the Staff at the Public Health Institute, LJMU, in particular Mark Whitfield and Howard Reed for preparation of needle and syringe data for 2015, Geoff Bates for literature retrieval and Jen Lovelady for proof reading the final manuscript. We would also like to thank contributing agencies to the NSP monitoring systems in Cheshire and Merseyside.
Declaration of interest
The authors do not have any conflict of interest to declare.