There are believed to be some 100,000 steroid users in Britain, most of whom are not involved in competitive sports.
The death at 38 last week of Florence Griffith-Joyner, the US Olympic champion sprinter, highlighted the issue of sports stars who use performance-enhancing drugs. But the alleged drug-taking of top athletes like Flo-Jo is reckoned to be only the tip of the iceberg.
Although the British government banned steroids in 1986, there is still no strategy that recognises the extent of the physical and psychological health dangers they cause. Only two small drugs projects address the problem in the UK.
Mark Harrison is the nurse who co-ordinates a specialist clinic in Durham which deals with the effects of anabolic steroids. (The other clinic is in Eltham, South-east London.) He said: "There is a real need for services around the country. The health authorities must take responsibility. The steroid users are crying out for help."
Mr Harrison's Discus clinic (Drugs in Sport Clinic & Users' Support) is held weekly in Chester-le-Street and 330 people, 20 of whom are women, addicted to steroids and other performance drugs, attend it. They use its medical, counselling and advice service and needle exchange. Their ages range from 15 to 68.
Some are competition bodybuilders, others, "need to look big" because of their occupation, such as club doormen, but most "just want to look good", according to Mr Harrison.
The obsession to build the perfect body and attain the confidence that comes with it results in the steroid user becoming psychologically addicted, said Mr Harrison. Abusers risk numerous health problems, including kidney and liver disorder, heart disease and exposure to HIV through sharing needles. Some coming off the drugs have suffered acute depression and have even, in extreme cases, become suicidal.
"They feel they have lost everything. Though they still might be massive, they don't feel good about themselves without the steroids," said Mr Harrison. The Americans have dubbed it "Biggerexia".
Although many of the men and women he worked with appeared all-powerful they were haunted by the nightmarish consequences of their obsession to create a perfect body.
"They live in fear," he added. "They are concerned about their health and that they are risking their lives for their looks."
The most well-known side-effect in men is aggression - or "roid rage". A study by the Liverpool-based Drugs in Sport Information Service found that 20 per cent of steroid users said they had experienced urges to harm others. Pat Lenehan, who works for the service, said that despite the 1996 ban, steroids were widely available on a thriving black market.
In March, police seized 400,000 vials of injectable steroids worth pounds 1m at a warehouse in Newcastle. "The Government passed the law but they did not follow through with a policy," said Mr Lenehan. "Steroid abuse is an important public health issue."
Steroids, popular in the ultra-macho working-class communities, also are in heavy demand in the gay community, said Mr Lenehan. "Muscle Mandies", muscular gay men who form their own sub-culture within the gay scene are using them extensively.
Athlete Jane Flemming, who came seventh in the Heptathlon in the Seoul Olympic Games, believes the death of Flo-Jo has sounded a warning. "The news is shocking. I think it is a wake-up call. There'll be a lot of people rushing to their doctors today."Reuse content