In some areas of the country steroids are thought to be the fastest-growing form of recreational drug abuse. Needle exchanges, established to promote safer practices by heroin addicts, are now reporting a huge increase in clients whose only drug use is injecting steroids. One estimate says there could be as many as 60,000 users in London alone.
As the market expands - and with it the rewards available - the trade in steroids is increasingly moving away from informal deals in gym changing- rooms and is falling into the hands of established dealers of hard drugs. The first pounds 1m seizure of steroids by police has already happened.
At the same time the age of those using these drugs has steadily declined, with teenagers as young as 15 having been known to try them. Fears of discovery or ridicule, and the continuing reluctance by parts of the medical profession to treat them, mean that many have little or no idea about the health risks they are taking.
These range from kidney and liver disorders to an increase in heart disease and the danger of contracting HIV from shared needles.
A series of surveys of GPs in different areas - from Liverpool to Birmingham, Berkshire and Norfolk - show a consistent level of about a third who say they have encountered steroid use. "This is not just a local thing," Pat Lenehan, of the Drugs and Sport Information Service in Liverpool, says. "It is now all over the country, and there are no signs of it slowing down."
A study of needle exchanges in Merseyside and Cheshire for the five years to 1996 showed a 250 per cent increase in the number of steroid users reported at the centres. They accounted for almost a quarter of all drug users in these areas while in north Cheshire, this figure rose to more than a third.
Anecdotal evidence from one scheme in Gateshead tells of a staggering 80 per cent of those using the needle exchange as being on steroids.
Ritchie, from nearby County Durham, is typical of the new kind of recreational user. "It's a fashion thing," he said, cheerfully. "I did it to boost my self- confidence. I was sick of being a 10-stone weakling."
He spends about pounds 65 on a five-week course of steroids, which is a cycle he repeats two or three times a year with about three months between each. Used in conjunction with a gym training programme, he managed to put on three stones of muscle in his first six months on the "gear".
Far from apologising for his habit, Ritchie - who is in his mid-twenties with a wife, children and a job - said that the effects had been "brilliant" and saw no problem with boosting his size in this way.
"Why wait?" he said. "Why wait two years to get to a size that could take you six months?"
Ritchie (not his real name) is a client at the Discus clinic (Drugs in Sport Clinic and Users' Support) which is held every week in Chester-le- Street and funded by Durham Health Authority. It runs a series of health checks for users in a policy of "harm reduction", and counts both serious body builders and casual users among its clientele. It now has about 330 people on its books, built up since it was established at the end of 1994, but is still looking to attract more.
"We seem to have got our message across on the body building scene, and we are now trying to get a mixture of other sports to use it," Dr Rob Dawson, the clinic's resident doctor, said. "Already we have boxers, rugby players, kick-boxers and a footballer. It is widespread."
For the competitive body builders, some have moved on to more and more sophisticated cocktails of drugs to supplement their steroid use and maintain an edge over their rivals. Two of the newest and most worrying kinds encountered by Dawson are bordering on the bizarre.
One is Caverject, an impotence drug normally injected into the penis now used to inflate particular muscle groups. The other is Orimeten - a drug used in the treatment of advanced breast cancer cases.
"And that," Dawson says, "is pretty dangerous stuff."Reuse content