Pumped Up & Dangerous: The Hidden Epidemic Of Steroid Abuse

Editor’s Note: This story originally appeared in Volume III of B.H. Magazine. For access to future issues – including the forthcoming Volume IV – subscribe here.

When Socrates remarked upon how disgraceful it was to grow old without seeing the “beauty and strength” of which our bodies are capable, he couldn’t have possibly imagined the Faustian pact men would eventually sign in blood just to do so. 

A hidden epidemic currently grips the male population: the unfettered desire to become a living god. It’s pushing men beyond the boundaries of medicine, directly into the thorned embrace of unprescribed steroids. 

“I only see them [steroid users] when they get infections or abscesses where they inject,” one Sydney-based emergency doctor, who wished to remain anonymous, told B.H. Magazine.

“They never know what it is specifically that they inject, sometimes not even how much. Only when their last ‘cycle’ was.”

This isn’t a matter of willful ignorance, either.

In 2017, a pharmacology analysis of 1,200 different steroids and ancillary chemicals seized at the Swiss border found less than 20 per cent of the products contained the claimed substance and/or in the respective amount.

Alarming considering the average user is blindly “pinning” themselves with dosages 10-100 times higher than ever contemplated for medicinal use, if ever; and without monitoring their blood work or undertaking post-course therapy, as is recommended with official hormone treatments like testosterone replacement therapy (TRT). 

“There’s no thought process going into it,” said strength and conditioning expert Kev Toonen.

“You look at the adverse effects for a young male, it can shut down your endocrine system. It can shut down your natural hormone production for the rest of your life. It can take away your choice to have children.”

Toonen, a major advocate for chemically supplementing the right way, is uniquely suited to discuss what others have labelled “taboo.” 

The credentialled fitness authority has seen it all during his service in the Australian Special Forces – which included a stint as the SASR’s strength and conditioning coach – and while training elite athletes like the Cronulla Sharks and Sydney Roosters.

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The 45-year-old veteran has also recently begun TRT himself, after a blood test indicated his natural levels had dipped outside the “normal” range. He’s regained mental clarity, motivation to train, and pain relief after the better part of a year. 

“If it’s not being prescribed by a doctor that understands these things, and you’re not getting regular blood work done, then you are shooting in the dark and you’re a f**king idiot. There’s no two ways about it,” adds Toonen. 

“They’re not making this stuff in the pharmacy. You could be injecting Castrol oil and not know. None of it’s being kept in a medical freezer, either. So the chances you’re actually getting something worthwhile is slim.”

People tend to imagine a set of gilded scales, where the promise of bulging biceps, chiselled abs, and sexual currency in the dating market is balanced against the potential for mood swings, hair loss, aggressive acne, shrivelled testicles, erectile dysfunction, and gynecomastia (enlarged breasts).

But as alluded to by Toonen, steroids can exact a far heavier toll than the well-publicised rap sheet outlined above. Ironically, this misguided pursuit to become the very pinnacle of health – and for results that often only appear marginally better than average – can render you worse off than the everyday schlub.  

There’s thickened blood and excessive clotting, which in turn thickens the heart’s walls, and sets a course for malfunction. This pairs not-so delightfully with the failure of other vital organs, like the liver, and damage to the central nervous system.

“Like the reproductive effects, lingering adverse functional effects many years after apparent cessation of androgen abuse may reflect irreversible adverse cardiac effect,” Professor David J. Handelsman, Australia’s first Professor in Reproductive Endocrinology and Andrology, and a world-renowned authority on steroid abuse, wrote in Endocrine Reviews (Volume 42, Issue 4).

There are psychiatric disturbances beyond your garden variety “roid rage” – mania, anxiety, depression, and even cognitive impairment with a documented pipeline to dementia or delirium. Side note: steroid abuse has also been found to noticeably reduce both brain volume and grey matter.

“These may be aggravated features of pre-existing psychopathology and/or confounding effects of intensive weight training that are predisposed to (or are precipitated by) androgen abuse rather than (or in addition to) authentic drug effects,” caveated Professor Handelsman.

There are virtually endless worst-case scenarios, the most gruesome ranging from literally pissing out the tissue from a deteriorated kidney to paralysis (temporary or otherwise). All this before we consider the entirely irreversible prospect of an early death. 

A reliance on black-market enhancers like trenbolone acetate – a compound originally intended for raising heftier cattle – and the increasingly popular selective androgen receptor modulators (SARMS) – experimental medicine without the usual reproductive side effects of steroids, similarly deemed unfit for human consumption – has seen a sharp uptick in the 21st century.

According to the Australian National Drug Strategy Household Survey, non-medical anabolic steroid use nearly tripled between 2001 and 2019, a demographic that now includes 3.2 per cent of all high school boys. That’s 32 individuals per cohort of 1,000, who haven’t even given puberty a chance to finish the job. Globally, it’s estimated that lifetime use within the general population hovers at approximately one to five per cent.

How exactly do you procure anabolic steroids without a prescription? 

Once upon a time, they were almost exclusively distributed through local bodybuilding and drug-taking cultures (the classic cliché of “knowing a guy who knows a guy”). These days, all you have to do is ask.

Supply websites appear as quickly as they’re taken down, like an infallible cyber hydra. Online dispensaries listed in dummy entries of recycling bin directories – on Page 1 of Google in this author’s personal experience – can be reached via WhatsApp or Telegram. Then there are the morally flexible personal trainers with a booming side hustle.

“I reckon 80 to 90 per cent of people get their gear from s**tty PTs. Where the PTs are getting it from, I couldn’t tell you. That’s part of the issue,” says reformed SARMs user Dave*.

“The good and bad thing about ’roids is that if you want them, you can get them,” explains ongoing trenbolone devotee Peter*. “It just depends on what you’re after. Nothing’s really stopping you.”

A rising prevalence has certainly been felt on domestic borders. 

In 2022, there were 9,395 detections of performance and image-enhancing drugs (PIEDs) by the Australian Border Force. In 2023, this number rose to 11,016, and by the end of September 2024, there had already been 8,874 detections. 

“Performance and image-enhancing drugs, such as steroids, are regulated in Australia for very good reasons. They can have serious health impacts,” an agency spokesperson told B.H. 

“Criminals who attempt to import these types of substances should understand, no matter where or how you hide it, the Australian Border Force will detect the concealment and bring you to justice,” they add.

At a time when steroids have never been more readily available, the image-obsessed spectre of social media has reared its ugly head to establish “physique inflation.” Modernity has, in a sense, proven to be the perfect storm. 

A mainstream example of this cultural shift has been demonstrated throughout the evolution of Marvel films.

During the early 2000s, Tobey Maguire in Spider-Man (2002) and Hugh Jackman as Wolverine in X-Men (2000) both flaunted physiques deemed “superhuman.” 

However, in 2024, the actor who prolifically brought Peter Parker to life – while still admirable for a natural or “natty” effort – wouldn’t even be viewed as particularly impressive among the growing swathes of fitness influencers.

Jackman, on the other hand, has been forced to shed an undefined dad bod to become a paragon of unrealistic standards, despite being in his 50s. Supposedly without the aid of PIEDs, though certainly with the full weight of a Disney-owned studio’s resources behind him and all the favourable downlighting in the world. 

“The influencer-wellness sector has got a lot to answer for. They peddle these programs and promise results, and what they’re not disclosing is like, ‘Oh, by the way, I take all this stuff,’” says Toonen. 

“When Liver King was exposed, a bunch of people in my arena were like, ‘Is everyone else that stupid to believe he was just eating raw meat to look like that?’ Anyone who’s been to the gym for five minutes knows that this s**t takes a lot of time.”

If comparison is the thief of joy, then “aesthetics inflation” is embezzlement of the highest order. And almost the entire spectrum of masculinity can feel it in their bones. 

Dr Ben Buchanan, a leading clinical psychologist and adjunct research fellow at Monash University specialising in body dysmorphic disorder, has warned that any sort of comparative thinking can be hijacked by toxicity.

“The contrast between traditional social networks at gyms and the online environment is interesting,” Dr Buchanan tells B.H. 

“You’re not just comparing yourself to the person working out next to you, but all manners of world-class athletes. It’s a weakness of human cognition that we habituate – we get used to seeing particular things, and then compare everything to that.”

“In the same way that somebody could walk into a gym not knowing that it was the sort of place where steroids were frequently used, people inadvertently walk into social media bubbles where that’s subtly endorsed – protein powders and creatine to start with, graduating to illicit substances,” he adds.

In the age of gender equality, we’ve seemingly regressed in this department. Rather than fostering an environment where women are encouraged to feel as well-adjusted about body image as their male counterparts, in a disheartening plot twist, men have simply met the fairer sex somewhere in the middle to exchange tips on water-cutting, calorie deficits, Ozempic dosages, and what have you.

“You can track particular fashions of body types throughout history and I think men are catching up to those body type fashion cycles that have historically been prevalent for women,” says Dr Buchanan.

“My hunch is that it’ll correct as a new cycle kicks off, but it’s hard to predict.”

Synthesised for medicinal purposes, there is no question that steroids have a legitimate place in society. But this perspective may soon face its greatest publicity challenge yet with the Enhanced Games – a controversial reinvention of the Olympics bankrolled by the likes of billionaire PayPal co-founder Peter Thiel. 

Within the realm of athletics, steroids and PEDs/PIEDs have traditionally been viewed with disgust, for the basic reason that they undermine the very spirit of competition: rather than rely on the merits of skills and conditioning, honed over countless hours, with untold levels of dedication and sacrifice, you’re taking a dishonest “shortcut.” 

The Enhanced Games, on the other hand, is of the understanding that steroids alone do not make you a world-beater, and seeks to determine the upper limits of human capabilities at what’s been colloquially dubbed the “Steroid Olympics.” 

“Contemporary drug testing practised in sports today is not necessarily about athlete safety,” says King’s College London clinician and researcher Michael Sagner, a member of the Enhance Games’ scientific and medical advisory board. “It often skews the public perception of fairness and health in competitive sports,” he adds.

“I don’t think Australia is ready to embrace it, even though we know it happens everywhere. It’s going to be seen as cheating,” explains Toonen, who respectfully declined to be involved behind the scenes of the Enhanced Games when approached. “Steroids are only one side of the coin. You can’t just take them and stand there, there is work involved. Lance Armstrong would still be a winner if it was a clean playing field.”

There is a case to be made with Armstrong, who was both a national-level distance swimmer and the no.1 ranked junior Tri-Fed triathlete before he turned to professional cycling. In other words, a freak specimen through and through.

Granted, the astonishing 500-watt output Armstrong sustained while pedalling up mountains in the Tour de France certainly wouldn’t have been possible without chemical assistance. For reference, the average punter hits 100 watts on relatively unchallenging surfaces, whereas pros generate around 400 watts under identical conditions.

And lest we forget, Armstrong wasn’t the sole culprit of doping in professional cycling, simply its poster boy. The seven consecutive Tour de France titles he was stripped of (1999-2005) were officially declared without a winner due to the sheer number of runner-ups who’d committed similar offences. 

This is, however, merely another talking point in an increasingly nebulous conversation obscured by a deafening chorus of dubious health claims. One that will soon need to address actionable harm-prevention measures – like mandatory disclosure of use for fitness advertising – and confront whatever burden long-term steroid abuse may impose upon public healthcare systems already groaning under significant strain.  

“It’s not going to go away, and it’s going to get worse before it gets better,” says Toonen.

We’re only beginning to awaken to what debilitating horrors may lie ahead.

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