The rise of steroid use: Irish men are feeling pressure to get a ripped Love Island body
What's behind the rapid rise in steroid use and why is it so dangerous?
News that a physically fit, sporty adolescent, had died from severe brain-swelling, triggered by a muscle-building steroid, sent shock waves across the country.
Earlier this month, the Coroner for the case said he was satisfied that that the cause of the death of 17-year-old Luke O'Brien-May from Kilmallock, Co Limerick, was linked to the ingestion of the steroid, Stanozolol.
We can never be sure why Luke O'Brien-May decided to take the steroid. But there are growing concerns that, encouraged by the toned, muscular male physiques displayed in hit reality TV shows like Love Island, more and more young men are turning to steroids - not to improve their sporting prowess, but to develop the "ideal" masculine physique as touted by images across social media and TV.
"The use of steroids is growing significantly in this country," warns anti-doping chief Dr Una May, Director of Participation and Ethics at Sport Ireland.
She points to figures released by the Health Products Regulatory Authority, which show it "was recording very significant increases in the number of seizures of steroids" over the past five to 10- years - a sign, she warned, of increasing demand for the drugs in this country.
In April the HPRA revealed that anabolic steroids accounted for almost half (47pc), of the close to one million, highly potent prescription medicines seized in 2017. Of 948,915 dosage units seized last year, 450,000 were anabolic steroids, almost 12 times the amount seized in 2015.
At the time, Director of Compliance, John Lynch expressed concern at the increase in the number of seizures of steroids, which he pointed out had been linked to a range of "significant" side- effects including liver damage, blood clots, heart attacks, and strokes.
"This is very much a public health issue. The use of steroids is very much bigger than sports," says Dr May.
"We believe it is everywhere. Steroids are being taken across the board and a significant motivator is around body image concerns. "There is a definite issue around young males having a concern about body image.
"The research we see shows body image is becoming more of an issue for boys - like girls. Body image seems to be significantly greater concern than sports performance," she observes.
Young men are very self-conscious about their appearance, agrees Jim O'Sullivan, who has run a gym in Cork city for more than two decades.
He has noticed the emergence of "a small but growing number of males who would be into the whole Snapchat, Instagram generational thing. They all want to look a particular way," he said, adding however that in his experience, the majority of youths are not obsessed with how they look and will "just train, have a shower and go home."
O'Sullivan believes that there should be more education around how to train properly, because even at school-level, he said, many sports are now "very competitive:"
"Some of the young fellas in school who are coming in here have diets, strict training nutritional plans and a programme.
"It's like a professional sport and they're only in school," he says, adding that he also has concerns that some sports-mad teenagers seeking faster recovery from injury, could potentially be open to experimenting with steroids because they are unaware of the possible side-effects.
"That can open the door to the problem. Sport has become so ultra-competitive that it can open door into the murky world of enhancement and to 'what can I do to make myself better.'
"A player who could be struggling with an injury might try something like this in order to recover quicker.
"These things can aid recovery and give you a boost and you can feel stronger and faster, but the downside is you don't know what you're taking," adds O'Sullivan.
A 2014 study on steroid use by Merchants Quay Ireland (MQI), the charity which provides support services for drug users and the homeless, found that some users, all male, had begun to take steroids as early as age 16, while others had begun to use the drugs in their late teens.
However, the research also showed that many of those using the drugs said they did so because they simply wanted to look good. They were not taking them in order to win at sports, according to Mark Kennedy Head of Recovery at MQI.
"We have seen people who reported starting on steroids as young as 16," comments Kennedy, who observes that modern children grow up surrounded by images of toned, muscle-bound males such as Action Man and Ken (of Barbie and Ken).
"There are people out there using steroids and the number of seizures of steroids are significantly up. They're coming into Ireland in large quantities," he says.
"Steroids are available and young people are encouraged to use them very early in the game.
"You don't always know where they've come from and there is evidence to suggest that the range of side effects can be very devastating."
The MQI study revealed that side-effects of steroid use can include, increased appetite, increased aggression, growth of excessive body hair, acne , sudden mood changes, insomnia muscle or joint pain, anxiety and depression.
"You'd have concerns about what people are putting into their bodies," Mr Kennedy says.
However, according to GP and TV3 doctor Brian Higgins, the road to actual steroid use is a long one which rarely culminates in the use of steroids before the age of 20.
As a result, he explained, rather than looking for actual signs of steroid use in young teenagers, parents should be on the alert for tell-tale signs that a boy in his mid-to-late teens, for example has started on that journey.
"People do not go from taking nothing to steroids. This is a gradual process," he says. "It's rare you would see teenagers on steroids."
The sheer cost of the drugs is a deterrent for many, he adds, while acknowleding that it was not beyond the bounds of possibility that some teenagers could find the money to purchase such substances.
"They are so expensive that generally teenagers cannot afford them. "When someone is using steroids they can use them in cycles of eight, 12 and 16 weeks, so they need to have enough money to fund them."
The root of the problem, says Dr Higgins, lies in the emergence, often in the mid-teens, of body dysmorphia, which is an intense dissatisfaction with one's physical appearance.
Expectations of the male physique is changing, he warns. "Men feel pressure to look lean and muscular to have big arms, shoulders and chests but low body fat, which, unless you are an athlete, is very difficult to maintain."
A young teenager can start becoming overly body-conscious, putting too much emphasis on his physique and how he looks, he adds.
"Body image is the start of a problem, which can end up with steroid use by a young male in his twenties."
A teenager overly-fixated on their "aesthetic" will often choose activities which focus on "physique development, like weight lifting and body-building," explains Dr Higgins.
Such activities may be quite anti-social as they can involve working out alone in the gym and watching YouTube videos about body building, all of which, he warns are "feeding into their expectation of what they should look like," he says.
However, once the progress from the gym-work inevitably plateaus, he explains, the teenager can become "quite obsessive" about diet and may start spending money on protein supplements.
Next he will often stop enjoying food, which is now perceived as "just fuel" to build and maintain the "aesthetic."
By the late teens, some teenagers will find that even with supplements, their progress has once again start to "plateau off" - and it is then that they may start looking at alternatives, including the use of steroids.
So, what are the signs parents should look for if they are worried that a son or daughter has become overly-concerned about their physique and may be on the road to steroid use?
"Check to see if they are spending a lot of time in the gym," advises Dr Higgins.
"Have they stopped eating the same meals as the rest of the family? Have they become overly obsessed with 'clean eating', for example, consuming only sweet potatoes instead of ordinary potatoes, refusing sauces or eating an exceedingly plain diet?
"Have you noticed that your teen seems to have lost his or her enjoyment in food? Has he or she begun to miss out on social occasions in favour of isolated workouts in the gym?
"Parents can intervene before a child ends up on steroids." Dr Higgins suggests that parents try talking to their teenager about their fixation on their physical appearance.
"Try to encourage your teenager into a healthier or more social hobby," he advises.
"Try to help him or her to eat in a healthier way and to train in a different way, rather than taking it too far."
And remember, he adds, if a young person is becoming fixated on body image it is possibly due to another source of anxiety, such as bullying or insecurity about his or her appearance.
Try to cultivate a relationship with your children where you can sit down and get an idea as to whether they are fixated like this:
"Sometimes it's a phase they go through and they just need a distraction or another social outlet.
"However if you are very worried it might be a good idea to talk to the GP."
How can I talk to my sons about body image?
"There is an awful lot of pressure on a consistent basis, regarding how young men should and shouldn't lead their lives - including a lot of the 'fitness inspiration' content and the use of steroids to bulk up," says Malie Coyne, Clinical Psychologist and NUIG Lecturer.
"This can have a really damaging impact on teenagers whose reasoning brains are still developing and who are very susceptible to peer pressure," she says, and this is particularly the case for those with lower self-esteem and negative self-beliefs. Here's how Dr Coyne suggests your approach you teenager if you have concerns:
• Talking face-to-face rarely works with teenagers. Bringing up things casually as you are sitting side by side (in the car say) works best.
• As much as you can, keep an eye on their social media use and what they are watching on YouTube/TV.
• Look out for any noticeable behaviour changes which you could gently use in your conversation with your son, for example, "I noticed that you seem a bit down lately".
• If you are concerned about your son, broach your worries gently, as you don't want them to close down the communication.
• Take interest in their fitness regime and what they are hoping to achieve with it. Ask what their friends are getting up to etc. • During the course of your fitness talks, you could mention what you have heard about the increased use of steroids amongst teens and ask about their thoughts concerning that.
• Most importantly, try to be compassionate. Try to remember what it was like to be a teenager and the pressure you felt. Your child is possibly just trying to stack up to others and has the added pressure of social media which is seriously tough for them.
Health & Living