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Addressing the doping timebomb which has little to do with sport

IT'S more than 25 years since The Herald identified anabolic steroids and human growth hormone as a public health threat.

The issue went far beyond drugs in the sporting arena. This was simply about narcisstic young men wanting to look ripped, showing off their pecs, lats, and biceps in clubs and discos. This was performance enhancement of a different kind – about increasing pulling power.

They pumped iron and injected steroids, even sharing needles. It had reached epidemic proportions. We revealed that the number of needle exchanges in Scottish cities was as great for steroid as for recreational drug use.

Needle exchanges in pharmacies and HIV-Aids harm-reduction clinics did not specify what type of needles had been exchanged: intra-muscular or venous, which would have helped identify whether they were for steroids or recreational substances. They simply recorded needle numbers which led to an assumption that exchanges were by traditional drug-users.

We exposed this as myth because harm reduction workers reported that it was "easy to tell the difference between a heroin or cocaine-user and somebody pumping iron."

The consequence of this simplistic reportage of exchanges meant Scottish Office and UK government data was flawed. Hard drug use seemed significantly greater than in reality. The Home Office used the information to finance and regulate harm-reduction programmes and draw up policies to combat hard drug use.

MPs promised to review legislation, and Sir Menzies Campbell attempted to criminalise possession of steroids without a prescription. But in vain. The suggestion made informally to me was that police dismissed our evidence because it might result in their resources being cut – because we had exposed "real" drug use as being at a much lower level than they wanted their funding sources to believe.

In 1991 we presented further evidence of steroid use away from mainstream sport. Edinburgh-based psychiatrist and weightlifter Dr Doug Williamson infiltrated four clubs in the capital, and told The Herald that a quarter of regular attenders were steroid users. Infamous for a high rate of HIV infection among intravenous drug-users, the city now had serial needle users in its gym culture.

Perhaps as pertinently, Williamson did ground-breaking research on the role of steroids in psychiatric problems.

Among recent murderers identified as steroid users were Raul Moat, Norwegian mass-killer Anders Breivik, and US army sergeant Robert Bales who went on an alleged rampage which resulted in the deaths of 17 Afghan civilians.

It's almost 20 years since Williamson discussed steroid abuse beyond the sporting arena, and in the Journal of Forensic Psychiatry reviewed literature which suggested steroids could cause aggressive behaviour and precipitate mental disorder. He also discussed steroid use as a potential defence in cases of violent crime.

All of the foregoing demonstrates that performance-enhancing drugs are not a sports issue, but a public health one, and has been out there as such for quarter of a century. What is remarkable is that only now are the major agencies taking an interest.

A two-day seminar, Doping as a Public Health Issue, opens in Stockholm on Friday. It's billed as a first, and brings together the IOC, WADA, WHO, Unesco and Interpol. It's the brainchild of an octogenarian Swedish professor, Arne Ljungqvist, the witch-finder general of global anti doping. He has been prime mover in that field for the world athletics governing body and for WADA. He hopes it will serve as a starting point for broader co-operation between national sports and social authorities.

I put it to the seminar organisers that the sub-agenda is to have the issue recognised globally as a public health one – to have it policed by government, rather than the stretched (and frozen) resources of WADA. The organisers acknowledged my question but have yet to respond.

Michele Verroken, head of ethics and anti-doping for UK Sport until 2004, and now in charge of anti-doping in golf and director of Sporting Integrity, is attending the seminar. "It would be interesting if Unesco were to attempt to make steroids a totally controlled substance across the world, and put steroids in a controlled category like cocaine," she says. "Privacy is not regarded as an issue in elite sport, but it is for ordinary mortals. There is a potential minefield down that route."

Verroken has had numerous discussions with UK government. "They were adamant that under no circumstances were we to talk about steroids being a public health issue. 'It's specific to sport,' they told us – this despite all the growing evidence of social recreational use which shows it to be a public health one. I think maybe there is a change in mindset coming, driven by the need for new funding."

Ljungqvist told a UK parliamentary select committee a couple of years ago that the best thing they could do was criminalise steroid posession.

His radical views already have a grip in Scandinavia with attempts to license gyms. Flying squads have surrounded fitness and health clubs to test members – not an attempt to catch sport drug cheats, but simply to police the system.

This smacks of a breach of privacy and human rights. For all that I deplore sports cheats, the majority of these people aren't involved in competitive sport. They are simply part of a culture of image obsession.

Dr Rob Dawson, a Scottish GP based on Tyneside, believes such tactics will simply drive users underground, and insists that Sir Menzies's attempt to criminalise possession, "though well-meaning, would be a public health disaster".

Medical director for the North East Council on addiction and medical officer for the Drugs In Sport Clinic and User's Support, he has worked with the UK Advisory Committee on the Misuse of Drugs. He says steroid users now comprise 43% of Britain's total substance injectors. "But some of that 43% collect packs for fellow club members. If they collect 200 needles, it still registers as just one exchange. The scale of this is huge.

"Most users are ordinary people, getting on with their day-to-day lives; nothing to do with competitive sport. At what stage should the state intervene – possibly compromising harm reduction?"

He suggests little has changed in 25 years. Data on needle exchanges remains largely anecdotal, dependent on honest responses to harm reduction questions about users' preferred substance of abuse. Some exchange directors suggest steroid injectors should not get work packs – surely a recipe for a potential HIV epidemic.

There is a doping timebomb out there which has nothing to do with sport.

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