Steroid use is 'exploding' in Australia — but quitting is a lonely road
SOURCE:ABC Australia|BY:Charmayne Allison
A rising number of Australians are using steroids. But one expert says a lack of knowledge and widespread stigma make it tough to get clinical support.
Working to calm his breathing, George Napper bent down to grip the loaded barbell in front of him.
Just weeks earlier, the powerlifter had been close to death — his body pumped so full of steroids that he suffered a heart attack and was hospitalised.
Yet despite the heart attack and multiple warnings from friends, Mr Napper was only a month out of hospital when he drove to Melbourne to compete in a powerlifting tournament.
"It was an absolutely idiotic decision," he says now.
"Was I really so amped up and so lost on these steroids?"
George Napper was taking high doses of steroids when he had a heart attack. (Supplied: George Napper)
In the days after the competition, Mr Napper had a wake-up call — something had to change.
Over the next year, he worked to wean himself off the steroids that had slowly consumed his life.
But with very little clinical support available, Mr Napper largely relied on his friends at the gym for guidance.
"We've got doctors who will give you all the information on heroin and other drugs," he says.
"Steroids have been around for years — so why don't we have the same level of support for this drug?"
Steroid use is "exploding" in Australia, according to researchers. (Supplied: SAPOL)
No clinical guidelines for quitting steroids
Anabolic androgenic steroids are synthetic drugs that mimic the male hormone testosterone.
The Alcohol and Drug Foundation says they can be used for medical reasons — such as hormone issues — or non-medically to build strength and muscle mass.
Non-medical use of these drugs is illegal in Australia.
Despite this, there has been an "absolute explosion" in the number of Australians taking up steroids in recent years, according to University of Queensland steroid researcher Tim Piatkowski.
Australian drug data shows that in the seven years to 2022-23, there was an almost 40 per cent increase in the rate of Australians who reported ever using steroids.
Border detections recently reached record levels, rising 64 per cent in 2020-21 compared with the previous year.
And yet, the health sector hasn't kept up with this surge in uptake, according to Dr Piatkowski.
Tim Piatkowski says there is a lack of clinical expertise when it comes to steroids. (ABC News: Mark Leonardi)
He says Australia doesn't even have standardised clinical guidelines for how to safely quit or recover from steroids.
"We've got to ask, if people are starting — and we're seeing more of them — at some point you'd think that people should be stopping," he says.
"And we actually don't have anything effective for that."
Cycle or 'blast and cruise'
Mr Napper experimented with steroids in his 20s, resuming use about 15 years later after he was diagnosed with low testosterone — possibly because of his earlier steroid use.
While steroids don't cause physical dependence, the confidence boost they provide can be psychologically addictive, as Mr Napper experienced firsthand.
"I was getting comments from other people, 'You're looking really good,'" he says.
"So I started experimenting with increasing the dosage."
Steroid users often "cycle" doses or "blast and cruise". (Az Cosgrove)
Users often "cycle" doses — using for a period before taking a break to recover in an effort to manage risks.
They can also "blast and cruise" — switching between high and low doses without a full break.
Mr Napper chose the latter, riskier option, but ran "quite high doses" between blasts.
Soon, he started to notice concerning side effects — he was struggling to breathe and could barely sleep because he kept choking under the weight of his heavy, fluid-filled frame.
"Eventually, things do catch up," he says.
Long-term steroid use can lead to cardiovascular issues, poor liver function, kidney failure and mental illness. (ABC News: Mark Leonardi)
'They just shut me down'
While everyone's experience is different, side effects from steroids can include water retention, increased aggression, baldness, severe acne and changes in sex drive.
Men can develop breasts and struggle with infertility — sometimes permanently — while women can experience excessive hair growth and a deepened voice.
Long-term use can lead to more serious impacts, including cardiovascular issues, poor liver function, kidney failure and mental illness.
As Mr Napper's significant steroid use continued, he sought out blood work to check certain health markers.
But while he eventually found a supportive doctor, he says many others responded with judgement.
"They go, 'Oh look, you shouldn't be doing that,'" he says.
"They just shut me down and asked me to leave."
Tim Piatkowski says many steroid users are turning to online forums for advice. (ABC News: Janelle Miles)
Users turning to online forums
Dr Piatkowski says many steroid users like Mr Napper have been told by doctors to "just stop" or "you've done this to yourself".
"That stigma really stops people from having open and transparent discussions," he says.
This can leave them vulnerable to inconsistent, inaccurate or even dangerous advice, he said.
"Some people [appear] to be more focused on short-term health improvements rather than long-term health promotion or longevity," he says.
Quitting steroids can already be a risky process.
Dr Piatkowski says withdrawal symptoms can include severe fatigue, muscle and bone density loss and, most dangerous of all, depression, which can lead to suicidal thoughts.
Many online forums discuss "post cycle therapy" (PCT) — a process of taking other substances after a steroid cycle, such as medications used to treat women's breast cancer, to kickstart recovery.
But while some observational studies suggest PCT could restore natural hormone production and help ease withdrawal symptoms, it isn't a clinically approved or standardised medical treatment.
Dr Piatkowski says it is crucial Australia's health sector does more work in this space, including sharing knowledge with online forums and influencers.
"Options are there," he says.
"We really need to get a robust evidence base going and see what's possible."
George Napper says his battle against steroid addiction was tough, but he now feels a thousand times better. (Supplied: George Napper)
'I'm living that now'
It's been two years since Mr Napper suffered a heart attack and decided something needed to change.
While he has managed to break his addiction to steroids and is now "a thousand times better", he says it wasn't an easy road.
"It's just a nightmare," he says.
"There needs to be more information available, and there needs to be more doctors on board with the pros and cons of using steroids."
Mr Napper says young men still approach him at the gym to ask about steroids, but his instant response is: "Don't."
"If you abuse your body when you're young, you're going to pay for it when you're older," he says.