A watchdog revealed that healthcare services should do more to help a growing number of young people in Britain who face health risks by injecting steroids or other performance or image enhancing drugs.
Conservative estimates suggest almost 60,000 people aged between 16 and 59 in England and Wales have used anabolic steroids in the last year, according to the National Institute for Health and Care Excellence (NICE).
Many needle and syringe programmes have reported an increase in the number of steroid users, particularly among men aged 18-25, in the last few years, fuelled by increasing pressures to look good, NICE said in a study.
It wants these people to be offered sterile equipment to reduce the spread of blood-borne viruses and infections from contaminated needles.
"Since we last published our guideline on needle and syringe programmes in 2009, we've seen an increase in the use of image and performance enhancing drugs such as anabolic steroids," said Professor Mike Kelly, director of the NICE Centre for Public Health
"We've also heard anecdotal evidence that more teenagers are injecting these drugs too.
"We're updating our guideline to make sure all of these groups of people are considered in the planning and delivery of needle and syringe programmes," Kelly said.
David Rourke of the Arundel Street Project, a needle and syringe programme in Sheffield, said: "We run a weekly clinic for steroid users but we have people coming through the door on a daily basis, with at least seven new clients a week.
"We know there are many more people out there who are not using needle and syringe programmes because this group of users do not see themselves as drug users," he said.
"Traditionally they are more sexually active than users of heroin or crack, so there is more potential for the spread of infections through sex," added Rourke.