Performance-enhancing Drugs and Body Image

Debate between Dan Poulter and Neil O'Brien

Tuesday 21st February 2023 Westminster Hall

[The Parliamentary Under-Secretary of State for Health and Social Care (Neil O’Brien)]

It is a pleasure to serve under your chairmanship, Mr Mundell, and to listen to my hon. Friend the Member for Bosworth (Dr Evans). I knew as soon as he secured the debate that he would bring us something special, and he did not disappoint—it was a fascinating speech. Without wishing to spoil the impact of my response, there were so many good questions and important ideas in it that I will not be able to bottom all of them out this afternoon, but we should see this as the start of a conversation that I am keen to pursue with him. Likewise, there were many important and interesting observations from other hon. Members, including about the issue of roid rage, which was raised by the hon. Member for Rutherglen and Hamilton West (Margaret Ferrier), and about the position of young men in society, which was raised by my hon. Friend the Member for Don Valley (Nick Fletcher). I was sorry to hear about the tragic case of Matt, which was raised by my hon. Friend the Member for Rochford and Southend East (Sir James Duddridge), and I am sure our hearts go out to his parents and family.

I will touch on the positive steps we took last week in the substance misuse and recovery strategy—the 10-year drugs strategy. My hon. Friend the Member for Bosworth mentioned that the strategy has a heavy focus on alcohol, heroin and crack, and the reasons for that are obvious. Indeed, as part of the launch, I met my hon. Friend the Member for Central Suffolk and North Ipswich (Dr Poulter), who will appreciate that there is a big focus on those drugs because they drive about half of all acquisitive crime. Alcohol is one of the big killers and addictions that causes so many problems. As part of that 10-year drugs strategy, we have created a ministerial working group across Departments of exactly the kind that my hon. Friend the Member for Bosworth talked about creating. There is every reason to look, through that group, at what we can collectively do, particularly on the illegal sale of some of these drugs.

To mention a bit about the strategy, this is a £421 million investment over the next two years to improve the number of recovery and treatment places. Perhaps I can cheekily use this opportunity to thank everyone working in the drug and alcohol treatment sector for all the fantastic work they are already doing, and there are many other things we want to extend out to, which my hon. Friend the Member for Bosworth has raised today.

[Dr Dan Poulter (Central Suffolk and North Ipswich) (Con)]

I draw Members’ attention to my declaration in the Register of Members’ Financial Interests—I am a practising addiction psychiatrist. I thank the Minister for the focus he is bringing to bear on this area and for the fact that the Government have put in place a comprehensive strategy for the next 10 years that focuses on alcohol, crack cocaine and opiate use, which is absolutely the right focus. I also thank him for the fact that the strategy is backed up with substantial investment, which is very much needed and which I am sure will make a big difference over time.

However, we do not have good data collection for steroid misuse. A good way of collecting data about drug use in the general population is through the crime survey for England and Wales. I wonder whether the Minister might be able to take that away from the debate and collect some more robust data to ensure that steroid use is properly captured in that crime survey. Perhaps he might have conversations with colleagues in other Departments because that will give us a much stronger basis to work from, and an evidence base is important in drug and alcohol treatment.

[Neil O’Brien]

My hon. Friend brings huge expertise to the debate. He and my hon. Friend the Member for Bosworth are right that we need better data. Perhaps one route is through the CSEW, as he says. It may be that there are other routes for getting better data on prevalence. There are limits to how much people will report some of these crimes when it is something they are taking, rather than a case of stealing to fund that, but there may be different ways we can get the right data.

In terms of what we know, a small cohort of people—only 0.2% of people aged between 16 and 59—use steroids. However, these individuals, as my hon. Friend and other Members have pointed out, may not be fully aware of the health risks associated with the drug or the impact it can have on their mental or physical health. As Members present certainly know, anabolic steroids are prescription-only medicines that help patients gain weight and rebuild tissues that have become weak because of serious injury or illness—that is their clinical use. These drugs are sometimes taken without medical advice to try to improve muscle mass or athletic performance. Anabolic steroids are a class C drug under the Misuse of Drugs Act 1971. Although it is not illegal to possess them for personal use, possession, importation and exportation are illegal if deemed to be with the intent to supply others. So people who are involved in these issues need to be extremely careful.

Lots of work is under way across multiple Departments on this important issue, and I want to talk about just some of the actions the Government are taking, notwithstanding the need to do more on a range of fronts. The Government are committed to stopping the illegal trade in human medicines. The majority of IPEDs are sold online through illegal trading websites based overseas. The Medicines and Healthcare products Regulatory Agency works with private sector partners to try to reduce the presence of such websites and, with the Home Office Border Force, to intercept and seize medicines entering the UK.

We are also taking action in the Online Safety Bill to prevent criminal activity, including the illegal sale of steroids. The intention is that companies that fail to comply with the Bill when it has been enacted will face stiff financial penalties or, in the most serious cases, have their sites blocked by the independent regulator, Ofcom. I hope that that addresses some of the concerns about the frightening-sounding websites that the hon. Member for Croydon Central (Sarah Jones) mentioned.

Of course, we know that preventing the trade in steroids is not enough to tackle the problem. As my hon. Friend the Member for Bosworth rightly said, the wider issue lies with the increased prevalence of body dysmorphia and the societal preference for young men to look a particular way. The rise of social media has undoubtedly increased this pressure in recent years, as young people have greater access to platforms promoting often unrealistic and digitally altered body images.

Schools play a really important role in helping young people to make positive choices about their wellbeing through their compulsory relationships, sex and health education curriculum. The Office for Health Improvement and Disparities has worked with the Department for Education to create quality teaching resources for teachers in order to help prevent substance abuse and to address some of the issues with young people feeling that they should look a certain, completely unrealistic. To pick up on some of the horrifying stories that the hon. Member for Croydon Central shared about the young Scouts she met who were all fans of Andrew Tate, that is also something that we need to address in education in schools.

As well as informing students about the risks associated with harmful substances—this goes to the point that my hon. Friend the Member for Bosworth made about harm reduction as well as prevalence reduction—schools have an important duty to protect pupils from harm and to provide mental and physical health support. Through statutory health education, secondary school pupils are taught about the similarities and differences between the online world and the physical world, including how people may curate a particular image of their life online, how information is targeted at them, and how to be a discerning consumer of information online. I am always interested in how we can improve what is taught in schools, because the world facing young people is so different from the world that the generation of people represented here experienced when they were young.

I am proud to highlight that the Government have committed to offer all state schools and colleges a grant to train a senior mental health lead by 2025. That will enable schools to introduce effective, whole-school approaches to mental health and wellbeing. Backed by £10 million in 2022-23, over 8,000 schools and colleges have taken up the offer so far.

We are also taking significant steps to tackle body image issues. On 2 February, the Government responded to the Health and Social Care Committee’s important report on the impact of body image on mental and physical health. We welcomed the Committee’s report and recommendations, and we agree with the Committee that image and performance-enhancing drugs are a significant public health issue. However, we know that prevention is better than cure, and when it comes to harmful substances, it is crucial that we ensure the public have access to sufficient information to inform them of the harms associated with substances such as steroids. The Government-commissioned website Talk to FRANK provides detailed information on the mental and physical health risks of taking steroids, and it is updated on a regular basis.

Additionally, UK Anti-Doping already has an outreach and communication programme that is run in partnership with ukactive, which has been live since 2018. The partnership aims to improve education and awareness around image and performance-enhancing drugs in gyms and leisure centres because, as my hon. Friend the Member for Bosworth rightly pointed out, such places are a focus for these issues. They are the right places to target, and we need to work with sporting bodies, gyms and the like to try to tackle the problems where they are most concentrated.

I draw Members’ attention to the investment that we are making in mental health services. The Government will have invested £2.3 billion a year by 2024 in expanding the services available in England, including for people with body dysmorphic disorder. An additional £54 million is being invested in children and young people’s community eating disorder services in 2022-23. That investment is alongside the development of a major conditions strategy, which will address prevention and treatment for mental ill health, with an aim of producing an interim report in the summer.

I once again thank my hon. Friend for securing this debate on an important issue, and for his many, many ideas. He set out a whole suite of things that we need to be doing. It was a fascinating speech. I commend his work in this area, including his image campaign last year, which achieved national media coverage and will no doubt have had a beneficial impact.

The Government are taking significant steps to protect the mental health of the nation, and particularly young people, and we are ensuring that the right support is in place for those suffering or at risk of body dysmorphic issues. Although a review is not currently planned, the Department of Health and Social Care, the Department for Education and the Department for Digital, Culture, Media and Sport will continue to work closely on tackling the use of anabolic steroids, educating the public on the risks associated with them and ensuring that mental health support is available for all those who need it.