‘Tom” was in prison when he began taking steroids. For the first eight years of a decade-long sentence he had trained obsessively and eaten properly after purging himself of narcotics, but he found he could not bulk up beyond 11½ stone. He decided he needed help.

“I wanted to be bigger, so two years before I finished my sentence I went on steroids,” says Tom, who had easy access to the drugs. “You don’t get the same kind of buzz you get off heroin or cocaine. It just makes you feel like you’re 13 again, full of testosterone, going through puberty. You’re confident, self-esteem is up, bodywise you look good, your ego is huge – vanity. All that kind of stuff.”

At the beginning he would inject drugs twice a week before going to the prison gym, spending three months on anabolic steroids, then spending three months off them. After leaving prison he decided to stack – meaning he would inject multiple substances, such as trenbolone, a hormone for bulls, and boldenone (aka Equipoise), a hormone for racehorses, together – and often ended up taking as many as a dozen before training. He generally found his steroids online.

When we meet, Tom he is being treated in a psychiatric unit of a Dublin hospital after an episode of “roid rage”. Despite describing himself as a passive, laid-back person, he had found it hard to control his emotions after taking his usual course of performance-enhancing drugs. He lashed out at his partner, hitting her in public, “like you would a man”. After that Tom sought help for his behaviour.

Sixteen days after that incident the last traces of steroids are being washed from his system, and he is undergoing complete hormone-replacement therapy in an attempt to undo years of self-inflicted damage. He has lost four stone since his admission to hospital – he weighed almost 17 stone at the time of the incident – and has a resting heart rate of 124, down from 140 a week earlier.

“It made me quite psychotic and paranoid, which I never thought it would do to me,” he says. “As a result of taking steroids my testicles have gone back into my stomach. It’s like two hot pins sticking there when I go to the toilet. Physically my body is craving testosterone . . . I don’t know how I haven’t had a heart attack. Now I’m hitting a hormonal crash. If you know what depression is, multiply it by 100.”

Tom’s reaction to steroids was extreme, but it provides a cautionary tale for the increasing numbers of young men taking anabolic steroids in Ireland.

Merchants Quay Ireland, which runs one of the largest needle-exchange operations in the capital, says that over the past two years 50 per cent more people – mostly young men between the ages of 18 and 35 – have come to the service for needles and other equipment to inject steroids.

This group, 280 or so strong, now accounts for more than 10 per cent of the men who come to the exchange. They typically take bundles of needles to supply their friends, who prefer not to visit a service that is largely used by homeless drug users.

Indeed, steroid users tend to be in work and have homes. They usually see their habit as eminently healthy, according to Mark Kennedy of Merchants Quay.

Their increasing number is something of a phenomenon, he says, and it’s all about looks. “Pretty much all of these people train very frequently, typically four or five times per week, but their motivation for using [anabolic steroids] is not to win at sport. It is very much aesthetics: it’s to look good.

“You’re trying to cheat, in a way, in that you’re trying to get results very, very quickly, over and above what the human body is capable of in terms of muscle growth.

“These people would maybe view themselves as being very healthy,” says Kennedy. “They wouldn’t fit into your typical image of a chaotic drug user, and they don’t see themselves as such.”

They want so many needles and other supplies that Merchants Quay will soon launch a weekly clinic for them, so that they can visit discreetly and without having to mix with Merchants Quay’s other users.

Workers in needle exchanges across the State talk about a surge in the number of young men using steroids. The problem is hard to quantify exactly, given that younger injectors tend not to visit the exchanges or take up the educational support they offer. The staff say that even seasoned users of their services are alarmed by the number of young men, some of whom are only 16, taking performance-enhancing drugs.

“There’s definitely a huge increase in the Tallaght area of under-20-year-olds using steroids in the gyms,” one project co-ordinator, in southwest Dublin, says.

There is a “culture of unofficial education in the gyms” among steroid users, “telling people how to use them”, the co-ordinator says. But “there’s nothing official getting done” in the gyms, in terms of education. “There’s no scientific education being passed on.”

Although the problem has grown recently, it’s not new. In 2012 and 2013 Tim Murphy was involved in a Cavan-based mobile needle exchange that steroid users came to. It lost its State funding in 2014, and a promised replacement has not yet materialised. Murphy fears for the welfare of the people who used to get clean equipment from the service, which was run by the Ana Liffey Drug Project. “There probably is a big dark figure of HIV and hepatitis-C transmission among injecting steroid users,” he says.

Mark Kennedy says that steroid users are generally safety conscious, but Murphy is less sure. “Heroin users got pretty responsible pretty quickly after needle-exchange services were started. With steroid users I think there’s a lot of ignorance,” he says. “They don’t know what they’re doing. A lot of them don’t understand the risks of blood-borne virus transmission.”

Rachel Conway, who leads Ana Liffey’s team in the midwest, also talks about a surge in steroid activity in her region.

“There’s some people who’ve seen really bad practice in gyms: lads reusing the same needle for weeks at a time, getting abscesses and sores from use,” she says.

“We’ve tried in the last year to get into gyms and to pass around leaflets and posters, but they’re generally not receptive. They generally don’t want to be seen as having that going on in their business.”

The Irish Times asked the HSE about its prevention and education policies for steroid use, but it has not replied.

“James” is a steroid user from Co Laois. He claims to get his fix from a fellow gym enthusiast. “The person who started me off doing them was doing them for years. I put on a stone and a half in about a week and a half, because I was doing this training right and eating right,” says James, who has taken a break from steroids to regulate his weight.

He does not perceive steroid use as a big health hazard. “This thing people are saying, that you get mood swings and all that, I never ever got mood swings. Let’s put it this way: a lad I worked with used to go out at the weekends, and he’d take cocaine, ecstasy tablets and all that, and he’d say to me, ‘Taking steroids is very bad for you.’ ”

“I was eating healthy, I was training every day, and at the weekend I wasn’t drinking or taking drugs,” says James, whose adds that his fellow gym-goers all use performance-enhancing drugs. “If you get into the bodybuilding business there’ll always be someone selling them . . . It’s more than likely they’d be on steroids themselves.”

In Ireland it’s illegal to procure anabolic steroids without a prescription or from anywhere other than a pharmacy. Each year the Health Products Regulatory Authority seizes tens of thousands of illicit tablets and other substances imported from abroad.

Some are easy to buy on the internet, usually from countries with laxer regulations; criminal gangs might also be importing steroids: the Garda recently seized 26,000 tablets in Dublin.

Anabolic steroids are proscribed for a good reason. Many of those available online are not made by pharmaceutical companies and have misleading ingredient labels, according to Mark Kennedy. Others are imported as raw materials and mixed in uncontrolled and potentially unhygienic facilities in Ireland.

He says that side effects can include insomnia, testicular atrophy, the growth of excessive body hair, mood swings, aggression, and liver and heart problems.

“They’re certainly not harmless drugs . . . It really is very risky behaviour,” says Dr Kieran Harkin, a GP who has dealt with steroid users. Most ask for blood tests, to track their hormone levels; Harkin says no.

“What they want and what they need are different things. What they want is someone who will guide them and will be able to prescribe the stuff, and then will give them the maximum amount of drugs that will bring them to peak performance.

“My view on it is that it’s a bit like some fellow banging his hand with a hammer and wanting to get an X-ray every day to see is his thumb broken.”

Although steroids are favoured by people who are obsessed with sculpting the ideal body, they are part of a broader societal dynamic, according to Dr Travis Ryan, a psychologist who has studied body image among young Irish men.

“The muscular ideal is more out there in the media, and men that have different body types that might be more representative of the general population are being shown less and less in mass media,” he says.

Ryan cites advertising that promotes the idea “that having bigger muscles and needing more protein is something that’s necessary”. With buff bodies adorning billboards (and figuring large in reality-TV shows) the world over, body-building foods have become almost as ubiquitous: protein supplements used to be available only from specialist retailers; now protein-based snacks are available in convenience stores, protein bars occupy prime slots at petrol-station tills, and global confectionary brands have rolled out protein versions of their products.

“When the drive for muscularity becomes obsessive,” Ryan says, “it is correlated with men taking supplements and other things that would increase muscles.”

Some have criticised health authorities for being slow to address what is now a mainstream issue, with little in the way of prevention or educational advice about steroids. Tom says that urgent action is needed to curtail some worrying trends. “The young teenagers are taking steroids now, and I don’t think this country is equipped and ready for what’s going on when it comes to steroids,” he says. “When I went to England they were on the ball straight away, but when I came back here there was a two-year waiting list to see an endocrinologist.

If you think that “heroin, crack and cocaine are an epidemic at the moment”, he says, be prepared. In years to come “we are going to have a lot of crazy kids out there on steroids”.