Injecting human growth hormone as a performance-enhancing drug—perspectives from the United Kingdom

Injectable human growth hormone has been used as a performance-enhancing drug in the United Kingdom since at least the mid-1980s. However, because of its prohibitive cost and limited supply it was initially restricted to a relatively small number of people. More recently data suggest that there has been a large increase in the use of the hormone within some sections of the general population. Here the hormone is usually taken as part of a high-dose polydrug regimen (which includes multiple types of anabolic steroids) predominately to enhance physique and/or bodily aesthetics. However, detailed systematic studies of the cultural diffusion of this drug (including the motivations for use, prevalence, patterns of use, and supply network) are lacking. Moreover, questions about growth hormone's efficacy, effectiveness, and safety (including risks from injecting and the use of adulterated products) when used as a performance-enhancing drug remain largely unanswered. This article reviews the data that are available on the self-directed use of growth hormone in the United Kingdom and the associated risks to individual and public health.