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27 December 2014, 10:58 | Updated: 27 December 2014, 11:03
More than 1,400 hospital admissions caused by people taking performance or image-enhancing drugs in the last four years could be the "tip of the iceberg'', the Conservatives have warned.
Figures released by health boards showed that since 2010 there have been 1,424 cases where people were treated in hospital after using substances such as anabolic steroids, caffeine stimulants, diuretics and botox.
There were 373 hospital admissions last year but as some health boards - including both NHS Greater Glasgow and Clyde and NHS Lothian - said they did not hold this information, the real total could be higher.
Of the health boards that did respond, NHS Ayrshire and Arran had most admissions, with 450 over the four years, including 92 last year, while there 449 admissions in the NHS Fife area, including 118 last year.
In contrast, there were just one such hospital admission in NHS Shetland last year, bringing the total there to six over the four years.
Scottish Conservative health spokesman Jackson Carlaw said: "We are seeing a series of new challenges being posed to the NHS by not only legal highs, but drugs used to enhance image and performance.
"The numbers involved are just the tip of the iceberg, there's clearly a much larger problem bubbling away underneath.
"We can't afford to be blindsided by this because so much of our attention is dominated by what we would regard as traditional problem drug users.''
The Tory MSP added: "It's important that both performance and image-enhancing drugs and legal highs form a key part of any future drugs strategy in Scotland.
"As a snapshot, this is extremely concerning and I hope we can take action to see these numbers drop in future years.''
A Scottish Government spokesman conceded that the use of performance and image-enhancing drugs was a "concern'' and added that while ministers were keen for proper regulations to be brought in, the matter is reserved to Westminster.
He said: "The growing use of performance and image-enhancing drugs is of concern.
"This is a matter that is reserved to Westminster and we are keen to see proper regulations of these substances.
"We have made a record investment of over £224 million in frontline drug treatment and support services, with £30.4 million of this provided for frontline drug treatment services and support in 2014-15 alone, ensuring that people have credible and accessible advice on drugs to help them make the right health choices.
"If anyone does experience adverse effects they should seek medical help immediately or discuss the use of such substances with a medical professional before using.''