Ten people a week are being banned from WA nightspots as police and bar owners crack down on late night violence and out-of-control behaviour.
Police issued 513 barring notices last year, twice the number of 2012, banning patrons who behaved violently or were disorderly from attending one or more licensed venues for 12 months.
The statistics were revealed as doctors and hospitality bosses gave an insight into how alcohol and drugs contributed to aggressive and violent behaviour.
They also spoke of growing concerns about steroid use, which is on the rise in WA and across the country with seizures by customs at an all-time high.
Australian Hotels Association WA chief executive Bradley Woods said it was frustrating to see crackdowns on alcohol while people continued to use illegal drugs.
"There is a continual, almost epidemic level of rampant use of drugs and steroids that are being purchased online," he said.
"No matter what we do we won't be able to control the impact of these drugs on people's behaviour."
Nightclub owner David Heaton, from Amplifier Capitol and Metropolis Fremantle, said steroid use seemed to be increasing among young men.
"I'm dealing with 20-year-old kids who are 6 foot 2 and 110kg which doesn't seem natural," he said.
"As a rule, increased steroids, increased aggression, increased harm. It is like giving a 14-year-old a weapon."
Mr Heaton said antisocial behaviour had decreased at his venues after he introduced electronic fingerprinting and replaced glass with plastic.
Police barring notices, which were introduced in 2010, had also had an impact.
Supt Jim Migro, from the licensing enforcement division, said police were "embracing" the merit of barring notices and the fact there had been fewer than 12 repeat offenders showed they were working.
Royal Perth Hospital emergency physician Kerry Hoggett sees the consequences of alcohol and drug use every weekend, from hand and head injuries caused by fighting to serious trauma from car accidents.
"In terms of alcohol, it is certainly a lot more now than it was 10 years ago," Dr Hoggett said.
She said alcohol and drugs were a factor in one-third of ED cases and bystander injuries were also more common.
Steroid users were starting to present to ED with side effects, which were often from drugs sold as steroids but contained other chemicals.
RPH head of plastic surgery Mark Duncan-Smith said glassing and bashings were increasing in line with population growth.
"What's more concerning is they are certainly not going down," he said. "We see facial fractures, fractured jaws, punches, hand fractures and reasonably frequently we see stabbings to hands as well as glassings.
Criminologist David Indermaur said Australia's "over- masculinised culture" was partly to blame for a spate of violent attacks across the country.
"We've got ourselves into a bit of a corner with this syndrome of angry young men," he said. "We've celebrated the big masculine man for a long time."