PIEDs: What’s the problem?

People are increasingly using performance and image enhancing drugs (PIEDs) to help them meet their ‘body-image-related goals’. This includes substances such as anabolic-androgenic steroids to increase muscle mass and strength, and the use of weight-loss drugs for fat burning purposes.

Alongside this increase in use, there has been an associated rise in the number of reported health complications [1] associated with the use of performance and image enhancing drugs. While many established harms reported are superficial (e.g. acne, balding), there are more severe physical (e.g. cardiovascular disease and liver function) and psychological (e.g. dependence and mood changes) problems. In addition, many people using PIEDs inject their drugs and are therefore at risk of injecting related harms, such as injection site infections (e.g. swelling and abscesses), and are also vulnerable to infection with blood borne viruses.

Despite the established health risks of PIEDs and the risky behaviours associated with their use, in 2014 the European Commission [2] noted that little research exists on the prevention of recreational PIED use, which impedes the development and implementation of prevention measures and other policy initiatives. The same issues apply for secondary prevention programmes that aim to reduce health harms among current users (harm reduction).

Healthcare professionals in various countries report difficulties engaging with PIED users coupled with a lack of knowledge about these substances. Users are frustrated by this lack of knowledge, and often do not disclose enhancement drug use, turning to their peers or the Internet to obtain information or to seek help, instead of educational programmes or healthcare services. Effective education for healthcare professionals and other stakeholders on performance and image enhancing drugs is therefore urgently needed.

What does the DELTS project offer?

The Doping E-learning Tools (DELTS) project will evaluate the accessibility, usability and utility of several PIED e-learning programs focused on recreational athletes. E-learning tools are cost-effective, easily accessible and provide on-demand learning and scalability to large numbers of stakeholders (e.g. healthcare providers, fitness staff, etc.).

Our project also has the potential to drive clinical outcomes as the e-learning tools are focused on improving best practice in healthcare by offering tailored interventions to provide better health education and counselling. Not only will we test the effectiveness of several prevention programmes, but we will ensure that the evaluation tools can be easily replicated and implemented in different countries in order to improve communication and co-ordination.