Performance & image enhancing drugs

How are PIEDs used?

PIEDs are commonly swallowed, injected under the skin, or rubbed onto the skin.⁸

People who use anabolic steroids may practice: 

• Stacking: Taking different types of steroids at specific doses, to achieve a specific effect. 
• Cycling: Taking periods on and off steroid use, to avoid side effects of use. 
• Blasting and cruising: Taking a higher amount, then lower amount of steroids, to avoid losing muscle or withdrawal symptoms.⁹

There is little evidence that these approaches work. Taking more than one steroid at a time and continuous use, increases the risk of harm.⁹

Effects of PIEDs

Use of any drug can have risks. It’s important to be careful when taking any type of drug. 

PIEDs affect everyone differently, based on:

• size, weight and health
• whether the person is used to taking it
• whether other drugs are taken around the same time
• the amount taken
• the strength of the drug (varies from batch to batch)
• method of use (oral vs injection)
• The type of PIEDs used

Effects may include:

• acne
• hair loss 
• mood and behaviour changes
• joint problems
• high blood pressure
• increased tiredness
• water retention
• numbness of hands and feet
• heart and kidney problems
• liver damage
• changes in sex drive
• shrinking testicles and prostate problems
• changes in menstrual cycle
• developing or shrinking breast tissue
• stunted growth for young people^9,4,10

If PIEDs are injected, there is an increased risk of:

• tetanus
• infection
• vein or skin damage.⁶

If sharing needles with other people, there is an increased risk of:

• Hepatitis B
• Hepatitis C
• HIV.⁸

Many synthetic peptide hormones are experimental or not yet approved for human use, which can cause unpredictable effects.⁴

Overdose

If you take a large amount, of PIEDs, or have a strong batch, you could overdose. Overdose risk, as well as symptoms, will depend on the type of PIED used.

Call an ambulance straight away by dialling triple zero (000) if you, or someone else, has any of the following symptoms:

• sweating
• paleness
• fast heart rate
• feeling faint
• trembling
• blurred vision
• confusion
• seizures.⁵

Ambulance officers do not need to involve the police.

Long-term effects

Regular use of PIEDS may eventually cause:

• heart damage/disease
• liver or kidney damage/disease
• fertility problems 
• infection 
• muscle damage
• mental health conditions.^5-7

PIEDs and mental health

People who use PIEDS may experience muscle dissatisfaction, general lack of interest, anxiety, depression, fatigue, irritability, and aggression. PIEDs use has also been linked to eating disorders and body and muscle dysmorphia.¹

Tolerance and dependence

People can develop a psychological dependence to PIEDs, due it effects on physique and strength, that can result in increased self-esteem and confidence. Some people can also develop a physical tolerance to PIEDs.¹⁰

Mixing PIEDs with other drugs 

Anabolic steroids + stimulants (cocaine/amphetamine): increases risk of heart disease, high blood pressure, aggression, and sleep problems.⁷

Reducing harm

There are ways you can reduce the risk of harm when taking PIEDs:

• Avoid using high doses and take regular breaks to reduce side effects
• Never inject directly into biceps, calf muscles or pecs
• Avoid injecting into same area of body
• Use sterile injecting equipment 
• Don’t share or reuse injecting equipment and dispose of used equipment safely
• Consider getting regular liver and kidney function tests.^9,12

Withdrawal 

Giving up PIEDs after using for a long time is challenging because the body has to get used to functioning without them. 

Withdrawal symptoms and times vary depending on PIED type, but often should settle down after a few days and mostly disappear after 2 weeks.¹³

Symptoms may include:

• low mood
• fatigue and low energy
• trouble sleeping
• decreased appetite
• decreased or loss of sex drive⁵

Getting help

If your use of PIEDs is affecting your health, family, relationships, work, school, financial or other life situations, or you’re concerned about a loved one, you can find help and support.

Call the National Alcohol and Other Drug Hotline on 1800 250 015 for free and confidential advice, information and counselling about alcohol and other drugs

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If you're looking for other information or support options, send us an email at druginfo@adf.org.au