Health education and promotion materials on PIED consumption cover a range of topics including safe injecting practices, risks and harms, and the potential side effects of specific compounds and consumption patterns (e.g. ‘cycles’, ‘blasting and cruising’ or continuous use). Although health promotion materials on performance and image-enhancing drugs are relatively limited, below we present Australian and international material designed by government and non-government organisations to inform consumers about PIED use. These include pamphlets, factsheets, booklets, posters and websites. These resources were gathered in June 2018 using Google searches, and include resources and materials published since 2010 and will be updated in six months’ time. Searches were performed through Google’s standard search field using the search terms: ‘performance and image enhancing drug education; ‘performance and image enhancing drug health resources’; ‘steroid(s) education’; ‘steroids health resources’.

Australian health education resources

The materials below display a range of approaches to PIED consumption, however, by far the most common subject matter is safe injecting technique and the potential side effects of performance and image-enhancing drugs.

Title: Steroids: How drugs affect you

Author: Alcohol and Drug Foundation

Publishing details: 2017. Alcohol and Drug Foundation, Victoria.

Type: Factsheet (3 pages in colour: text and image)

Content overview: This factsheet provides information about anabolic steroids, how they work and their potential side effects.

Title: Injecting steroids & other performance & image enhancing drugs

Author: WA Substance Users Association (now Harm Reduction WA, HRWA)

Publishing details: No date. WASUA, Western Australia.

Type: Pamphlet (2 pages in colour: text and images)

Content overview: This pamphlet outlines typical equipment needed to inject performance and image-enhancing drugs and provides information about courses, cycles and potential side effects.

Title: Performance and image enhancing drugs

Author: No author

Publishing details: Last updated in 2018. Alcohol and Drug Foundation, Victoria.

Type: Webpage and printable factsheet (2 pages in B/W: text)

Content overview: This four page printable factsheet describes different kinds of anabolic steroids and discusses why people use performance and image-enhancing drugs and potential harms. It also links to three other topics: performance and image-enhancing drugs and the law, performance and image-enhancing drug statistics and references.

Title: Steroids

Author: No author

Publishing details: No date. The Better Health Channel, Victorian Department of Health and Human Services, Victoria.

Type: Webpage and printable factsheet (3 pages in B/W: text).

Content overview: The content was produced in consultation with and approved by the Australian Drug Foundation and provides a summary of steroids and potential harms associated with use.

Title: Anabolic steroids

Author: NSW Health & St Vincent’s Alcohol & Drug Information Service

Publishing details: 2018. NSW Health, New South Wales.

Type: Webpage

Content overview: Your Room is an online portal providing ‘facts about alcohol and other drugs’ with textual and visual information. The tab on anabolic steroids presents a range of information including cycling and stacking, mixing with other drugs, withdrawal and dependence.

Title: Performance and image enhancing drugs: Factsheet

Author: No author.

Publishing details: 2018. Positive Choices, Australia.

Type: Webpage

Content overview: Positive Choices is an online portal to help teachers and school communities’ access accurate, up-to-date drug education resources and prevention programs.

Title: Performance and image-enhancing drugs: What you need to know 

Author: Larance, B., Jacka, B. in consultation with Lawler, S.,  Grummitt, L.  & Stapinski, L.

Publishing details: 2017. Australian Government Department of Health, ACT.

Type: Booklet (7 pages in colour: text only)

Content overview: This information booklet covers the risks of using performance and image-enhancing drugs, including their health effects, potential for addiction and overdose and legality.

 

Title: Steroids and performance and image enhancing drugs

Author: No author

Publishing details: No date. Drug Aware, Western Australia.

Type: Webpage

Content overview: This webpage provides information about motivations and patterns of use, health effects and risks, mental health, and pregnancy and breast-feeding, as well as other topics.

 

International health education resources

The health education materials, infographics and websites below target people who consume PIEDs, and may be contemplating initiating PIED use. They address a range of topics to inform people in the safe consumption and injection of PIEDs.

Title: Human Enhancement Drugs

Author: No author

Publishing details: No date. Human Enhancement Drugs Network.

Type: Website

Content overview: The goal of the Human Enhancement Drug website is to provide evidence-based information on the growing field of human enhancement drugs. They have collated and developed a range of health materials and educational videos and reproduced toolkits produced by a number of organisations. Below are a range of pamphlets and posters intended to assist health care providers and people who consume enhancement drugs in obtaining information on all types of human enhancement drugs.

Infographics

The following infographics are available on the Human Enhancement Drugs website.

Title: A typology of male steroid users and their risks

Reference: Christiansen, AV., Vinther, AS. & Liokaftos, D. (2016). Outline of a typology of men’s use of anabolic androgenic steroids in fitness and strength training environments. Drugs: Education, Prevention and Policy, 24(3), 295-305.

Content overview: An infographic proposing a typology of male steroid users and the purported risks associated with each ‘type’ of consumer.

Title: Stigmatisation of steroid users

References: Murray, SB., Griffiths, S., Mond, JM., Kean, J. & Blashill, AJ. (2016). Anabolic steroid use and body image psychopathology in men: Delineating between appearance-versus performance-driven motivations. Drug and Alcohol Dependence, 165, 198-202.

Yu, J., Hildebrandt, T. & Lanzieri, N. (2015). Healthcare professionals’ stigmatization of men with anabolic androgenic steroid use and eating disorders. Body Image, 15, 49-53.

Content overview: An infographic explaining the many ways in which steroid use and people who use steroids are stigmatised.

Title: Do you even supplement?

Reference: Kreider, RB., Wilborn, CD., Taylor, L., Campbell, B., Almada, AL., Collins, R. … & Kerksick, C. (2010). International Sports and Science Nutrition exercise and sport nutrition review: Research and recommendations. Journal of the International Society of Sports Nutrition, 7(1), 7.

Content overview: An infographic exploring the research on supplement use and their effectiveness.

Title: Adverse effects

References: Pope Jr, Harrison G., et al. Adverse health consequences of performance-enhancing drugs: an Endocrine Society scientific statement. Endocrine Reviews 35.3 (2013): 341-375.

Llewellyn, W. (2010). Underground anabolics. Molecular Nutrition, Jupiter, Florida.

Content overview: An infographic presenting some of the ‘adverse events’ associated with steroid use.

Title: Peer networks

Reference: Kimergård, A. (2015). A qualitative study of anabolic steroid use amongst gym users in the United Kingdom: Motives, beliefs and experiences. Journal of Substance Use, 20(4), 288-294.

Sagoe, D., Molde, H., Andreassen, CS., Torsheim, T. & Pallesen, S. (2014). The global epidemiology of anabolic-androgenic steroid use: A meta-analysis and meta-regression analysis. Annals of Epidemiology, 24(5), 383-398.

Content overview: An infographic exploring how peer networks provide education and harm reduction.

Title: Key periods for adoption of steroid use within bodybuilding/fitness

References: Boardley, ID., Grix, J. & Dewar, AJ. (2014). Moral disengagement and associated processes in performance-enhancing drug use: A national qualitative investigation. Journal of Sports Sciences, 32(9), 836-844.

Boardley, ID. & Grix, J. (2014). Doping in bodybuilders: A qualitative investigation of facilitative psychosocial processes. Qualitative Research in Sport, Exercise and Health, 6(3), 422-439.

Content overview: This infographic explores the different motivations associated with body-building and fitness that might influence the adoption of steroid use.

Title: Reasons for uptake

References: Kimergård, A. (2015). A qualitative study of anabolic steroid use amongst gym users in the United Kingdom: Motives, beliefs and experiences. Journal of Substance Use, 20(4), 288-294.

Sagoe, D., Molde, H., Andreassen, CS., Torsheim, T. & Pallesen, S. (2014). The global epidemiology of anabolic-androgenic steroid use: A meta-analysis and meta-regression analysis. Annals of Epidemiology, 24(5), 383-398.

Content overview: This Infographic describes various motivations that may influence men who use steroids.

Title: Post-cycle therapy (PCT) for steroid users

References: Griffiths, S., Henshaw, R., McKay, FH. & Dunn, M. (2017). Post-cycle therapy for performance and image enhancing drug users: A qualitative investigation. Performance Enhancement and Health, 5(3), 103-107.

Content overview: This infographic explains what post-cycle therapy is, how it is used and the barriers to access that people experience.

Title: Exchange supplies

Author: No author

Publishing details: No date. Exchange supplies, United Kingdom.

Type: Website

Content overview: Exchange Supplies develops products and information for injecting drug users, drug services, and needle exchanges to reduce harm. Their website offers information on steroids and performance enhancing drugs, including booklets, postcards, posters and practitioner’s guides.

Title: Practitioners guide to steroids: Poster

Author: No author

Publisher details: No date. Exchange Supplies, United Kingdom.

Type:  A full colour poster

Content overview: A full colour poster to accompany the Guide to Steroids. The poster covers injectable steroids, oral steroids, aromatase inhibitors and oestrogen modulators, PCT, fat loss and thyroid drugs, growth enhancers and peptides. It also provides a guide to terminology, risks and side effects, needle selection and safe injecting.

Title: Steroids and other drugs used to enhance performance and image

Author: Campbell, J. & Preston, A.

Publisher details: 2017. Exchange Supplies, United Kingdom.

Type: Spiral bound booklet (50 pages in colour: text and images)

Content overview: The book covers information on fitness and building muscle, PIED drugs and routes and administration, risks and harm reduction.

Title: Anabolic Steroids – guide for users & drug workers

Author: Lenehan, P. & Miller, T. This edition is updated by Gary Beeny.

Publisher details: 2015. Exchange Supplies, United Kingdom.

Type: Booklet (56 pages in colour: text and images)

Content overview: This booklet provides detailed information on anabolic steroid use and substances. It also includes a step-by-step guide to intramuscular injection and tips for safer practice.

Title: Injecting anabolic steroids: Step by step visual guide

Author: Kemplay, R.

Publisher details: 2016. Exchange Supplies, United Kingdom.

Type: Booklet (24 pages in colour: text and images)

Content overview: This booklet provides information about the intramuscular injection of anabolic steroids.

Title: Anabolic Steroids hardcore info (3rd edition)

Author: No author

Publisher details: July 2018. Exchange Supplies, United Kingdom.

Type: Booklet (36 pages in colour: text and images)

Content overview: This guide provides information to people who consume steroids about the nature and effects of various steroids and related products.

Title: Anabolic Steroids

Author: No author

Publisher details: 2016. Exchange Supplies, United Kingdom.

Type: Postcard (Two-sided in colour: text and images)

Content overview: This postcard provides information about the effects of steroids and includes tips on safer injecting technique.

Title: Steroidabuse.com

Author: No author

Publisher details: 2018. Association Against Steroid Abuse, United States.

Type: Website

Content overview: The Association Against Steroid Abuse provides information on the negatives effects associated with steroid consumption and performance and image-enhancing drugs.

Title: Steroid campaign

Author: Linnell, M.

Publisher details: 2013. Unknown.

Type: Photographic campaign (images and text)

Content overview: The steroid campaign features images of men who consume performance and image-enhancing drugs alongside key messages for other men who use steroids. The materials were adapted and used by Public Health Wales for a Welsh national campaign.

Title: The S.M.A.R.T Method: For strength and conditioning

Author: HSE Pharmacy Needle Exchange with the assistance of Bellinger, L. & Campbell, J.

Publisher details: No date. Health Service Executive Pharmacy Needle Exchange Program, United Kingdom.

Type: Information booklet (24 pages in colour: text and images)

Content overview: This publication describes nutrition and training required for safe and effective muscle building.

Title: Recovery.org: Steroid addiction and recovery facts

Author: Williams, S.

Publisher details: 2015. Recovery.org., United States.

Type: Webpage

Content overview: This website addresses recovery from a range of substances including steroids.

Title: Image & performance enhancing drugs

Author: No author

Publisher details:  Last updated 2018. Public Health Wales and the Centre for Public Health, Liverpool John Moores University, United Kingdom.

Type: Website

Content overview: The website aims to provide reliable and evidence-based information and advice to reduce the harms associated with use of performance and image-enhancing drugs.