Coaching, testing, and harm reduction: Preliminary thoughts and insights

Tim Piatkowski

It is well established that performance and image enhancing drugs (PIEDs) are effective in increasing muscle mass and strength.


PIEDs are unique in that while harm may result from use, there is no evidence of widespread individual or social harm comparable with other substances [1]. Due in part because the harms from these substances differ substantially to those of other substances, and in part because the motivations underlying the use of these substances differ from those of other substances, research has shown that healthcare professionals lack knowledge about these substances, even those who work in the alcohol and other drugs field [2]. While PIED consumers are concerned about their health and do seek medical advice when experiencing harm [3] they are not the first group that consumers turn to; instead, social networks involving other PIED consumers appear to be more preferred and trusted options – enter coaches.

These established members of the community straddle roles in mentoring and harm reduction. Coaches are uniquely positioned to provide advice around PIED use through mentorship via lived experience. For Australia (and Worldwide) the coaching space has proliferated over social media platforms, in particular Instagram. Coaches do represent a pragmatic solution for harm reduction; however, how is education around harm reduction being furthered for this group? In meeting the needs of the coaches, who have the potential to act as peer-conduits, some of my preliminary data – from discussions with coaches working in this industry – shows us that increasing awareness alongside education and substance literacy may be a viable direction:

[On resources to target PIED users’ needs] I think education to coaches. Because that’s going to be people’s resource most of the time right. Better education to coaches to teach people how to help their clients through harm reduction, telling people about the legalities behind it, teaching coaches about how underground stuff is made, how to test for the quality of things, what to be aware of for women and men um I think could be one of the good ways.


Coaches are particularly well placed to encourage their clients to participate in harm reduction initiatives – such as testing the compounds being used. Testing the quality and reliability of the compounds you are using is one way to reduce harms. I hope continued collaboration can spur more discussion and work in this space, merging research and lived experience together more effectively.



  1. Dunn, M., F.H. McKay, and J. Iversen, Steroid users and the unique challenge they pose to needle and syringe program workers. Drug and alcohol review, 2014. 33(1): p. 71-77.
  2. Piatkowski, T.M., et al., Understanding harm reduction perspectives of performance and image enhancing drug consumers and health care providers. Performance Enhancement & Health, 2022: p. 100223.
  3. Tighe, B., et al., Information sought, information shared: exploring performance and image enhancing drug user-facilitated harm reduction information in online forums. Harm reduction journal, 2017. 14(1): p. 1-9.

Tim Piatkowski is a researcher and lecturer based in Australia. His research fits broadly in the health and wellbeing space, with a focus on sport and applied psychology nested within harm reduction frameworks. He has investigated performance and image enhancing drug use among men and women in Australia. More details and contact information via: or


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