"Peers and social networks are an important component of the performance and image enhancing drug (PIED) community. Past research has demonstrated the importance these networks play in the supply of PIEDS [79], the distribution of injecting equipment [10, 11], and the sharing of advice and information about use [1214]. Information was shared through networks, such as friends or fitness trainers, or physical documents such as fitness magazines, underground steroid manuals, and the scientific literature [15, 16]. Face-to-face interactions followed a strict social protocol that relied heavily on establishing trust and often took place in the public domain, for example in gyms [15, 16]. Links into these networks need to be made; usually some form of friendship is needed to facilitate engagement with the PIED-using community, and a new potential member must demonstrate a level of cultural knowledge to be accepted [8]. Socialisation into the group is an important part of the process [14].

"However, the Internet has shifted the way those who consume substances seek and share information [17]. The Internet allows users to gain information from a large number of people without the need for potentially risky and identifying face-to-face interactions [1, 2]. Peer-led online forums in particular have been identified as common sources of information for PIED users [18] who report accessing Internet forums frequently to anonymously gain specific and detailed responses from other forum members about PIED use [19]. Furthermore, the first-hand information posted by anabolic-androgenic steroid (AAS) ‘veterans’ has been described as highly valued and is a preferred source for some who struggle to find accessible, straightforward information from reputable sources [20].

"As information has shifted to online communities, there has been an increased research focus on the use of online forums by those who engage in substance use. Davey et al. [21] explored the key characteristics of online drug forums, finding that forums can provide users with anonymity, a space to communicate with others who are engaging the same, largely illicit, behaviour that is free from geographical limitations, and a dedicated place to share information with a community of individuals with similar interests. The notion that forums and forum members are a community has similarly been identified by others [6, 22, 23]. Forum members often possess a strong identity and group cohesion, strengthened by a sense of shared experience. Drug-related forums can also function as an avenue for social support, as well as advice mechanisms for crises, such as overdoses. Knowledge exchange, particularly regarding harm reduction practices, is a key feature [6, 23, 24], with users providing what has been described as ‘lay person evaluations’ of the risks and benefits of use [25]."


Tighe B, Dunn M, McKay FH, Piatkowski T. Information sought, information shared: exploring performance and image enhancing drug user-facilitated harm reduction information in online forums. Harm Reduct J. 2017 Jul 21;14(1):48. doi: 10.1186/s12954-017-0176-8. PMID: 28732534; PMCID: PMC5521146.