"The Global Commission on Drug Policy recently advised governments to make harm reduction measures, including drug checking services, widely accessible (Bewley-Taylor & Tinasti, 2020; Buxton et al., 2020).
"One of the consequences of drug prohibition is the lack of knowledge regarding the composition and purity of illicit substances (Miron, 2003; Taylor et al., 2016).
"The use of APEDS was common among young males in the current study, and it was more related to the drive for muscularity and sexual orientation than symptoms of EDs. In a large national sample (N = 7401) of college and university students, including both sexes in the US (ages 18–30 years), the lifetime prevalence of the use of protein supplements and creatine was 23.8% and 7.7%, respectively [30].
"Qualitative work from Ip and colleagues examined a sample of female AAS users through web-surveys [32]. Their findings demonstrated that women experience AAS use differently to men and, therefore, may have their own unique needs. More recently, Havnes et al. [33] explored the experiences and harms of women who use AAS. Their study utilised a sample of women (n = 16) aged 18 and above who reported current or past AAS use.
"The desire to achieve a thin physique has stemmed from women’s ideal bodies traditionally being considered ‘thin’ [1]. More recently, the ideal body type for women is changing and social influences (e.g. media) have been promoting athletic female beauty ideals alongside defined and muscular body shapes for women [2, 3].
"Peers and social networks are an important component of the performance and image enhancing drug (PIED) community.
"Stimulants are a class of performance-enhancing substances some bodybuilders use to increase focus, alertness, and energy during their workouts. Some of the most commonly used stimulants in bodybuilding include amphetamines, caffeine, ephedrine, and clenbuterol. These substances are believed to enhance mental and physical performance, reduce fatigue, and improve endurance [25]. While stimulants can provide short-term benefits, their misuse can have serious health consequences.
"Diuretics are drugs that increase the rate of urine production by the kidneys, resulting in a loss of water and electrolytes from the body. In bodybuilding, diuretics are sometimes used to help reduce water retention in the body and promote a more defined and muscular appearance on stage. The use of diuretics in this manner is sometimes referred to as "cutting water weight" [21]. However, the misuse of diuretics can have serious health consequences.
"Insulin is a hormone that plays a crucial role in regulating blood sugar levels. The pancreas produces it, and its primary function is to help cells in the body absorb glucose from the bloodstream, which is then used for energy. In bodybuilding, insulin is often used as a performance-enhancing substance due to its anabolic effects. Insulin stimulates the uptake of amino acids and glucose into muscle cells, promoting muscle growth and repair [16]. However, the misuse of insulin can have serious health consequences.
