For people who use image and performance enhancing drugs (IPEDs), the risks do not just come from the compounds themselves, but from not knowing what’s really in the products they are using.
From underground to lab: How Steroid Checking is Changing the Game for Harm Reduction
In the world of anabolic steroids, mislabelled and counterfeit substances are everywhere. Globally, over 3.3% of people report using IPEDs [1], but as the market has exploded, often fuelled by online suppliers and social media influencers [2] [3], so has the prevalence of fake or dangerously altered products. In fact, more than two-thirds of IPEDs circulating globally are thought to be misrepresented or substandard [4] [5].
This poses serious health risks. Cardiovascular damage, hormonal disruption, liver toxicity, and psychological harms like depression can all result—not just from expected side effects, but from unintended exposure to potent compounds like trenbolone [6] [7].
Enter: The World’s First Steroid Checking Program
In 2023, Queensland became the first Australian jurisdiction to support state-sanctioned drug checking services [8] [9], including fixed-site and mobile clinics. These services analyse the composition of submitted substances and provide tailored feedback to users—including unexpected contents or contaminants [10].
From this groundwork, the world’s first steroid checking pilot was launched—an ambitious project combining advanced chemical analysis with community engagement.
Steroid checking gives people objective information about what’s actually in their vials, tablets, or powders. It’s not about judgment—it’s about equipping people with knowledge to make safer decisions. With rising concerns about mislabelled compounds like trenbolone, this is becoming a vital harm reduction tool [7] [11] [12].
And it’s working. Check out the largest public library of steroid checking results ever compiled, open to everyone and growing fast: 👉 Steroid Checking Project Results
Want a no-nonsense overview of how to reduce harms from steroid use? 👉 Download the Safer Use Primer
Research Backing It Up
Dr Piatkowski and colleagues have published the results from this world-first pilot, which included lab testing, community feedback, and dissemination of misrepresented product alerts through social media and posters in gyms and clinics [13] [14]:
📘 The World’s First Anabolic-Androgenic Steroid Testing Trial 📘 Community Response to Mislabelled Steroids in Australia
These studies show how testing, when paired with credible outreach, can shift behaviour, boost trust, and even reshape how people think about health in the context of steroid use.
Want to Be Involved?
If you’re someone who uses steroids or supports people who do, Tim’s team is running new surveys right now to shape the next phase of steroid harm reduction: 📝 Take the Survey Here
The Bottom Line? People who use PIEDs want to stay as safe as possible—and when you combine community knowledge with science, real change happens.
Got questions? Want to collaborate? Follow the conversation and help push the future of harm reduction forward.
References
- Sagoe, D., et al. (2014). The global epidemiology of anabolic-androgenic steroid use: A meta-analysis and meta-regression analysis. Annals of Epidemiology, 24(5), 383–398.[↩]
- Cox, L., Gibbs, N., & Turnock, L.A. (2023). Emerging anabolic androgenic steroid markets; the prominence of social media. Drugs: Education, Prevention and Policy, 1–14.[↩]
- Turnock, L., et al. (2023). Big business: The private sector market for image and performance enhancing drug harm reduction in the UK. International Journal of Drug Policy, 122, 104254.[↩]
- Coomber, R., et al. (2014). The supply of steroids and other performance and image enhancing drugs (PIEDs) in one English city. Performance Enhancement & Health, 3(3–4), 135–144.[↩]
- Maghsoudi, N., et al. (2022). Drug checking services for people who use drugs: A systematic review. Addiction, 117(3), 532–544.[↩]
- Zahnow, R., et al. (2017). Adverse effects, health service engagement, and service satisfaction among anabolic androgenic steroid users. Contemporary Drug Problems, 44(1), 69–83.[↩]
- Piatkowski, T.M., Neumann, D.L., & Dunn, M. (2023). ‘My mind pretty much went to mush’: A qualitative exploration of trenbolone in the performance and image enhancing drug community. Drug and Alcohol Review.[↩][↩]
- ABC News. (2023). Queensland government announces pill testing trial at fixed and mobile sites.[↩]
- ABC News. (2024). Queensland to introduce pill testing at Rabbits Eat Lettuce Festival.[↩]
- Barratt, M.J., & Measham, F. (2022). What is drug checking, anyway? Drugs, Habits and Social Policy (ahead of print).[↩]
- Piatkowski, T., et al. (2023). “They sent it away for testing and it was all bunk”: Exploring perspectives on drug checking among steroid consumers in Queensland. International Journal of Drug Policy.[↩]
- Lamb, H., et al. (2024). “I go back to it every f**king time”: The normalization of problematic trenbolone use in online AAS communities. Addiction Research & Theory, 1–7.[↩]
- Piatkowski, T., et al. (2025). The world’s first anabolic-androgenic steroid testing trial. Addiction, 120(7), 1366–1377. https://doi.org/10.1111/add.70009[↩]
- Piatkowski, T., et al. (2025). Development, dissemination, and community response… Drug and Alcohol Review, 0(0), 1–7. https://doi.org/10.1111/dar.14015[↩]