Performance and image enhancing drugs (PIEDs)

  • insulin
  • thyroxine
  • clenbuterol
  • diuretics
  • human growth hormone
  • steroids
Are PIEDs a problem for you?
Get Help

What are PIEDs?

​PIEDs (Performance and Image Enhancing Drugs) are substances used to improve a person’s physical appearance and/or athletic performance. PIEDs are most commonly used by younger male athletes/body builders who are seeking a variety of effects. 

Some drugs used as PIEDs are prescribed by doctors for other medical conditions, however they can be dangerous when used without proper medical supervision as they can cause serious harms.

Download the PIEDs fact sheet and the anabolic steroids fact sheet

Learn more
Performance and image enhancing drugs (PIEDs)
Performance and image enhancing drugs (PIEDs)



Because PIEDs can come from many different classes of drugs the effects (including side effects and related harms) are very different. Combining multiple PIEDs together increases the chances there will be additional side effects on the body. The risks tend to be similar for both men and women.  

PIEDs are used in different ways, some are injected, while others are taken in tablet form. Injecting carries specific risks such as infection, tetanus and vein or skin damage

Physical effects can include

  • Rapid or irregular heartbeat (Thyroxine, clenbuterol, stimulants)
  • High blood pressure (clenbuterol, stimulants)
  • Heart attacks (stimulants)
  • Enlarged thyroid - goitre (Thyroxine)

Effects can depend on...

What PIEDs do to you depends on how much you use, how often you use, your size and weight, your age and whether you are male or female.

It can also depend on how good your general health is, whether you use PIEDs with other drugs and if there is a family history of health issues such as blood pressure, kidney problems or liver problems etc.

How PIEDs affect your body

Tap a body part to learn more of the effects PIEDs places on your body.

Psychological effects can include

  • anxiety (steriods and thyroxine)
  • paranoia and psychosis (stimulants)
  • increased aggression (steroids)
  • depression (steroids)
  • anger (steroids)
  • mood changes (steroids, stimulants)

General information

Are PIEDs a problem for you?

See full support list
  • The Alcohol & Drug Information Service (ADIS) is a free and confidential counselling helpline for NSW residents with concerns around alcohol and/or drug misuse and is available 24 hours a day, 7 days a week. ADIS is staffed by professional counsellors who provide education, information, counselling, support and referrals to other appropriate services in NSW.

    Are you worried you could be drinking too much or consuming drugs in a way that has become a problem? Are you worried about your friends or family finding out and want to get help quickly and quietly? Are you worried about the drug use of someone close to you – maybe a family member or friend? Maybe you just want to know where someone can get help? 

    ADIS clinicians understand the difficulties of speaking out, seeking help and finding appropriate drug and alcohol treatment, and use their knowledge and experience to assist you and answer questions, such as:

    • How can I cut-down or stop my alcohol or drug use?
    • What help can I get?
    • Do I have to wait long to get help?
    • Can anyone ring ADIS?
    • Who do I talk to when I ring ADIS?
    • Will drug and alcohol treatments be difficult?
    • What is this drug doing to me?
    • What are the short and long term problems that could develop if I continue using?
    • Will ADIS tell anyone that I rang?
    • What can I expect when I ring?
    • Does ADIS record calls?

    You can call ADIS 24 hours a day, 7 days a week on 1800 250 015 or for Sydney Metropolitan 02 8382 1000 or alternatively you can start a Web Chat.

    ADIS Web Chat is available from Monday to Friday 8.30am – 5pm (including public holidays).

    ADIS also has a range of telephone lines offering specialised drug and alcohol information and support to particular groups.

    24 hour support line

    1800 250 015

    More about Alcohol and Drug Information Service (ADIS) NSW
  • The Alcohol & Drug Information Service (ADIS) Web Chat is a live online conversation with a professional counsellor. The service is free, confidential and open to anyone affected by alcohol and other drugs, including people concerned about their own use, or about a family member or friend. Web chat is only available for people living in NSW.

    The service is provided by ADIS at St Vincent's Hospital, in partnership with the NSW Ministry of Health.

    What to expect

    • A counsellor will chat with you about your alcohol or other drug concerns
    • A counsellor can provide a referral or contact information for relevant alcohol and drug services in NSW
    • Our chat is confidential unless you disclose any intention to harm yourself or others.
    • WebChat is provided in English however if you prefer to speak in a language other than English we would be happy to arrange a telephone call with you through the Translating and Interpreting Service (TIS National). Please call the Alcohol and Drug Information Service on 1800 250 015 to arrange this.

    Emergency Assistance

    Call Emergency Services on 000 if you:

    • require urgent medical attention or
    • are in immediate danger or
    • are at risk of harming yourself or someone else.

    Monday to Friday 8.30am – 5pm (including public holidays)

    #;Web Chat

    More about ADIS Web Chat
Your Room > A-Z of Drugs > Performance and image enhancing drugs (PIEDs)