„Performance enhancement drugs“: myths, facts, and what to do

Disclaimer: This article is for educational purposes only. It does not provide medical diagnosis, treatment, or individualized advice. Laws and anti‑doping rules vary by country and sport. Always consult a qualified healthcare professional and follow applicable regulations.

Key takeaways (TL;DR)

• “Performance enhancement drugs” (PEDs) include a wide range of substances with very different risks and legal status.
• Benefits are often overstated; harms—especially cardiovascular, hormonal, and mental health risks—are underplayed.
• Testing and regulation lag behind use; “undetectable” claims are unreliable.
• Non‑drug strategies (training, sleep, nutrition, mental skills) deliver most performance gains for most people.
• If someone is considering or already using PEDs, harm‑reduction and medical monitoring matter.

Myths and facts

Myth: Performance enhancement drugs are only used by elite athletes.

Fact: Use spans competitive sports, fitness, aesthetics, cognitive work, and even recreational settings. Surveys suggest non‑elite use is common, though exact prevalence is uncertain.

Why people think so: Media coverage focuses on professional doping scandals.

Practical action: If you coach or lead programs, include education that speaks to gym‑goers and students—not only elite athletes. See our prevention and education resources.

Myth: If a substance is prescribed, it’s safe to use for performance.

Fact: Safety depends on indication, dose, duration, and supervision. Off‑label or non‑medical use can carry substantial risk.

Why people think so: “Doctor‑approved” sounds reassuring.

Practical action: Discuss goals with a clinician and ask about non‑drug alternatives and monitoring plans.

Myth: Anabolic steroids always deliver dramatic, permanent gains.

Fact: Gains vary widely and may regress after stopping; adverse effects can persist. Long‑term outcomes are unpredictable.

Why people think so: Transformation stories and selective before‑after photos.

Practical action: Set realistic expectations and prioritize sustainable training and recovery programs.

Myth: New “designer” PEDs are undetectable and therefore safer.

Fact: Detection methods evolve, and “undetectable” claims are often marketing. Safety data are usually limited.

Why people think so: Online forums and vendor claims.

Practical action: Assume unknown risk with novel compounds; avoid products without robust safety evidence.

Myth: Stimulants only improve focus without physical risk.

Fact: Stimulants can affect heart rhythm, blood pressure, sleep, and anxiety—especially with misuse or stacking.

Why people think so: Widespread caffeine use blurs risk perception.

Practical action: Optimize sleep, workload, and time‑management before considering any stimulant approach.

Myth: Hormone boosters sold as supplements are harmless.

Fact: Supplements vary in quality; some contain undisclosed ingredients or interact with medications.

Why people think so: “Natural” labeling implies safety.

Practical action: Choose third‑party tested supplements and disclose all products to your clinician.

Myth: Blood manipulation techniques are only risky in competition.

Fact: Risks (clotting, infection) exist regardless of setting and can be severe.

Why people think so: Focus on anti‑doping rules rather than health outcomes.

Practical action: Emphasize endurance gains through training periodization and altitude exposure under professional guidance.

Myth: Everyone responds the same way to PEDs.

Fact: Genetics, sex, age, health status, and co‑use drive highly variable responses and risks.

Why people think so: Anecdotes substitute for data.

Practical action: Avoid comparisons; tailor goals and track well‑being markers over time.

Myth: Stopping PEDs is always easy.

Fact: Some users experience withdrawal symptoms or hormonal disruption; support may be needed.

Why people think so: Underreporting of difficulties.

Practical action: Seek medical advice for tapering and recovery support. Learn more in our support measures guide.

Statement	Evidence level	Comment
Anabolic agents can increase muscle mass	Moderate–High	Short‑term gains documented; long‑term safety varies
Stimulants improve endurance	Low–Moderate	Effects context‑dependent; risk increases with misuse
Many supplements are contaminated	Moderate	Third‑party testing reduces but doesn’t eliminate risk
Non‑drug strategies yield most gains	High	Training, sleep, nutrition have strong evidence

Safety: when you cannot wait

• Chest pain, fainting, or severe shortness of breath
• New severe headaches or visual changes
• Uncontrolled anxiety, agitation, or mood swings
• Signs of infection (fever, redness, swelling)
• Jaundice or dark urine
• Thoughts of self‑harm

FAQ

Are all PEDs illegal? No. Legality depends on substance, country, and sport regulations.

Can testing miss some substances? Yes, but detection improves continually; relying on “undetectable” claims is risky.

Do PEDs guarantee better performance? No. Benefits vary and can be offset by side effects.

What about cognitive enhancers? Evidence is mixed; sleep and workload management often outperform drugs.

How can I reduce risk if someone won’t stop? Encourage medical supervision, honest disclosure, and harm‑reduction education.

Are supplements safer than drugs? Not necessarily; quality and contamination vary.

Sources

• World Anti‑Doping Agency (WADA): https://www.wada-ama.org
• CDC – Anabolic Steroid Misuse: https://www.cdc.gov
• NIH Office of Dietary Supplements: https://ods.od.nih.gov
• European Medicines Agency (EMA): https://www.ema.europa.eu
• UpToDate (patient education summaries): https://www.uptodate.com

For programmatic approaches and screening tools, explore our screening overview and training program basics.