Performance and image enhancing drugs use in active military personnel and veterans: A contemporary review

The use of performance and image enhancing drugs (PIEDs) among active mili-tary personnel and veterans presents a public health concern. Deeper understanding of PIEDs use in those populations is necessary to understand what underpins their use and provide information to help shape interventions with the aim of reducing impacts on individuals’ health, wellbeing, social circumstances, public perception and, in serving personnel, any wider military performance. A contemporary review was conducted using five academic journal databases, citation searching, and hand searching. Studies were excluded if published prior to 2000 or did not specify PIEDs use. Following this search, 20 studies were identified for review. Findings suggest that anabolic steroids and weight-loss supplements were the most used PIEDs. Image enhancement was mentioned the most as a reason for PIEDs use followed by keeping up with the physical and emotional demands of active duty. Additionally, findings suggested that young, male non-commissioned Army personnel were most likely to use PIEDs. There were clear gaps in the current literature surrounding PIEDs use, as well as an understanding of when service personnel began using PIEDs. Further research should aim to answer these questions.