The Drug Trends program is an internationally renowned system that NDARC has coordinated since 1996. The program is key to identifying emerging problems in substance use in Australia and providing impetus for policy responses and intervention. Drug Trends is funded by the Australian Government under the Drug and Alcohol Program.

This bulletin aims to examine: i) the proportion of Tasmanian NSP transactions related to performance and image enhancing drug (PIED) use between 1 July 2019 and 24 June 2026, overall and by region; and ii) differences in the age and gender profiles of clients accessing injecting equipment for PIEDs versus other drugs.

Key findings

• PIED-related NSP transactions more than tripled between 2019 and 2026, accounting for 12.2% of all transactions in the first half of 2026.
• There were, however, geographical differences, with PIED-related transactions most common in Tasmania's North region.
• Clients accessing equipment for PIED use were more likely to be male and younger than those accessing equipment for opioid or stimulant use.

Discussion

It is clear that there has been an abrupt increase in attendances at NSPs in Tasmania to access equipment for peptides and other PIEDs, particularly since Q3, 2025. This is rapidly escalating (by 1.5-2% of transactions per quarter currently), and represents 12% of all transactions statewide – and more than one in five in some regions.

In challenging financial circumstances, this increase in transactions has the potential to substantially impact on the ability of NSPs to respond to this new group of clients. There have been previous debates in the Australian literature about the response to increased service demand for PIEDs. These papers have reported that people accessing NSP for PIEDs have extremely low rates of receptive needle syringe sharing and hence have low risks for blood-borne virus transmission, and also require relatively greater amounts of injecting equipment than other NSP clients. It is important to note that this does not infer that there should be any restriction on access to sterile equipment for PIEDs consumers, as there are important health and equity issues at play. Qualitative studies have shown that NSP workers may feel less well informed about the substances being used by PIEDs clients or the best options for equipment, with these issues and demographic differences impacting the degree of rapport workers could build with clients. Similarly, interviews with those who use PIEDs accessing NSPs for equipment has indicated that they have distinct service needs (e.g., opening hours) and preferences for peer roles in these agencies.

These studies were conducted in the context of a much lower, and stable, proportion of NSP clients accessing equipment for PIEDs. NSPs are also currently reporting supply issues for the very type of injecting equipment most appropriate for peptide administration, which are also in demand among those using drugs intravenously (such as methamphetamine). Given the rapidly expanding interest in peptides, as well as very disparate reasons for use (e.g., anti-ageing and cosmetic rather than primarily muscle-growth) and hence likely new demographic subgroups accessing services for equipment, it would be timely to review NSP funding requirements, equipment access approaches, and training needs for NSP workers.

Read the full bulletin

Recommended citation

Bruno R, Radke S, Briggs, M. Trends in Performance and Image Enhancing Drug use among a sample of people who access Needle and Syringe Programs in Tasmania, 2019-2026. Drug Trends Bulletin Series. Sydney: National Drug and Alcohol Research Centre, UNSW Sydney; 2026. Available from: https://doi.org/10.26190/unsworks/32527

Funding and copyright

Drug Trends is supported by funding from the Australian Government Department of Health, Disability and Ageing under the Drug and Alcohol Program.

©NDARC, UNSW SYDNEY 2026 

This work is copyright. You may download, display, print and reproduce this material in unaltered form only (retaining this notice) for your personal, non-commercial use or use within your organisation. All other rights are reserved. Requests and enquiries concerning reproduction and rights should be addressed to the information manager, NDARC, UNSW Sydney, NSW 2052, Australia via drugtrends@unsw.edu.au.

Download this resource

• Trends in Performance and Image Enhancing Drug use among a sample of people who access Needle and Syringe Programs in Tasmania, 2019-2026

Contact

For further information, contact Raimondo Bruno at raimondo.bruno@utas.edu.au