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Prevalence and effects of performance enhancing drugs in different groups: lessons for a preventive and curative policy in Belgium (PREVPED)

Research project DR/87 (Research action DR)

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Performance enhancing drugs (PED) are used to enhance physical and cognitive performances. This entails nutritional supplements and vitamins, but also hormones or anabolic steroids. The use of these drugs was long limited to sports, but nowadays there is proof that PED are used in various settings. For example, amateur sports, prisons, work environments, and student life. Because of its widespread use, PED are dangerous to public health. As such, policy makers are currently spending more attention to the phenomenon. At the same time, more and more scientific studies on PED are being conducted.

PED-use in the general population
Researchers started a study on PED-use under the supervision of prof. dr. Wim Hardyns, at Ghent University, KU Leuven, and the University of Lausanne, in February 2019. The study’s aim was to research potential risk factors for PED-use in the general population. The researchers focused on three contexts with an increased risk: prison, sports, and work environment, with special attention to the hospitality and transport industry.
The first part of the research project focusses on the existing knowledge regarding PED in- and outside Belgium. By means of the existing literature, the researchers mapped the worldwide prevalence of PED-use. The researchers also looked into the motives for PED-use and the effects of PED-use on the user’s physical and mental health.
The second part zooms in on the Belgian population. By means of a representative population survey (n=1,753), the researchers tried to get a general idea of the prevalence of PED within the Belgian population. Data collection was performed in October and November 2018 as part of the project Social Capital in Neighborhoods (SCAN).

Fitness, a high risk for PED-use?
The research project’s third part focusses on fitness, prisons, and work environment. The prevalence of PED-use in the fitness world was mapped by means of an online survey aimed at Belgian fitness practitioners. The questions enquired about the respondent’s fitness profile, the use of nutritional supplements and vitamins, the use of anabolic steroids, the motives behind the use of anabolic steroids, and the attitude with regard to doping. The online survey was distributed on fitness.be, the trade association for the fitness and wellness industry. They stimulated managers and fitness centre owners to distribute the survey among their members. The survey was also distributed through bodybuilding fora and the research project’s Facebook page. This way, the researches were able to reach a total of 1,706 fitness practitioners.

In addition, the researchers organised focus groups with practitioners, fitness centre managers, and anabolic steroid users. One focus group was organised in Flanders, one in Brussels, and one in Wallonia.

Work and prison
The risk of PED-use is believed to be higher for people detained in prisons and employees of the hospitality and transport industry.
Regarding the work environment, the researchers developed a survey aimed at employees of the hospitality and transport industry. The questionnaire’s link was distributed through websites of employers and trade unions, and via social media. The researchers also organised focus groups with stakeholders from both sectors.
Regarding the prison system, one prison per region (gewest) was included in the research. In the Flemish prison, 50 detainees answered the questionnaire. They responded to questions on the use of fitness provisions, and steroid use. After then, a focus group was organised with detainees who had used anabolic steroids before or during their detention. The researchers used participant observations in both the prisons in Brussels and Wallonia. They conducted individual interviews with detainees who had already used anabolic steroids. In both prisons, the researchers also organised a focus group.

Origin of PED and assistance
In the fourth part of the research project, the researchers studied the origin of the products being dealt on the Belgian market. For this reason, an in-depth interview was conducted with an expert specialised in drug trafficking and drug markets in Belgium. The researchers also analysed the databases regarding seizures of postal shipments by customs, the police, and the Federal Agency for Medicines and Health Products (Federaal Agentschap voor Geneesmiddelen en Gezondheidsproducten).

The fifth part of the research project aimed at mapping the current care provisions in Flanders, Brussels and Wallonia. Included herein are first care assistance, specialists and aid organisations dealing with alcohol and drugs. The researchers examined if these caregivers provide specific information and customised care for employees, detainees, and fitness practitioners. As such, the researchers could identify potential shortcomings in care provision. For this part, the researchers used a survey distributed among general practitioners, sports medicine doctors, occupational physicians of the Internal and External Services for Prevention and Protection at work, caregivers in the specialised alcohol and drug sector, and caregivers in prisons.

In the sixth and final part, recommendations were made, based on the previous research activities. These recommendations are aimed at sensitising users, prevention workers and caregivers about the phenomenon of PED-use.

Documentation :


  • DR/87 on the Drugs website

    Prevalence and effects of performance enhancing drugs in different groups: lessons for a preventive and curative policy in Belgium (PREVPED): final report 2020  Lambrechts, Clio - Boets, Isabelle - Mendes Fonseca, Diana ... et al.  Brussels : Belgian Science Policy, 2020 (SP2938)
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    Prevalence and effects of performance enhancing drugs in different groups: lessons for a preventive and curative policy in Belgium (PREVPED): summary 2020  Lambrechts, Clio - Boets, Isabelle - Mendes Fonseca, Diana ... et al.  Brussels : Belgian Science Policy, 2020 (SP2939)
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    Prevalence and effects of performance enhancing drugs in different groups: lessons for a preventive and curative policy in Belgium (PREVPED): samenvatting  Lambrechts, Clio - Boets, Isabelle - Mendes Fonseca, Diana ... et al.  Brussel : Federaal Wetenschapsbeleid, 2020 (SP2940)
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    Prevalence and effects of performance enhancing drugs in different groups: lessons for a preventive and curative policy in Belgium (PREVPED) : résumé  Lambrechts, Clio - Boets, Isabelle - Mendes Fonseca, Diana ... et al.  Bruxelles : Politique scientifique fédérale, 2020 (SP2941)
    [To download