ABSTRACT
Chapter 3 explores the scale and scope of PIEDS use. The scope, magnitude and diversity of substance use in sport make its study complex. For example, some substance use is common, benign and even advantageous to health. Such usage includes the infrequent use of painkillers, the moderate consumption of coffee and the liberal use of most vitamins and recovery supplements like protein powders. At the same time, both recreational athletes and elite athletes use a range of additional substances, the health implications of which range from the uncertain to the severely dangerous. In some cases, athletes employ pharmaceutical products designed for use with animals, while in other cases they test out the latest—probably ineffectual—designer nutritional supplements. In short, a huge variety of PIEDS are available for athletes to ingest or inject. Adding to the uncertainty is the combination of widespread availability—often through Internet order mail—and limited (or no) regulation ensuring security around the quality, efficacy and legality of the PIEDS. Since most athletes, both recreational and elite, self-prescribe PIEDS, they tend to engage in potentially dangerous practices such as the ingestion of high dosages, failure to cycle off or in lower dosages, the use experimental substances, the use of experimental combinations and the unknowing use of tainted, contaminated, mislabelled and inauthentic substances, all the while receiving advice on use from a variety of different quality sources such as coaches, peers, supplement marketers or web forums.
