Mainline: doping in recreational sports

Although evidence is somewhat scattered, the use of performance and image enhancing drugs (PIEDs) is long said to be on the rise in the recreational sport scene. It concerns substances that help people lose weight and/or build stronger muscles. Mainline is part of a new European project that aims to test two online interventions around PIED use. 

The new project makes efficient use of the experience and knowledge that is available in the projects' partner countries: Finland, Greece, Lithuania, the United Kingdom and the Netherlands. It is up to Mainline to see whether the existing interventions from other countries fit the Dutch context and whether they can contribute to the health of those who use PIEDs.

Doping education

The project runs from January 2018 to December 2019. The formal title of the project is: ‘Towards doping education in recreational sports’. However, informally, the group named the project the DELTOID-project after the muscle that is often used to inject steroids.

The project seeks to fill a gap in the public health field that was already identified by the European Commission in 2007 (EU White Paper on Sport) and reaffirmed in 2013 via a European expert group. European experts found that:

  • Doping in recreational sports is likely to become a public health issue;
  • The adverse effects of doping substances include long-term physical and psychological health risks and social problems;
  • Education and prevention need to target wider audiences and not just top-level competitive athletes;
  • The European Commission calls on actors with a responsibility for public health to take the health-hazard aspects of doping into account;
  • The EU would benefit from a more coordinated approach in the fight against doping.
    This project directly addresses the above call to action.


The project has two core objectives:

  • To evaluate the acceptability of online performance and image enhancing drug/substance prevention programmes and tools focused on amateur and recreational athletes in the EU; 
  • To enhance the knowledge of various stakeholders (doping researchers, health care providers, anti-doping officials, etc.) in order to improve performance and image enhancing drug/substance prevention strategies within the EU.

Mainline’s responsibility is to test one of the interventions in the Dutch context. Our main target group is people who work in the health sector and who might come across PIED users. Naturally, Mainline will, over the course of the project, try to find out whether we could play a role to offer harm reduction services to people who use PIEDs in a recreational setting.


The project brings together a group of people with extensive expertise in complementing areas. The lead partner is Dopinglinkki- a department of the Finish A-Clinic Foundation. A-Clinic is, like Mainline, a harm reduction organisation in Finland. They established a multifunctional project that focuses on low-threshold health advice and education: Dopinglinkki. In their country, Dopinglinkki focuses on the recreational sport scene, where the national doping authority focuses on professional athletes.

The partnership further consists of two research institutes renowned for their research on PIED use- the Aristotle University of Thessaloniki in Greece and for their systematic and evaluative drug research Liverpool John Moores University in the United Kingdom. Mainline is the second NGO in the project and brings its expertise on harm reduction. The partnership is completed with the anti-doping Agency of Lithuania.

The online interventions

One intervention is an e-learning tool that was developed by Dopinglinkki in Finland. Mainline will set out to evaluate the acceptability of this tool in the Dutch setting and among health care workers. This could include doctors, nurses and medical staff with a specialisation in PIEDs, general practitioners and people who work at traditional drug services. The online modules will be translated to English and Dutch and tested for its acceptability in Finland, the Netherlands and the United Kingdom. The Finish module originally targeted those who work in the fitness industry. This original module is translated to Lithuanian and tested by the Lithuanian Anti-doping Agency.

The Aristotle University of Thessaloniki has been the lead partner in an earlier European project, the SAFE YOU project. The second intervention that will be tested was designed under this project. It focuses on coaches and trainers in the recreational sports scene and on (potential) users of PIEDs. The SAFE YOU project was extended due to its success. The application that results from the project will be evaluated under the DELTOID project. It will be tested in Lithuania and Greece.


Are you interested in learning more about this project? Or would you like to see the options for collaboration? Please contact Machteld Busz (

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