A surge in illegal peptides is fuelling unprecedented demand for sterile injecting equipment, placing immense pressure on decades-old needle and syringe programs originally designed to combat the rise of HIV during the heroin epidemic.
This new cohort of drug injectors now account for up to 40 per cent of clients at some services, sparking shortages of thinner-tipped needles used to inject peptides under the skin or into muscles.
About 20 per cent of visitors to cohealth’s needle and syringe program this year have been using performance- and image-enhancing drugs, including peptides and steroids. This compares with about 5 to 8 per cent over the past decade.
“There is a real potential for current needle and syringe program services to be overwhelmed by peptide users, placing both people who use peptides and people who use psychoactive drugs at risk of harm,” said Andrea Fischer, cohealth’s director of community-based drug and alcohol responses.
“Consideration needs to be given as to how to increase services to meet the needs of both groups.”
She said the sudden demand had caused supply shortages of the finer, shorter needles, although stocks were adequate at the moment.
Fischer said the programs needed urgent resourcing to expand storage, extend opening hours and establish new services in areas of high need. She’s also calling for improved referral pathways to general practitioners and fast-tracked education materials.
Regional services are also feeling the impact. At Barwon Health, performance- and image-enhancing drugs including peptides now drive roughly 40 per cent of all activity handled by its mobile needle and syringe program.
The mobile service delivers clean injecting equipment to the community and picks up and disposes of used syringes.
“We’re also seeing a clear rise in people seeking equipment for performance- and image-enhancing drugs, including peptides, and our priority is ensuring everyone has safe, non-judgmental access to sterile equipment and harm-reduction support,” said a Barwon Health spokeswoman.
Uniting Alcohol and Drug Services, which runs a needle and syringe program in Coburg in Melbourne’s inner north, said about one quarter of its clients were now using peptides or steroids.
The service has more than doubled the number of syringes it is distributing.
Nathan Farley, a senior harm-reduction clinician at Uniting, said many people using black market peptides felt uncomfortable purchasing syringes from pharmacies due to stigma.
“We try to provide a warm space where everyone is welcome and there is no judgment,” Farley said.
“A chemist would only stock a really limited range, and people accessing a chemist for injecting equipment aren’t treated the best. They are asked a lot of questions.”
He said the peptide users were predominantly men aged in their 20s to 50s who had purchased the peptides online. Many of Uniting’s clients were seeking sterile injecting equipment for black market peptides used for muscle growth as well as weight loss.
Victorian Alcohol and Drug Association chief executive Chris Christoforou said the situation was placing immense pressure on a decades-old health infrastructure designed in the 1980s to combat the rise of HIV.
“There’s been an explosion in demand for clean injecting equipment [from] a new cohort of injecting drug users – those who use performance- and image-enhancing drugs,” he said.
He said some services were reporting that clients were ordering boxes of up to 500 syringes for their personal use.
Christoforou said this new cohort of injecting drug users were frequently sustaining avoidable injuries and infections due to a lack of tailored health advice.
The Salvation Army’s alcohol and other drugs Victorian manager, Juanita Davis, confirmed the service’s needle and syringe program was also experiencing a peptide-fuelled surge in demand.
Between January and May 2026, more than 683,000 needles and syringes were distributed, an increase of about 185,000 compared to the same period last year.
“Our staff are highly experienced in harm reduction and continue to adapt their approach, supporting people – especially those new to injecting – with practical, trusted safety advice and information as new trends emerge,” she said.
A Victorian government spokesman said needle and syringe programs were designed to be adaptable and responsive to changing patterns of drug use. This included emerging trends such as the use of performance- and image-enhancing drugs, including peptides.
“The needle and syringe program provides a critical frontline public health response, ensuring people who inject drugs have access to sterile equipment, harm-reduction education, and referral pathways to support services,” he said, adding that the government had invested more than $3 billion to expand drug treatment, supports and harm-minimisation services across Victoria.
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