The death of bodybuilder Rich Piana did not come as a surprise on August 25, 2017. Most people knew things weren’t looking good for the larger-than-life social media personality. Piana had been in a medically-induced coma for over two weeks after collapsing at his Florida home from an apparent heart attack. Now the bodybuilding community wants to know why Piana died. And the circumstances surrounding Rich Piana’s death do matter.

They matter because Piana represented a group of extreme athletes. He represented the bodybuilders who were willing to use anabolic steroids and practically every muscle-building drug imaginable in order to build a monstrously hypermuscular physique.

Piana was a public figure. His bodybuilding fans who have chosen to live a similar lifestyle deserve to know if anabolic pharmacology contributed to his death – either directly or indirectly. They deserve to know if some other party drugs were involved. They deserve to know if a pre-existing medical condition was involved.

The determination of the cause of death in Piana’s case is a service to all of those who participate in the bodybuilding lifestyle but are interested in harm reduction. If Piana’s tragic death can help minimize harm for other people who are willing to go to such extreme to “get big as fuck”, then we should never stop asking questions about Piana’s death.

One big question surrounding Piana’s medical emergency involves the alleged “drug overdose” that caused him to collapse. TMZ reported that paramedics responded to a potential drug overdose and reportedly administered two dose of Narcan (naloxone) to counteract the suspected overdose. In addition, TMZ claimed that “lines of powder” and a straw were discovered on the counter in the bathroom where Piana collapsed.

The fact that Piana used recreational “party” drugs was not a secret. In a Youtube video posted by Piana on November 8, 2016, Piana blamed his ex-wife Sara Piana nee Heimisdotter for introducing him to a partying lifestyle that involved the use of recreational drugs.

 

“I’m not much of a partier you know. I’m not someone that ever really partied you know. I’ve been a bodybuilder who takes steroids. You guys know that. When it comes to, you know muscles and being big, I’ve taken every drug there is. But as far as recreational drugs, it’s not something I’ve ever really been into… It’s something that… she was into and… we talked about it. I mean guys I’m with this 26 year old beautiful girl and I’m down you know hey let’s do this all right let’s do it.”

 

Immediately after Rich Piana died, Sara seemed to imply that it was a drug overdose that led to Piana’s hospitalization. She also suggested that Piana had overdosed once previously when they were together but that she had saved his life.

 

“We had our ups and downs but we sure had an awesome time in each other’s presence along with us fighting through some dark times together… I know that people say stuff on social media but I truly am not the “bad” person people think I am. I actually saved Rich’s life 1 time before, glad I was there for him at that time.”

However, Chanel Jansen, Piana’s girlfriend who was with him when he collapsed in the bathroom, has categorically denied that recreational party drugs were involved. In an emotional video uploaded to Piana’s Youtube page, Jansen confirmed that Piana had snorted some lines of powder but she insisted that it was only a legal pre-workout supplement.

 

“No mention of drugs or overdose,” Jansen said. “So please get that out of your brain. I never ever called and said anything about drugs to anyone – not to the police, not 911, not to TMZ – as it’s been reported… I just want to make that very clear as far as this white powdery substance goes. Remember when he was with Mutant and he was in Germany? I was with him there at the time. That was four years ago and he snorted Mutant Mayhem. That at all sound familiar? Hate to break it to you guys but the white powdery substance isn’t coke. Think logically. If him and I were coke heads, don’t you think that we would be a lot thinner than we are? Don’t you think we’d be tweaking all the time and making cracked-out videos? No we weren’t doing that so it was pre-workout on the table. And as I said before not a conventional guy and always has done shit his own way. So he snorted his pre-workout so it hit him that much faster and in order to get a good workout.”

Update (September 19, 2017): Sara Piana has dismissed Jansen’s claim that Piana was snorting a pre-workout supplement instead of a recreational drug.

 

“[T]he video [Chanel Jansen] posted on his YouTube page was a flat out LIE! Anyone that is stupid enough to believe that he was snorting his pre-workout while she was cutting his hair must also be dumb enough to think he was having sleep apnea instead of a heart attack!”

 

Most people outside of the bodybuilding community have immediately jumped to the conclusion that Piana died from his steroid use. After all, Piana’s popularity was due, in no small part, to his honest discussion of his personal steroid use. Piana admitted to regularly using steroids for over 25 years.

As one example of his steroid use, Piana’s infamous 3-month “Get BIG as FUCK” steroid cycle involved sizable dosages of more than a dozen bodybuilding drugs. It included the injectable anabolic steroids Deca Durabolin, Equipoise, Masteron, Primobolan Depot, Proviron, testosterone cypionate, testosterone enanthate, trenbolone enanthate, Anadrol, Anavar, Dianabol, hCG, hGH and Arimidex.

Did any of these muscle-building drugs actually cause his death? It would be disingenuous for anyone to dismiss the possibility that steroids contributed to his death. Twenty-five years of steroid use would likely have cardiovascular consequences.

Some media reports have suggested that Piana died from an acute steroid overdose. The media has even located medical doctors willing to go on record to this effect. For example, Dr. Irving Sobel with the Access Medical Group in California discussed steroid overdose as a culprit in the deaths of Piana and IFBB pro bodybuilder Dallas McCarver.

 

“Abusing anabolic steroids can lead to overdose. Symptoms of a steroid overdose include stroke, coma, heart attack and convulsions. Longterm abuse affects so many areas of the body including the adrenal glands, the heart, mental health and it can often lead to liver cancer.”

In reality, it is practically impossible to die from an acute anabolic steroid overdose. If steroids played any role in Piana’s death, steroids were most certainly not the culprit in a drug overdose death. Long-term steroid use spanning 25 years is another story.

Drugs are easy to demonize. It doesn’t matter whether it is anabolic steroids, cocaine or heroin. It is natural for people to seek out some drug to blame when someone dies young. Unfortunately, the cause of death is rarely so easily explained. It is usually much more complicated and multifactorial. But the more that we can learn about the circumstances surrounding such deaths, the more we can do to prevent such tragedies in the future.