Adverse Health Consequences of Performance-Enhancing Drugs: An Endocrine Society Scientific Statement PMC

Sporting Integrity Australia works closely with the World Anti-Doping Agency (WADA), an international agency set up to monitor the code. GlobalDRO has information about the banned status of medicines based on the current World Anti-Doping Agency Prohibited List.

A. Androgenic-anabolic steroid

Following this, we examine how groups have organized systems of doping using strategies, similar to those outlined above, that work to reduce harm to athletes and enable safer use of PEDs. Athletes have clear incentives to perform at an optimal level in their sport. The reward value of such incentives generally increase as athletes progress to more elite competitive levels, culminating in major awards, international recognition, educational opportunities in the form of university scholarships, and the opportunity to make one’s (often well-compensated) livelihood in sport. Thus, some athletes will be tempted to use substances that have the potential to make them stronger and faster, thereby improving their athletic performance. Indeed several studies among athletes at varying competitive levels have shown that the primary reason athletes choose to use performance-enhancing substances is to improve their athletic performance (Miller, Barnes, Sabo, Melnick, & Farrell, 2002; Rexroat, 2014).


New models that also incorporate the measurement of hemoglobin, erythropoietin levels, and soluble transferrin receptor levels provide greater sensitivity, especially in users who may have taken small or moderate doses of recombinant erythropoietin several days or weeks before the test. Direct detection of blood transfusions and ESAs (erythropoietin, novel erythropoiesis stimulating protein darbepoetin alpha, and continuous erythropoietin receptor activator) is often difficult. Therefore, there’s a growing trend toward monitoring biomarkers of erythropoiesis (hemoglobin, hematocrit, and reticulocytes) over time (for an individual athlete) and analyzing these data using analytical models to identify patterns suggestive of doping (396). With this information, athletes can either be sanctioned directly based on their profile or targeted with conventional doping tests.

Doping enabling processes and environments

Athletes who unknowingly or accidentally ingest a prohibited substance are held to the same standard as those who intentionally use doping substances and must demonstrate a lack of intent. First time Code Top 5 Advantages of Staying in a Sober Living House violations are punishable by a competition ban lasting up to four years (WADA, 2019). The primary medical use of these compounds vary, but include treatment of cancer or aiding those born prematurely.

  • The effectiveness of the system was clear after Russia dominated the medals table at the 2010 Winter Olympics and then performed better than expected at the 2012 Summer Olympics, all while protecting most athletes from testing positive (McLaren, 2016a).
  • Ignoring factors such as the level of competition or age of the athlete in question, further reinforces the potentially harm- and stigma-producing, punitive approach even in cases where the fair-play ideal is not really at stake.
  • In 1998, police found a large number of prohibited substances, including ampoules of erythropoietin, in a raid during the Tour de France.25,26 The scandal led to a major reappraisal of the role of public authorities in anti-doping affairs.
  • Of even greater concern is the introduction of synthetic anabolic steroids such as 17-desmethylstanozolol, methylclostebol, and methyltrienolone into the market as dietary supplements.

Doping from the beginning to the present day

Using EPO can increase blood pressure and can reduce the body’s natural capacity to make EPO. Considering these promising findings, as well as the overall support for different types of environmental interventions in other populations, athletic organizations should consider contextual strategies designed to limit alcohol and other drug use. Many large organizations have clear rules and policies built into their larger systems, such as suspensions for positive drug tests or alcohol-related arrests.

Risk environments can, broadly, be understood as the ‘space – whether social or physical – in which a variety of factors interact to increase the chances of drug related harms’ (Rhodes, 2002, p.91). Substance use research and policies have historically tended to focus on the individual and individual responsibility for risky behaviours (Rhodes, 2009). This is a trend mirrored in sport doping research that focuses heavily on motives and prevention at the individual level.

  • The body turns andro into the hormone testosterone and a form of the hormone estrogen.
  • Depending on the substance, the dosage and the duration of use, some PEDs have been proven to have severe side effects and can cause irreversible damage to an athlete’s body.
  • PED users are increasingly encountered in needle-exchange programs, where they may sometimes represent most of the clientele (79, 80).
  • I didn’t know if I could die from that, and sure enough, from the research that I’ve found out, that, yeah, it could have been really bad.

negative effects of drugs in sport

Endurance athletes also like to use caffeine as it helps to better transport fat in the blood and decrease the impact of pain. Some athletes use diuretics to mask the presence of other drugs such as anabolic steroids. The athletes who need to ‘make a weight’ such as a boxer or judo player may also be tempted to use a diuretic as it can cause rapid weight loss. Carrying out anti-doping controls both in and out of competitions is a benefit for athletes who do not use banned substances, the number of athletes who have been positively detected outside competitions is much higher than those who are found doped in competitions. The number of doping substances is very high, and their individual cataloging is not the purpose of this article. A classification from S0 to S9 (Table 1) for prohibited substances and from M1 to M3 (Table 2) for prohibited methods has been developed.

PEDs to the average person might produce slightly better results than diet and exercise alone. That is because the drugs and hormones they use allow them to improve at a much greater extent than any other type of intervention that is found on the market today. Training regimens, biomechanical measurements, and complex physiological responses cannot match what the enhance effects of doping provides. When you’re looking at the “best of the best,” it is clear to see that there are “natural” results, and then there are “enhanced” results. Through doping, we understand the use by athletes of substances prohibited by the antidoping agencies in order to gain a competitive advantage.

Athletes in this system were well looked after; the quality of their doping substances and protection from reputational and economic ruin was improved as long as they remained within the system—a type of omerta. Rodchenkov described perfecting his protocol to maximise benefit, limit risk, and avoid detection, as well as his frustration at athletes who would use additional substances that put them at risk of testing positive (Ruiz & Schwirtz, 2016). The reports on Russia also included evidence that athletes had been extorted by various members of the Russian sport apparatus in exchange for keeping their doping and/or positive anti-doping tests from becoming public (McLaren, 2016b). Blood doping, which often involves the use of prohibited erythropoietin, or EPO, increases the number of red blood cells in the body. This increase thickens the blood, making it difficult for the heart to pump. The result is a higher risk of life-threatening diseases including stroke, heart disease, and cerebral or pulmonary embolisms.

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