Discussion Paper
Chapter 16
Performance-Enhancing Drugs
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Reasons for concern include:
Athletes are role models for young people
Drugs may provide an unfair advantage during competition
Athletes at all levels of ability may risk their health or lives by taking drugs
Concerns about Drug Use by Athletes
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Early products
May not have provided any true physical performance enhancement
Probably had only a placebo value
Ancient Greek Olympians and Aztec athletes used plant-based stimulants
Athletic competitions probably developed in tribal societies as a means of training for war or hunting
Drugs were also often used for these activities
History: Ancient Times
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Strychnine
At low doses = a CNS stimulant
Higher doses may lead to convulsions and death
1904 Olympic marathon winner used brandy and strychnine
Despite associated dangers, some use of strychnine may have continued into the 1960s
Cocaine
Available beginning in the 1800s
Mariani’s Coca Wine was used by the French cycling team
Athletes later used pure cocaine
Caffeine
Many athletes used coffee and/or pure caffeine
Early Use of Stimulants
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Potential benefits over other stimulants:
More potent than caffeine
Safer than strychnine
Seemed to be the ideal ergogenic drug
Probably in use by athletes soon after they were introduced in the 1930s
Many early reports of the use by boxers, cyclists, and soccer players
Examples of adverse events:
1950s Olympics: Many reports of amphetamine use, a few deaths
1960 Olympics: One cyclist died, several others hospitalized due to amphetamine use
History: Amphetamines
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1968:
International Olympic Committee established rules to disqualify any athlete who used banned drugs or refused to be tested
Scope of testing at the Olympics has continued to expand over time
More than 5000 urine tests at London 2012 games, but fewer drug disqualifications than the three previous games
International Drug Testing
- 1960s:
- Some sports began testing athletes, but problems continued
- Example: cyclist died during 1967 Tour de France
- Amphetamines found in his system
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1960s:
Many football players used amphetamines during games
Attitudes toward amphetamines changed
American Football
1971: NFL banned the distribution of amphetamines by team officials
Initially no testing of players, who could still obtain the drug on their own
Current NFL policy restricts all use of amphetamines and many other drugs
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1960s: Many U.S. athletes used steroids
Weight lifters and bodybuilders
Track and field athletes
1970s: Testing in athletic events began
History: Steroids
Testosterone was used for weight gain in malnourished people
Soviets began to use testosterone to build up athletes in the 1950s
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Rumors of steroid use by certain professional baseball players
June 2003: Evidence surfaced that athletes were using tetrahydrogestrinone
Previously unknown steroid that did not show up in tests developed by the U.S. Anti-Doping Agency
BALCO Laboratories founder Victor Conte was implicated
Along with a number of professional athletes from several different sports
The BALCO Scandal
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1980s: Reports of drug use among athletes grew
Most sports organizations adopted stricter testing guidelines
Longer lists of banned substances
Despite extensive and expensive tests, use of performance-enhancing substances continues
There is ongoing development of new drugs and strategies to help athletes avoid detection
The Battle Over Testing
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Types of drugs used as performance enhancers include:
Stimulants
Steroids
Human growth hormone
Beta-2 agonists
Creatine
Performance Enhancers
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Are stimulants effective?
Amphetamines:
Studies indicate that most athletes perform better
But the improvement is small
At high levels of competition, small improvements can make a big difference
Underlying mechanism of improvement is unclear
Increased physical ability (increased strength, masking of fatigue)
Effects on the brain (increased confidence, winning attitude)
Stimulants as Performance Enhancers
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Caffeine:
Improves endurance under laboratory conditions
May not be effective under certain conditions
May need large amounts of caffeine
Ephedrine:
On Olympic and NCAA lists of banned substances
Professional sports organizations were slower to ban it
Example: Major League Baseball
2003: Death of pitcher Steve Bechler in 2003 was attributed to ephedrine-related heat stroke
Stimulants as Performance Enhancers
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The male sex hormone testosterone has two type of effects
Androgenic effects (masculinizing)
Growth of the penis and other male sex glands
Deepening of the voice
Increased facial hair
Anabolic effects (tissue building)
Increased muscle mass
Control of the distribution of body fat
Increased protein synthesis
Increased calcium in the bones
- Synthetic anabolic steroids have fewer androgenic effects
Steroids
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Synthetic anabolic steroids enhance the natural process of muscle building
Vigorous workouts cause microtrauma to muscles
Muscle repair leads to larger and stronger muscles
Steroids speed up the recovery and repair process
- Synthetic anabolic steroids allow the athlete to return to heavy training more quickly
Steroids
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Are steroids effective?
Research findings
Animal studies: Synthetic anabolic steroids build muscle in castrated animals
Laboratory research on healthy men
Steroids can produce small increases in lean muscle mass and muscular strength
No evidence for increase in aerobic capacity or endurance
Unclear if giving anabolic steroids to males who have normal testosterone levels will have a significant effect
Steroids
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Difficult to extrapolate laboratory findings to athletes
Athletes may use much higher doses
Athletes may use combinations of steroids (“stacking”)
Psychological effects of steroids may affect results
Users report that they feel stronger and can thus work harder
Possible active placebo effect
Steroids: Research Issues
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Anecdotally, steroids produce a stimulant-like high and increased aggressiveness
May allow for more work done during training and increased intensity of effort during competition
Concerns about high dose use
Psychological dependence, resulting in mood swings and depression when users don’t take the drugs
Interference with social relationships and other areas of life
“Roid rage”:
Stories may be exaggerated
But there are many reports of violent feelings and actions among steroid users that raise concern
Steroids: Psychological Effects
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Risks for young users
Premature closure of the growth plates of the long bones
Risks for men
Atrophy of the testes, breast enlargement
Risks for women
Decreased breast size, enlargement of the clitoris, increased facial hair, deepening of the voice
Risks for all users
Peliosis hepatitis (Bloody liver cysts)
Changes in blood lipid levels that may contribute to atherosclerosis, high blood pressure, and heart disease
Steroids: Adverse Effects
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Issues leading to regulation
Large black market for the drugs
Concerns about use among adolescent boys, even non-athletes
Anabolic steroids are listed on Schedule III
Limited prescription refills
More record keeping
Steroids: Regulation
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HGH: pituitary hormone
can potentially increase height and weight to gigantic proportions
Administration of doses of HGH may produce a more controlled increase in body size
Experiments have shown HGH may increase lean body mass but may not improve strength
It is illegal to distribute HGH for nonmedical purposes
Human Growth Hormone
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Example: clenbuterol
Mechanism of action and effects
Selective stimulation of the beta-2 subtype of adrenergic receptors
Sympathomimetic effects on the bronchi of the lungs
Used in treating asthma
Animal studies showed a possible effect on muscle mass
No evidence for improved athletic performance
Banned for use in competition
Beta-2 Agonists
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A natural substance found in meat and fish
Sold legally as a dietary supplement
Mechanism of actions and effects
Helps regenerate ATP, which provides the energy for muscle contractions
Users tend to gain weight, some of which is water weight
May improve strength and short-term speed in sprinting
No evidence for improvement in longer-distance events
Performance may decrease possibly due to weight gain
Creatine
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Increasingly, bodybuilders are seeking a strong and lean look
“Cut” refers to a lean, strong body, a “sculpted” body
Body fat percentage may be as low as 6 to 9 percent
14-20% is ideal for a healthy male
Getting “Cut”
Many bodybuilders take “fat burners”
Dietary supplements of questionable safety and effectiveness
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