Doping goes back to ancient times, prior to the development of organized sports. Performance-enhancing drugs have continued to evolve, with “advances” in doping strategies driven by improved drug testing detection methods and advances in scientific research that can lead to the discovery and use of substances that may later be banned. Many sports organizations have come to ban the use of performance-enhancing drugs and have very strict consequences for people caught using them. There is variable evidence for the performance-enhancing effects and side effects of the various substances that are used for doping. Drug abuse in athletes should be addressed with preventive measures, education, motivational interviewing, and, when indicated, pharmacologic interventions.

Therefore, it is of great importance for paediatric physicians to be aware that drug use in sports is not only an adult problem. Athletes who use supplements often have no knowledge regarding their effects on sports performance and overall health. It is reported that most athletes get nutritional advice from coaches, fellow athletes, family members and friends,169 suggesting that more wide reaching educational interventions, at an early age, are necessary. According to the List of Prohibited Substances and Methods,2 beta-blockers are banned drugs in certain skill-based sports such as shooting and archery, due to the performance benefit offered by lowering heart rate and reducing anxiety and tremor.


Because these designer steroids have not undergone toxicologic or safety testing in humans or animals, they potentially pose an even more serious health risk than the more traditionally used AASs, which have received some level of animal or human testing. As sport and anti-doping drive harsher policies, more invasive surveillance techniques, and push the cultural narrative around ‘clean sport’, doping groups have responded with techniques for avoiding detection and keeping overall risk as low as possible. In order to understand how enabling environments are produced we must consider those instances where the environment has been altered in order to reduce the social, political, economic, and physical risks of doping. As noted above, online doping forums may be seen as a form of user-led, ‘grassroots’ harm reduction communities, although such venues may focus on the maximisation of physical or performance benefits. Moreover, the very nature of the doping risk environments may limit the ability of individuals to effect harm reduction through mere behavioural change. One model has called for a partial change to anti-doping by relaxing current rules to allow for harm reduction to be introduced.

In the event that an athlete and his or her medical providers feel it necessary, for documented medical reasons, that he or she continue to take a banned substance, WADA may consider granting a therapeutic use exemption, a concept mentioned earlier. A therapeutic use exemption must be on file before an athlete tests positive for the substance allowed by that therapeutic use exemption. Note that individual growth factors are still prohibited when given separately as purified substances as described in S.2.5. Creatine seems to help muscles make more of an energy source called adenosine triphosphate (ATP).

What types of drugs are used to enhance performance?

I called them committee meetings and just kind of think about what I was up to and the consequences if it all went bad, how ugly that was going to look. Cycling has impacted my life positively in so many different ways from the incredible people along the way, I’ve traveled all around the world, seen different cultures, different everything, just a whole different world. The primary medical use of beta-blockers is to control hypertension, cardiac arrhythmias, angina pectoris (severe chest pain), migraine, and nervous or anxiety-related conditions.

My life went from being a wide-eyed, green bike racer from Marblehead, Massachusetts to a few years later in a little bit of a dark world, very secretive, two different faces. I felt more like a number, the numbers that I produced on the bike, you have all this data that you can record while you’re cycling, those numbers became kind of whether I was happy or not. They slow the heart rate, reducing blood pressure, anxiety and muscle tremors. This may improve the performance of athletes who need a steady hand, such as in archery, shooting, darts and golf. In general, the long-term effects of performance-enhancing drugs haven’t been studied enough.

How are steroids harmful?

On how many occasions (if any) have you taken steroids on your own—that is, without a doctor telling you to take them? ” The limitations of these data include the potential for false positives from a respondent’s lack of understanding of the question as well as the potential underestimation of the problem because AAS users do not begin using steroids until they reach their early 20s. WADA revises and publishes its list of banned substances approximately annually.

Consistent with this, NSAIDs have been reported to interfere with muscle hypertrophy and strength gains in response to chronic resistance training in young individuals. Overall, we encourage greater awareness among athletes, coaches, and support staff on the potential adverse effects of these drugs. A risk-benefit analysis and professional guidance are strongly advised before the athlete negative effects of drugs in sport considers analgesic medicine for training or competition. Though there is a range of motivations for engaging in doping (Henning & Dimeo, 2014), a primary one at the elite level is winning. For elite and professional athletes, the monetary incentives to win can be huge and provide a reason for athletes to use prohibited substances (Aubel & Ohl, 2014; Fincoeur, Cunningham & Ohl, 2018).


Instead of using doctors to look for ways to beat doping tests, these medical professionals could consult with each athlete to determine the best training regimen to follow that maximizes results. Without this supervision, athletes are often forced to work on their own, which creates a higher risk to their health. Anti-doping authorities may claim that they increase the penalties for anti-doping rule violations or have developed new anti-doping strategies based on increased number of anti-doping tests and sophisticated reliable methods for detection of doping substances. Furthermore, the core of sports culture should always be the athlete and not the pharmacist or the geneticist.

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