Drugs in Sport
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Drugs in Sport

Drugs in Sport

In sum, the processes of building enabling environments require simultaneously understanding the multi-layered risk environments that may limit their impact and effectiveness – or be shaped positively in turn. Another means of conceptualizing environmental interventions for alcohol and drug abuse is behavioral economics theory, which posits that the decision to use substances is related to availability and price of both the substances themselves and alternative sources of reinforcement (Vuchinich & Tucker, 1988). For example, all else being equal, adolescent alcohol use would theoretically be lower in a community that had numerous alcohol-free social activities available that were reinforcing to young people than a community that did not have such alternative activities. Behavioral economic theory also posits that alcohol and drug use will be lower when individuals are orientated toward future rewards incompatible with substance use, such as successful educational and vocational outcomes (Murphy & Dennhardt, 2016).

negative effects of drugs in sport

Indeed, many organizations already have a punishment-related system affiliated with drug testing (e.g., suspensions for positive drug tests); a contingency management system would involve the reverse of this, where athletes received incentives for negative drug tests. Such a program would likely be most appropriate for athletes who have been experiencing fairly significant alcohol and drug problems and are attempting to eliminate their use of the substances. Overall, there is considerable empirical support for the efficacy of motivational enhancement interventions. Several meta-analyses have shown that brief (1–2 sessions) in-person interventions are effective at reducing at-risk alcohol and drug use (Burke, Arkowitz, & Menchola, 2003; Jensen et al., 2011; Lundahl, Kunz, Brownell, Tollefson, & Burke, 2010). Further, interventions that provide personalized feedback in the absence of individual clinician contact have also been shown to be efficacious at impacting substance use (Miller et al., 2013). A handful of studies have examined the efficacy of motivational enhancing interventions specifically among athletes, with promising results.


The body image pathway refers to the observation that many individuals initiate AAS use because they exhibit symptoms of muscle dysmorphia, a form of body dysmorphic disorder where individuals develop severe preoccupations that they are not adequately muscular (242,–246). The serotonergic system also may have an important function in the control of the aggressive dominance induced by AAS (236). The serotonergic 5-hydroxytryptamine (5HT)1B or 5HT2 receptors may play a role in the mediation of emotional states and behavioral changes that we see among human AAS users (237). Because AASs, hGH, insulin, and erythropoietins are the most frequently used PEDs, we address the medical consequences of their use in detail below. Although AAS use is widespread in Western countries, the United States appears to have the largest absolute number of AAS users.

Athletes who limit alcohol and drug use due to performance-related concerns may choose to increase their use outside of these formal competitive seasons. Several research studies have shown that transitioning from in- to off-season serves as a risk factor for heavy drinking among athletes. Studies among college athletes in the United States found heavier alcohol consumption outside of their athletic season, including one longitudinal study that reported average drinking rates doubled during the off season (Bower & Martin, 1999; Martens, Dams-O’Connor, & Duffy-Paiement, 2006; Thombs, 2000). Another study of professional Australian Football League players showed a dramatic increase in risky drinking between pre-season and in-season time periods versus the off season (Dietze et al., 2008).

Sports, Drugs and Addiction

We also need to further investigate the interactive effects of PEDs with sports injuries and other high-risk behaviors as well as innovative approaches to enhance public awareness of the serious health consequences of PEDs. Erythropoietins increase red cell mass and plasma viscosity and thereby augment the risk of thrombosis, cardiovascular events, and stroke (Table 3). Although there has been considerable media speculation that erythropoietin could have been implicated in the deaths of as many as 18 European professional bicycle racers between 1987 and 1991, there is no forensic documentation from verifiable sources substantiating this claim (388, 389).

  • Also, it has been our observation that people are less apt to disclose PED use than other forms of drug use, perhaps because doing so would acknowledge that their physical prowess is largely due to chemical enhancement (20, 21).
  • When considering the acute and chronic consequences of both contact and noncontact sports and the physical changes they induce, the sports physician plays an important role by monitoring training, practice, game conditions and activities; it is part of the physician’s responsibility.
  • The biomarkers test is based on a score calculated from the age of the athlete, the IGF-1 concentration, and the P-III-NP concentration (384).
  • Athletes may choose to use illegal PEDs for different reasons and with varying risks.

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 https://ecosoberhouse.com/ 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). The primary medical use of these compounds vary, but include treatment of cancer or aiding those born prematurely.


This model goes beyond the others to include several levels of ethical concern (self, other, play, display, humanity) and acknowledges the complex reality of implementing changes to the existing system. These latter models offer specific recommendations for how sports policy may adapt to allow negative effects of drugs in sport for harm reduction. Taking these into account, we next apply the risk environment framework to the current context to analyse how anti-doping policies have created an intolerant environment that drives doping into the shadows of sport, increasing various risks to athletes along the way.

  • Here is how the top three mental health conditions can influence addiction in athletes.
  • An athlete who injures their shoulder, tears their ACL or breaks their leg receives opioid medications for use after surgery, and it does help the pain ⁠— but only at first.
  • Thus, athletes who may be at-risk for developing a substance abuse problem may often find it relatively easy to be in social settings where alcohol and drugs are readily available.
  • Athletes should be educated about doping, and about the side and adverse effects of the use of the various prohibited substances, with the aim of educating athletes to prevent the doping phenomenon.
  • If a player’s performance is weak because of drug use, the player will have to live knowing that he or she has disappointed the team, the coach and others – all for a few minutes of a false high.
  • Given that older AAS users (who started AAS use in their peripubertal years in the 1980s) are just now entering the fifth decade of their life, we may have more evidence regarding AAS use and prostate cancer in the coming years.

Androgen precursors are either inactive or weak androgens that the body converts into potent androgens. These include naturally occurring precursors to testosterone such as 4-androstenediol, 5-androstenediol, 4-androstenedione, and dehydroepiandrosterone as well as precursors to synthetic AASs, including 4-norandrostenedione, 4-norandrostenediol, and 5-norandrostenediol, which the body converts to nandrolone. The widespread, unregulated sale of dietary supplements on the Internet has greatly increased the number of anabolic steroids available. Of even greater concern is the introduction of synthetic anabolic steroids such as 17-desmethylstanozolol, methylclostebol, and methyltrienolone into the market as dietary supplements. A partial list of steroids contained in dietary supplements can be found at The Steroid Control Act of 2004 banned most of these substances.

Legal drugs

Since 2004, the World Anti-Doping Agency (WADA) has annually updated their Code and related documents that outline the official international anti-doping standards. The aim of this review is to gather and critically analyze recent developments and information regarding this sensitive issue, in order to offer a better understanding towards its foundation provided by previous research and to help develop practical strategies to effectively combat doping in sports. Under the terms of the licence agreement, an individual user may print out a single article for personal use (for details see Privacy Policy and Legal Notice). VKA achieve their anticoagulant effect by interfering with several coagulative factors like II, V, VII, and IX. Their metabolism is significantly affected by substances acting on cytochrome (CYP) P450.

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