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

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Doping is commonly understood as the use of prohibited performance enhancing substances or methods in sport. The official definition accepted by most sport organisations and athletes is that doping is the violation of one of the anti-doping rules laid out in the World Anti-Doping Code. The WADA  Code (2019) includes as its fundamental rationale the promotion of athlete health. In this view, health promotion is achieved by prohibiting athletes from using substances for which ‘medical or other scientific evidence, pharmacological effect or experience that the Use of the substance or method represents an actual or potential health risk to the Athlete’ (WADA, 2019, p.30). Ostensibly, this is related to the perceived health risks of doping substances, though it is also related to broader war on drugs style policies and politics (Coomber, 2014; Dimeo, 2007).

negative effects of drugs in sport

By analysing known cases of systematic doping we can see how they employed strategies similar to those outlined in Table 2. Applying the heuristic developed by Rhodes (2002, 2009) to outline the factors and levels of environmental risk to the sport context illustrates several ways that sport and anti-doping policy create a risk environment that may produce doping behaviours (see Table 1
). Anti-doping policies are underpinned by a sport culture in which doping is positioned as an issue of both morality and health. Much like other prohibitive substance use policies, these policies also create their own set of risks for athletes. Indeed, many studies have identified the criminalisation of drug possession for recreational use as among the most damaging features of those risk environments, not least because such policies often preclude or limit the formation of enabling environments. As a part of a broader ‘war on drugs’ climate (Coomber, 2014; Henning & Dimeo, 2018), anti-doping policies tend to increase risk across categories for doping athletes.


However, the physical and social risks of doping are multiplied when individuals must secure their own supply, determine their own doses, minimise side effects, and prevent being caught through in or out of competition testing. One way of avoiding some of these issues is for athletes to collectively dope, thereby sharing the burden of risks and working together to minimize them. Systematic doping involves centrally organising doping for a group of athletes. This is often done by an entity above the individual, such as by a team or a state, which often stands to benefit from the cumulative boost in performance among its member athletes. While motivated by both shared and unique interests, systematic doping is similar to the phenomenon of Heroin Assisted Treatment (HAT), or the (tenuously) legal dispensing of pharmaceutical-grade heroin to individuals who have struggled with other modalities of opioid use treatment (Kilmer et al., 2018). In both cases, the supply and use are centrally managed in order to manage the risks of substance use for individuals who would be otherwise incapable of doing this effectively on their own.

Sports and injuries go hand and hand, but what sports do not account for are or tolerate are drugs and substance abuse. Athletes are held to a standard they are expected to follow and live up to. That stress put on many student athletes can lead to them turning to drugs, which open the doors to many negative effects. Athletic life may lead to drug abuse for a number of reasons, including for performance enhancement, to self-treat otherwise negative effects of drugs in sport untreated mental illness and to deal with stressors, such as pressure to perform, injuries, physical pain and retirement from sport. It creates a situation where athletes are often operating outside of medical supervision. The legalization of performance enhancing drugs in competitive events could help to reduce the risks to the health of the athlete because it would place them under medical supervision for their activities.

Effects of Performance-Enhancing Drugs

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. Research has convincingly established that for some substances, particularly alcohol, athletes have higher levels of at-risk use than individuals not participating in athletics. Conversely, rates of use for many other types of drugs are lower among athletes than nonathletes. Nonetheless, it is important to focus on understanding and limiting drug use among athletes, considering the myriad negative effects of such use on this population at all competitive levels.

Steroid users may become overly aggressive or combative, a condition commonly referred to as “’roid rage.” Uncontrolled aggression causes some steroid users to become confrontational with friends and family; sometimes, they end up in trouble with the law. 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. VKA require periodic INR control and have a delayed and prolonged effect that lasts even after suspension.


AAS use has also been linked to alcohol use in humans (81) and rats (82). Steroid-induced alterations in opioid peptides in the brain reward system may explain the increased sensitivity to alcohol (82). Other studies have observed an imbalance in dopaminergic pathways in the nucleus accumbens, a brain area involved in reward, leading to speculation that the alterations in the actual peptidergic and monoaminergic systems promote the rewarding effects of ethanol, thereby increasing alcohol intake (83). Additional studies have reported increased sensitivity to cocaine (84) and amphetamine (85) in rats exposed to high doses of AAS.

My ‘smart drugs’ nightmare –

My ‘smart drugs’ nightmare.

Posted: Tue, 05 Jan 2016 08:00:00 GMT [source]