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Drugs in Sport

Associate Professor Peter Brukner

Centre for Sports Medicine Researchand Education

Ancient civilisations Greeks (mushrooms) Romans (herbs) Egyptians (hooves) Norway (Berserkers

-mushrooms)

Nineteenth century caffeine alcohol nitroglycerine opium strychnine

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Anabolic steroids 1927 - Fred Koch bull testicles World War II 1952 Olympics (Russians)

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Blood doping Finnish distance runners 1970s

Growth hormoneErthropoietin

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Drugs in sportDefinition of doping

Doping is the deliberate orinadvertant (accidental)use by athletes of bannedsubstances or methods thatmay enhance performance

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Drugs in sport

1. Stimulants2. Narcotic analgesics3. Anabolic agents (a) anabolic androgenic steroids

(b) Beta-2 agonists4. Diuretics5. Peptide hormones & analogues6. Anti-oestrogenic compounds7. Masking agents

Banned substances or methods

Stimulants CNS stimulants

amphetamines caffeine

sympathomimetics cocaine

Amphetamines first used in 1930s narcolepsy, ADD delay fatigue increase alertness acute behavioural side-effects

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Caffeine increased alertness shortened reaction time improved concentration diuretic effect ? glycogen sparing Urinary concentration of caffeine > 12

mg/L is illegal ?8 cups of coffee over 2-3 hours

Sympathomimetics diet pills cold remedies hay fever pills

Cocaine widely used in US deaths among athletes

Len Bias (Boston Celtics) Don Rogers (Cleveland Browns)

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Narcotic analgesics e.g. dextropropoxyphene (Digesic)

destromoramide (Palfium),morphine, pethidine

Anabolic steroids anabolic androgenic steroids derivatives of testosterone

ν ⇑anabolic effectν ⇓androgenic effect

Anabolic steroids

hypogonadal males stimulate erythropoiesis carcinoma breast advanced osteoporosis

Clinical uses

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Anabolic steroids

Do they work?

Anabolic steroids

⇒⇑ muscle size and strengthif…….. intense weight training adequate protein intake

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Anabolic steroids sense of well-being feeling of increased energy increased aggression

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Anabolic steroids ?effect on endurance

anticatabolic effect erythropoiesis

Anabolic steroids:side effects common most relatively minor usually reversible occasional serious side effects ?effect of long term use

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Anabolic steroids:side effectsν ⇓ testicular size, sperm volumeν feminizationν abnormal liver functionν abnormal lipid profilesν hypertensionν skin changesν violence

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Anabolic steroids:females menstrual irregularities deepening of voice male pattern baldness hirsutism alterered libido enlarged clitoris

Anabolic steroids:side effectsAdolescents acneν ⇑ facial and body hairν premature closure of epiphyseal

growth platesν male pattern baldnessν deepening of voice

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Anabolic steroid and healthrisk behaviours 1 million users in USA spend more than $100 million 4-11% of male adolescents 0.5-2.9% of female

adolescents

Anabolic steroidsAddicted in same way as other drugs ⇒ roid rages severe mood liability aggressive or violent behaviour disinhibition impaired judgement anxiety, panic paranoid delusions

Withdrawal from the drug may also produce acutesymptomatology similar to that seen during alcoholand opioid withdrawal

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Anabolic steroidsWhere are they obtained?

doctors gymnasiums mail order

Anabolic steroids cyclical pyramid stacking different steroids for different

needs

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Beta 2 agonists All Beta 2 agonists are banned except

inhalants containing the ingredientssalbutamol and terbutaline e.g.Ventolin, Bricanyl, Respolin

Diuretics rapid loss of weight⇒ dangerous

excrete or dilute illegalsubstances

Peptide hormones andanalogues

Human growth hormone (HGH),human chorionic gonadotrophin(HCG), corticotrophin (ACTH),erythropoeitin (EPO)

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Human Growth Hormone(HGH)

produced by pituitary gland essential for normal growth treatment of dwarfism from cadavers since 1985 recombinant HGH

Insulin-like growthfactors (IGFs)Previously known assomatomedins

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Erythropoietin naturally occurring hormone secreted by kidney stimulates bone marrow increased red blood cell production synthetic EPO available treatment of anaemia of chronic renal

failure

Eythropoietin Marked increase in haematocrit

increased oxygen carrying capacityof the blood

increase in viscosity of bloodespecially if associated withdehydration

potentially fatal

Prohibited methods1. Enhancement of oxygen transfer

- Blood doping- Modified haemoglobin products

2. Pharmacological, chemical and physicalmanipulation

3. Gene doping

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Blood doping withdraw blood 6 weeks prior allow time for blood count to

return to normal reinfuse blood day or two before

competition

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Pharmacological, chemical andphysical manipulation

administration of diuretics catheterization sample substitution inhibition of renal excretion

Gene Doping ? the future ? legal ? undetectable ? ethical

Drugs in sportRestricted substances

alcohol cannabinoids local anaesthetic glucocorticosteroids beta blockers

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Corticosteroids Corticosteroids are permitted under the

following conditions: creams, ointments, eye drops, inhalants

e.g. Becotide, local injections

Beta blockers Beta blockers will only be tested

for in sports where they are likelyto enhance performance e.g.archery, shooting, bobsleigh,diving, luge, modern pentathlon,ski jumping

Drugs in sportWhat drugs are tested for in acompetition test? anabolic steroids stimulants diuretics narcotic analgesics (ex codeine) peptide hormones masking agents

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Drugs in sportWhat drugs are tested for in anout-of-competition test? anabolic steroids diuretics masking agents

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Why athletes take drugs1. Belief that their competitors are taking drugs2. Do anything possible to succeed3. Pressure from coaches, parents & peers4. Pressure from authorities5. Lack of access to legal methods to enhance

performance6. Community attitudes and expectations regarding

success and performance7. Financial rewards8. Influence of media in facilitating expectations and

rewards