chapter 2: performance enhancing drugs used in sports

Athletes and family members need to know that many performance-enhancing drugs are not safe, not legal and even potentially addictive. In this chapter, we will cover the effects of doping in sports, from steroid use to Adderall abuse in athletes.

Chapter 2: Performance-Enhancing Drugs Used In Sports

Athletes have used performance-enhancing drugs for thousands of years in hope to increase strength, speed and endurance. Ancient Greeks experimented with herbs, wine potions and hallucinogens. They ate animal hearts or testicles as they sought the most powerful performance-enhancer to prepare for the Olympic Games.

Roman gladiators ingested stimulants to run faster and boost energy. In the early 20th century, athletes widely used mixtures of heroin, cocaine and other ingredients.

Finally, in 1928, the International Association of Athletics Federation (IAAF) prohibited doping, or the use of performance-enhancing drugs, by athletes.

Not all performance-enhancing substances are illegal or harmful to the body. For example, an athlete might drink a cup of coffee to boost energy before a game or practice. However, many sports fans and athletes are aware of steroid abuse in sports. Likewise, some athletes use illegal stimulants to push themselves further in a race to be the best.

Athletes might take steroids to help the body produce more protein which increases muscle size and strength. They might also take steroids to increase aggressiveness and be more competitive out on the field or in the ring. Like any drug, steroid use comes with many risks affecting health and career.

Despite health risks and drug policies, athletes continue to use performance-enhancing drugs like steroids and stimulants. For example, between 2005 and 2015, 47 MLB players were suspended for using banned drugs. In the NFL, suspensions jumped from 21 in 2011 to 82 in 2012.

Baseball and football are not the only sports affected by steroid abuse, and it is difficult to say what sport has the most drug use. Doping affects all sports, and any athlete could turn to drugs to enhance performance and cope with the pressure to win.

Nevertheless, it has been reported that cycling had the greatest number of positive test results for doping in the Olympics, followed by weightlifting, boxing, triathlon and baseball. The exact number of athletes who are doping is unknown because many athletes do not want to admit they use performance-enhancing drugs.

Are Performance-Enhancing Drugs Illegal?

Whether or not a performance-enhancing drug is legal or illegal depends on the substance. The World Anti-Doping Agency (WADA) provides a list of drugs that it prohibits.

Most drugs, like anabolic steroids, are illegal without a valid prescription. Since 1991, anabolic steroids have been a Schedule III drug on the federal list of controlled substances. The possession or sale of anabolic steroids without a prescription can lead to jail time and thousands of dollars in fines.

Other performance-enhancing substances like energy drinks or dietary supplements such as creatine are not illegal. However, any substance may be banned in high doses depending on the sport.

Athletes who wish to use a dietary supplement or caffeine should first check the WADA list of banned drugs. Remember, there are always healthy and legal ways to enhance performance without the need for substance abuse.

Are Performance-Enhancing Drugs Addictive?

Some performance-enhancing drugs are addictive. For example, athletes can become addicted to stimulants like cocaine or amphetamine. They can also become addicted to steroids.

Users might continue to take anabolic steroids despite the harmful effects to avoid withdrawal symptoms and to cope with body image issues. Athletes who use anabolic steroids may experience depression, restlessness and mood swings when they stop using steroids. Stimulants also produce many unpleasant withdrawal symptoms which keep users from stopping.

Steroids are often used alongside other drugs such as opioids or alcohol, adding to the complexity of the addiction. About 32 percent of individuals who misuse anabolic steroids become dependent.

What Are the Risks of Using Performance-Enhancing Drugs?

Performance-enhancing drugs carry many risks for one’s health and athletic career. If you abuse performance-enhancing drugs, any of the following could happen:

  • You could get suspended.
  • You could become dependent on the drug.
  • The effects of doping might lead to heart problems, high blood pressure and psychological issues.
  • You could get in trouble legally.
  • You could overdose on a drug.

Substance abuse also impacts relationships and finances. The risks of substance abuse always outweigh the benefits.

Despite the risks, we understand it is not always easy to stop using. Substance abuse among athletes is just as complex as it is for anyone. Often, underlying issues influence athletes to use drugs in the first place. Effective treatment addresses the cause for addiction and ways to change behavior.

Adderall Abuse and College Athletes

Adderall abuse needs its own section because it is commonly abused by college students, including college athletes. A John Hopkins University study found that Adderall misuse among college-age students is on the rise. The study, which occurred over a six-year period, reports 60 percent of individuals who used Adderall for nonmedical purposes were between the ages of 18 and 25.

We will look at more college-athlete drug abuse statistics as well as the effects of amphetamines on sports performance to illustrate the dangers.

What Is Adderall?

Adderall is a stimulant used to treat attention deficit hyperactivity disorder (ADHD). It is meant to help individuals with ADHD stay focused. Side effects include weight loss, dry mouth, nausea, trouble sleeping and dizziness.

College students and athletes use Adderall even when they do not have a prescription to boost academic or athletic performance.

What Is Adderall’s Effect on Sports Performance?

Adderall abuse in sports is not uncommon. Athletes use Adderall to increase energy, react quicker, improve concentration and mask pain. College athletes may be at greater risk of Adderall abuse, because the drug is more widespread, and more accepted, in a college atmosphere.

It is also readily available. For example, 90 percent of students have access to prescription drugs like Adderall because friends or family members have prescriptions. They obtain the drug simply by asking for it. Sometimes they buy or steal Adderall. Consider the following statistics:

  • Full-time college students are twice as likely to use a stimulant for nonmedical reasons than those who are not in college or who go part-time.
  • In 2009, researchers found 90 percent of college students who used Adderall non-medically were also binge drinkers.
  • Students who take prescription drugs for non-medical reasons are five times more likely to develop a drug abuse problem than those who don’t.
  • Research from 2014 reports three percent of college athletes used stimulants in the past year.

What Are the Long-Term Effects of Adderall Use in Sports?

Adderall is addictive, and it is meant only to be part of a treatment plan for disorders like ADHD or narcolepsy. Taking more than the recommended dose or when it is not needed to treat a medical condition can be very dangerous for an athlete.

Athletes who abuse Adderall might experience side effects such as:

  • Gastrointestinal issues
  • Rashes
  • Uncontrollable shaking
  • Increased blood pressure and heart rate
  • Decreased appetite

Some athletes experience increased nervousness from Adderall and are not able to concentrate. Adderall might also prevent an athlete from getting the sleep they need to perform at their best.

Long-term abuse can lead to serious issues like an enlarged heart or psychosis. Using Adderall or any amphetamine could potentially lead to the following:

  • Organ damage
  • Addiction
  • Overdose
  • Heart attack
  • Stroke
  • Death

Athletes who combine Adderall with alcohol face even more significant health dangers. Adderall may prevent them from realizing how much alcohol they consumed, which could lead to alcohol poisoning or high-risk behaviors.

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What Are Other Performance-Enhancing Drugs In Sports?

A performance-enhancing drug is any substance used to boost athletic performance. Most performance-enhancing drugs are either illegal or banned and are considered unethical and dangerous. Generally, performance-enhancing drugs fall under one of these groups:

  • Stimulants
  • Human growth hormone
  • Steroids
  • Erythropoietin

Erythropoietin is a hormone produced by the kidneys, and it helps create red blood cells which ultimately help blood transport oxygen through the body. Athletes might use erythropoietin, referred to as blood doping, to deliver more oxygen to their muscles and make them perform better.

Performance-enhancing drugs might be used to enlarge muscles, increase speed or reduce pain perception. They can include anything from illicitly-taken prescription medications to diet pills and laxatives. When an athlete uses any illegal substance to improve athletic performance, it is considered doping. Below is a list of substances athletes might abuse, and the effects these performance-enhancing drugs have on the body.

1. Anabolic Steroids

An anabolic steroid is a type of steroid that builds muscle. Anabolic steroids are available with a doctor’s prescription in the form of a pill, injection or cream. They are used to treat certain illnesses and help patients build up weak tissues. Athletes abuse anabolic steroids to build muscle mass, increase speed and quickly recover from a workout.

Professional athletes widely use anabolic steroids, but non-pro athletes also abuse steroids. In 2015, the Centers for Disease Control and Prevention (CDC) found that 3.5 percent of all high school students in the U.S have used anabolic steroids without a prescription. Risks of anabolic steroid use include:

  • Aggressive behavior
  • Can stunt growth in young users
  • Increased risk of diseases associated with sharing needles
  • Liver disease
  • Increased risk of heart disease and cancer
  • Breast growth in men and facial hair growth in women

2. Androstenedione

Androstenedione is a hormone produced by the adrenal glands, ovaries and testes. Both men and women typically convert androstenedione into testosterone. It is considered a controlled substance and is illegal as a performance-enhancing drug. Health risks in men include:

  • Breast growth
  • Reduced testicle size
  • Acne
  • Decreased sperm production

For women, androstenedione poses the following risks:

  • Acne
  • Male-pattern baldness
  • Deepened voice

Both men and women are at higher risk of a stroke or heart attack from using androstenedione.

3. Human Growth Hormone

The human growth hormone is a hormone used to improve muscle mass and performance. It’s available only by prescription and is administered through injection. Risks of use include:

  • Enlarged heart
  • Diabetes
  • Joint pain
  • Fluid retention
  • High cholesterol
  • High blood pressure
  • Weakness in muscles
  • Vision problems

4. Epoetin

Epoetin is a synthetic form of erythropoietin. Epoetin improves movement of oxygen to the muscles and is used to treat anemia. However, endurance athletes, like cyclists, commonly abuse this drug.

Epoetin is dangerous as a performance-enhancing drug and could lead to any of the following:

  • Stroke
  • Heart attack
  • Pulmonary embolism

5. Diuretics

Diuretics are medications used to remove fluid from the body by increasing urination. Diuretics are used to treat conditions such as high blood pressure. Athletes use diuretics to decrease body weight or to pass a drug test by diluting the urine. By abusing diuretics, athletes might experience:

  • Dehydration
  • Dizziness
  • Impaired coordination
  • Muscle cramps
  • Rash
  • Death

6. Stimulants

Stimulants include amphetamine, cocaine and methamphetamine. Stimulants excite the central nervous system which increases blood pressure and heart rate. Athletes may use stimulants to improve endurance, suppress appetite, reduce fatigue and increase aggressiveness. Stimulants can lead to serious side effects such as:

  • Nervousness
  • Dehydration
  • Abnormal heartbeat
  • Hallucinations
  • Heart attack
  • Insomnia
  • Addiction
  • Weight loss
  • Stroke
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