Athletes at the elite level, including Olympic weightlifters, bodybuilders, sprinters, marathoners and even archers and shooters, to name a few categories, are looking to gain a competitive advantage. Training programs are the fundamental tool for development of high performance. Even so, some athletes look to increase their competitive advantage by utilizing illegal substances. Drug testing of athletes is very sophisticated in the modern era, and 'dumb' doping attempts will almost certainly be detected, resulting in the athlete's being disqualified. Yet while testing sophistication has grown, so has the ingenuity of the drug cheats.
Sports doping, drugs in sport, illegal steroids, blood doping, banned stimulants and supplements -- and many other familiar terms denote the illegal use of certain pharmaceutical and chemical substances to improve sports and exercise performance.
Although testing provides some reassurance of legal competition, invariably some doping instances will go undetected. Below are the most popular categories of banned performance enhancing drugs and how they are used.
Synthetic Anabolic Steroids
Anabolic steroids are popular agents in activities where bulk and strength count for performance. Although natural testosterone can be described as an anabolic agent, various synthetic versions of steroids have been made popular by bodybuilders. Most steroids are relatively easy to detect, and amateur cheating has a low rate of success. Example, stanozolol.
Testosterone and Related Hormones
Testosterone is the natural male (and female) hormone. Increasing body testosterone will provide an anabolic effect. Precursor hormones that lead to increased testosterone are also used. Drug testers like to rely on 'normal ranges' because testosterone itself is naturally occurring. Examples, testosterone, DHEA.
Amphetamines and Other Stimulants
Chemical and drug agents that stimulate the nervous system and reaction times have been popular performance enhancing drugs for decades. Amphetamines in many forms, and substances like cocaine that provide similar stimulating effects have been used in a variety of sports from football to cycling, weightlifting and sprinting. Example, dexedrine.
EPO and Blood Doping
Erythropoietin is EPO, a hormone that increases red blood cell (RBC) production, which in turn improves oxygen availability to tissues. Increased oxygen improves performance, mainly in endurance events like marathons, triathlons and endurance cycle racing. There are also precursors of EPO that are banned, but this may be a lucrative source of as yet undetectable performance enhancing drugs. Examples: EPO, CERA.
Before EPO was blood doping. Blood doping is the practice of drawing and saving your own blood, allowing your body to replenish your blood supply, and then adding your own blood back to provide increased oxygen carrying capacity, much like with EPO doping.
Diuretics and Other Masking Agents
When you take steroids and other drugs they inevitably leave a trail that testers can find. One way to attempt to avoid this is to use another agent that increases urine output that might excrete traces of the banned drug. Now, though, testers look for the so-called 'masking agents' as well, so there is no escape, unless the masking agent diuretic is excreted or metabolized as well. Example, chlorthalidone (and many more).
This is an interesting one. It seems that agents that promote muscle at the expense of fat are in demand. This area could be very sophisticated, with exotic compounds such as those used in traditional weight loss treatment acting as potential performance enhancing agents. Example, clenbuterol.
Human growth hormone or HGH has been used as a supplemental drug for many years by bodybuilders and more recently by athletic sprinters. HGH is a naturally occurring substance produced by the body. A range of drugs that stimulate growth hormone production in the body are also targeted by testers. Example, HGH.
The murky world of peptides, which are essentially small proteins, have been utilized for a range of performance targets, including growth hormone stimulation and body repair. Example, thymosin.
Beta blockers are a class of drugs traditionally used in heart disease and blood pressure treatment. They slow the heart rate down substantially. Competitors such as archers, shooters and billiards players have used them to steady their shots. Example, propranolol.
This groups includes many chemical agents with somewhat idiosyncratic uses, ranging from hormonal manipulation to metabolic effects. For example, the anti-estrogen drug tamoxifen, prescribed for breast cancer treatment, has been used by men to oppose the estrogenic effects of anabolic steroids.
Drug Test Anal. 2013 Jan;5(1):1-19. Annual banned-substance review: analytical approaches in human sports drug testing. Thevis M, Kuuranne T, Geyer H, Schänzer W.