AMH >

Drugs in sport

Despite lack of scientific data, there is widespread belief that many drugs will enhance sporting performance. Misuse of drugs at all levels of competitive and non-competitive sport is prevalent, and has been condemned by all sporting bodies.

Health professionals may be consulted by athletes to treat medical conditions arising from the use of drugs, to advise on complications that may occur as a result of drug use, or to prescribe drugs for the purpose of performance enhancement.

When consulted, health professionals should be non-judgmental and objective in their advice. There are no controlled data showing that prescribing drugs in this area will either minimise use or decrease adverse reactions. Physicians should not condone or prescribe drugs for the purpose of enhancing sporting performances.

The primary concern of health professionals should be the health of the athlete.

‘Doping’ is the use of substances or methods which are capable of enhancing performance and are potentially harmful to an athlete’s health. This term covers the attempted use or possession of prohibited substances and methods attempting to mask their presence.

Most sports take guidance from the World Anti-Doping Code (WADC). This is produced by the World Anti–Doping Agency (WADA) and revised at least annually (see website below). It currently divides prohibited substances into 9 main groups:

anabolic agents, eg nandrolone, stanozolol, testosterone
hormones and related substances, eg growth hormone, erythropoietin
beta₂ agonists, except inhaled drugs used for asthma with the proper medical authority
hormone antagonists and modulators, eg clomiphene, tamoxifen
diuretics and other masking agents, eg probenecid
stimulants, eg amphetamines, ephedrine and related substances
narcotics, eg morphine
cannabinoids, eg marijuana
glucocorticosteroids (depending on route of administration).

If drugs are required to manage a medical condition in an elite or competitive athlete, care must be taken to avoid any prohibited drugs. The athlete and their physician should confirm with the Chief Medical Officer of the relevant sport whether it may be used legitimately under the doping rules of the specific sport. In some cases a therapeutic use exemption can be requested.

Performance enhancing drugs are often taken in combination, administered in an unsupervised manner, and involve doses well in excess of those used in treatment. Health professionals should be alert to the possibility of unusual adverse reactions occurring in athletes, such as occlusive vascular events, hyperthermia or psychotic episodes. Continuing research is needed to monitor the use and adverse effects of drugs in sport, and to detect and evaluate the effects of new drugs emerging in this area.

The substances that are banned or restricted by most national sporting organisations are based on those banned by WADA and the International Olympic Committee (IOC). For current advice about prohibited or allowed products, contact the Australian Sports Anti-Doping Authority (ASADA) hotline, phone 1800 020 506 (during office hours). The current edition of the Anti-Doping Handbook, published by the ASADA for use by athletes, is also recommended.

Links to the prohibited list as well as general information may be found at the following websites: