Category: Performance Enhancing Drugs

Pass Long Response

A performance-enhancing drug is one that is used largely by athletes to enhance their sporting performance and gain an overall advantage over their opponents in order to win their selected sport. Performance-enhancing drugs have been around for decades and has been an ongoing problem aware within the sports community today. Nowadays there are numerous performance-enhancing drugs that can be obtained and used today. Some of these performance-enhancing drugs include Anabolic Steroids, EPO, and Diuretics. Each of these drugs have their benefits and downfalls which will be discussed throughout this response.

Currently, one of the most popular and commonly used performance-enhancing drugs within the sporting community is anabolic steroids. Anabolic Steroids are types of drugs that help aid and improve how your body deals with the growth and repair of muscle tissue. Anabolic steroids are a synthetic drug that imitates testosterone, which is the male sex hormone, commonly found in men. Anabolic steroids work by mimicking the many properties of hormones and adjusting them so they can be used by athletes. Its these common properties that enable the user to gain significant muscle mass due to the drug causing your body to increase its muscle tissue production, resulting in increased muscle mass and growth. Anabolic Steroids has its vast number benefits that seem enticing for athletes to use. Athletes take this drug due to it being a muscle-enhancing drug that provides quick and easy results that improves their athletic performance and allows them to have a solid advantage over their opponent. On the other hand, along with its many benefits, anabolic steroids have many negative side effects that come with its use. These negative effects have proven to be dangerous and sometimes fatal if the drug is abused or mistreated. Some of the short and long-term negative effects include, acne, more frequent colds, increased sex drive, and sleeping difficulties, and the long-term effects being liver damage, cardiovascular complications, and tendon and ligament damage. The negative effects are also different between genders with men more likely to experience reduced sperm count and fertility, baldness, and shrunken testicles as well as women dealing with irregular periods, depended voice, facial hair growth, and smaller breasts.

Throughout the year many athletes have been caught ‘doping’ or taking these illicit steroids to improve their performance. One of the most renowned athletes who have been caught doping was Lance Armstrong. Lance Armstrong was considered the king of cycling in the world for many years, as he dominated the Tour De France seven times in a row. This wasn’t until he was accused for doping and finally in 2013 he came clean and admitted to using steroids, resulting in his seven-year win being stripped immediately from him. Overall, anabolic steroids have their many benefits and downfalls that both impact the user in ways both good and bad, as seen with professional athlete Lance Armstrong.

Another popular performance-enhancing drug commonly used by athletes are diuretics. Diuretics are powders or pills that are available to get over-the-counter as they are most commonly used to treat patients with high blood pressure. These over-the-counter diuretics are mainly used to alter our bodies balance of electrolytes, as well as increasing the amount of water and salts that the body expels. This performance-enhancing drug is utilized as a form of quick weight loss as well as to dilute and mask any traces of other doping-banned drugs that are found in the body’s urine. Diuretics are known to have some minor risks that follow its use, including symptoms like dehydration, muscle cramps, dizziness, and blood pressure fluctuations. However, these minor side effects could be potentially fatal if potassium deficiencies increase, it will cause irregular heartbeat and ultimately kidney failure. During 2013, Olympic runner and world 200m champion of the time Veronica Campbell-Brown was tested and came back positive for banned diuretics found in her system. These banned substances that were found in her system resulted in her receiving a two-year suspension from participating in athletics. Apart from this suspension she faced a lot of hate and had her already great reputation ruined due to taking this performance-enhancing drug. To conclude, diuretics have the ability to make or ruin an athlete’s reputation as evident in Veronica Campbell-Brown’s case, where due to her taking this banned drug it caused her reputation to collapse as well as being suspended from the sport.

The last performance-enhancing drugs that aren’t banned are stimulants. Stimulants are drugs that are used to stimulate our central nervous systems in order to raise your heart rate and blood pressure. Most of these stimulants are used due to many of them being readily available nearly anywhere and most importantly not banned by the World Anti-Doping Agency, (WADA). The most common form of these stimulants is caffeine, found in many energy drinks which are very common within the sporting community. These stimulants are preferred as they are used to improve your overall endurance, suppress your appetite, reduce fatigue and increase alertness and aggressiveness. On the other hand, there are also the illicit stimulants that have the same purpose of giving energy however it is almost two times faster in entering the body and delivering the results. These illicit drugs include methamphetamines and cocaine which provide these quicker results. These benefits are followed by the risks which include dehydration, heatstroke, insomnia, and even addiction or tolerance to the drug. The more negative and dangerous side effects that certain stimulants have include, hallucinations, heart palpitations, heart rhythm abnormalities, and even heart attacks and strokes. An example of an athlete using stimulants as a performance-enhancing drug was Andreea Raducan, a Romanian gymnast that competed in the 2000 Summer Olympics in Sydney. Andreea succeeded in winning a gold medal in the Olympics that year but unfortunately had it stripped from her after she had been tested positive for pseudoephedrine, a stimulant that is found in common medicines like Sudafed. This example shows us the benefits that performance-enhancing drugs have, however, due to the use of these drugs there is great chance that the user could get disqualified or banned from the sport further justifying why it shouldn’t be used in the first place.

Overall, anabolic steroids, diuretics, and stimulants are performance-enhancing drugs that have their many benefits to help improve athletic performance as well as many side effects that follow its use. These benefits are very appealing to athletes that want to shape up, lose weight, gain muscle mass, and have increased endurance and reflexes while competing in their chosen sport. Despite these benefits, they have many negative consequences and effects like being embarrassed, disqualified, banned, and having their medal stripped away. Performance-enhancing drugs have proven to be beneficial as well as having many negative consequences which can be faced as further proven by the athletes said in the response.

Some athletes in their careers may choose to use performance-enhancing drugs to gain an advantage or improvement in their performance due to the physiological adaptions made by their body as a result of taking performance-enhancing drugs. Athletes may take the opportunity or risk-taking drugs for various reasons, however, this often creates an unfair competitive advantage for that athlete therefore it is unethical as well as medically dangerous.

Performance-enhancing drugs are predominantly used with the intention to accelerate visible athletic improvements, ranging from building mass and strength, speeding up recovery from injuries and masking the use of other drugs as well as to improve athletic performance. Commonly used performance-enhancing drugs consist of Human Growth hormones which stimulate the growth of muscle, cartilage and bone. Anabolic steroids are usually used by athletes to improve strength and power, whereby the drug enhances the male reproductive and secondary sex characteristics due to it having a similar structure to testosterone. Erythropoietin is another common enhancing drug as it increases oxygen absorption, metabolism and the healing process as well as improves endurance and reduces fatigue. Finally, both Diuretics (including; Thiazide, loop, and potassium-sparing diuretics) and alcohol are frequently used to mask the use of other drugs. Diuretics are also used to control weight and alcohol assists the athlete develop self-confidence which may lead to developed risk-taking behaviours during performance. By using performance-enhancing drugs athletes experience an acceleration to aid improvement of sports performance and to improve the physiological adaptations which are developed through training. For example; Diuretics are commonly utilised by weightlifters prior to a fight or competition (24 hours before a weight class weigh-in) to make themselves lighter to be put into a lighter weight class, then they rehydrate to be heavier then their opponent.

Athletes may choose to take performance-enhancing drugs to increase their physiological adaptations to training. For example; a sports person may utilise Human Growth Hormones (HGH) to increase muscle hypertrophy. HGH is frequently used to increase muscular endurance, and muscle size and to build muscular strength as well as improve the mass of muscles and bones. Bodybuilders may use HGH as it repairs torn muscles quicker, allowing athletes to recover quicker, therefore, enabling them to train more frequently at high intensities. This results in improved performance as the body build can gain strength through hypertrophy quicker. Whilst Erythropoietin (EPO) is used to assist the stimulation of muscle fibres which causes them to grow and to improve performance by enabling the athlete to exert greater force and repeat movements more often. However, Anabolic steroids also increase muscle hypertrophy as a result of the drug enhancing male reproductive and secondary sex characteristics (testosterone). Anabolic steroids increase the availability of hormones as a result of a higher concentration of testosterone in males in the body which as a result makes hypertrophy easier. Both these drugs assist in improving muscle hypertrophy and is beneficial for anaerobic athletes who participate in sports such as shot put, sprinting and rugby or AFL and NRL which require explosive movements. For example, a weightlifter may use anabolic steroids so that they can train hard and longer, whilst getting stronger faster.

Additionally, Erythropoietin (EPO) is used by athletes to increase their oxygen uptake a physiological adaptation. This drug increases the production of red blood cells within the body which increases oxygen absorption and allows for more efficient transportation of blood, nutrients and oxygen to working muscles. Therefore, the athlete will have a higher blood volume and cardiac output which enables the athletes to remove lactate and carbon dioxide quicker meaning the athlete is able maintain higher intensities for longer as lactate removal and oxygen delivery are faster. This is beneficial for athletes participating in aerobic sports such as; cycling, walking and swimming. For example; a cyclist may use EPO to enhance their aerobic ability, which as a result allows the cyclist to cycle harder for longer.

Erythropoietin and blood doping is also a commonly used performance-enhancing drug which is used by athletes to improve aerobic capacity. EPOs and Blood Doping contribute to a decrease in the resting heart rate of an athlete. Athletes train to decrease their resting heart rate so that their heart doesn’t need to contract as frequently, allowing them to perform at higher intensities for longer resulting from the additional room between their resting heart rate and their maximum heart rate. Having a lower resting heart rate in sports including rowing, aquarobics and running or swimming will assist the athlete to gain an advantage during their performance.

Stroke volume can also increase or improved by utilising Erythropoietin as it increases oxygen absorption and increases the number of red blood cells produced. Increases in blood flow and oxygen throughout the body means the same amount of blood can be transported around the body with fewer heart contraction. This is a beneficial adaptation as it allows the athlete to maintain high intensities for a long duration as a result of the increase efficiently in removing lactate and oxygen delivery. Improving stroke volume is particular rewarding for aerobic athletes such as runners, swimmers, or cyclists as they receive profound advantages and increased performance by using aerobic training.

Using performance-enhancing drugs in sports is considered unethical as they provide the athlete with an unfair advantage, where the competition is no longer based on an even playing field and disregards the natural ability of the players, consequence establishing an inequality of opportunity for the participating athletes. The effects on the health of the athletes is another ethical consider involved with the use of performance-enhancing drugs in sports. The drugs are often associated with numerous medical conditions and side effects which have a major influence of the athletes’ health. These medical concerns include; an increased risk of developing a heart disease as well as countless side effects which vary from drug to drug. For example; Diuretics can cause dehydration, dizziness, cramps, heart damage and kidney failure, where Erythropoietin effects consist of; hypertension, blood cancers/ leukaemia, anaemia, pulmonary embolism, nausea and can lead to an increased thickening of blood, which can cause clotting, thrombosis and may ultimately cause a heart attack or stroke. Sports persons who use performance-enhancing drugs are developing an unfair advantage, as well as contributing to ethical concerns by gaining something such as performance-enhancing drugs which are not available to all athletes, especially athletes who follow the rules.

Introduction

It can be seen throughout the history of sports that there have always been ways of enhancing an athlete’s performance. Some ways may be natural, but the one that brings the most controversy is the use of performance-enhancing drugs. These performance enhancement drugs are used by primarily athletes and bodybuilders to increase their muscle size and strength as well as their appearance and performance in events (1). The main type of performance enhancement drug is anabolic-androgenic steroids (2). The history of individuals using performance enhancement drugs can be traced back to nearly a century ago in 1939 when Germany was designing anabolic-androgenic steroids to help treat medical conditions such as depression and cryptorchidism. It has even been speculated that during World War 2 that the Nazis used these anabolic-androgenic steroids and gave them to their soldiers to enhance their performance and aggressiveness in battle (3). Use of anabolic-androgenic steroids then began to be used and abused by Olympic athletes until they were eventually banned in 1976. Even though they were banned, some athletes still continue to use them to this day and risk getting caught using the illegal substances. It is also not uncommon for these athletes to use multiple performance-enhancing drugs at the same time such as amphetamines and diuretics. An athlete may use a diuretic drug for the purpose of covering up the use of another performance-enhancing drug. The way that the diuretic does this is by diluting the urine of the athlete and some can even change the pH of the urine and only allow certain aspects of drugs to leave the body (4). Diuretics were eventually banned by the International Olympic Committee and the World Antidoping Agency and they continue to annually update the list of banned substances (4). With this list being annually updated and performance-enhancing drugs being harder to detect through a test, the ethical question must be asked about whether or not athletes should be allowed to use performance-enhancing drugs or not.

Just like any other argument, there are two sides and both sides will be addressed in this paper. The majority of this argument lies in the social and ethical issues of allowing athletes to use these drugs. One of the ethical issues is whether or not the spirit of sport would be violated by allowing athletes to use these performance-enhancing drugs. The spirit of sport can be defined as the values of ethics, the health of the players, and equality for all players (5). One side sees that performance enhancement drugs would make sports an unequal playing ground and would completely change the dynamics of sports as we see them today. From this point of view, it would turn sports into a competition of who has the better technology and substances to enhance their players and not necessarily a competition of who is more physical naturally (6). On the other side of this argument, the argument made is that performance-enhancing drugs are allowed in other professions and they are not nearly as criticized as much as professional athletes who get caught using performance-enhancing drugs. It has been seen that there have been musicians who will use beta-blockers to decrease their heart rate and blood pressure to control their performance anxiety and stage fright (6).

It has been mentioned earlier that these performance enhancement drugs can drastically increase the strength and endurance of an athlete as well as other advantages. These advantages need to be compared with the short-term and long-term effects on the physical and mental health of the individuals who choose to take these performance enhancement drugs. The majority of the short-term health effects of using anabolic-androgenic steroids for example are reversible, but the same cannot be said about the long-term effects (7). Some of the mental health aspects that can also be associated with performance enhancement drugs such as behavioral changes. The Dark Triad has been associated with athletes who choose to use these drugs. The Dark Triad consists of the personality traits of Machiavellianism, psychopathy, and narcissism and will be discussed later on in the paper (8). There are plans to implement a better support system for health issues that are associated with performance enhancement drugs and these will be addressed later as well. Although there are side effects seen that could be potentially detrimental to an individual’s health, there is a side to the argument that sees the risk of performance-enhancing drugs as equivalent to any other risk that comes when participating in sports. Players are always at risk for injuring themselves in sports whether they are minor or major injuries, so it is important to take into account that the risks of short-term and long-term health effects of the athletes will not go away by not allowing performance enhancement drugs into sports.

Biology/Scientific Background:

Anabolic-androgenic steroids (AAS) are hormones that consist of testosterone and other derivatives. All AAS have both anabolic and androgenic effects on the body (Kanayama, 2017). Anabolism is when nitrogen is retained in lean body mass through protein synthesis and there is a decrease in protein breakdown. Androgenism is the physical changes in the body which primarily consist of secondary male characteristics (Osta, 2016). The anabolic effects include an increase in muscle growth and fat loss and the androgenic effects include deepening of the voice and increases other secondary male characteristics such as facial hair (Kanayama, 2017). The steroids are able to do this because the testosterone is an androgen and has different ways of effecting the body. One way is testosterone will bind to androgen receptors in target tissues and will work on producing androgenic effects such as secondary male characteristics and libido. The second step in how these drugs work is that then the testosterone will be reduced to 5 α- dihydrotestosterone and will act on the androgen receptor. Another way that testosterone may act on the body is that it may be changed to an estradiol and have more estrogenic effects such as retaining water, increase in breast tissue size, and increasing body fat deposition (Osta, 2016). Besides testosterone, there are three other active compounds that are found in AASs which are nandrolone, boldenone, and trenbolone (Osta, 2016).

In order to use anabolic-androgenic steroids, testosterone first has to be isolated. This was first discovered in 1935 by Dutch and German chemists. By discovering how to do this, the intention of these chemists was to use these anabolic-androgenic steroids to treat medical conditions such as the dropping of testosterone levels in middle-aged men (Kanayama,2017). Once it was discovered that these drugs could be used to increase muscle size and strength and help with other athletic activities, they started to be used and abused by athletes in order to achieve an advantage over their competition. An infamous example of this was seen by the German Democratic Republic (GDR) during the Cold-War era. The entire country had a program set in place in which their Olympic athletes would be given AAS to increase their performance in the Olympics. Even though the use of AAS was banned by the Olympics in 1967, the GDR was able to evade detection by using various techniques to pass the urine tests that the Olympic committee had in place to test for the use of AAS. These techniques included having the athletes stop taking the drugs within a certain time frame before the test date was scheduled to take place (Kanayama, 2017). The GDR was able to achieve 150 gold medals between 1960 and 1990 before the information of this program was released due to the fall of the Soviet Union. It was also found that a majority of their athletes were females and they were suffering from substantial and even in some cases irreversible masculine characteristics due to the androgenic effects of AAS (Kanayama, 2017). Some of the effects that are experienced by female users include their voices deepening, decrease in breast size, acne, more body hair, and an increase in the size of the clitoris (Bird, 2015).

Although these changes were seen in females from the GDR, the majority of side effects of using AAS is seen in males due to the fact that majority of AAS users are male. Some of the other side effects seen by taking AAS include acne, hair loss, and urinary tract infections due to the prostate enlargement are due to the androgenic effects of AAS. The more serious side effects are seen in long-term and heavy users of AAS. Normally, AAS are taken either orally or injected during 4-12 week periods known as cycles. Heavy users are known to use a technique known as the mass building-stacks which is when the user will take testosterone and other drugs that will maximize their muscular and strength capacity. This will then lead into a cycle known as the cutting cycle which is where drugs with a larger dose of androgens will be taken for body definition. This cutting cycle will then be followed by a post-cycle therapy which includes drugs with anti-estrogens to restart androgen production in the user’s testicles (Osta, 2017). When going through these cycles, the kidneys are significantly impacted. Chronic use of AAS has been linked to renal failure. This could be due to the fact that diuretics are being used by athletes and bodybuilders along with AAS to help increase performance and as a masking agent.

Diuretics have been banned in sports both competitively and noncompetitively since 1988. One of the reasons why they have been banned is due to the fact that users can use diuretics due to the fact that these drugs have the ability to remove water from the body. This can allow athletes such as boxers or any other sport that uses weight classes to fluctuate between weight classes due to the ability of these drugs having the capability to cause rapid weight loss. The main reason why these drugs have been banned is due to the fact that diuretics can be used as a masking agent for other drugs such as AAS, which is why they are used in unison with these drugs (4). The diuretics will increase the volume of the user’s urine and will dilute the concentration of other substances that could be detected in the urine, making it harder to determine a positive test result (4).

A study at Columbia University that was conducted on ten bodybuilders who used AAS for many years and it was found that there was proteins leaking into the urine and there was a significant decrease in kidney function in these individuals. In 90% of the subjects being tested, it was found that they all had scarring on the kidneys that is usually seen when the kidney is overworked. The scarring seen was worse than what is seen in morbidly obese patients. The researchers conducting the study believe that when these athletes and bodybuilders are extremely increasing their muscle mass and size that it is causing their kidneys to increase their filtration rates. These increased rates put more stress on the kidneys which leads to the scarring and failure (https://www.sciencedaily.com/releases/2009/10/091029141202.htm). On top of the renal issues seen in AAS users, the main health concerns are involved with the heart and the heart’s activity.

Testosterone is a prevalent ligand of androgen receptors in skeletal and cardiac tissue. With the prevalent use of AAS, it will cause harmful effects on the body such as cardiac toxicity (3). There have been studies to test to see how the prolonged use of AAS could cause cardiac toxicity. It has been seen that when someone takes AAS, it will cause changes in their lipid metabolism such as increases in low-density lipoprotein (LDL) levels and decreases in high-density lipoprotein (HDL) levels. This is due to the AAS increasing hepatic triglyceride lipase activity, which causes the LDLs to be made and the HDLs to be broken down (3). These changes are however reversible, but the risk of cardiac disease is three times more likely to occur when someone uses AAS. AAS has also been found to cause heart attacks in young patients who have never had any trace of coronary heart disease. This is due to AAS use causing coronary vessel reactivity. Once the AAS is in the body and the bloodstream, it will lower the production of cyclic guanosine monophosphate and does this by inhibiting geranyl transferase. This will work with the increased levels of LDL, not allowing nitric acid in the body to activate guanylyl transferase. This will in turn cause damage to the vascular endothelium in the heart (3). Another aspect of the body that AAS will have an effect on is the gonads and reproduction in the users.

Androgen is involved in the development of male reproductive organs such as the epididymis, vas deferens, seminal vesicles, prostate, and penis, and is necessary for puberty to take place as well. There is also a high amount of testosterone that is needed for spermatogenesis to take place (Osta, 2016). When an AAS user takes these drugs though, it will reduce the concentrations of gonadotrophic hormone, luteinizing hormone, and follicle-stimulating hormones due to the AAS preventing the hypothalamic-pituitary-testicular axis in the body (Bird, 2015). Another substance that is reduced in this process is globulin, which acts as a sex hormone- binder. These reductions in hormones will result in other changes such as smaller testicle size and altered sperm production and characteristics such as lower sperm counts, and altered motility and morphology (Bird, 2015). Most of these side effects seem to be reversible in users once they stop taking AAS after 4-12 months, but these results can lead to infertility in chronic users of AAS (Osta, 2016). AAS use has also been associated with mental health issues and this could be due to the physiological changes that happen to the brain with chronic AAS use (Bird, 2015).

Performance Enhancing Drugs

History

Performance-enhancing drugs have been used since the Greek Olympic games around 776-393 BC. Some forms of drugs that athletes would use included herbal mixes, wine potions, and hallucinogens (History of Performance Enhancing Drugs in Sports). According to a timeline Roman gladiators used stimulants and hallucinogens to prevent fatigue and injury (History of Performance Enhancing Drugs in Sports). The gladiators would use these drugs during chariot races to make their horses faster. The gladiators themselves would also take hallucinogens and stimulants such as strychnine to stave off fatigue and injury to improve the intensity of their fights.

Late 19th Century.

In a timeline of performance-enhancing drugs, it states, “The modern applications of a drug is n sports began in the late nineteen century, with preparations made from the coca leaf — the source of cocaine and related alkaloids”(History of Performance Enhancing Drugs in Sports). As performance-enhancing drugs were getting more and more popular in the normal world, they began to reach more far-spread to anyone willing to take them. In the 1904 Olympics marathon runner, Thomas Hicks was using a mixture of brandy and strychnine and nearly died(History of Performance Enhancing Drugs in Sports). By no means are any form of drug good for you, therefore Hicks almost died by mixing drugs to increase his odds of winning in the 1904 Olympics. In 1928 there was a breakthrough of the first rule against doping in sports. The International Association of Athletics Federation was the first governing body to prohibit doping by athletes. In 1940 to 1945 Nazis were testing steroids on prisoners and Hitler himself. In 1945 to 1947 anabolic steroids were used to help reverse wasting effects of war and concentration-camp imprisonment (Si Staff). In 1954 the U.S.S.R. began dominating the sport of powerlifting. The doctor of the Soviet team allegedly revealed that the team had been using testosterone to beat the U.S. team. The doctor of the U.S. team began working on creating a refined synthesis technique that would cut all of the side effects of the current technique of synthesizing testosterone. Ziegler makes a new anabolic steroid that is named Dianabol. In 1958 the FDA approved the first anabolic steroid. The International Olympic Committee began drug testing athletes for the Olympics started. The normal people in society read a magazine published by Sports Illustrated that exposed athletes that took tranquilizers, cocaine, and other drugs in elite sports. This magazine sparked a fire for Sports Illustrated, as they produced a three-part investigation about performance-enhancing drugs in sports in 1969. As more and more athletes and bodybuilders began using drugs to increase their performance in their field, organizations began catching them by performing drug tests on them to punish them for using them. The anti-doping regime started to gain its current form in the 1970s. According to an article by Harvard, “In 1971, the IOC Medical Commission released the first list of banned substances, which included stimulants and narcotic analgesics”( Performance Enhancing Drugs: History, Medical Effects & Policy (2006 Third Year Paper)). The most famous Olympic scandal was the positive test of Ben Johnson. He was one of the world’s fastest sprinters during that time. Canada favored him so much that he had earned the Order of Canada, which was Canada’s highest civilian award. In the 1988 Olympics, he had to face his rival, Carl Lewis. The end result was Johnson winning the gold medal with Carl with a silver medal. After the event had ended the post-race testing had tested positive for stanozolol, which was a powerful anabolic steroid. Johnson was stripped of his gold medal in which Carl had been given the gold medal. In the end, Canada established the Commission of Inquiry Into the Use of Drugs and Banned Practices to Increase Performance. Another scandal that occurred happened ten years later in 1998. The scandal involved Willy Voet during the Tour de France. Voet was arrested for possession of various illegal prescription drugs, including narcotics, erythropoietin, growth hormones, testosterone, and amphetamines.