Doping in Competitive Sports

Products

Doping agents include approved drugs, legal and illegal intoxicants, experimental agents, and illegally manufactured and trafficked substances. Doping includes non-drug doping methods, such as blood doping, in addition to drugs.

Effects

Doping agents differ in their pharmacological activities. Stimulants, for example, stimulate and thus increase alertness and aggressiveness for competition. In contrast, beta-blockers provide a steady hand, which is required for sports shooting, for example. Anabolic steroids promote muscle building and fat loss. Opioids are analgesic and depressant, and EPO stimulates red blood cell formation in the bone marrow and improves oxygen-carrying capacity. Masking agents such as diuretics disguise drug abuse by increasing their excretion. Incidentally, the extent to which doping agents may actually improve athletic performance is controversial.

Abuse

For illegal performance enhancement in amateur and professional sports.

Dosage

For administration, basically the different types of application are used. For example, doping agents can be ingested, injected, inhaled or given transdermally. They are administered as needed, before or during competition, on a regular basis, or in therapeutic cycles.

Active Ingredients

The following is an incomplete selection of doping agents. The current doping list valid for Switzerland can be found at the Foundation Antidoping Switzerland (https://www.antidoping.ch). This is based on the internationally valid list of the World Anti-Doping Agency, which is updated annually (World Anti-Doping Agency, WADA, https://www.wada-ama.org). Which substances are banned also depends on the sport, the dose, diseases (e.g. beta2-sympathomimetics in asthma) and whether the athlete is in the training phase or in competition. For example, most stimulants and narcotics are prohibited only during competition. However, it should be noted that active substances with a long half-life can still be detected for days or weeks. This is the case for cannabis, for example. Alcohols:

Anabolic steroids (anabolic steroids) / androgens:

  • Dehydroepiandrosterone (DHEA)
  • Nandrolone
  • Stanozolol
  • Testosterone

Aromatase inhibitors:

  • Anastrozole
  • Exemestane
  • Letrozole

Beta blockers:

  • Bisoprolol
  • Metoprolol
  • Propranolol

Beta2-sympathomimetics:

  • Clenbuterol
  • Fenoterol
  • Salbutamol
  • Salmeterol
  • Terbutaline

Blood products:

  • “Blood doping”
  • Blood manipulation (doping method), artificial blood.

Cannabinoids:

  • Cannabis
  • Spice
  • Tetrahydrocannabinol
  • Cannabidiol is allowed, but CBD products may contain the banned THC.

Diuretics (masking agents):

  • Potassium-sparing diuretics
  • Loop diuretics
  • Thiazides

Epoetins:

  • EPO

Gene doping:

  • Nucleic acid polymers
  • Nucleic acid analogs
  • Genetically modified cells, vectors such as bioengineered viruses.

Glucocorticoids:

  • Cortisone
  • Deflazacort
  • Hydrocortisone

Hormones:

  • Somatropin (growth hormone)
  • Growth factors
  • Growth hormone-releasing hormone

Infusions:

  • Intravenous infusions and/or injections of more than 100 ml in a 12-hour period, with exceptions such as hospital treatment or surgery.

Opioids:

  • Fentanyl
  • Heroin
  • Methadone
  • Morphine
  • Oxycodone

SERM:

  • Raloxifene
  • Tamoxifen

Metabolic modulators:

  • GW1516
  • Insulins
  • Meldonium
  • Trimetazidine

Stimulants:

  • Amphetamines
  • Cathinone derivatives
  • Cocaine
  • Methylphenidate
  • Modafinil
  • Nicethamide

NOT prohibited are, for example, caffeine, nicotine or ammonia.

Doping and drug therapy

Despite the numerous prohibited doping substances and methods, it must be possible for athletes to use medicines in case of illness or injury. For this reason, the Antidoping Switzerland Foundation publishes a selection of permitted and doping-free medicines, the “List of permitted medicines”. When medicines are supplied to athletes, it must be ensured that the preparations do not contain any critical substances. A database of the Antidoping Switzerland Foundation, an app and a telephone information service are available for this purpose. Caution, foreign medicines with the same name may contain other active substances. High-quality medicines without possible impurities should be used. Even seemingly harmless and over-the-counter medicines such as cold and cough remedies may contain doping agents. Another example is gly-coramine with the active ingredient nicethamide. This also applies to herbal remedies (e.g. with ephedrine) and even homeopathics (possibly traces of strychnine in Nux Vomica). Caution is also advised with so-called supplements, as they may be contaminated with doping agents – such as ephedrine, sibutramine or even anabolic steroids. This applies especially to products of inferior quality.

Adverse effects

Many of the agents presented can cause severe and even life-threatening adverse effects. In the case of illegally manufactured agents, there is the additional problem of impurities. Also, there is no guarantee that they actually contain the correct active ingredient in the specified dose. Legal doping with painkillers such as ibuprofen and other NSAIDs can also trigger numerous side effects. The fact that a drug is not on the doping list does not mean that it is well tolerated.