Prevalence of Substance Abuse in Sports Accurate assessment is difficult to achieve Accurate assessment is difficult to achieve

because of the sensitive and personal nature because of the sensitive and personal nature of the problem.of the problem.

Prevalence of Substance Abuse in Sports Most studies have focused on alcohol and Most studies have focused on alcohol and

steroid use:steroid use: Alcohol use: 55% of high school athletes, 87-Alcohol use: 55% of high school athletes, 87-

88% of college athletes.88% of college athletes. Performance-enhancing drugs: 5% of high Performance-enhancing drugs: 5% of high

school and college athletes report using them school and college athletes report using them (40-60% among elite athletes).(40-60% among elite athletes).

Why Athletes and Exercisers Take Drugs Physical reasons include wanting to:Physical reasons include wanting to:

enhance performanceenhance performance treat injurytreat injury look betterlook better control appetite and lose weightcontrol appetite and lose weight

Why Athletes and Exercisers Take Drugs Psychological reasons include wanting to:Psychological reasons include wanting to:

escape from unpleasant emotions or stressescape from unpleasant emotions or stress build confidence or enhance self-esteembuild confidence or enhance self-esteem get buzzed/wasted or seek fun/ excitementget buzzed/wasted or seek fun/ excitement

Social Reasons include:Social Reasons include: emulating athletic heroesemulating athletic heroes peer pressurepeer pressure

Ergogenic Aids - Definition

Any substance or treatment that Any substance or treatment that either directly improves either directly improves physiological variables associated physiological variables associated with exercise performance or with exercise performance or removes subjective restraints that removes subjective restraints that may limit physiologic capacitymay limit physiologic capacity

Ergogenic Aids

TypesTypes PsychologicalPsychological MechanicalMechanical PharmacologicalPharmacological PhysiologicalPhysiological NutritionalNutritional

Psychological Phenomena

HypnosisHypnosis MusicMusic Performance Enhancement Performance Enhancement

Techniques (PST)Techniques (PST) ““Placebo Effect” / SuperstitionsPlacebo Effect” / Superstitions

Mechanical Factors

ClothingClothing EquipmentEquipment Heat and Cold ApplicationHeat and Cold Application Improved Body MechanicsImproved Body Mechanics Environment (Playing Conditions and Environment (Playing Conditions and

Surface)Surface)

Pharmacological Agents

Over the Counter Drugs:Over the Counter Drugs: Caffeine, Nicotine, Amphetamines, Caffeine, Nicotine, Amphetamines,

Melatonin….etc;Melatonin….etc; Recreational DrugsRecreational Drugs::

Alcohol, Marijuana, Cocaine…….etc;Alcohol, Marijuana, Cocaine…….etc; Prescription DrugsPrescription Drugs::

Anabolic Steroids, BenzodiazepinesAnabolic Steroids, Benzodiazepines, , Beta-Beta-Adrenergic Agents…….etc;Adrenergic Agents…….etc;

Caffeine’s Proposed Ergogenic Effect Increased mental alertness/concentrationIncreased mental alertness/concentration

central nervous system stimulantcentral nervous system stimulant Elevated moodElevated mood Decreased fatigue Decreased fatigue Enhanced catecholamine releaseEnhanced catecholamine release Improved muscular strengthImproved muscular strength

Caffeine (Con’t)

Effect Depends onEffect Depends on:: Individual caffeine statusIndividual caffeine status Individual variabilityIndividual variability Caffeine dosage and administrationCaffeine dosage and administration

IllegalIllegal (>12ug/ml) (>12ug/ml) approx.. 5-6 cups of strong coffee or 4 vivarin for a 150 approx.. 5-6 cups of strong coffee or 4 vivarin for a 150

pound person consumed 2-3 hours before performancepound person consumed 2-3 hours before performance Problem:Problem:

caffeine is a diuretic; impairs heat tolerance;caffeine is a diuretic; impairs heat tolerance; stomach upsets; nervousness - “stomach upsets; nervousness - “unethical?unethical?””

Alcohol as an Ergogenic Aid

source of energy (?); one beer appr. 150 calories, source of energy (?); one beer appr. 150 calories, 13 grams of carbohyd. and 13 grams of alcohol13 grams of carbohyd. and 13 grams of alcohol

““uneconomical” - more oxygen needed to uneconomical” - more oxygen needed to metabolize a gram of alcohol than a gram of metabolize a gram of alcohol than a gram of carbohydrates or fatcarbohydrates or fat

psychological effect: reduced anxiety, less psychological effect: reduced anxiety, less muscle tremor (archery, not supported by muscle tremor (archery, not supported by research); greater self-confidenceresearch); greater self-confidence

Alcohol continued

negative effects on performance;negative effects on performance; increased heart rate and oxygen increased heart rate and oxygen

consumptionconsumption increased blood pressure and blood lactateincreased blood pressure and blood lactate increased reaction timeincreased reaction time impaired hand-eye coordination and visual impaired hand-eye coordination and visual

perceptionperception currently not banned by IOC except for currently not banned by IOC except for

shooting competitionsshooting competitions

Anabolic Steroids

Testosterone (must be injected or it will be Testosterone (must be injected or it will be destroyed by digestive enzymes)destroyed by digestive enzymes)

Anabolic Androgenic Steroids (AAS)Anabolic Androgenic Steroids (AAS) synthetic drugs designed to mimic the effects synthetic drugs designed to mimic the effects

of testosterone; taken orally or injectedof testosterone; taken orally or injected Human Growth Hormone (anabolic)Human Growth Hormone (anabolic)

used like steroids to increase muscle massused like steroids to increase muscle mass Beta Adrenergic Agents (Clenbuterol)Beta Adrenergic Agents (Clenbuterol)

Ergogenic Effect and Side Effects of AAS Increase muscle mass; decrease body fat; Increase muscle mass; decrease body fat;

improve strength even without trainingimprove strength even without training Side Effects (AAS):Side Effects (AAS):

acne; hair loss; male secondary sex characteristics like acne; hair loss; male secondary sex characteristics like deepening of the voice;deepening of the voice;

increased aggression, depression, hostility, suicide increased aggression, depression, hostility, suicide attempts, tendency to commit violent acts;attempts, tendency to commit violent acts;

cardiovascular disease (elevated cholesterol, blood cardiovascular disease (elevated cholesterol, blood pressure)pressure)

severe liver damage;tumors (Alzado)….. etcsevere liver damage;tumors (Alzado)….. etc

Effects and Side Effects of Growth Hormone hormone secreted by pituitary gland; stimulates hormone secreted by pituitary gland; stimulates

bone and muscle growth; effects protein, bone and muscle growth; effects protein, carbohydrate and fat metabolismcarbohydrate and fat metabolism

currently no data showing ergogenic effects currently no data showing ergogenic effects beyond the effect generated by strength trainingbeyond the effect generated by strength training

may lead to diabetes; thickening of soft tissue in may lead to diabetes; thickening of soft tissue in face, hands and feet; enlargement of organs such face, hands and feet; enlargement of organs such as liveras liver

Effects and Side Effects of Clenbuterol (illegal)

increase lean muscle mass and strength; increase lean muscle mass and strength; decrease body fat decrease body fat

less potent than anabolic steroids less potent than anabolic steroids side effects:side effects:

tachycardiatachycardia muscle tensionmuscle tension headaches and dizzinessheadaches and dizziness

Physiological Agents

Bicarbonate LoadingBicarbonate Loading Blood DopingBlood Doping Erythropoietin (EPO)Erythropoietin (EPO) Altitude TrainingAltitude Training GlycerolGlycerol Phosphate LoadingPhosphate Loading

Doping Definition (USOC)

“…“…..the administration of or use by a ..the administration of or use by a competing athlete of any substance foreign competing athlete of any substance foreign to the body or of any physiological to the body or of any physiological substance taken in abnormal quantity or substance taken in abnormal quantity or taken by an abnormal route of entry into the taken by an abnormal route of entry into the body, with the sole intention of increasing body, with the sole intention of increasing in an artificial manner his/her performance in an artificial manner his/her performance in competition is regarded as doping..”in competition is regarded as doping..”

Erythropoietin - EPO

Hormone produced by kidneys to stimulate Hormone produced by kidneys to stimulate the bone marrow to produce red blood cellsthe bone marrow to produce red blood cells

Has same effect as “blood doping” and Has same effect as “blood doping” and altitude training (more efficient use of Oaltitude training (more efficient use of O2))

IllegalIllegal Dangers: increased blood viscosity, clotting Dangers: increased blood viscosity, clotting

potential, increased risk for stroke and heart potential, increased risk for stroke and heart failure, or pulmonary edemafailure, or pulmonary edema

Nutritional Agents

Amino Acid SupplementationAmino Acid Supplementation Bee PollenBee Pollen Carbohydrate LoadingCarbohydrate Loading CarnitineCarnitine Coenzyme Q-10Coenzyme Q-10 Creatine PhosphateCreatine Phosphate Water or Special BeveragesWater or Special Beverages

Vitamins as Ergogenic Aids

Bee Pollen: Bee Pollen: mixture of vitamins, minerals, amino acids and mixture of vitamins, minerals, amino acids and

other nutrients thought to improve other nutrients thought to improve performanceperformance

Coenzyme QCoenzyme Q1010 (ubiquinon): (ubiquinon):

facilitates aerobic metabolism as part of the facilitates aerobic metabolism as part of the electron transport chain (classified as a electron transport chain (classified as a vitamin)vitamin)

Ergogenic Effect not supported by Research Ergogenic Effect not supported by Research

“There is still no sphere of nutrition in which faddism,

misconceptions, ignorance, and quackery are more obvious than

in athletics..”

(M.H. Williams in Nutrition for Fitness and Sport, 4th ed., 1995)

Ergogenic Effect Supported by Research Legal Supplements Legal Supplements

Creatine PhosphateCreatine Phosphate CaffeineCaffeine Altitude training Altitude training (equivocal)(equivocal)