Onderzoek naar het gebruik van prestatieverhogende middelen bij bodybuilders in Nederland / A. de Boer, S.F. van Haren, F. Hartgens, D. de Boer, A.J. Porsius. - Universiteit Utrecht; i.o.v. Nederlands Centrum voor Dopingvraagstukken (NeCeDo). – Rotterdam : NeCeDo, 1996

• ISBN 908009285l

Evaluation of the use of doping among bodybuilders in the Netherlands / A. de Boer, S.F. van Haren, F. Hartgens, D. de Boer, A.J. Porsius. – Utrecht University; Netherlands Centre for Doping Affairs (NeCeDo). - Rotterdam : NeCeDo, 1996

• ISBN 908009285l

Inhoud:

1.1 Aanleiding tot het onderzoek
1.2 Doelstelling
Methode
2,1 Studie-opzet
2,2 Plaats van uitvoering
2.3 Deelnemers
2.4 Vragenlijst
2.5 Analyse
Resultaten
3.1 Algemene karakteristieken van de deelnemers
3.2 Gewichtstraining
3.3 Androgene-anabole steroïden
3.3.I Perceptie schadelijkheid
3.3.2 Prevalentie gebruik en preparaatkeuze
3.3.3 Toepassingswijze
3,3.4 Motivatie gebruik
.3.3.5 Gewenste en ongewenst effecten
3.3.6 Herkomst en begeleiding
3.4 Andere prestatie verhogende middelen
3.5 Determinanten voor het gebruik van AAS
3.6 Risicogedrag onder gebruikers van androgene-anabole steroïden
4. Discussie
4.1 Deelnemers
4.2 Androgene-anabole steroïden
4.2.I Perceptie schadelijkheid
4.2.2 Prevalentie gebruik en preparaat keuze
4.2.3 Toepassingswijze
4.2.4 Gewenste en ongewenste effecten
4.2.5 Herkomst en begeleiding
4.3 Andere prestatie verhogende middelen
4.4 Determinanten voor het gebruik van androgene-anabole
steroïden
4.5 Risicogedrag naast het gebruik van androgene-anabole steroïden
5. Conclusie
6. Aanbevelingen

Summary:

The aim of the study described in this report was to evaluate the use and handling of doping by bodybuilders in the Netherlands. Twelve hundred questionaires were aministered to bodybuilders who visited the Dutch Championship of Bodybuilders in 1994. Twenty-four percent of the questionnaires (291 participants) were returned to the investigators with acceptable information.
The number of male and female participants was 227 (79%) and 59 (21%), respectively and the average age was 28 years (range 15 to 63). Anabolic-androgenic steroids (AAS) were ever used by 128 (44%) of the participants (female 17% and male 52%). Stratification for competitive versus recreational bodybuilders showed ever-use by 77% (female 57%, male 79%) and 37% (female 12%, male 45%), respectively. Fourty-seven different proprietary-titled AAS preparations were mentioned by the participants and, especially, male bodybuilders often switched between different compounds. Mostly, the compounds were obtained from the black market (more than 70%) and most AAS-using bodybuilders had no medical guidance (less than 30%). The average duration of regular use of AAS was 3.5 years (range 0.2 to 40 years). The doses per week for all AAS varied from 10 to 800 mg.
The route of administration was oral in 18%, parenteral in 9%, while 71% used both routes. The average duration of a course of AAS was 8.6 weeks (±2.4; range 3.5-20) and the average number of courses per year was 2.0 (±1.0; range 1.0-6.5). Fifty-seven percent reported to have ever used more then one AAS concomitantly ('stacking').
Combinations of 2, 3 and 4 AAS occurred in 49, 37, and 14%, respectively. The combination of a methandrostenolone and nandrolone preparation was reported most often. Between courses 12% reported to use AAS as maintenance therapy.
Especially, niethonolone (Primobolan®) was used for this purpose (by 73%). Part of the maintenance therapy was to overcome withdrawal symptoms (reported by 18%) after an AAS course. Six percent of the male bodybuilders reported to be addicted to AAS.
Almost 90% of the AAS-using bodybuilders reported to experience side-effects of these compounds. Most often reported were increased sexual drive (51%) and aggressiveness (47%), hypertension (21%) and fluid retention (37%). Women, especially, reported acne (50%) and increase in body hair (30%). Twenty-three percent of the male and 17% of the female participants had ever used doping other then AAS. Especially, chorionic gonadotrophin, clenbuterol, lonamin®, tamoxifen and clomiphene citrate were reported.
For a number of determinants there was a statistically significant association with the ever-use of AAS: gender (male versus female: odds ratio 5.2 with 95% confidence interval 2.5-10.8), age(> 35 versus 15-25 years: odds ratio 2.3; 1.1-4.8), motivation for bodybuilding (expansion of muscle volume versus other reasons: odds ratio 6.0; 2.3-15.9 and competitive versus recreational bodybuilding: odds ratio 5.0; 2.5-10.0). Also intensity of bodybuilding, body weight and the use of dietary supplements were strongly associated with AAS-use. Among the bodybuilders who had ever used AAS, the use of soft and hard drugs was increased compared to nonusers of steroids (odds ratio 2.0; 1;2-3.4). The odds on ever smoking among ever users of AAS was 2.0 times higher (1.3-3.3) compared to bodybuilders who never used steroids. There was no association between the use of alcohol and steroid-use (odds ratio 0.8; 0.5-1.3). The use of drug-doping other than AAS was reported 6.3 times as often (3.2-12.5) among users of MS. This risk-behavior was more pronounced among male bodybuilders.
In conclusion, although the representativeness of this study is unknown the use of doping appears to be wide spread among bodybuilders in the Netherlands. Due to the often unknown origin of the compounds, the lack of medical guidance and other risk-behavior among AAS-users, these bodybuilders have an increased risk for health problems.

Samenvatting:

In dit rapport is een onderzoek beschreven waarbij het gebruik van prestatie verhogende middelen middels een vragenlijst is geïnventariseerd bij bodybuilders in Nederland. In 1994 werden op de Nederlandse kampioenschappen bodybuilding twaalfhonderd vragenlijsten uitgedeeld aan bezoekers die aan bodybuilding deden en aan deelnemers van de wedstrijd. In totaal werden 291 vragenlijsten (24%) met bruikbare informatie geretourneerd.
Het aantal mannelijke en vrouwelijke deelnemers was respectievelijk 227 (79%) en 59 (21%) en de gemiddelde leeftijd was 28 jaar (uitersten 15 tot 63 jaar). Van de deelnemers had 44% (vrouwen 17% en mannen 52%) ooit anabole-androgene steroïden (AAS) gebruikt. Voor de bodybuilders die aan wedstrijden deelnamen was dit 77% (vrouwen 57% en mannen 79%) en voor de recreatieve bodybuilders 37% (vrouwen 12% en mannen 45%). Het aantal gebruikte merkpreparaten was 47 en met name de mannelijke bodybuilders wisselden vaak van preparaat. De preparaten kwamen meestal van de zwarte markt en er was beperkt sprake van medische begeleiding. De AAS werden vaak parenteraal toegediend, de kuurlengte was gemiddeld 8 weken en gemiddeld werden 2 kuren per jaar gebruikt. Het gelijktijdig toedienen van meerdere AAS ('stacking') kwam bij 68% van de AAS-gebruikers voor en 12% gebruikte tussen de kuren in ook nog AAS als onderhoudstherapie. Voor een deel diende het laatste ter onderdrukking van onthoudingsverschijnselen en 6% van de mannelijke AAS-gebruikende bodybuilders achtte zichzelf verslaafd aan AAS. Wedstrijdbodybuilders en vrouwen bleken voor wat betreft de genoemde factoren respectievelijk onveiliger en veiliger om te gaan met AAS.
Bijna 90% van de bodybuilders gaf aan bijwerkingen te ondervinden van het gebruik van AAS. Met name werden een verhoogde sexuele aandrang (51%) en agressiviteit (47%), hoge bloeddruk (21%) en vochtretentie (37%) genoemd. Vrouwen gaven tevens acné (50%) en toegenomen haargroei (30%) op.
Drieëntwintig procent van de mannelijke en 17% van de vrouwelijke bodybuilders hadden ooit gebruik gemaakt van andere prestatie verhogende middelen dan AAS. Met name Pregnyl®, clenbuterol, Ionamine®, Nolvadex® en Clomid® werden hierbij opgegeven. Voor een aantal factoren werd een duidelijke samenhang aangetoond met AAS gebruik. Duidelijk risicofactoren voor AAS-gebruik waren het mannelijk geslacht, oudere leeftijd, vergroting van de spiermassa als motivatie voor gewichtstraining en competitiedeelname. Ook duur en intensiteit van training, lichaamsgewicht en het gebruik van voedingssupplementen hingen sterk samen met AAS-gebruik. Ten opzichte van de bodybuilders die geen AAS gebruikten, vertoonden de mannelijke en in mindere mate de vrouwelijke AAS-gebruikende bodybuilders tevens een risicogedrag ten aanzien van het gebruik van genotmiddelen (tabak en soft en hard drugs) en andere prestatie verhogende middelen.
Alhoewel de representativiteit van deze studie onduidelijk is, is het gebruik van prestatie verhogend middelen bij bodybuilders waarschijnlijk wijd verspreid. Door de onbekende herkomst van de preparaten en het gebrek aan medische begeleiding lopen deze sporters duidelijke gezondheidsrisico's

Tricker R, Connolly D.
J Drug Educ. 1996;26(2):159-81.
Department of Public Health, Oregon State University, Corvallis 97331-6406, USA.

In general there is a lack of information describing the components and structure of drug education and prevention programs (DEPP) for college student athletes. While concern about the prevalence of drug abuse among college student athletes has increased, a relative lack of clarity remains regarding what elements of drug education prevention programs have been successful or unsuccessful in this setting. In an effort to address this issue at Oregon State University a two-credit ten-week DEPP was implemented as a requirement for all collegiate athletes. This article describes the evaluation of this program.

Altogether 635 student athletes from three National Collegiate Athletic Association (NCAA) Division One universities provided data in this two-year evaluation project. Participants were student athletes from Oregon State University (OSU), a Mid-Western University (MWU), and another Pacific North-Western University (PNWU). Pre- and post-test data were collected regarding knowledge about drugs, attitudes toward drug use, drug use, and decision-making factors. Students at OSU and MWU were enrolled in a structured DEPP, and the third group from PNWU was used as a control and did not receive regular instruction.

The baseline data taken before the drug education course indicated that athletes at OSU, MWU, and PNWU were no different in their knowledge of drugs, attitudes toward drugs, or perception of the value of drug education in preventing drug abuse among student athletes. However, the data at the end of the ten-week course revealed many significant improvements among OSU and MWU students athletes, in knowledge, attitude related to performance enhancing drugs and recreational drugs, and perceptions of drug education.

At the end of the course 88 percent of the participating OSU athletes agreed that drug education can be effective in preventing drug abuse among student athletes.

PMID:
8758886
[PubMed - indexed for MEDLINE]

Linn Goldberg, MD; Diane L. Elliot, MD; Gregory N. Clarke, PhD; David P. MacKinnon, PhD; Leslie Zoref, PhD; Esther Moe, PhD; Christopher Green, MEd; Stephanie L. Wolf
Arch Pediatr Adolesc Med. 1996;150:713-721

Objective: To develop and test a school-based intervention to prevent anabolic androgenic steroid use among high-risk adolescent athletes.

Design: Nonrandom controlled trial.

Setting: Two urban high schools.

Participants: Fifty-six adolescent football players at the experimental school and 24 players at the control school.

Intervention: Eight weekly, 1-hour classroom sessions delivered by the coach and adolescent team leaders, and eight weight-room sessions delivered by research staff. The intervention addressed sports nutrition and strength training as alternatives to steroid
use, drug refusal role play, and antisteroid media campaigns.

Outcome Measures: A preintervention and postintervention questionnaire that assessed attitudes toward and intent to use steroids and other drugs; knowledge of drug effects; and diet, exercise, and related constructs.

Results: Compared with controls, experimental subjects were significantly less interested in trying steroids after the intervention, were less likely to want to use them even if their friends used them, were less likely to believe steroid use was a good idea, believed steroids were more dangerous, had better knowledge of alternatives to steroid use, had improved body image, increased their knowledge ofdiet supplements, and had less beliefin these
supplements as beneficial.

Conclusions: Significant beneficial effects were found despite the sample size, suggesting that the effect of the intervention was large. This outcome trial demonstrates an effective anabolic androgenic steroid prevention program for adolescent athletes, and the potential of team-based interventions to enhance adolescents' health.

Linn Goldberg, MD; Diane Elliot, MD; Gregory N. Clarke, PhD; David P. MacKinnon, PhD; Esther Moe, PhD; Leslie Zoref, PhD; Christopher Green, MEd; Stephanie L. Wolf; Erick Greffrath; Daniel J. Miller, MS; Angela Lapin
JAMA 1996;276:1555-1562
Health Promotion and Sports Medicine, Department of Medicine, Oregon Health Sciences University, 3181 SW Sam Jackson
Park Rd, CB 615, Portland, OR 97201-3098.

Objective.—To test a team-based, educational intervention designed to reduce adolescent athletes' intent to use anabolic androgenic steroids (AAS).

Design.— Randomized prospective trial.

Setting.—Thirty-one high school football teams in the Portland, Ore, area.

Participants.—Seven hundred two adolescent football players at experimental schools; 804 players at control schools.

Intervention.—Seven weekly, 50-minute class sessions were delivered by coaches and student team leaders, addressing AAS effects, sports nutrition and strength-training alternatives to AAS use, drug refusal role play, and anti-AAS media messages. Seven weight-room sessions were taught by research staff. Parents
received written information and were invited to a discussion session.

Main Outcome Measures.—Questionnaires before and after intervention and at 9- or 12-month follow-up, assessing AAS use risk factors, knowledge and attitudes concerning AAS, sports nutrition and exercise knowledge and behaviors, and intentions to use AAS.

Results.—Compared with controls, experimental subjects at the long-term follow-up had increased understanding of AAS effects, greater belief in personal vulnerability to the adverse consequences of AAS, improved drug refusal skills, less
belief in AAS-promoting media messages, increased belief in the team as an information source, improved perception of athletic abilities and strength-training self-efficacy, improved nutrition and exercise behaviors, and reduced intentions to use AAS. Many other beneficial program effects remained significant at the long-term
follow-up.

Conclusions.—This AAS prevention program enhanced healthy behaviors, reduced factors that encourage AAS use, and lowered intent to use AAS. These changes were sustained over the period of 1 year. Team-based interventions appear to be an effective approach to improve adolescent behaviors and reduce drug use risk factors.

Drug and alcohol use by Canadian university athletes : a national survey / J.C. Spence, L. Gauvin. - (Journal of Drug Education 26 (1996) 3 (1 September); p. 275-287)

• PMID: 8952211
• DOI: 10.2190/V8KU-CW0L-WAQH-1D3A

Abstract

To gauge the extent of drug and alcohol use in Canadian university athletes, we estimated the proportion of Canadian university athletes using social and/or ergogenic drugs through survey methods. A secondary purpose was to examine athletes' perceptions of the value of drug testing and drug education programs. Using a stratified random sampling procedure, 754 student athletes were surveyed in eight different sports from eight universities across Canada. Results showed that 17.7 percent of athletes have used major pain medications over the past twelve months, 3 percent reported use of weight loss products, 0.9 percent reported anabolic steroid use, 16.6 percent reported use of smokeless tobacco products, 94.1 percent reported use of alcohol, 65.2 percent reported use of caffeine products, 0.7 percent reported use of amphetamines, 1.0 percent reported use of barbiturates, 19.8 percent reported use of marijuana or hashish, 5.9 percent reported use of psychedelics and 0.8 percent reported use of cocaine/crack.

Melia P, Pipe A, Greenberg L.
Clin J Sport Med. 1996 Jan;6(1):9-14.
Canadian Centre for Drug-free Sport, Gloucester, Ontario, Canada.

OBJECTIVE:
To assess the prevalence of use of anabolic-androgenic steroids and other presumed performance-enhancing drugs and the associated knowledge, attitudes, and behavior of school-aged Canadians.

DESIGN:
A national survey was conducted using a self-report questionnaire distributed randomly to schools within each of five Canadian regions.

SETTING:
Canada.

SUBJECTS:
The subjects were 16,119 Canadian students, in the sixth grade and above, from 107 schools drawn randomly from five Canadian regions.

MAIN OUTCOME MEASUREMENTS:
The number of students reporting the use of anabolic-androgenic steroids and other performance-enhancing drugs in the year before the survey, the nature of such drug-taking activities, and the attitudes underlying the decision to take anabolic-androgenic steroids.

RESULTS:
More than 83,000 young Canadians (2.8% of the respondents) are estimated to have used anabolic-androgenic steroids in the year before the survey. Of those taking such drugs, 29.4% reported that they injected them; of the latter group, 29.2% reported sharing needles in the course of injecting anabolic-androgenic steroids. Significant numbers of respondents reported using other substances (caffeine, 27%; extra protein, 27%; alcohol, 8.6%; painkillers, 9%; stimulants, 3.1%; "doping methods," 2.3%; beta-blockers, 1%) in attempts to improve sport performance.

CONCLUSIONS:
The use of anabolic-androgenic steroids is more widespread than may have been assumed and is often accompanied by high-risk needle-sharing. Anabolic-androgenic steroid use is often intended to alter body build as opposed to accentuating sport performance. Many young Canadians use a variety of other substances in attempts to improve sport performance. Drugtaking of this kind represents a special challenge for educators, health professionals, and sport authorities.

PMID:
8925377
[PubMed - indexed for MEDLINE]

Avis consultatif TAS 95/144 Comités Olympiques Européens (COE)

Related case:

CAS 1994/128 UCI vs CONI
January 5, 1995

• Anti-Doping Rules
• Competence to regulate doping in multidisciplinary competitions organized by Associations of National Olympic
• Committees

On 5 January 1995, at the request of UCI and CONI (TAS 94/128 UCI-CONI), the Court of Arbitration for Sport (CAS) ruled in an advisory opinion about four questions. In the matter about the authority in international competitions the CAS Panel ruled that the UCI is authorized as International Federation and NOC and any other national sports body are subsidiair.

Because of this remdered opinion TAS 94/128 the Intenational Olympic Committee (IOC) requested in August 1995 the CAS Panel to render an advisory opinion about 2 questions:

1.) Can Associations of National Olympic Committees (NOC) that organize multidisciplinary international competitions, such as the Pan American Games, the Mediterranean Games, the European Youth Olympic Days, in particular, fully implement the IOC Anti-Doping Rules?
2.) Are the NOC Associations authorized in this matter?

On 21 December 1995 CAS Panel rules:

1.) The Anti-Doping Rules applied to multidisciplinary competitions organized by continental or regional NOC Associations fall under the IOC Medical Code as enforcement of Rule 48 of the Olympic Charter.

2.) Without prejudice to the answer to the first question, it seems advisable that NOC Associations organizing multidisciplinary competitions in their constitutive texts should clearly refer to the IOC Medical Code constituent the applicable anti-doping rules.

3.) In multidisciplinary competitions organized by NOC Associations any other anti-doping regulations than the IOC Medical Code can only be applied subsidiair.

Wide L, Bengtsson C, Berglund B, Ekblom B. Detection in blood and urine of recombinant erythropoietin administered to healthy men.
Med Sci Sports Exerc. 1995 Nov;27(11):1569-76.

Pharmacokinetics and pharmacodynamics of cocaine / Edward J. Cone

• Journal of Analytical Toxicology 19 (1995) 6 (October), p. 459-478
• PMID: 8926741
• DOI: 10.1093/jat/19.6.459

Abstract

A dramatic shift has occurred over the last decade in the route of cocaine administration by drug abusers in the United States. The favored route has changed from intranasal and intravenous use to administration of cocaine ("crack") by the smoking route. The reasons for this shift are not well understood but may include social and environmental factors such as the ease and convenience of the smoking route, avoidance of needle-transmitted disease, and possible pharmacological differences produced by the different routes of administration. This study examined the influences exerted by changes in the route of administration on pharmacokinetic parameters and drug-induced behavioral and physiological effects of cocaine. Six male subjects who provided informed consent and had a recent history of cocaine use by the intravenous and smoked routes participated in a blind, double-dummy, crossover study conducted on a clinical research ward. On different occasions, subjects received single doses of cocaine by the intravenous (25 mg, cocaine HCl), intranasal (32 mg, cocaine HCl), and smoked (42 mg, cocaine base) routes. Physiological and behavioral measures were collected prior to and periodically after drug administration. Concurrent blood samples were collected and analyzed for cocaine and metabolites by gas chromatography-mass spectrometry, Plasma concentrations of cocaine and benzoylecgonine were fitted to pharmacokinetic models by nonlinear regression analysis. Behavioral measures of "good" drug effects and "liking" were higher by the smoked route than the intravenous route, but physiological changes were approximately equal at equivalent plasma concentrations of cocaine. Intranasal cocaine administration was characterized by lower cocaine plasma concentrations and a slower onset of pharmacological effects that were generally of lesser magnitude than those observed by other routes of administration. Overall, this study demonstrated that cocaine administration by the smoked route produced substantially higher behavioral responses than an equivalent dose of cocaine administered by the intravenous route. This finding suggests that smoked cocaine (crack) has a higher abuse liability and greater dependence-producing properties than equivalent doses of cocaine administered by the intravenous or intranasal route.

G K Lijesen, I Theeuwen, W J Assendelft, and G Van Der Wal
Br J Clin Pharmacol. 1995 September; 40(3): 237–243.

Abstract

1. A meta-analysis was conducted to assess if there is scientific ground for the use of human chorionic gonadotropin (HCG) as adjunctive therapy in the treatment of obesity.
2. Published papers relating to eight controlled and 16 uncontrolled trials that measured the effect of HCG in the treatment of obesity were traced by computer-aided search and citation tracking.
3. The trials were scored for the quality of the methods (based on four main categories: study population, interventions, measurement of effect, and data presentation and analysis) and the main conclusion of author(s) with regard to weight-loss, fat-redistribution, hunger, and feeling of well-being.
4. Methodological scores ranged from 16 to 73 points (maximum score 100), suggesting that most studies were of poor methodological quality. Of the 12 studies scoring 50 or more points, one reported that HCG was a useful adjunct. The studies scoring 50 or more points were all controlled.
5. We conclude that there is no scientific evidence that HCG is effective in the treatment of obesity; it does not bring about weight-loss of fat-redistribution, nor does it reduce hunger or induce a feeling of well-being.