Understanding the Influence of Proximal Networks on High School Athletes’ Intentions to Use Androgenic Anabolic Steroids

1 Jan 2014

Understanding the Influence of Proximal Networks on High School Athletes’ Intentions to Use Androgenic Anabolic Steroids / Jules Woolf, Rajiv N. Rimal, Pooja Sripad. - (Journal of Sport Management 28 (2014) 1 (January); p. 8-20) 

  • DOI: 10.1123/jsm.2013-0046


Understanding what influences adolescent athletes is important for managers designing anti-doping initiatives. It is commonly assumed that elite athletes who dope influence adolescent athletes to similarly dope. Using the theory of normative social behavior, the effect of norms on adolescent athletes’ intentions to use steroids was examined. The social distance between respondents and the source of normative information was systematically varied to include four separate levels (friends, teammates, college athletes, professional athletes). Data were collected from 404 male adolescent athletes. Participants indicated their intentions to use steroids and their perceptions of descriptive and injunctive norms of referent others. Descriptive and injunctive norms were predictive of intentions to use steroids with the magnitude of explained variance greater with more proximal referents. Adolescent athletes’ intentions to use steroids are influenced by social norms. Moreover, the social distance of referents is consequential. Interventions strategies should incorporate teammates and friends, rather than professional athletes.

Androgenic anabolic steroid policy and high school sports: results from a policy Delphi study

12 Feb 2013

Androgenic anabolic steroid policy and high school sports : results from a policy Delphi study / J. Woolf, P. Swain. - (International Journal of Sport Policy and Politics 6 (2014) 1; p. 89-106)

  • DOI: 10.1080/19406940.2013.767852


In this article, androgenic anabolic steroid policy targeted at American high school sports is investigated. In recent years several states have instituted androgenic anabolic steroid testing of high school athletes. These programmes have produced few positive tests and subsequently have been heavily criticized. A heterogeneous panel of sixteen experts was invited to debate the issue of steroid use among high school athletes using a policy Delphi method. The panel included executive managers from anti-doping organizations, academic researchers and advocates for steroid legalization. Panellists communicated their response to three rounds of questionnaires via e-mail. The dominant view expressed by the panel is that steroid use among high school athletes is likely underestimated and will increase in the future. Of concern were the quality of steroids consumed and the unintended consumption of steroids via tainted supplements. The panel was in near unanimous agreement that steroid abuse at this level needs to be addressed. However, the panel was divided on the ways in which doping policy should be implemented at the high school level. A small majority favoured the inclusion of drug testing of athletes. Those in favour of drug testing believed that educational efforts, while necessary, are insufficient to address this issue. Panellists stated that educational initiatives should be presented using a balanced approach that covers the positive and negative effects of steroids. Moreover, educational programmes need to emphasize alternative approaches to performance enhancement and include a moral education component. These issues were explored and the implications for policy discussed.

Muscle Dysmorphia Among Current and Former Steroid Users

1 Mar 2011

Muscle Dysmorphia Among Current and Former Steroid Users / Rebecca Davies, Dave Smith, Kevan Collier. - (Journal of Clinical Sport Psychology 5 (2011) 1 (March) ; p. 77-94)

  • DOI: 10.1123/jcsp.5.1.77


This study examined the presence and experience of muscle dysmorphia among current and former steroid-using recreational bodybuilders. The Muscle Dysmorphia Inventory was given to 60 male participants, with 9 of these being interviewed to examine the predisposing factors, characteristics, and negative consequences of muscle dysmorphia comprising Lantz, Rhea, and Mayhew’s (2001) conceptual model. Quantitative results from the MDI data showed no significant differences between current and former steroid users in their experiences of muscle dysmorphia. In contrast, interviews suggested that former users appeared to be more susceptible to some of the characteristics of muscle dysmorphia, including physique protection and body distortion/dissatisfaction, which suggests perhaps a limitation in the amount of information that can be extracted from a questionnaire. These preliminary findings also raise concerns about the lack of a diagnostic tool available for the condition and are discussed in relation to Lantz et al.’s (2001) conceptual model.

Abuse of medicines for performance enhancement in sport: why is this a problem for the pharmaceutical industry?

26 Jul 2012

Abuse of medicines for performance enhancement in sport : why is this a problem for the pharmaceutical industry? / Steve Elliott, Barbara Leishman. - (Bioanalysis 4 (2012) 13 (26 July); p. 1681-1690)

  • PMID: 22831483
  • DOI: 10.4155/bio.12.137


The misuse of medicines for performance enhancement in sport (doping) is not approved by regulatory agencies, and is illegal in many countries. In addition to the 'traditional' doping agents such as steroids, β-blockers and blood transfusions, the list of agents and techniques used in doping is increasing and now includes newer medicines such as erythropoiesis-stimulating agents and growth hormones. Innovative new medicines are of particular interest as would-be dopers may believe them to be undetectable by current methods. Close collaboration between the biopharmaceutical industry and anti-doping agencies such as the World Anti-Doping Agency is critical to a successful anti-doping strategy. Industry is ideally placed to identify the doping potential of new medicines at early stages and to support early development of detection assays. A strong, united front between the biopharmaceutical industry and anti-doping agencies is essential to counter the misuse of medicines for performance enhancement, as well as to promote fair play and clean sport.

WTC 2019 WTC vs Andrew Starykowicz

25 Nov 2020

Related case:

CAS 2020_A_6892 Andrew Starykowicz vs USADA
August 5, 2020

In October 2019 the American triathlon Athlete Andrew Starkowics suffered from an acute respiratory infection with bronchoconstriction. He underwent medical treatment and used several prescribed medication including the prohibited substances Methylprednisolone (Medrol), Glucocorticoids including Fluticasone Furoate and Vilanterol inhalation powder (Breo).

The Athlete applied for a TUE for the use of Medrol and Breo and on 8 November 2019 the USADA TUE Committee granted the use of Medrol.

Before the approval of the TUE the Athlete had participated in an IRONMAN triathlon on 2 November 2019 and was subjected to sample collection. Consequently in December 2019 the World Triathlon Corporation (WTC) reported an anti-doping rule violation against the Athlete after his A and B samples tested positive for the substance Vilanterol without a valid TUE. After notification in December 2019 a provisional suspension was ordered.

At the time of the notification the Athlete had no TUE for Vilanterol due to his applications for Breo had been repeatedly denied by the USADA TUE Committee and finally by the WADA Therapeutic Use Exemption Committee. Both Committees deemed that suitable permitted alternatives were available but were not prescribed by his pulmonologist.

In March 2020 the Athlete appealed with the Court of Arbitration for Sport (CAS) challenging the denial of his TUE applications for Breo. However on 5 August 2020 CAS dismissed the Athlete's appeal and deemed that the Athlete failed to demonstrate that the existing alternative therapies suggested by USADA were not reasonable.

Hereafter WTC resumed the proceedings against the Athlete and contended that the Athlete had committed an anti-doping rule violation on two occasions without a valid TUE. In view of the amendment in the WADA Prohibited List regarding Vilanterol, WTC requested for a reduced sanction of 2 years.

The Athlete admitted the violation and the use of Vilanterol in and out of competition between October and November 2019. He requested for a reduced sanction based on No Significant Fault or Negligence. He acknowledged that pending his TUE application he was warned by USADA when participating in a competition without a TUE he would commit an anti-doping rule violation.

The Sole Arbitration regards that the Athlete is highly experienced and fully aware of his anti-doping obligations. Further he establishes that at the relevant time USADA timely had processed and granted the Athlete's TUE application and that significant delays in the application were attributed to the Athlete.

Considering the Athlete's conduct in this case the Sole Arbitrator concludes that the he had acted negligently while he was duly informed by USADA about permitted alternative medication. As a result the Athlete failed to establish that he bears No Significant Fault of Negligence.

Due to the Vilanterol amendment of the WADA 2021 Prohibited List the Sole Arbitrator decides on 25 November to impose a reduced period of ineligibility on the Athlete. The period of ineligibility will start on the date of the provisional suspension, 5 December 2019, and end on 1 Januari 2021.

Overview of Scientific Research funded by the World Anti-Doping Agency and Partnership for Clean Competition in the last 20 years : Scientific Research Report

27 Sep 2021

Overview of Scientific Research funded by the World Anti-Doping Agency and Partnership for Clean Competition in the last 20 years : Scientific Research Report / Institute of National Anti-Doping Organisations (iNADO). - Bonn : iNADO, 2021


1. Introduction
2. Evolution of Scientific Research on Doping
3. Funded Research Projects per Region and Country
4. Funded Research Projects per Research Area

  • 4.1 Funded Research on Analytical Methods for the Detection of Prohibited Substances/ Methods
  • 4.2 Funded Research on the Effect of Substances and Methods on Physical Performance
  • 4.3 Funded Research on Social Sciences

5. Organizations that have conducted research projects funded by WADA and PCC
6. Conclusions

In this report and in this short video, we present you the results of a project we conducted to get an overview of social and scientific research on anti-doping in the last 20 years, focusing mainly on research projects funded by two of the major funding organizations: the World Anti-Doping Agency (WADA) and Partnership Competition Partnership (PCC), amounting each to over $83 million and $29 million in the last 20 years.

The report highlights how research evolved in terms of topics researched, the progressive increase of fundings and finally shed some light on trends: which countries and types of organizations concentrate most of the fundings, what are the new topics researchers focus on. The project also puts in perspective the trends observed with the funding organizations’ strategies, the current involvement of NADOs in Scientific and Social Sciences Research.

WADA - Summary of Operation Hercules

21 Oct 2021

Summary of Operation Hercules / Intelligence and Investigations (I&I) Department. -- Montreal : WADA, 2021

The World Anti-Doping Agency’s (WADA’s) independent Intelligence and Investigations (I&I) Department has published its summary report following an investigation into allegations that the National Anti-Doping Organization of Ukraine (NADC) engaged in practices that contravened the International Standard for Testing and Investigations (ISTI).

WADA I&I’s investigation, known as ‘Operation Hercules’, was launched in 2019, and has uncovered evidence to suggest that since 2012 NADC has conducted unjustified advance-notice sample collections, arranging to test athletes – including groups of athletes – by appointment at the NADC offices. The ISTI states that, save in exceptional and justifiable circumstances, sample collection must take place with no advance warning to the athlete – a fundamental feature of an effective, unpredictable testing program.

‘Operation Hercules’ has compelling evidence to suggest that in 2021, NADC knowingly reported at least six in-competition samples as out-of-competition samples, in contravention of various articles of the World Anti-Doping Code and the ISTI. The Doping Control Forms (DCFs) for the six misreported samples confirm they were collected in competition but, in each instance, the DCFs listed the sample as being collected “out-of-competition”.

WADA I&I commissioned a re-analysis of these six samples through the in-competition laboratory analysis menu, which includes more prohibited substances than the out-of-competition analysis menu. All sample results were returned negative (i.e. without a prohibited substance).

“‘Operation Hercules’ has raised serious questions about the integrity of NADC’s testing practices, and the competence of some staff. Moreover, the apparent longevity and brazenness of these practices suggests significant organizational failings within NADC.”

Due to the gravity of the allegations and the risk posed by any continuation of the alleged non-compliance by NADC, ‘Operation Hercules’ provided all pertinent information from its investigation to the relevant entities prior to the finalization of this report. This included the relevant departments of WADA, namely, the Compliance, Rules and Standards Department and the Testing Department, for their immediate action. A compliance process has been initiated regarding NADC, under the provisions of the International Standard for Code Compliance by Signatories.

‘Operation Hercules’ also investigated allegations that a doping and protection scheme existed within the Ukrainian Athletics Federation (FLAU) but found no evidence to support this charge. However, potential evidence of erythropoietin (EPO) trafficking was identified against an individual from within FLAU. The individual in question has denied the allegation and ‘Operation Hercules’ has reported this matter to the Athletics Integrity Unit for its consideration.

A Selective Androgen Receptor Modulator (OPK-88004) in Prostate Cancer Survivors: A Randomized Trial

21 May 2021

A Selective Androgen Receptor Modulator (OPK-88004) in Prostate Cancer Survivors : A Randomized Trial / Karol M. Pencina, Arthur L. Burnett, Thomas W. Storer, Wen Guo, Zhuoying Li, Adam S. Kibel, Grace Huang, Michelle Blouin, Donna L. Berry, Shehzad Basaria, Shalender Bhasin. - (Journal of Clinical Endocrinology & Metabolism 106 (2021) 8 (August); p. 2171-2186)

  • PMID: 34019661
  • PMCID: PMC8277210 (available on 2022-05-21)
  • DOI: 10.1210/clinem/dgab361


Background: Androgen deficiency is common among prostate cancer survivors, but many guidelines consider history of prostate cancer a contraindication for testosterone replacement. We determined the safety and efficacy of a selective androgen receptor modulator (OPK-88004) in symptomatic, testosterone-deficient men who had undergone radical prostatectomy for low-grade, organ-confined prostate cancer.

Methods: In this placebo-controlled, randomized, double-blind trial, 114 men, ≥19 years of age, who had undergone radical prostatectomy for low-grade, organ-localized prostate cancer, undetectable PSA (<0.1 ng/mL) for ≥2 years after radical prostatectomy and testosterone deficiency were randomized in stages to placebo or 1, 5, or 15 mg OPK-88004 daily for 12 weeks. Outcomes included PSA recurrence, sexual activity, sexual desire, erectile function, body composition, muscle strength and physical function measures, mood, fatigue, and bone markers.

Results: Participants were on average 67.5 years of age and had severe sexual dysfunction (mean erectile function and sexual desire domain scores 7.3 and 14.6, respectively). No participant experienced PSA recurrence or erythrocytosis. OPK-88004 was associated with a dose-related increase in whole-body (P < 0.001) and appendicular (P < 0.001) lean mass and a significantly greater decrease in percent body fat (P < 0.001) and serum alkaline phosphatase (P < 0.001) than placebo. Changes in sexual activity, sexual desire, erectile function, mood, fatigue, physical performance, and bone markers did not differ among groups (P = 0.73).

Conclusions: Administration of OPK-88004 was safe and not associated with PSA recurrence in androgen-deficient men who had undergone radical prostatectomy for organ-confined prostate cancer. OPK-88004 increased lean body mass and decreased fat mass but did not improve sexual symptoms or physical performance.

Ethical Considerations on Physical Enhancement in the Competitive Sports World: With Regard to a Better Body

15 Mar 2018

Ethical Considerations on Physical Enhancement in the Competitive Sports World : With Regard to a Better Body / Mizuho Takemura. - (International Journal of Sport and Health Science 16 (2018) 15 March; p. A25-A36)

  • Original article published in Japan J. Phys. Educ. Hlth. Sport Sci. 59: 53-66, 2014 (in Japanese)
  • DOI: 10.5432/ijshs.13050


Medical technology has made remarkable advances in recent years. On the one hand, these advances have the benefit of contributing to the happiness of humankind; on the other hand, they can raise various ethical and social issues, precisely because they are applied to individual humans. One such issue is enhancement technology, which can be used not only for the purpose of treating disease, but also for improving or enhancing the body or mind; humans themselves can become subject to alterations without any medical purpose. Body enhancement used to improve athletic performance is of particular concern in competitive sports. In this study, body enhancement was considered to be an act of pursuing a better-performing body, and examined the issues related to “better-ness” in this context from an ethical viewpoint. Specifically, I (1) elucidate the meaning of the word “better-ness” within the phrase “better performing” and (2) examine whether the act of pursuing a body that is “better” is an act of overall human betterment by engaging in an ethical discussion of its pros and cons. I use the principle of act described in Kant's practical philosophy as a framework for discussion. With regard to (1), I conclude that the meaning of “better” in the context of body enhancement in competitive sports is defined by theoretical (logical) judgment, and not by moral judgment. With regard to (2), I describe what an unacceptable act is according to Kant's Formula of the End in Itself. I also present the limits of this study, and point out the need to clarify in future studies the concept of what comprises human nature.

Effect of muscle dysmorphia on image-and-performance-enhancement drugs use intentions in a non-clinical sample: The role of social cognition

13 Oct 2020

Effect of muscle dysmorphia on image-and-performance-enhancement drugs use intentions in a non-clinical sample : The role of social cognition / L. Skoufa, V. Barkoukis, L. Lazuras, H. Tsorbatzoudis. - (Performance Enhancement & Health (2021) 13 October; 1002004)

  • DOI: 10.1016/j.peh.2021.100204



The use of image-and-performance-enhancement drugs (IPEDs) among exercisers represents an emerging public health challenge, and muscle dysmorphia (MD) presents an important risk factor for this behavior. However, there is little evidence on the direct and indirect association of MD dimensions with IPEDs use, via the effects of more proximal, social cognitive variables. The present study used an integrative model that assessed the direct and indirect association between MD dimensions and intentions to use IPEDs via the effects of behavior-specific social cognitive variables.


One hundred and ninety-seven recreational exercisers (M age = 24.5 years, 66.3% males) completed a survey including the Muscle Dysmorphia Inventory (MDI), social cognitive variables related to IPEDs use, and intentions to use IPEDs in the next year.


Hierarchical linear regression analysis and regression-based mediation modelling showed that the MD dimensions of exercise dependence, drive for size/symmetry and pharmacological use were indirectly associated with intentions, via the effects of attitudes and situational temptation.


The present results indicate that MD dimensions may be differentially associated with intentions to use PEDs among recreational exercisers, and highlight the importance of social cognitive variables that are more closely related to IPEDs use. The theoretical and practical implications of the findings are discussed.

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