The final frontier of anti-doping: A study of athletes who have committed doping violations

6 Aug 2014

The final frontier of anti-doping : A study of athletes who have committed doping violations / Terry Engelberg, Stephen Moston, James Skinner. - (Sport Management Review 18 (2015) 2 (May); p. 268-279)

  • DOI: 10.1016/j.smr.2014.06.005


Although the use of banned drugs in sport is not a new phenomenon, little is known about the experiences and perceptions of athletes who have committed anti-doping rule violations. This study qualitatively explored the experiences of 18 athletes (from the sports of bodybuilding, powerlifting, cricket, sprint kayak, rugby league, and swimming) who had committed anti-doping violations. Themes explored included motivations for initiating and maintaining doping, the psychology of doping, deterrents to doping, and views on current anti-doping policy. In most cases doping had started early in their careers. The perceived culture of the sport was considered central to the ‘normalization’ of doping, particularly in bodybuilding. When explaining their decision to dope, athletes engaged in processes or moral disengagement (including advantageous comparison, minimizing consequences and diffusion of responsibility). Ironically, moral arguments were perceived as the most effective deterrents to doping. Findings are discussed in relation to the difficulties in establishing credible deterrents and suggestions for the future development of anti-doping policy.

Recreational Use of Selective Androgen Receptor Modulators

18 Jun 2020

Recreational Use of Selective Androgen Receptor Modulators / Melissa A. Burmeister, Timothy K. Fincher, William H. Graham. - (US Pharmacist 45 (2020) 60 (18 June); p. 15-18)


Selective androgen receptor modulators (SARMs) are anabolic compounds that bind to androgen receptors. They have been studied as potential treatments for cancer, osteoporosis, sexual dysfunction, multiple sclerosis, Alzheimer’s disease, and muscle wasting. Recently, SARMs have been placed in various supplements marketed to fitness enthusiasts. SARMs have been found to reduce endogenous testosterone, affect cholesterol levels, and alter liver function. Recreational users of SARMs may take them in combination with each other on a cyclical basis. They may also practice postcycle therapy, which involves the use of SERMs in between cycles to help restore hormone balance. Pharmacists should be aware of the adverse side effects of SARMs use in order to advise individuals of the potential risks.

The global epidemiology of anabolic-androgenic steroid use: a meta-analysis and meta-regression analysis

30 Jan 2014

The global epidemiology of anabolic-androgenic steroid use : a meta-analysis and meta-regression analysis / Dominic Sagoe, Helge Molde, Cecilie S. Andreassen, Torbjørn Torsheim, Ståle Pallesen. - (Annals of Epidemiology 24 (2014) 5 (May); p. 383-398)

  • PMID: 24582699
  • DOI: 10.1016/j.annepidem.2014.01.009


Purpose: To estimate the global lifetime prevalence rate of anabolic-androgenic steroid (AAS) use and investigate moderators of the prevalence rate.

Methods: A meta-analysis and meta-regression analysis was performed using studies gathered from searches in PsycINFO, PubMed, ISI Web of Science, and Google Scholar among others. Included were 187 studies that provided original data on 271 lifetime prevalence rates. Studies were coded for publication year, region, sample type, age range, sample size, assessment method, and sampling method. Heterogeneity was assessed by the I(2) index and the Q-statistic. Random effect-size modeling was used. Subgroup comparisons were conducted using Bonferroni correction.

Results: The global lifetime prevalence rate obtained was 3.3% (95% confidence interval [CI], 2.8-3.8; I(2) = 99.7, P < .001). The prevalence rate for males, 6.4% (95% CI, 5.3-7.7, I(2) = 99.2, P < .001), was significantly higher (Qbet = 100.1, P < .001) than the rate for females, 1.6% (95% CI, 1.3-1.9, I(2) = 96.8, P < .001). Sample type (athletes), assessment method (interviews only and interviews and questionnaires), sampling method, and male sample percentage were significant predictors of AAS use prevalence. There was no indication of publication bias.

Conclusion: Nonmedical AAS use is a serious widespread public health problem.

Gene doping and genomic science in sports: where are we?

19 Jun 2020

Gene doping and genomic science in sports : where are we? Sheila López, João Meirelles, Vanessa Rayol, Gabriella Poralla, Nicole Woldmar, Bruna Fadel, Mariana Figueiredo, Mônica da Costa Padilha, Francisco Radler de Aquino Neto, Henrique Marcelo Gualberto Pereira, Luciana Pizzatti. - (Bioanalysis 12 (2020) 11 (19 June); p. 801-811)

  • PMID: 32558587
  • DOI: 10.4155/bio-2020-0093


The misuse of sport-related gene transfer methods in elite athletes is a real and growing concern. The success of gene therapy in the treatment of hereditary diseases has been most evident since targets in gene therapy products can be used in healthy individuals to improve sports performance. Performing these practices threatens the sporting character of competitions and may pose potential health hazards. Since the World Anti-Doping Agency pronouncement on the prohibition of such practices in 2003, several researchers have been trying to address the challenge of developing an effective method for the detection of genetic doping. This review presents an overview of the published methods developed for this purpose, the advantages and limitations of technologies and the putative target genes. At last, we present the perspective related to the application of the detection methods in the doping control field.

Can β2-agonists have an ergogenic effect on strength, sprint or power performance? Systematic review and meta-analysis of RCTs

3 Aug 2020

Can β2-agonists have an ergogenic effect on strength, sprint or power performance? Systematic review and meta-analysis of RCTs / Amund Riiser, Trine Stensrud, Julie Stang, Lars Bo Andersen. - (British Journal of Sports Medicine (2020) 3 August; p. 1-10)

  • PMID: 32747344
  • DOI: 10.1136/bjsports-2019-100708


Objectives: We aimed to examine the effect of β2-agonists on anaerobic performance in healthy non-asthmatic subjects.

Design: Systematic review and meta-analysis.

Eligibility criteria: We searched four databases (PubMed, Embase, SPORTDiscus and Web of Science) for randomised controlled trials, published until December 2019, examining the effect of β2-agonists on maximal physical performance lasting 1 min or shorter. Data are presented as standardised difference in mean (SDM) with 95% confidence intervals (95% CI).

Results: 34 studies were included in the present meta-analysis. The studies include 44 different randomised and placebo-controlled comparisons with β2-agonists comprising 323 participants in crossover trials, and 149 participants in parallel trials. In the overall analyses, β2-agonists improved anaerobic performance by 5% (SDM 0.29, 95% CI 0.16 to 0.42), but the effect was related to dose and administration route. In a stratified analysis, the SDM was 0.14 (95% CI 0.00 to 0.28) for approved β2-agonists and 0.46 (95% CI 0.24 to 0.68) for prohibited β2-agonists, respectively. Furthermore, SDM was 0.16 (95% CI 0.02 to 0.30) for inhaled administration and 0.51 (95% CI 0.25 to 0.77) for oral administration, respectively, and 0.20 (95% CI 0.07 to 0.33) for acute treatment and 0.50 (95% CI 0.20 to 0.80) for treatment for multiple weeks. Analyses stratified for the type of performance showed that strength (0.35, 95% CI 0.15 to 0.55) and sprint (0.17, 95% CI 0.06 to 0.29) performance were improved by β2-agonists.

Conclusion/implication: Our study shows that non-asthmatic subjects can improve sprint and strength performance by using β2-agonists. It is uncertain, however, whether World Anti-Doping Agency (WADA)-approved doses of β2-agonists improve performance. Our results support that the use of β2-agonists should be controlled and restricted to athletes with documented asthma.

The growth hormone/insulin-like growth factor-I axis in exercise and sport

1 Oct 2007

The growth hormone/insulin-like growth factor-I axis in exercise and sport / James Gibney, Marie-Louise Healy, Peter H. Sönksen. - (Endocrine Reviews 28 (2007) 6 (1 October); p. 603-624)

  • PMID: 17785429
  • DOI: 10.1210/er.2006-0052


The syndrome of adult GH deficiency and the effects of GH replacement therapy provide a useful model with which to study the effects of the GH/IGF-I axis on exercise physiology. Measures of exercise performance including maximal oxygen uptake and ventilatory threshold are impaired in adult GH deficiency and improved by GH replacement, probably through some combination of increased oxygen delivery to exercising muscle, increased fatty acid availability with glycogen sparing, increased muscle strength, improved body composition, and improved thermoregulation. In normal subjects, in addition to the long-term effects of GH/IGF-I status, there is evidence that the acute GH response to exercise is important in regulating substrate metabolism after exercise. Administration of supraphysiological doses of GH to athletes increases fatty acid availability and reduces oxidative protein loss, particularly during exercise, and increases lean body mass. Despite a lack of evidence that these metabolic effects translate to improved performance, GH abuse by athletes is widespread. Tests to detect GH abuse have been developed based on measurement in serum of 1) indirect markers of GH action, and 2) the relative proportions of the two major naturally occurring isoforms (20 and 22kDa) of GH. There is evidence that exercise performance and strength are improved by administration of GH and testosterone in combination to elderly subjects. The potential benefits of GH in these situations must be weighed against potential adverse effects.

Substance use in athletics: a sports psychiatry perspective

1 Oct 2005

Substance use in athletics : a sports psychiatry perspective /  David R. McDuff, David A. Baron. - (Clinics in Sports Medicine 24 (2005) 4 (1 October); p. 885-897)

  • PMID: 16169452
  • DOI: 10.1016/j.csm.2005.06.004


Athletes use substances to produce pleasure, relieve pain and stress, improve socialization, recover from injury, and enhance performance. Therefore, they use some substances in substantially higher rates that nonathletes. Despite these higher rates of use, rates of addiction may in fact be lower in athletes. This article reviews the prevalence and patterns of use, health and performance effects, and preventive and treatment interventions for alcohol, tobacco, stimulants, and steroids. Each substance is considered from the differing perspectives of abuse/addiction and performance enhancement models. Similarities and differences between college and professional athletes are discussed. Finally, suggestions for future research are made.

Testing for GW501516 (cardarine) in human hair using LC/MS–MS and confirmation by LC/HRMS

16 Apr 2020

Testing for GW501516 (cardarine) in human hair using LC/MS–MS and confirmation by LC/HRMS / Pascal Kintz, Alice Ameline, Laurie Gheddar, Jean‐Sébastien Raul. - 
(Drug Testing and Analysis 12 (2020) 7 (July); p. 980-986)

  • PMID: 32298044
  • DOI: 10.1002/dta.2802


GW501516, also known as GW‐1516 or cardarine and endurobol, is a peroxisome proliferator‐activated receptor delta (PPAR‐δ) agonist. Activation of the receptor will increase fat‐burning capacity and muscle production, as it changes the body's fuel preference from glucose to lipids. GW501516 has no therapeutic use, but can be abused for performance‐enhancing purposes using the oral route, at dosages of 10 to 20 mg per day, for 6 to 8 weeks. Both athletes and amateurs can abuse GW501516 as the drug can be easily obtained via the Internet. Since January 2009, the list of prohibited substances and methods of doping as established by the World Anti‐Doping Agency includes GW‐501516, first as a gene doping substance and now in the S4.5 Metabolic modulators class. It is prohibited at all times. Using LC/MS–MS and confirmation by LC/HRM, after methanol incubation of 20 mg with ultrasound for 1 hour, GW501516 was identified in the hair of a male abuser at 32 and 22 pg/mg in 2 × 2 cm segments. The result is the first evidence that this compound with a carboxylic acid function is incorporated in human hair.

Analysis of anabolic steroids in human hair using LC–MS/MS

30 Apr 2010

Analysis of anabolic steroids in human hair using LC–MS/MS / Nawed Deshmukh, Iltaf Hussain, James Barker, Andrea Petroczi, Declan P. Naughton. - (Steroids 75 (2010) 10 (October); p. 710-714)

  • PMID: 20435054
  • DOI: 10.1016/j.steroids.2010.04.007


New highly sensitive, specific, reliable, reproducible and robust LC-MS/MS methods were developed to detect the anabolic steroids, nandrolone and stanozolol, in human hair for the first time. Hair samples from 180 participants (108 males, 72 females, 62% athletes) were screened using ELISA which revealed 16 athletes as positive for stanozolol and 3 for nandrolone. Positive samples were confirmed on LC-MS/MS in selective reaction monitoring (SRM) mode. The assays for stanozolol and nandrolone showed good linearity in the range 1-400pg/mg and 5-400pg/mg, respectively. The methods were validated for LLOD, interday precision, intraday precision, specificity, extraction recovery and accuracy. The assays were capable of detecting 0.5pg stanozolol and 3.0pg nandrolone per mg of hair, when approximately 20mg of hair were processed. Analysis using LC-MS/MS confirmed 11 athletes' positive for stanozolol (5.0pg/mg to 86.3pg/mg) and 1 for nandrolone (14.0pg/mg) thus avoiding false results from ELISA screening. The results obtained demonstrate the application of these hair analysis methods to detect both steroids at low concentrations, hence reducing the amount of hair required significantly. The new methods complement urinalysis or blood testing and facilitate improved doping testing regimes. Hair analysis benefits from non-invasiveness, negligible risk of infection and facile sample storage and collection, whilst reducing risks of tampering and cross-contamination. Owing to the wide detection window, this approach may also offer an alternative approach for out-of-competition testing.

Androgen abuse epidemiology

1 Jun 2018

Androgen abuse epidemiology / Dominic Sagoe, Ståle Pallesen. - (Current opinion in endocrinology, diabetes, and obesity 25 (2018) 3 (June); p. 185-194)

  • PMID: 29369917
  • DOI: 10.1097/MED.0000000000000403


Purpose of review: To systematically review current epidemiological literature on androgen abuse. Estimates from 32 empirical epidemiological articles were reviewed.

Recent findings: Generally, androgen abuse epidemiology and prevalence is higher in Europe, the Middle East, North America (the USA), Oceania (Australia and New Zealand), and South America (Brazil) and lower in Africa and Asia. In contrast to the general population, androgen abuse epidemiology and prevalence is higher among athletes, injection drug users, recreational sportspeople, and sexual and gender minorities.

Summary: From the 1970s, androgen abuse spread from athletes into the general population. Consistent with previous evidence, reviewed studies suggest that androgen abuse epidemiology and prevalence is higher in Western cultural contexts, the Middle East, and South America (Brazil) and lower in Africa and Asia. Evidence also corroborates indications that androgen abuse is less prevalent among women (vs. men), and in the general population in contrast to particular subpopulations consisting of athletes, injection drug users, recreational sportspeople, and sexual and gender minorities. Adolescents' androgen abuse should be of special concern. Androgen abuse in some nonsports occupations (e.g. security workers) requires further exploration. Polypharmacy and the Internet proliferation of androgens and other PIEDs require surveillance for prevention and harm reduction.

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