Convergence of Innovation & Entrepreneurship

Bodybuilding: A Comprehensive Review of Performance-Enhancing Substance Use and Public Health Implications PMC

Until recently EPO has been very difficult to detect in tests and it is thought that hundreds of road cyclists avoided detection for EPO in the 1990s. Using EPO can increase blood pressure and can reduce the body’s natural capacity to make EPO. When diuretics were introduced on the list of forbidden substances by the International Sports Authorities, the first attempts to create a screening method for their detection were based on HPLC. At that time, UV diode array was used as detector as it facilitated peak identification (Ventura and Segura, 1996). According to IOC/WADA requirements, the confirmation procedures needed to support a positive case should be based on MS. Because of this, a GC/MS method after methylation of the compounds was, in most of the cases, the technique of choice.

Why is it an issue now? A brief history of doping

Drug abuse in athletes is a significant problem that has many potential underlying causes. The drive to be the best in sport dates to ancient times, as does the use of performance-enhancing substances. With the ever-mounting pressures faced by athletes, it is not surprising that drug abuse by athletes exists across essentially all sports and age groups. Selective androgen receptor modulators are negative effects of drugs in sport not approved for use in humans in any country, but athletes are able to obtain these substances on the Internet.32 No studies were found looking at the effects of selective androgen receptor modulators on muscle strength or mass in humans. This app provides information about the health effects of performance enhancing drugs (doping) through an interactive virtual reality style experience.

• Using EPO can increase blood pressure and can reduce the body’s natural capacity to make EPO.
• This article will use secondary literature in order to review and analyse known cases of systematic doping through the risk and enabling environment frameworks.
• In small doses narcotics have medical uses that include relieving severe pain and inducing sleep.
• This raises the risk of a serious problem that can happen when the heart doesn’t get enough blood, called a heart attack.
• Ostensibly, this is related to the perceived health risks of doping substances, though it is also related to broader war on drugs style policies and politics (Coomber, 2014; Dimeo, 2007).

History of doping in athletes

In 2008, diuretics represented 7.9% of all Adverse Analytical Findings reported by WADA laboratories, with a total number of 436 cases (WADA, 2009a). All classes of diuretics were represented in the positive cases; hydrochlorothiazide was the most common diuretic detected, with 137 cases. Table 1 summarizes the statistics of positive diuretic findings by all WADA laboratories from 2003 to the present.

Inhibitors of renal epithelial Na+ channels

In 2018, the International Olympic Committee banned Team Russia from the Winter Olympics, allowing Russian athletes to compete independently under the neutral Olympic flag. Even athletes who were not part of the doping system suffered reputational and economic damages. Diuretics also may help athletes pass drug tests that check for signs of drugs in the urine. The anabolic steroids used by athletes are often forms of testosterone made in a lab. The pressure to win leads some athletes to use drugs that might give them an edge. Androgens include exogenous testosterone, synthetic androgens (eg, danazol, nandrolone, stanozolol), androgen precursors (eg, androstenedione, dehydroepiandrosterone), selective androgen receptor modulators, and other forms of androgen stimulation.

• The mass spectrometry method Phulara and Seneviratne used to image the samples maintains their integrity, and therefore retains spatial information.
• Only four compounds are included in this diuretic class, glycerin, isosorbide, mannitol and urea.
• As stated in the World Anti-Doping Code by WADA, doping is defined as the occurrence of one or more of the anti-doping rule violations outlined in Article 2.1 through Article 2.11 of the Code.[1] The term doping is widely used by organizations that regulate sporting competitions.
• Canrenone and spironolactone together accounted for 4.3% of positive diuretic doping samples in 2008 (WADA, 2009a).
• Overall, empirical support for these types of programs has been mixed, which is not surprising considering the diversity of approaches (Cronce & Larimer, 2011).

Roberto Heras was stripped of his victory in the 2005 Vuelta a España and suspended for two years after testing positive for EPO. These are substances such as EPO (erythropoietin) – which increases bulk, strength and red blood cell count and gives athletes more energy – and HGH (human growth hormone), which builds muscle. This article will use secondary literature in order to review and analyse known cases of systematic doping through the risk and enabling environment frameworks.

• The use of diuretics in this manner is sometimes referred to as “cutting water weight” [21].
• These modulators are not approved for human use, and the adverse effects have not been well documented because they are still in clinical trials.
• Playing sports is a great way for young people to be physically active, make friends, and have fun.
• Designer stimulants that attracted media attention in 2010 included mephedrone, ephedrone, and fluoroamphetamines, which have chemical structures and effects similar to ephedrine and amphetamine.
• In addition to the potential health risks of the performance-enhancing drug itself, harms of a positive doping test result can include the negative health and social impacts of sanctions prohibiting participation and the potential emotional damage related to being labeled a cheater.
• The Canadian sprinter tested positive for anabolic steroids at the 1988 Olympic Games in Seoul.

Consequences of doping

Nutritional supplements include vitamins, minerals, herbs, extracts, and metabolites.39 Importantly, the purity of these substances cannot be guaranteed, such that they may contain banned substances without the athlete or manufacturer being aware. The members of the diuretic class of drugs vary greatly in structure, physicochemical properties and site and mechanism of action. In the 1990s the analysis of diuretics in doping (by LC-UV or GC/MS) was a challenge for anti-doping laboratories due to the heterogeneity of the substances included. Since the advent of robust and reliable LC/MS instruments their detection in urine samples is no longer a problem. Future goals of diuretic analysis include developing more efficient and more economical detection methods. Increasing the sensitivity of the methods and the number of compounds in the screen while decreasing the analysis time and cost to laboratories would be welcome improvements.

Athlete Testing Guide Sport Integrity Australia

The new features of the instruments and the extension of the screening methods to other compounds expand the possibilities of sample preparation. Specific SPE procedures can be performed in robotic systems (Goebel et al., 2004) and some analytical procedures require no sample preparation, just a dilution the urine sample and subsequent direct injection into the LC/MS system (Politi et al., 2007; Thorngren et al., 2008). The improvements in the scanning speed of the mass spectrometers as well as better performing LC columns and LC pumps allow an increase in the speed of analysis (UPLC or fast LC) and of more heterogeneous screening procedures by LC/MS/MS. Currently, there are analyses that includes diuretics among other doping substances where more than 100 different compounds can be analysed in less than 10 min (Thorngren et al., 2008; Ventura et al., 2008). A new study in ACS Pharmacology & Translational Science led by Nav Raj Phulara, a chemistry graduate student at the University of Maryland, Baltimore County (UMBC), used a novel combination approach to increase understanding of the relevant mechanisms. First, tissue imaging showed that Efavirenz alters lipid metabolism in mouse brains.

What are anabolic steroids and other appearance and performance enhancing drugs (APEDs)?

The legal status of other performance-enhancing substances, such as growth hormones and insulin, also varies from country to country. In the United States, growth hormone is legal only with a prescription for specific medical conditions. In contrast, it is legal for anti-aging purposes in some European countries, like Germany and France. Similarly, insulin is legal only with a prescription in most countries, but in others, like the UK and Canada, it can be purchased over the counter without a prescription [52]. Patients who are deliberately using performance-enhancing drugs may not disclose use because of shame, legality concerns, or lack of trust.

The interventions addressed thus far in this chapter are individual interventions, in that they are designed to change thoughts, behaviors, and emotions of specific individuals who receive the intervention. In contrast, environmental interventions are not necessarily targeted to specific individuals but are designed to create a context that disincentivizes alcohol and drug use among all of those in the environment. Most of these interventions have focused on alcohol use because it is a legal substance readily available in most communities. An example of a well-known environmental https://ecosoberhouse.com/ intervention involved raising the drinking age in the United States from 18 to 21, which resulted in a decrease in alcohol consumption and traffic crashes (Wagenaar & Toomey, 2002). There is evidence to suggest that 12-step programs are as efficacious as other interventions/treatments (Ouimette, Finney, & Moos, 1997; Project MATCH Research Group, 1997). However, it can be difficult to examine the efficacy of individual 12-step programs; by definition, they are usually anonymous and assignment to appropriate control conditions is logistically challenging.