Performance-enhancing drugs in athletics

We've got that familiar athletics fever again. But history shows that before these championship games are over, a few names will be called in relation to cheating.

Every single movement of our bodies, every bodily function, from breathing, blinking, laughing and chewing, to running or swimming at lightning speed, relies on muscles. Those who choose to use drugs to improve athletic performance are mainly attempting to manipulate muscles to be more efficient. Banned substances either give athletes unfair advantage by artificially improving their performance or endangering their health. Many of these substances can kill the user.

Banned substances

There are numerous banned substances, including steroids like stanazolol and nandrolone. Human growth hormone (HGH) may increase lean body mass. Amphetamines, caffeine and cocaine decrease fatigue and may increase mental sharpness and confidence.

Pseudo-ephedrine and similar ingredients in cough and cold preparations help clear passages in the lungs, making it easier to breathe, increasing availability of oxygen and increasing performance. Alcohol, narcotic painkillers like oxycodone and pethidine, and cannabinoids like hashish and ganja are also listed.

There are exemptions

If the athlete has a medical condition which requires prescribed drug therapy, he or she must declare all medical details in writing to the relevant sporting authority before competition. Some prescribed medications are allowed.

For some drugs, if the testing authority finds higher than a certain level of it in blood or urine, it is regarded as a dose not intended for therapeutic use. The sporting authority will, therefore, regard the result as an adverse analytical finding.

Methods in cheating

Some athletes employ banned practices to improve performance or change blood/urine test results.

Manipulate urine: the athlete presents somebody else's urine for testing, or manipulates his or her own urine sample to mask banned substances before testing. Probenecid and some diuretics like furosemide or amiloride are common masking agents. Masking agents dilute urine, which lowers the amount of steroid or other banned substance which would show up in the urine test.

If the athlete gets permission to use a diuretic for medical reasons, the exemption is withdrawn, if authorities test and find diuretics present above the allowed therapeutic concentration. The authorities will then look for the other banned substance which they think is being masked.

Manipulate weight: Diuretics make us lose water and can lower the athlete's weight which is desirable in some sports.

Dope blood: The athlete injects a hormone like erythropoetin (EPO) to boost production of more blood, so the athlete's muscles can carry more oxygen. Alternatively, the athlete may remove some of his own blood, forcing the body to produce more. Just before competition the athlete replaces his old blood in his body, so he can store more oxygen in muscles and give a better performance.

Inject Insulin: the athlete inject insulin regularly which, along with high carbohydrate diet and exercise, increases muscle size and strength to maximise performance.

Dr Dahlia McDaniel is a pharmacist with a doctorate in public health. She is the chief executive officer of two pharmacies and a medical practice in Kingston; email: yourhealth@gleanerjm.com.