As the field of athletics involves more money and more competition, more athletes may resort to drugs as a way of giving them an edge. Performance enhancing drugs, such as anabolic steroids and erythropoietin (EPO) are used for weight reduction, body mass buildup, allowing the blood to carry more oxygen, and masking pain felt during competition. These drugs work in a variety of different ways, therefore detection can be difficult. Many drugs, such as EPO, mimic a normally occurring function of the body and are therefore even harder to detect. A voiced concern is that children, who hold performance drug using athletes as role models, might feel that the only way to compete is with drugs. There are many concerns of industry insiders that performance enhancing drugs are taking away from the sport and making them, in essence, a battle of chemists. Drug enhanced performance does not allow an even playing field.


There are several different types of drugs grouped by their function. The main groups are: Stimulants, muscle builders, relaxants, weight reducers, oxygen delivery enhancers, and pain maskers. Most of these groups have legitimate uses outside of the sports world. Some, like pain maskers include things like cortisone and local anesthetics which may be necessary at times during events.

Muscle Builders

Mass and strength building drugs are usually used by athletes sports such as body building, where large amounts of muscle over quickness is needed. Included among the drugs are anabolic steroids, which build muscle and bone mass primarily by stimulating the muscle and bone cells to make new protein. Along with the increase in hormones such as testosterone, which along with other natural hormones are the primary components of steroids, come many side effects including mood swings, breast development, and infertility. In females, anabolic steroids promote masculine features to develop. Another type of mass and strength builder is human growth hormone or hGH. The normal function of hGH is to promote growth, typically during early years. When an athlete uses hGH they experience increased muscle mass (due to increased protein synthesis), as well as stronger bones and reduced body fat. As a result of the rapid growth structures such as hands, feet, and face grow disproportionately.

Pain Maskers

Different from other performance enhancing drugs, yet still beneficial, are drugs used to alleviate or mask pain. Athletes may wish not to feel certain pain (whether due to injury or mere competing), so as to gain an advantage. Several substances that are used to deal with pain are often necessary and legal outside of some competitions, which makes the regulation of pain masking drugs very difficult. Narcotics such as morphine and heroin are used by top level athletes, who often become addicted. In addition to addiction, narcotics can impair mental and physical abilities. Local anesthetics and cortisone, although different, fall under the “sometimes necessary” category and are therefore hard to moderate in sporting events. Generally one who competes with an injury is not playing smart, especially while taking a pain alleviator, for one could further the injury and not be able to feel it.

Stimulants and Relaxants

Stimulants are effective in maintaining alertness and aggressiveness. The body’s normal functions are sped up, resulting in high blood pressure, convulsions or even death. Certain stimulants, such as coffee, might be too common place to label as a performance enhancing drug. Stimulants maintain neurotransmitter release or postpone re-uptake of said neurotransmitter. Relaxants are the complete opposite of stimulants, for they block the reception of neurotransmitters. In athletics they are used to relax, which in turn induces better performance in certain athletes. Relaxants include alcohol and marijuana. Both of these drugs often relax the athletes, yet at the same time markedly decrease the person’s functions such as mental ability and coordination.

Oxygen Delivery Enhancers

Another group of performance enhancing drugs specialize in increasing oxygen transport. These are useful for endurance athletes, and typically are the hardest to detect. The most widely known of this category is EPO, which will be discussed later in length. Possibly the most interesting drugs are artificial hemoglobins. Hemoglobin is the substance within one’s red blood cells that actually carries oxygen. The benefits of using artificial hemoglobin are not well documented and it could actually have adverse effects on performance. Possible side effects range from immune system problems to kidney damage. More of a practice rather than a drug, blood doping involves infusing blood from a high EPO source to an athlete in order to increase oxygen delivery to tissues.


Erythropoietin (EPO) is a naturally produced hormone that acts on the bone marrow (along with other processes), stimulating the production of oxygen carrying red blood cells (RBCs). The secretion of EPO can be stimulated both by androgens and growth hormone, but usually lack of oxygen in the tissues is the secreting stimulus. This method is used by athletes in endurance sports because by raising the oxygen-carrying capacity of the blood, EPO improves endurance. As previously mentioned EPO is produced naturally by the body, but a deficit of EPO results in anemia, a disease involving lack of oxygen in the blood. Artificial EPO is manufactured by pharmaceutical companies to treat some forms of anemia. Endurance athletes, such as cyclists and cross country skiers, can use this artificial form of EPO to increase their RBCproduction, thus their endurance. EPO is naturally synthesized in the kidneys when prompted by a condition known as hypoxia (low oxygen). Developing red blood cells have anywhere from 3 to 400 receptors for EPO. When these receptors are stimulated by EPO they trigger responses to produce the fully mature erythrocytes. Iron is a large part of the EPO/RBC cycle. Seventy percent of the body’s iron in the circulating RBCs. In its most basic form the production of new RBCs can be broken down between EPO and iron. Iron is essentially what fuels production, and EPO is the accelerator. Iron and EPO must be delivered at the correct time for a maximum level of RBCs to be produced. This whole process can be triggered by artificially created EPO, which was discovered in the 70’s. Artificial EPO differs slightly in its molecular structure from natural EPO, yet creates the same biological effects. When a large amount of EPO is injected the result is an overabundance of RBCs, as well as resulting oxygen carrying capacity. Due to the blood viscosity the usefulness of artificial EPO is limited. As more RBCs are produced (due to high EPO levels) the resistance to flow increases due to congestion, which actual reduces oxygen supply.


Recent developments in the Tour De France have brought the controversy of EPO to public view. A book written by a team “trainer” recounts endless doses of potentially hazardous drugs, especially EPO. The notion that nearly every top cyclist takes EPO is taken as fact by cycling elite. During the 1998 Tour De France, EPO as well as other performance enhancing drugs were discovered in a cars belonging participating team’s. Of special notoriety was when French trainer was arrested possessing 234 vials of EPO, and 24 vials of growth hormones and testosterone. Since this incident allegations regarding nearly every winning team in the sport has become routine news, and as a result a public outcry for developed testing methods has erupted. The mass media continued the trend straight through to the 2000 Olympic Games in Sydney, where rapid testing was done to try to come up with a solution. The biggest problem that faced EPO testing was the fact that it occurs naturally in the body, therefore merely detecting it would not suffice. Some proposed tests included testing molecular make-up of the RBCs for it changes slightly, as well as shape and size of RBCs. When artificial EPO is injected the resulting RBCs are larger and less disc like. Current approved tests measure the ratio of blood cells to actual liquids in the blood vessels. After numerous tests scientists found that the average top level athlete has about a 43% level (43% red cells and 57% plasma), so they capped the limit at 50%. Death can occur from abuse of EPO, but these deaths are rarely attributed to the drug to avoid scandal. While not the most deadly drug, EPO is one of the most effective and undetectable. If tests can be refined until they are extremely reliable then, hopefully, the threat of EPO tainting sports will diminish.


There are so many drugs in the market that effect athletes in so many ways that it is hard to develop tests that account for them all. Also due the the nature of certain drugs, for example drugs that have natural counterparts in the body, it is difficult to distinguish unnatural from natural even with proper testing. Several tests exist for detection of performance enhancing drugs. One method is gas chromatography. In gas chromatography the sample (urine/blood) is vaporized and placed in a machine. The different substances in the vapor stay in gas form for different amounts of time, and are typically absorbed into a solid or liquid, which is later analyzed for traces of drugs. The drugs have different retention times. These retention times are compared with the athlete’s sample and if they match then the test is positive.

The adverse physical effects of performance enhancing drugs are varied, but all have long term consequences for the athlete. Many mimic natural body functions, while others are supercharged synthetics. The drug problem is created, and perpetuated by drug using athletes. The success of one who uses performance enhancing drugs requires others to follow suit to win. The drugs are embedded in the culture of some sports, which means even more dangers for coming generations. Performance enhancing drugs, especially EPO, create a conflict that is outside of sports, which results in uneven competition.

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