Use Of Performance-enhancing Substances Research Articles

Performance-enhancing: substances and their use among adolescent athletes.

1. Jason J. Koch, MD* 1. *Southdale Pediatrics, Edina, MN After completing this article, readers should be able to: 1. List the names and actions of performance-enhancing substances. 2. Describe the signs and symptoms of anabolic steroid use. 3. Describe the signs and symptoms of growth hormone use. 4. Characterize the adverse effects of anabolic steroids and other performance-enhancing substances. 5. Describe the clinical changes seen in patients using anabolic steroids and growth hormone. Pediatricians see many adolescent patients who present for sports physical examinations, camp physical examinations, or immunizations. One area of concern in the health of these patients should be the use of performance-enhancing substances (PES), which may be better known as ergogenic aids or performance-enhancing drugs. The use of these agents has grown significantly among athletes to help performance and among nonathletes to improve appearance. Use of substances such as anabolic steroids, creatine, and dietary supplements is widespread among adolescents and is related to numerous pressures to excel in academics, at home, and on the athletic field. To be prepared to discuss PES with our patients, we should know the names of the substances, how they are believed to work, and problems associated with their use. We should be aware of the current epidemiology, prevalence, and popular attitudes. We also should know the clinical aspects of PES, including symptoms and signs of use and abuse as well as the science behind the chemicals and the studies that have been published. Finally, we should understand our role in the management of patients using these substances and how we can act as educators, spokespersons, and advocates for child athletes. PES have been present as long as there has been human competition. Aztec athletes and warriors ate human hearts to give them strength in battle and competition. Ancient Greek Olympians used special mushrooms they believed gave them added power. In the 1800s, European cyclists used …

Analytical advances in detection of performance-enhancing compounds

The use and abuse of performance-enhancing substances has been an issue in sports since the ancient Greeks. The availability of numerous synthetic steroids and recombinant peptide hormones has made testing an analytical challenge. Recent advances in mass spectrometry have provided an opportunity to decrease detection limits. The Atlanta Olympic Games in 1996 marked the first time every specimen was screened by gas chromatography (GC) coupled to high-resolution mass spectrometry (MS). A further improvement may be seen with GC/MS/MS and quadrupole ion traps. Electrospray HPLC/MS has also been applied to the detection and confirmation of peptide hormones in urine. The ability to detect subtle differences in oligosaccharide structure may provide a way to detect abuse of recombinant glycoproteins. Simply decreasing detection limits is not enough; new technology also allows development of a foundation on which to base interpretation. Application of HPLC/MS/MS has allowed direct measurement of steroid conjugates in urine. The relative importance of sulfate, glucuronide, and other conjugates and metabolites of testosterone and epitestosterone can now be assessed. In the international sports arena, the impact of genetic metabolic disposition must also be considered if we are to provide an equitable system. Further research will establish more-refined criteria for the detection threshold of abused substances.

Discourses on Drug Use: The Social Construction of a Steroid Scandal

At the 1988 Olympic games, a urine test on Canadian sprinter Ben Johnson left him bereft of his gold medal and nullified his record-breaking time in the 100-meter event. Immediate media reactions to this affair, shaping the popular discourse surrounding it, were distorted by the ideological constructs of the Olympic games philosophy. A national inquiry into the use of performance-enhancing substances in sports focused unyielding attention to details of the reality of Canada's athletes who had used drugs. This initiated a conceptual shift into a more familiar discourse, the demonic perspective on illicit drug use. This is a notoriously unproductive framework for policy analysis. Consequently, potentially instructive parallels among drugs on the street, drugs in medicine and drugs in sports were obscured. Reality is socially defined. But the definitions are always embodied, that is, concrete individuals and groups of individuals serve as definers of reality. To understand the state of the socially constructed universe at any given time, or its change over time, one must understand the social organization that permits the definers to do their defining (Berger and Luckmann 1967:134).