Ergogenic Aids in Sports

1. Ergogenic Aids in Sports

2. OBJECTIVES • Historical review • Factors influencing athletes to use drugs • Types of drugs and their risks • Preventing drug use in athletes

3. INTRODUCTION • Major problems facing sport today • Growing attention • Deaths of elite athletes • Increasing attention of media • Contrary to the ethical principles of athletic competition • Wide spread among athletes

4. DEFINITION: ERGOGENIC AIDS • Ergo = work • Gennan = to produce • Any substance or method used to enhance performance through increased energy utilization: • production • control • efficiency

5. TYPES OF ERGOGENIC AIDS • Biomechanical aids - light weight shoes • Psychological aids - hypnosis • Physiological aids - blood doping • Pharmacological aids - steroids • Nutritional aids -

6. DRUGS MISUSED BY ATHLETES • Therapeutic drugs • OTCs, Diuretics, Opioids, Beta-blockers, etc. • Performance enhancing drugs • Amphetamines, Caffeine, Anabolic steroids, Growth hormone, etc. • Drugs typically misused • Alcohol, Nicotine, Marihuana, Cocaine, etc.

7. HISTORICAL PERSPECTIVE • Ancient civilizations • Mushrooms, herbs, liquor • 19th Century • Alcohol, Caffeine, nitroglycerine, opium, strychnine, trimethyl • World War II • Amphetamines, testosterone

8. HISTORICAL PERSPECTIVE • Post war era • Amphetamines • Anabolic steroids • Newer agents • Blood doping • Erythropoietin • Growth hormone

9. CURRENTLY PROHIBITED BY IOC • Drugs • Stimulants, Opioids, Anabolic agents, Diuretics, Peptide hormones • Methods • Blood doping, artificial oxygen administration, plasma expanders, pharmacological, chemical and physical manipulation • In certain circumstances • Alcohol, Cannabinoids, local anesthetics,  blockers

10. WHAT FACTORS INFLUENCES ATHLETES? • Belief that competitors take drugs • Have to use them to be competitive • Need the edge to win! • Dissatisfaction with size/ weight • Peer/ Team Pressure • Community attitudes and expectations • Financial rewards and media influence • …

11. THERAPEUTIC DRUGS • Over-The-Counter (OTC) drugs: • NSAIDs, laxatives, analgesics, weight loss medicines, corticosteroids, local anesthetics • Low potential for misuse • Increased risk of further injury, GI bleed, anemia, eating disorders

12. THERAPEUTIC DRUGS • Diuretics • Rapid weight loss • Boxing, wrestling, judo • Excretion or dilution of illegal substances • Overall negative impact on performance • Dehydration, hypotension, muscle cramps, electrolyte imbalance

13. THERAPEUTIC DRUGS • Opioids • Prescription pain killers most common • Allow performance while injured • 75% used after injury only • Increased risk of further injury, dependence, drowsiness, mental clouding, and in high doses: respiratory depression, hypotension, addiction

14. THERAPEUTIC DRUGS • Beta-Blockers • Anti-tremor, anxiolytic effect • Shooters, ski jumpers, archery • Negative effect on endurance • Depression, bronchospasm, fatigue

15. PERFORMANCE ENHANCING DRUGS • CNS Stimulants • Amphetamines • Delay fatigue, increase alertness, enhance speed, power, endurance, concentration • Hypertension, angina, vomiting, abdominal pain, cerebral hemorrhage, addiction and death

16. PERFORMANCE ENHANCING DRUGS • CNS Stimulants • Caffeine • Shortened reaction time, improved concentration, diuresis • Glycogen sparing leading to delayed fatigue • > 12 ug/mL is a positive urine per IOC • Dyspepsia, cardiac damage, combination of caffeine with other stimulants (e.g., ephedrine) may be fatal

17. PERFORMANCE ENHANCING DRUGS • Systemic stimulants • Adrenalin • Normally used in local anesthetics • Ephedrine and pseudoephedrine • As cold and allergy remedies • Phenylpropanolamine • As diet pills • High doses are similar effects to the amphetamines

18. PERFORMANCE ENHANCING DRUGS • Anabolic androgenic steroids • Derivatives of testosterone • Drug and method sought for maximum anabolic and minimum androgenic properties • Sprinting, weight lifting, body building • Acne, abnormal Lever function tests, virilization,premature closure of the epiphysial plates, behavioral changes “roid rage”, CVAs, cardiomyopathy

19. PERFORMANCE ENHANCING DRUGS • Beta 2 agonists • Isoproterenol, epinephrine, norepinephrine • Sympathomimetic amines, anabolic properties • Cardiac arrhythmias in overdose, headaches • Peptide hormones: HCG • Increases testosterone • Maintains testicular volume with anabolic steroid use • Ovarian cysts

20. PERFORMANCE ENHANCING DRUGS • Pituitary and synthetic gonadotropins • Increases testosterone, anti- estrogenic • Ovarian cysts • Corticotropins • Increase testosterone • Rare and related to excess corticosteroids- pituitary suppression,  immunity, osteoporosis, hyperglycemia

21. PERFORMANCE ENHANCING DRUGS • Growth hormone • Increase muscle mass & decrease fat mass • Gigantism, acromegaly, hypothyroidism, cardiac disease, myopathies, arthritis, diabetes mellitus, impotence, osteoporosis

22. PERFORMANCE ENHANCING DRUGS • Erythropoietin (EPO) • Stimulates RBC production • Increases oxygen carrying capacity • CVAs • Blood doping • RBC transfusion, artificial oxygen carriers • Increases oxygen carrying capacity • Allergic reactions, sludging of blood

23. FOOD SUPPLEMENTS • Viewed as legal means of gaining edge • 76-100% of athletes use vs. 50% general population • May or may not contribute to enhanced performance • Creatine, colostrum, antioxidants, sodium bicarbonate, vitamins, proteins, amino acids • Adverse effects not investigated

24. TYPICAL DRUGS OF MISUSE • Alcohol • Most frequently used • Negative impact on reaction time, hand-eye coordination, balance, strength • Excessive heat production and dehydration • Cardiovascular and GI complications, nutritional deficiencies, dependence

25. TYPICAL DRUGS OF MISUSE • Cocaine • Minimal performance enhancing effect • Heightened arousal and increased alertness with low doses • Over confidence leading to increased risk of injury • MI, CVA, seizures, arrhythmias, addiction

26. TYPICAL DRUGS OF MISUSE • Cannabinoids • Most frequent illegal drug used in the US • Male athletes have higher incidence than non-athletic peers (opposite for females) • Psychomotor impairment, distorted perception, amotivational syndrome and decreased testosterone with long-term use

27. TYPICAL DRUGS OF MISUSE • Nicotine • Majority use in form of smokeless tobacco • Males >> females • Cardiovascular and pulmonary disease, oral cancers, addiction

28. DRUG PROGRAMS • Programs administered by leagues and associations (ex. NCAA, NFL, NBA) • Are responsible for relevant events, fairness, quality of competition, safety, the image of their participants and events • Deter use by testing and discipline • Some include evaluation and treatment • Coaches can discourage use

29. DRUG PROGRAMS • Programs identify individuals with drug problem to facilitate treatment • Keys to successful drug program: • Inclusion of all involved parties • Reliable and sensitive testing program • Consistent discipline • Evaluation of effectiveness • Confidentiality • Early prevention

30. CHALLENGES • Most drugs not prescribed • Viewed as essential for success • Easy access to drugs • Our dilemma/role • Monitoring side effects • Why?, discuss pro/cons, appraisal, explore options • Need for collaboration

31. SUMMARY • Substance use in athletes dates to ancient times • Multiple factors why athletes use drugs • Types of drugs used range from therapeutic and performance enhancing to typical drugs of misuse • Needs to educate athletes on the risks of using drugs