Luke

Meyer

Student ID: 2167725

HLPE1551: Sport in Society

Literature Review

Performance Enhancing Drugs in Sport

Introduction
In modern-day sport there is an ever-present prevalence of performance enhancing drugs
(PEDs) (Whitman, 2008). Historically, the use of PEDs has been dated back to ancient
Olympians who used natural extracts to gain an advantage over opponents (Kolt, 2012; Holt,
Erotokritou-Mulligan & Snksen, 2009) and has since grown significantly. Established in
1999, the World Anti-Doping Agency (WADA) has banned many substances that unfairly
give a district advantage to the consumer (Park, 2005). Despite the clear prohibition of
performance enhancing drugs and substantial penalties that can be applied from the WADA
athletes continue to illegally use PEDs. This literature review will discuss the health risks
involved when taking anabolic steroids (Chyka, 2003), creatine (Chyka, 2003) and
performing blood doping (Towns & Gerrard, 2014), perceived and actual incidence of PED
use (Moston, Engelberg & Skinner, 2015; Sottas, Robinson, Fischetto, Doll, Alonso, 2011;
Lentillon-Kaestner & Ohl, 2010), motives behind PED use for professional and nonprofessional athletes (Connor, 2009; Ehrnborg & Rosn, 2009), and the discussion of
legalization of performance enhancing drugs (Craciun, Siserman, Petrehu, Grosu & Dobosi,
2011; Kayser, Mauron & Miah, 2005; Murray, 2008).
.

Method
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Luke Meyer

Student ID: 2167725

Databases such as FIndIt@Flinders, Google Scholar, Proquest and Taylor & Francis Online
where used to locate information. Key words such as sport in society, drugs in sport,
performance enhancing, anabolic steroids, creatine, blood doping, health risks,
ethics and legalization were used in searches in previously mentioned databases and
journals including Sport in Society: Cultures, Commerce, Media, Politics and The
International Journal of the History of Sport. Searches in databases were also refined by
limiting the resource type to peer-reviewed journal articles and using articles post the year
2000, showing relevance. Flinders Central Library was also used to locate useful materials.

Body
Health Risks
Anabolic steroids are taken by athletes to enhance performance, increase muscle size and
decrease body fat (Chyka, 2003). Although they have a distinct positive Chyka (2003) states
that they can result in negative side effects. According to Chyka (2003) Effects include short
stature with childhood use, tendon rupture, left ventricular hypertrophy, liver tumours, HIV/
AIDS and hepatitis. Infertility, breast development and a high-pitched voice are male
related health risks while excessive growth of body hair and a low-pitched voice are female
Chyka (2003).
Creatine in its phosphylated form, phosphocreatine, is used in muscle cells to generate ATP
from ADP (Chyka, 2003). Supplementation of creatine monohydrate increases the
availability phosphocreatine in the production of ATP during anaerobic exercise and
promotes the aerobic resynthesis of phosphocreatine during recovery (Chyka, 2003).
Accoding to Chyka (2003) health risks of creatine include the retention of creatine in tissues,
the reduction of urine production, muscle enlargement due to water absorption and
massive onset weight gain from water retention.

Blood doping is used to increase the amount of oxygen in the blood by blood transfusion
into the circulatory system (Towns & Gerrard, 2014). Therefore, this increases an athletes
aerobic capacity. According to Towns and Gerrard (2014) bacterial contamination and viral
transmission are too ways in which disease can be transferred. HIV/ AIDS, the most common

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Luke Meyer

Student ID: 2167725

transfusion transmitted infection can also be transmitted though blood doping (Towns &
Gerrard, 2014).

Incidence of Performance Enhancing Drug Use

It can be widely recognised that there is a significant prevalence of performance enhancing
drugs in sport but the perceived incidence may be greater than the actual incidence
(Moston et al., 2015; Sottas et al., 2011; Lentillon-Kaestner & Ohl, 2010). The prevalence of
PEDs is difficult to measure as there a no reliable figures, according to Connor (2009) it can
rage from around 0.4% to 95% use for athletes. Moston et al. (2015) states that athletes and
coaches perceive that 18.75% of athletes use PEDs in all sports whereas in their own sports
they estimate that 9.85% of athletes us PEDs. He then indicates that this may be higher than
the actual use of performance enhancing drugs. Lentillon-Kaestner and Ohl (2010) add that
the perceived prevalence rate depends on the definition used by researchers, athletes and
coaches. This is shown as 2.2% of people surveyed by Lentillon-Kaestner and Ohl (2010)
were not sure if the substances theyve taken where doping substances.

Athletes Motives for Use
Despite the inability to reliably measure the incidence of performance enhancing drug use it
can be wildly recognised that PED use is an issue. Athletes are repeatedly motivated by
profit (Connor, 2009; Ehrnborg & Rosn, 2009) and the idea that everyone else is using
PEDs (Ehrnborg & Rosn, 2009). If athletes take PEDs their performance will increase and
therefore their chances of winning will increase. According to Connor (2009) winning leads
to contracts, media coverage, sponsorship, government support and prize money. Connor
(2009) states that the desire to win and make profit can override moral obligations and
possible consequences. Many athletes are also motivated by the fact that other competitors
are using performance enhancing drugs (Ehrnborg & Rosn, 2009). According to Ehrnborg
and Rosn this phenomenon is referred to as the doping dilemma. Even if athletes do not
use PEDs but there is a perception of PED use, it can ignite the desire of the athletes to
conform to the psychological pressure and use PEDs.

Discussion on Legalization
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Luke Meyer

Student ID: 2167725

Many different views are presented in the discussion of legalization of performance

enhancing drugs. Kayser et al. (2005) propose that PEDs should be legalized under medical
supervision as the policies are inconsistent with other legal form of performance
enhancement. They suggest that biological and environmental performance enhancements
are left unchecked and are the source of inconsistency. They state that getting an advantage
from a performance enhancing genetic predisposition is permitted and PEDs are not.
Craciun et al. (2011) also argue that a more permissive anti-doping policy would be more
beneficial to sport. They say that the current strict policies limit the effect that technology
has on sport and therefore constrict the rate of growth of sport.
Arguing against legalization Murray (2008) states that if anti-doping policies were lifted
athletes would continue take more and more risks and use excessive amounts of an
extensive array of drugs. He states that this may create a public health catastrophe and
young and fit athletes would do significant damage to their long term health.

Conclusion
This literature review has discussed the health risks for different performance enhancing
drugs as they are important to note as there is a prevalence of PEDs, the incidence of PED
use and suggests that the perceived incidence may be more prevalent than the actual
incidence, the motivation that athletes have for PED use including the profit motive and the
doping dilemma and some reasons to legalize and prohibit future PED use. As the actual
incidence of PEDs is unclear more research needs to be done to increase the accuracy of its
use in sport. This would then affect the perceived incidence and in turn the doping
dilemma, as stated by Ehrnborg Rosn (2009), may be minimized. Both sides of the
legalization argument present valid points and consider moral obligations and practical
benefits, but in the future the decision has to be made with great care as it will
detrimentally effect the way sport is performed and our opinions of it.

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Luke Meyer

Student ID: 2167725

References
Chyka, P. A. (2003). Health Risks of Selected Performance-Enhancing Drugs. Journal of Pharmacy
Practise, 16, 37-44. doi: 10.1177/0897190002239631

Connor, J. M. (2009). Towards a sociology of drugs in sport. Sport in Society: Cultures, Commerce,
Media, Politics, 12(3), 327-328. doi:10.1080/17430430802673676

Craciun, M., Siserman, C., Petrehu, D., Grosu, E. F., Dobo, S. (2011). Ethical Issues in Sport
Performance Enhancement. Romanian Journal of Bioethics, 9(3), 98-109. Retrieved from
http://search.proquest.com.ezproxy.flinders.edu.au/docview/1286689556?accountid=10910
Ehrnborg, C., Rosn, T. (2009). The psychology behind doping in sport. Hormone & IGF Research,
19(4), 285-287. doi:10.1016/j.ghir.2009.04.03

Holt, R. I., Erotokritou-Mulligan, I., & Snksen, P. H. (2009) The history of doping and growth
hormone abuse in sport. Growth Hormone & IGF Research, 19(4), 320-326.
doi:http://dx.doi.org/10.1016/j.ghir.2009.04.009

Kayser, B., Mauron, A., & Miah, A. (2005). Viewpoint: Legalisation of performance-enhancing drugs.
The Lancet, 366, 1. Retrieved from
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Kolt, G. S. (2012). Drugs in sport: Do we have what it takes to beat the battle?. Journal of Science and
Medicine in Sport, 15(5). Retrieved from
http://search.proquest.com.ezproxy.flinders.edu.au/docview/1041253767?accountid=10910

Lentillon-Kaestner, V., Ohl, F. (2010). Can we measure accurately the prevalence of doping?.
Scandinavian Journal of Medicine & Science in Sports, 21(6), 132-142. doi: 10.1111/j.16000838.2010.01199.x

Moston, S., Engelberg, T., & James Skinner (2015). Perceived incidence of drug use in Australian
sport: a survey of athletes and coaches. Sport in Society, 18(1). 91-105, doi:
10.1080/17430437.2014.927867
Murray, T. H. (2008). Doping in sport: challenges for medicine, science and ethics. Journal of Internal
Medicine, 264, 95-98. doi: 10.1111/j.1365-2796.2008.01994.x

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Student ID: 2167725

Park, J. (2005). Governing Doped Bodies: The World Anti-Doping Agency and the Global Culture of
Surveillance. Cultural Studies <--> Critical Methodologies, 5(2), 174-188.
doi:10.1177/1532708605274945
Sottas, P. E., Robinson, N., Fischetto, G., Doll, G., Alonso, J. M. (2011). Prevalence of Blood Doping
in Samples Collected from Elite Track and Field Athletes. Clinical Chemistry, 57(5), 762-769.
Retrieved from
http://search.proquest.com.ezproxy.flinders.edu.au/docview/865356955?accountid=10910

Towns, C. R., Gerrard, D. F. (2014). A fool's game: Blood doping in sport. Performance Enhancement
& Health, 3(1), 54-58. doi:10.1016/j.peh.2014.11.001

Whitman, J. H. (2008). Winning at All Costs: Using Law &(and) Economics to Determine the Proper
Role of Government in Regulating the Use of Performance-Enhancing Drugs in Professional Sports.
University of Illinois Law Review, 459. Retrieved from
http://heinonline.org.ezproxy.flinders.edu.au/HOL/Page?public=false&handle=hein.journals/unilllr2
008&page=459&collection=journals#

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