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Doping – winning with intoxication

by Josephine Andrews
Published: Last Updated on 197 views

Anabolic steroids, growth factors, blood doping – there are a number of substances and methods that athletes use to illegally increase their performance. In such cases one speaks of doping. Here you can find out what exactly is behind it, which doping agents are available, how they work and what side effects they have.

Striving for victory in competition is part of the basic endowment of human character. The sporting winner already enjoyed privileges in ancient times, but since then the “value for money” in sport has changed enormously: Olympic, Wimbledon and Tour der France winners are now multi-millionaires.

The desire for victory increases immeasurably. For this purpose, athletes repeatedly resort to illegitimate means.

What is doping?

The current definition according to the World Anti-Doping Agency (WADA) states: Doping is understood to mean all violations of the applicable anti-doping regulations. These provisions include, for example, the presence of a prohibited substance in an athlete’s body, refusal to provide a blood or urine sample for doping control, and aiding and abetting in doping.

WADA publishes an updated list of performance-enhancing substances and methods that are prohibited every year. However, it does not claim to be complete, because many things change quickly in medicine and new possibilities are constantly being explored.

Doping: Prohibited before, during and after competitions

The following list includes the following substances and methods that are prohibited in and out of competition :

Prohibited Substances

  • Anabolic substances (anabolic steroids)
  • Peptide hormones, growth factors, related substances and mimetics
  • Beta-2 agonists
  • hormone and metabolism modulators
  • diuretics and masking agents

Forbidden Methods

  • Manipulation of blood and blood components
  • Chemical and physical manipulation (e.g. substitution or adulteration of urine for urine samples)
  • Gene and cell doping

Prohibited during competitions

In addition, according to the WADA Prohibited List 2019, the following substances are prohibited in competitions :

  • stimulants
  • Narcotics
  • cannabinoids
  • Glucocorticoide
  • diuretics and masking agents

Bans on certain sports

In addition, so-called beta blockers are banned in certain sports (sometimes only in competitions, sometimes also outside of them), for example skiing, snowboarding, archery, billiards, golf and motor sports. Incidentally, beta blockers are drugs that inhibit the effects of stress hormones via certain mechanisms, so that blood pressure and heart rate drop.

Prohibited Substances

Below you will find more detailed information on the effects and risks of various doping substances.

Anabolic steroids (anabolic steroids)

In the past, the preparations were often used to help patients recover from debilitating illnesses such as cancer or serious infections. Because the hormones promote, among other things, the development of muscle tissue and blood formation. Artificial testosterone is indispensable as a hormone replacement therapy after surgical removal or in the event of a functional disorder of the testicles.

Anabolic Steroids: Doping

Depending on the substance, anabolic steroids have strong androgenic effects, which means they promote the development of secondary male sexual characteristics. These include beard growth, male physique and hair, often increased sexual desire and increased aggressiveness. As doping substances, anabolic steroids are among the classics – especially in strength and endurance sports. Because in addition to the muscle-building effect, anabolic steroids are said to accelerate regeneration. They promote protein synthesis and stimulate the release of the blood-forming hormone erythropoietin (EPO).

Anabolic steroids: side effects

Anabolic steroids can have significant and serious side effects. These include disorders of lipid metabolism, arteriosclerosis, damage to the heart muscle, thrombosis and embolism, liver and kidney tumors and breast cancer in men. In addition, the following was also observed: Increased willingness to be aggressive. In women masculinization, in men feminization of external appearance. Disorders of the cardiovascular system, development of hypertension .

Anabolic steroids: use in sports

Anabolic steroids are used in almost all sports where strength building or growth is desired. The most famous example: the case of Ben Johnson at the 1988 Olympics.

Anabolic steroids: Evidence

In the doping test, testosterone and its relatives can be detected via a changed steroid profile – the natural balance of hormones in the body is then disturbed. Isotope ratio mass spectrometry, which measures the ratio of different carbon molecules, is also used. This allows the body’s own steroids to be distinguished from those that are foreign to the body. Doping with anabolic steroids is considered to be easily detectable.

aromatase inhibitors

As medicines, they inhibit the enzyme aromatase, which is responsible for converting testosterone to estrogen. Aromatase inhibitors are used as an additional treatment in postmenopausal women with hormone-sensitive breast cancer to suppress the growth of cancer cells.

Doping with aromatase inhibitors

Because the active ingredient also inhibits the breakdown of the body’s own testosterone, the level of the male sex hormone increases even if no testosterone that is foreign to the body is supplied. The anabolic and masculinizing effects are particularly pronounced in women. However, the substance is also abused by male athletes for doping purposes.

Aromatase Inhibitors: Side Effects

In addition to many disorders such as weakness, nausea and loss of appetite, sleep and memory disorders, aromatase inhibitors can cause hair loss , muscle pain, blurred vision, bleeding, edema (water retention), osteoporosis (bone loss), thrombosis and infarctions in the lungs, heart and brain .

Aromatase Inhibitors: Evidence

Aromatase inhibitors can be directly detected in doping controls in the urine of athletes.


The hormone insulin produced by the pancreas plays a key role in sugar metabolism. Via special receptors on the cell membrane, insulin opens the door, so to speak, so that blood sugar can enter the body’s cells.

The release of insulin depends on the sugar intake. In people with diabetes, the hormone is not formed sufficiently (type 1 diabetes) or the sensitivity of the cells to the hormone is reduced (type 2 diabetes). All type 1 diabetics and many type 2 diabetics therefore have to artificially inject insulin.

Doping my Insulin

Insulin is mainly used as a doping agent in endurance and weight training. It not only accelerates the absorption of carbohydrates and the formation of the energy store glycogen in the liver and muscle cells, but also has an effect on the protein metabolism by activating certain genes. In a broader sense, insulin is one of the anabolic and regeneration-promoting doping substances.

Insulin: side effects

The most important and most dangerous side effect of the artificially administered insulin is the so-called low blood sugar (hypoglycemia). The effect of the hormone causes the blood sugar level to drop so much that the brain is no longer sufficiently supplied with fuel. The consequences are weakness, sudden disturbances of consciousness up to and including coma and, in the worst case, (brain) death.

Insulin: proof

Despite its short residence time in the bloodstream, which prevents direct detection of insulin, insulin abuse has been indirectly detectable for several years. In the case of artificial administration, the ratio of insulin to the so-called fragment C peptide, which is produced during the formation of endogenous insulin in a fixed ratio to the released insulin, changes.


Like insulin, the hormone naturally formed in the adrenal cortex is vital: Cortisol plays an important role in the formation of new sugars, in the breakdown of fat and in protein breakdown. In this way, it ensures an increased willingness to perform in stressful situations.

In medicine, cortisol in various precursors (cortisone) is used primarily to suppress the immune system. This can be useful, for example, in the case of allergies, skin and autoimmune diseases, joint inflammation or after organ transplants.

Doping my Cortisol

Cortisone is misused as a doping agent, especially during long and intensive exertion, because it pushes the natural stress limits – for example in long stage races in cycling or other extreme endurance exertion.

Cortisol: side effects

Frequent side effects of high-dose cortisone treatment are obesity of the trunk (truncal obesity) and full moon face, muscle wasting, disorders of the sugar metabolism, increased susceptibility to infections, acne , delayed wound healing, thinning of the skin (atrophy), pinpoint bleeding in the skin (petechiae) and bruising, water retention (oedema), cataracts, glaucoma, missed menstrual periods and impotence.

Cortisol: Evidence

Doping abuse of cortisone can be directly detected via the breakdown products of the hormone in the urine. If an athlete has a medical reason for taking it, such as an allergic or asthmatic condition, they must register this in advance with a certificate.

growth hormone

Growth hormone – also known as HGH or somatotropin – is responsible for human growth. Medically, it is mainly used in children to treat short stature. However, athletes also use the drug again and again because it has an effect on muscle building and fat loss.

You can read more about this in the article on growth hormones .

Other Prohibited Substances

Effect Stimulants (eg amphetamine) which stimulate the activity of the central nervous system. They increase self-confidence, cause a short-term increase in performance and suppress feelings of fatigue.
Negative consequences overload to the point of exhaustion or death. Tom Simpson died from amphetamines due to overexertion in the heat.
use in medicine Found in many cold medicines (ephedrine).
use as doping Declining due to effective controls.
Effect Painkillers from the opiate class act on the nervous system, dulling pain and elevating mood.
Negative consequences High addiction potential. The altered self-perception can lead to overwork, heart failure, or death.
use in medicine Pain relief of severe pain conditions.
use as doping Hardly ever used because of effective controls.
Effect Tetrahydrocannabinol (THC), the active ingredient in the cannabis plant, increases the activity of certain brain structures and stimulates the production of the happiness hormone serotonin.
Negative consequences Disabling fear increases risk-taking, which endangers the safety of athletes.
use in medicine Pain relief, desired increase in appetite.
use as doping Continues to be used, although retrospectively detectable long after use.
Anabolic Agents
Effect Promote muscle growth and muscle strength.
Negative consequences Increased aggressiveness. In women masculinization, in men feminization of external appearance. Disorders of the cardiovascular system, development of hypertension.
use in medicine Only rarely, for example in diseases with hormone disorders.
use as doping In almost all sports where strength building or growth is desired. The most famous example: the case of Ben Johnson at the 1988 Olympics.
Effect Endogenous substances that influence hormonal regulation. The best-known representative in relation to doping: Erythropoietin, EPO, which stimulates the formation of red blood cells and thus increases the oxygen content in the organism.
Negative consequences Thickening of the blood, which can lead to thrombosis and, in the worst case, death.
use in medicine Patients with kidney disease whose kidneys can no longer produce EPO receive artificial EPO and are therefore no longer dependent on blood transfusions.
use in sports Misused in endurance sports to increase aerobic performance by increasing blood oxygen levels. Only detectable in urine since 2001. Subject of the current wave of doping cases in cycling.
Beta-2 agonists
Effect Have an expanding effect on the bronchi.
Negative consequences Increase in heart rate and blood pressure.
use in medicine For the treatment of bronchial asthma.
use in sports For a short-term increase in performance through bronchodilation.
masking agent
Effect Not directly performance-enhancing, but can mask the use of banned substances. Example: So-called plasma expanders mask the intake of EPO by lowering the hematocrit value (hematocrit: proportion of all cellular components of the blood).
Negative consequences of a plasma expander Drop in blood pressure, dizziness, respiratory and circulatory arrest.
Effect Anti-inflammatory, suppression of pain sensation.
Negative consequences Mental disorders, hypertension.
use in sports Rather counterproductive, but probably still use because of the euphoric effect.

Forbidden Methods

Prohibited doping methods have the following effects or risks:

(Own) Blut doping
description Athletes have their blood drained during non-competitive training phases , administration of their own or someone else’s blood to improve the oxygen supply. Autologous blood doping is often combined with the abuse of EPO: The hormone is intended to accelerate the replacement of the blood cells that have been diverted.
Negative consequences See EPO. Improper preparation or storage of the canned goods or in a too rapid transfusion. Clumping can occur with the risk of embolism and infarction. Contaminated blood can lead to life-threatening blood poisoning (sepsis). In the case of foreign blood, there are also intolerance reactions, transmission of hepatitis or HIV.
use in sports Due to the detectability of EPO again increasingly in use. Since the blood cells that are transfused back are the body’s own cells, it is very difficult to prove autologous doping.
description Used in medicine as a therapy for diseases based on genetic defects.
Negative consequences Not fully explored yet. In the worst case, however, secondary diseases such as leukemia are suspected.
use in sports No known large-scale cases yet. Experts disagree. However, some suspect the abusive use of gene doping at the Beijing Olympics, for example to increase muscle growth.

Legal situation

Violations of the anti-doping law can result in severe fines or several years in prison.

In addition, violations of WADA’s anti-doping regulations are punished with clear sanctions: athletes who test positive in a doping control can be excluded from further competitions, depending on the substance. If someone is doped in competition and is caught, achievements (such as gold medals, etc.) can also be revoked retrospectively.

In team sports, this can also apply to the entire team. In addition, proceedings are always opened against the respective athlete, which can end with a ban of several years or even life. Last but not least, the person concerned often has to repay financial support and prize money received.

The penalties for doping are therefore justifiably severe. Because in sport it is not the person who wins that is right, but the person who does sport properly.


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