Introduction
Athletes dedicate their precious time in practicing and training in the hope of ultimate reward for their flawless performance. The competitive environment and passion for winning add extra motivation to their will to succeed. For a perfect athletic performance, a healthy and strong body is a primary necessity. To achieve new limits in their career athletes take good diet and a proper training and exercise regime. Literature suggests that the use of vitamins and nutritional supplements also contribute to enhancing the performance. Performance Enhancing Drugs (PED) are newly discovered options that can be presented as the next step in this progression. These drugs help in maintaining a finely tuned body that facilitates the athletic performance. In the last few decades, the use of PED has increased multiple times that has raised several ethical, moral and health-related issues (Robinson, 2009).
The purpose of this literature review is to discover the role of PEDs in athletic life and its adverse effects on human body. The paper also highlights the health and ethical issues related to the use of PEDs and how they can be managed.
Methodology
This paper presents a literature review on PEDs based on ten different sources. The sources were extracted from the online database of MEDLINE, using keywords “Performance Enhancing Drugs”, “Ethics” and “Athletes." Amongst all the ten sources, 9 are articles published in reputed journal including one book. All the references are currently published after 2000.
Definition of PED
PEDs are pharmaceutical agents that are ingested by the athlete as well as non-athlete weightlifters to improve their performance. In the sports world, the use of PED is also known as doping. There are several PEDs that are consumed based on different body types. The mostly used PEDs are anabolic androgenic steroids (AAS) that have a unique capability of increasing the muscle-mass while reducing the fat mass. It is the most prevalent illicit drug in the category of PEDs. Apart from AAS other used PEDs include Human GH (HGH) and IGF-1(Insulin Growth Factor) that are available relatively at a lower cost in the black market. Anabolic Steroids facilitate the building of muscular mass making the athletic body stronger through stimulating proteins. AAS consumption increases the body stamina and enables it for a longer period of training. Human Growth Hormone (HGH) is taken by athletes to improve the endurance capabilities and body strength. Other used substances for similar purposes are insulin hormones, beta-adrenergic agonists, diuretics (thiazides) and blood boosters (Pope et al., 2013; Kaur, Masaun and Bhatia, 2014; Robinson, 2009).
Role of WADA
The World Anti-Doping Agency (WADA) is an international agency that regulates the consumption of pharmacologic substances as PEDs. It monitors the anti-doping policies for competitive sports worldwide. WADA has released a world anti-doping code that includes a list of banned pharmacologic agents. WADA code is universally accepted and updated regularly. WADA code includes a set of three criteria for any substance to be banned.
1. Substance that is implied for enhancing performance
2. Any substance that is detrimental to health
3. If it violates the spirit of sports
Substances that are prohibited by WADA are anabolic steroids, diuretics, insulin-like IGF, HGH and Erythropoietin (EPO) (Pope et al., 2014; Robinson, 2009).
History of PEDs
An extensive range of literature is available that claims that PED consumption is not new. According to Yesalis & Bahrke (2002), in Ancient Greece Olympic athletes used to consume plants and animals extract to improve athletic performance, Pope et al. (2014) and Reardon and Creado (2014), also provided a similar historical description of doping. According to them, in the 1930s, people used to take testicular extracts to enhance mental and physical energy levels until the synthetic testosterones were not synthesized. The use of PEDs has been banned from Olympics since 1967. AAS was also given a red alert in 1975 until US Congress categorized AAS as a Schedule III controlled substance in 1991 (Yesalis & Bahrke, 2002).
Epidemiology of PED Abuse
The rapidly rising issue of current times is the use of PEDs amongst pre-teenagers, teenagers and adolescents (Dandoy, & Gereige, 2012; Ungerleider, 2003; Sherk, Erkenbeck & Becker, 2003). According to Pope et al., (2014), the median age of PED use across all the studies has been 22-24 years. Dandoy, & Gereige (2012), described multiple determinants responsible for the statistics on PED use that includes early participation in sports at a smaller age, the role of media, pressure from family and trainers, promotion of high muscular mass in males and thinness amongst females. Moreover, availability of PEDs in the market fueled up the scenario, especially among school students (Sherk, Erkenbeck & Becker, 2003).
Behavioral, Ethical and Health Related Issues of Doping
All the doping agents impose a long and short term impact on the human body. Androgen and testosterone are sex hormones, and they impose severe effects including hematologic hormonal, metabolic, cardiovascular, neuro and psychological impacts on the human body. Several animal studies have exhibited the neuropsychological effects of testosterone in animal subjects. Though, it is not possible to confirm the level of these effects because it would be unethical to use these agents on human subjects in such high doses that the athletes take. Some of the reviews show that PED use may result in infertility and sexual dysfunction, acne, testicular enlargement, low HDL level and low sperm count (Pope et al., 2014).
PED use has been associated with neuro-toxicity that may result in neuropsychiatric conditions such as anxiety, aggression and psychosis. On ethical values for doping, Sigman (2008) and Savulescu (2004), provided literary master pieces on safety and fairness regarding PED abuse. Savulescu (2004) justified doping claiming it to be a method of removing inequality amongst players. Giving an example of Ian Thorpe a big feet swimmer, the writer presents nature as unfair for other swimmers. This article provides a new direction to the whole topic through presenting the facts. It also provides several arguable points to law and policy makers and sportspersons. Sigman (2008), presented an economic approach towards law making for doping in sports. He focused on explaining that how private and federal authorities should work to minimize the present and future damage by doping.
Conclusion
The long term side-effects of PED abuse could not be appropriately studied yet, which is the biggest gap in our knowledge. Various retrospective analysis and case studies have revealed its serious health issues including psychological, behavioral, neurologic and cardiovascular disorders as well as high risk of death. Now the questions that are raised include how PED abuse can be prevented. It is also evident that the banning of PEDs has not been successful yet, and there is a high chance that it will never be successful. In fact, the forced prohibition may result in intrinsic harms. Thus, the next question that arises is that where does the gap exist that remains unexplored by policy and law makers. It is a debatable issue because few researchers have presented the PED ban as unfair resulting in inequality. They argue that by allowing PED consumption to everyone, it is possible to provide a level playing field to all.
The primary concern of policymakers should be the health of the athlete. It is necessary to evaluate the effect of PEDs and allow them according to the age of the athlete and type of the sporting activity. A proper parental counseling for teenagers is essential with the help of educators and trainers to protect them from unnecessary ingestion of PEDs.
References
Dandoy, C., & Gereige, R. S. (2012). Performance-enhancing drugs. Pediatrics in Review, 33(6), 265-272. Retrieved March 12, 2016, from http://pedsinreview.aappublications.org/content/33/6/265
Kaur, J., Masaun, M., & Bhatia, M. (2014). Performance enhancing drug abuse in athletes and role of psychotherapy. Delhi Psychiatry Journal, 17(2), 413-418. Retrieved March 12, 2016, from http://medind.nic.in/daa/t14/i2/daat14i2p413.pdf
Pope, H. G., Wood, J. I., Rogol, A., Nyberg, F., Bowers, L., & Bhasin, S. (2014). Adverse health consequences of performance-enhancing drugs: An endocrine society scientific statement. Endocrine Reviews, 35(3), 341-375. Retrieved March 12, 2016, from http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4026349/
Reardon, C. L., & Creado, S. (2014). Drug abuse in athletes. Substance Abuse and Rehabilitation, 5, 95-105. Retrieved March 12, 2016, from http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4140700/
Robinson, T. (2009). Performance-enhancing drugs. Edina, MN: ABDO
Publishing Company.
Savulescu, J., Foddy, B., & Clayton. (2004). Why we should allow performance enhancing drugs in sport. British Journal of Sports Medicine, 38, 666-670. Retrieved March 12, 2016, from http://bjsm.bmj.com/content/38/6/666.full
Sherk, J., Erkenbeck, J., & Becker, F. (2003). Student athletes and performance enhancing drug use. Prevention Tactics, 7(1), 1-5. Retrieved March 12, 2016, from
http://www.cars-rp.org/publications/Prevention Tactics/PT7.1.03.pdf
Sigman, S. M. (2008). Are we all dopes? A behavioral law and economics approach to legal regulation of doping in sports. Marquette Sports Law Review, 19(1), 125-208. Retrieved March 12, 2016, from http://scholarship.law.marquette.edu/cgi/viewcontent.cgi?article=
1026&context=sportslaw
Ungerleider, S. (2003). Teen steroid abuse is a growing problem. In J. Haley (Ed.), Performance-enhancing drugs (pp. 41-44). Farmington Hills, MI: Greenhaven Press.
Yesalis, C. E., & Bahrke, M. S. (2002). History of doping in sport. International Sports Studies, 24(1), 42-76. Retrieved March 12, 2016, from http://library.la84.org/SportsLibrary/ISS/ISS2401/ISS2401e.pdf
