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Ergogenic Aids in Sports. OBJECTIVES. Historical review Factors influencing athletes to use drugs Types of drugs and their risks Preventing drug use in athletes. INTRODUCTION. Major problems facing sport today Growing attention Deaths of elite athletes Increasing attention of media

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objectives
OBJECTIVES
  • Historical review
  • Factors influencing athletes to use drugs
  • Types of drugs and their risks
  • Preventing drug use in athletes
introduction
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
definition ergogenic aids
DEFINITION: ERGOGENIC AIDS
  • Ergo = work
  • Gennan = to produce
  • Any substance or method used to enhance performance through increased energy utilization:
    • production
    • control
    • efficiency
types of ergogenic aids
TYPES OF ERGOGENIC AIDS
  • Biomechanical aids - light weight shoes
  • Psychological aids - hypnosis
  • Physiological aids - blood doping
  • Pharmacological aids - steroids
  • Nutritional aids -
drugs misused by athletes
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.
historical perspective
HISTORICAL PERSPECTIVE
  • Ancient civilizations
    • Mushrooms, herbs, liquor
  • 19th Century
    • Alcohol, Caffeine, nitroglycerine, opium, strychnine, trimethyl
  • World War II
    • Amphetamines, testosterone
historical perspective8
HISTORICAL PERSPECTIVE
  • Post war era
    • Amphetamines
    • Anabolic steroids
  • Newer agents
    • Blood doping
    • Erythropoietin
    • Growth hormone
currently prohibited by ioc
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
what factors influences athletes
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
therapeutic drugs
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
therapeutic drugs12
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
therapeutic drugs13
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
therapeutic drugs14
THERAPEUTIC DRUGS
  • Beta-Blockers
    • Anti-tremor, anxiolytic effect
    • Shooters, ski jumpers, archery
    • Negative effect on endurance
    • Depression, bronchospasm, fatigue
performance enhancing drugs
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
performance enhancing drugs16
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
performance enhancing drugs17
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
performance enhancing drugs18
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
performance enhancing drugs19
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
performance enhancing drugs20
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
performance enhancing drugs21
PERFORMANCE ENHANCING DRUGS
  • Growth hormone
    • Increase muscle mass & decrease fat mass
    • Gigantism, acromegaly, hypothyroidism, cardiac disease, myopathies, arthritis, diabetes mellitus, impotence, osteoporosis
performance enhancing drugs22
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
food supplements
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
typical drugs of misuse
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
typical drugs of misuse25
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
typical drugs of misuse26
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
typical drugs of misuse27
TYPICAL DRUGS OF MISUSE
  • Nicotine
    • Majority use in form of smokeless tobacco
    • Males >> females
    • Cardiovascular and pulmonary disease, oral cancers, addiction
drug programs
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
drug programs29
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
challenges
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
summary
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
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