Title: Performance-Enhancing Drugs
1Performance-Enhancing Drugs Methods
2Definition of Performance-Enhancing Substance
- Performance-enhancing substance means a
manufactured product for oral ingestion,
intranasal application or inhalation containing
compounds that - Contain a stimulant, amino acid, hormone
precursor herb or other botanical or any other
substance other than an essential vitamin or
mineral - Are intended to increase athletic performance,
promote muscle growth, induce weight loss or
increase an individuals endurance or capacity
for exercise.
3Variations of Steroids and Performance-Enhancing
Substances
4Why do athletes take anabolic steroids or
performance-enhancing substances?
- To
- Boost athletic performance
- Build muscle
- Increase body mass
- Lose body fat
5What influences an athlete to take anabolic
steroids or performance-enhancing substances?
6Desire to Emulate Role Models
7Peer Pressure to Succeed
8Media Influences
Images that portray steroids in a positive light
9Cover Stories About Steroids
10Desired Body Image Based on Gender
11Dangers of Anabolic Steroids and
Performance-Enhancing Substances
- Steroids are dangerous for two reasons
- They are ILLEGAL.
- They can damage a persons mental and physical
health. - If used by adolescents, can have permanent
negative consequences
12Some Health Risks for Both Males and Females
- Acne, really bad acne, especially on face and
back - Stunted growth in teens (by causing bones to
mature too fast and stop growing at an early age) - High blood pressure, unhealthy cholesterol
changes, and heart disease - Blood clots and stroke
- Liver damage, jaundice, or liver cancer
- Headaches, aching joints, and muscle cramps
- Increased risk of ligament and tendon injuries,
which can end an athletes career for good - Needle sharing results in higher risk for serious
infections like Hepatitis B and C or HIV, which
causes AIDS - Baldness
13Gender Differences and Risks of Drug Use
- Young Females
- Self-esteem
- Depression/mood
- Body image
- Media
- Young Males
- Risky behavior
- Impulsivity
- Body image
- Media
Specific, based on gender
14Health Risks for Males
- Shrinking of the testicles
- Low sperm count
- Impotence (inability to get an erection)
- Increased breast growth in males, especially
teens - Possible lactating
- Enlarged prostate
15Health Risks for Females
- Breast shrinkage
- Male-type facial and body hair growth
- Deepening of the voice
- Problems with menstrual periods
- Enlarged clitoris
- Insatiable sex drive
16Health Risks for Both Genders
- Internal organ disease liver, kidneys,
arteriosclerosis - Various cancers
17Psychological Health Risks
- Roid rage- severe, aggressive behavior that may
result in violence, such as fighting or
destroying property - Severe mood swings
- Paranoia- extreme feelings of mistrust and fear
- Anxiety and panic attacks
- Depression and thoughts of suicide
18Definition of Cycling
- Anabolic steroids are taken orally or injected,
typically in cycles of weeks or months, rather
than continuously. - Cycling involves taking multiple doses of
steroids over a specific period of time, stopping
for a period, and starting again.
19Definition of Stacking
- Users often combine several different types of
steroids to maximize their effectiveness while
trying to minimize negative effects.
20Slang for anabolic steroids or performance-enhanci
ng substances
- You may have heard steroids called
- Roids
- Juice
- Hype
- Pumpers
- Gym Candy
- Arnolds
- Gear
- Weight Trainers
- Stackers
- 420 (pronounced four-twenty)
21What should you look for if you are concerned
that an athlete may be taking anabolic steroids
or performance-enhancing substances?
- Unfortunately, many of the symptoms of steroid
abuse look very similar to typical appearances
and attitudes that occur during adolescence.
Here are some signs to look for - Increased aggression
- Rapid weight gain (10 lb/month or 40lb/year)
- Pustular acne
- An obsession with and bragging about increased
performance (i.e. increased bench press) - Virilization in females (lowering of voice
facial hair, male pattern of hair growth on body)
22Common Myths
- Steroids are safe
- Taking any kind of steroid will result in death
- Injectable steroids are safer than oral steroids
- Steroids wont really stunt your growth
- All steroids are pretty much the same
- Steroid abuse isnt really a big problem in the
U.S. - All steroids are pills
- Only a certain kind of person uses steroids
- Steroids arent addictive
- Steroids arent as illegal as other drugs
- Steroids build muscle without working out
- Women dont use steroids
- Roid rage isnt real
23Stimulants
- Drugs that can reduce fatigue, suppress appetite,
and increase alertness aggressiveness - Stimulate the CNS, increase your heart rate,
blood pressure, body temperature metabolism
24Stimulants cont.
- Most common include caffeine and amphetamines
- Cold remedies often contain the stimulants
ephedrine pseudoephedrine (Sudafed) - Street drugs such as cocaine methamphetamine
belong to this group
25Stimulants cont.
- Can boost physical performance promote
aggressiveness on the field - Have side effects that can impair athletic
performance - Nervousness irritability, insomnia
- Can become psychologically addicted or develop a
tolerance so that they need greater amounts to
achieve the desired effect
26Stimulants cont.
- Other side effects may include
- Heart palpitations
- Heart rhythm abnormalities
- Weight loss
- Mild hypertension
- Hallucinations
- Convulsions
- Brain hemorrhage
- Heart attack other circulatory problems
27Ephedra
- Erythropoetin (EPO) increases endurance
- Ephedra delays fatigue
- On April 12, 2004, the Food and Drug
Administration prohibited the sale of dietary
supplements containing ephedrine alkaloids
(ephedra). - Ephedra, also called Ma huang, is a naturally
occurring substance derived from plants. Its
principal active ingredient is ephedrine, which
when chemically synthesized is regulated as a
drug.
28Ephedra cont.
- Ephedra products have been extensively promoted
to aid weight loss, enhance sports performance,
and increase energy. - Linked to significant adverse health effects,
including heart attacks and strokes - Increased risk of side effects, possibly may be
fatal - No evidence that ephedra products enhance
athletic performance - Short-term weight loss may be the only benefit
29Creatine
- Formal name is creatine monohydrate
- Compound produced by your body that helps release
energy in your muscles - Naturally occurring compound
- Can also ingest creatine from protein-rich foods
such as meat or fish - Take a nutritional supplement
30Creatine cont.
- May be able to produce small gains in short-term
bursts of power - Improving maximum-weight bench press or
increasing speeds of very short duration - Some studies show an increase in lean muscle mass
31Creatine cont.
- Helps muscles make circulate adenosine
triphosphate (ATP) - Nucleotide that helps give you energy
- ATP is used for quick, explosive bursts of
activity (weightlifting sprinting) - Also reduces energy waste products, such as
lactic acid - Can cause muscle fatigue
32Creatine cont.
- Said to enhance performance decrease fatigue
- No evidence that creatine enhances performance in
aerobic or endurance sports
33Creatine cont.
- Liver produces about 2 grams of creatine each day
- Stored in muscles, and levels are easily
maintained - Kidneys will remove excess creatine, the value of
supplements to someone who already has a high
muscle creatine content is questionable
34Creatine cont.
- Possible side effects of creatine that can
decrease athletic performance - Stomach cramps
- Muscle cramps
- Nausea
- Vomiting
- Diarrhea
35Creatine cont.
- Weight gain is a known side effect
- After prolonged use, weight gain is more likely
the result of water retention than an increase in
muscle tissue - High doses can potentially damage
- Kidneys
- Liver
- Heart
36Creatine cont.
- Unknown the effects from long-term usage
- Dosage levels vary widely depending on product
how much creatine you take - Not regulated by FDA
- Not sure of purity on market
37Creatine cont.
- Improves energy and performance in brief,
high-intensity activities - Short-term advantages increased energy in short
bursts can aid in improving athletic anaerobic
performance (weight lifting sprinting rowing)
delays muscle fatigue - Known disadvantages requires serious strength
training program dehydrates blood stream, so
requires excessive consumption of water with the
consumption of excessive amounts it has the
potential to cause renal disease
38Blood Doping
- Increasing the number of red blood cells in the
body to increase the oxygen carried to muscle - Administration of blood, red blood cells, or
related blood products - Erythropoietin
- Stimulates bone marrow to produce red blood cells
39Blood Doping proven effects
- 7 increase in Hgb
- 5 increase in VO2 max
- 34 increase in time to exhaustion at 95 VO2 max
- 44 second improvement in 5 mile treadmill run
time
(Williams and Branch summarized study findings)
40Blood Doping - Side Effects
- Transfusion reactions
- Infections
- Increased viscosity of blood
- Stroke, MI, PE
41Blood Doping - regulation
- Erythropoietin only by prescription
- Doping banned by USADA, NCAA
- Blood tested for antigens
- Ceiling on allowable Hct level at 50
42Beta-2-Agonists
- Physiology
- Bronchodilation, increased ventilation
- Examples albuterol, terbutaline, salmeterol
43Beta-2-Agonists proven effects
- Clear benefit in asthma and EIB
- Increased ventilation
- No increase in performance in NON-asthmatic
athletes - Side effects tremor, tachycardia
- Regulation
- USADA prohibited
- NCAA inhalation permitted
44Nitric Oxide-releasing agents
- Physiology
- Arginine is a precursor of NO
- NO regulates BP and blood flow to organs
- Most supplements Arginine a-ketoglutarate
- Claims
- Improves pump and blood flow to muscles
- Increases strength and size
- Speeds recovery
45Nitric Oxide-releasing agents
- Endurance exercise studies
- No benefit in endurance athletes
- Limited evidence of benefit in debilitated pts
- Strength exercise mixed results, no proven
benefit - More studies needed
46Sodium Bicarbonate
- Mechanism buffers metabolic acidosis after
strenuous exercise - Proven ergogenic efx in high-intensity exercise
- 100m 200m swim
- Repeated sprints
- Repeated judo throws
47Bicarbonate
- Limited conflicting evidence of benefit in
aerobic exercise - High-intensity running 17 better
time-to-exhaustion (30 vs 26 min) - 60-min max-effort cycle ergometry 14 higher
power vs Placebo - 60-min high-intensity cycling no difference vs
Placebo
48Bicarbonate
- Dose 0.2 - 0.3 mg/kg
- GI side effects common
49Carbs
- Sports drink consumption
- Carbohydrate loading
50Sports Drink Consumption
- Evidence supports enhanced endurance performance
vs water in events gt60 min - No benefit from added protein
51Carbohydrate Loading
- Known to increase muscle glycogen levels 13 -
100 - Prolongs time to exhaustion 2-3 in endurance
events gt90 minutes - Higher effect in Untrained persons
- 25-km treadmill
52Methods of Carbo Loading
- Classic 6-day regimen
- 3 days intense glycogen-depleting exercise
- 3 days high-CH diet, no exercise
- Modified 6-day regimen
- 3-day exercise taper, normal diet
- High-CH (70) light exercise 3d prior
- Single-day regimen
- 10 gm/kg/day CH 1-day prior
- Normal exercise regimen
53Carbohydrate Loading s
- Little standardization of methods
- Athletes need to try methods prior to competition
to see what works - Exact roles of glycogen-depleting exercise, type
of CH, and timing are unclear
54Miscellaneous Losers
- Vitamin E and other vitamins
- Minerals Cr, Mg, Zn, Se
- L-Carnitine
- Antioxidants
- Pyruvate
- Arginine
- Hydroxy-methyl-butyrate (HMB)
55Diuretics
- Drugs that change your bodys natural balance of
fluids salts - Can lead to dehydration
- Water loss may allow an athlete to compete in a
lighter weight class
56Diuretics
- Commonly used to treat high blood pressure
conditions that cause fluid retention (edema) - Such as congestive heart failure
- May cause
- Muscle cramps, exhaustion, decreased ability to
regulate body temperature, potassium deficiency,
heart arrhythmias
57Diuretics cont.
- Used to increase the amount of urine produced and
to increase kidney function, thereby speeding up
the elimination of fluid from the body - In turn this will cause rapid weight loss in
sports where performers are required to compete
within strict weight boundaries
58What healthcare professionals can do
-
- Be clear about your expectations
- Talk to student athletes that unless the
long-term effects of performance-enhancing drugs
on young athletes are known to be safe, you
expect him or her to avoid them - Discuss alternatives to performance enhancers,
include sports nutrition and strength training
techniques - Set rules. For example, if a student uses
performance-enhancing drugs, he or she will be
removed from the team - Teach students that short-term gains can lead to
long-term problems.
59What to docontinued
- Discuss ethics and proper training. Athletes
should compete fairly - Remind them that using a performance-enhancing
drug is similar to cheating, but even more
importantly, could lead to serious health
problems or even death. Another key message is
that a balanced diet and rigorous training are
the true keys to athletic performance - Encourage the student athlete to feel good about
his or her sports performance - Monitor for signs of drug use. Signs the student
may be taking anabolic steroids include increased
acne and male-pattern baldness. If a female takes
anabolic steroids, she may develop male
characteristics, such as a deep voice or dark
facial hair. Teens who take anabolic steroids may
seem unusually moody and have angry outbursts
known as roid rage - Discuss the school districts policy concerning
anabolic steroids and other performance enhancing
drugs with all student athletes
60Anabolic Steroids and Performance-Enhancing
Substances Prevention
- Least Effective Method
- Simply teaching students about steroids harmful
effects does not convince adolescents that they
personally will be adversely affected. - More Effective Method
- Presenting both the risks and benefits of steroid
use is more effective in convincing adolescents
about steroids negative effects, because they
find a balanced approach more credible and less
biased.
61Anabolic Steroids and Performance-Enhancing
Substances Prevention
- MOST EFFECTIVE Method
- Science-based, research-based curriculum with
predictable outcomes, combined with credible,
unbiased facts.