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Performance-Enhancing Drugs

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Title: Performance-Enhancing Drugs


1
Performance-Enhancing Drugs Methods
  • Chapter 16

2
Definition 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.

3
Variations of Steroids and Performance-Enhancing
Substances
4
Why do athletes take anabolic steroids or
performance-enhancing substances?
  • To
  • Boost athletic performance
  • Build muscle
  • Increase body mass
  • Lose body fat

5
What influences an athlete to take anabolic
steroids or performance-enhancing substances?
6
Desire to Emulate Role Models
7
Peer Pressure to Succeed
8
Media Influences
Images that portray steroids in a positive light
9
Cover Stories About Steroids
10
Desired Body Image Based on Gender
11
Dangers 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

12
Some 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

13
Gender 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
14
Health 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

15
Health 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

16
Health Risks for Both Genders
  • Internal organ disease liver, kidneys,
    arteriosclerosis
  • Various cancers

17
Psychological 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

18
Definition 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.

19
Definition of Stacking
  • Users often combine several different types of
    steroids to maximize their effectiveness while
    trying to minimize negative effects.

20
Slang 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)

21
What 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)

22
Common 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

23
Stimulants
  • Drugs that can reduce fatigue, suppress appetite,
    and increase alertness aggressiveness
  • Stimulate the CNS, increase your heart rate,
    blood pressure, body temperature metabolism

24
Stimulants 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

25
Stimulants 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

26
Stimulants cont.
  • Other side effects may include
  • Heart palpitations
  • Heart rhythm abnormalities
  • Weight loss
  • Mild hypertension
  • Hallucinations
  • Convulsions
  • Brain hemorrhage
  • Heart attack other circulatory problems

27
Ephedra
  • 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.

28
Ephedra 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

29
Creatine
  • 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

30
Creatine 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

31
Creatine 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

32
Creatine cont.
  • Said to enhance performance decrease fatigue
  • No evidence that creatine enhances performance in
    aerobic or endurance sports

33
Creatine 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

34
Creatine cont.
  • Possible side effects of creatine that can
    decrease athletic performance
  • Stomach cramps
  • Muscle cramps
  • Nausea
  • Vomiting
  • Diarrhea

35
Creatine 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

36
Creatine 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

37
Creatine 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

38
Blood 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

39
Blood 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)
40
Blood Doping - Side Effects
  • Transfusion reactions
  • Infections
  • Increased viscosity of blood
  • Stroke, MI, PE

41
Blood Doping - regulation
  • Erythropoietin only by prescription
  • Doping banned by USADA, NCAA
  • Blood tested for antigens
  • Ceiling on allowable Hct level at 50

42
Beta-2-Agonists
  • Physiology
  • Bronchodilation, increased ventilation
  • Examples albuterol, terbutaline, salmeterol

43
Beta-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

44
Nitric 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

45
Nitric 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

46
Sodium Bicarbonate
  • Mechanism buffers metabolic acidosis after
    strenuous exercise
  • Proven ergogenic efx in high-intensity exercise
  • 100m 200m swim
  • Repeated sprints
  • Repeated judo throws

47
Bicarbonate
  • 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

48
Bicarbonate
  • Dose 0.2 - 0.3 mg/kg
  • GI side effects common

49
Carbs
  • Sports drink consumption
  • Carbohydrate loading

50
Sports Drink Consumption
  • Evidence supports enhanced endurance performance
    vs water in events gt60 min
  • No benefit from added protein

51
Carbohydrate 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

52
Methods 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

53
Carbohydrate 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

54
Miscellaneous Losers
  • Vitamin E and other vitamins
  • Minerals Cr, Mg, Zn, Se
  • L-Carnitine
  • Antioxidants
  • Pyruvate
  • Arginine
  • Hydroxy-methyl-butyrate (HMB)

55
Diuretics
  • 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

56
Diuretics
  • 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

57
Diuretics 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

58
What 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.

59
What 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

60
Anabolic 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.

61
Anabolic Steroids and Performance-Enhancing
Substances Prevention
  • MOST EFFECTIVE Method
  • Science-based, research-based curriculum with
    predictable outcomes, combined with credible,
    unbiased facts.
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