IOC (International Olympic Committee) Restrictions:

I. Prohibited Classes of Substances:

1. stimulants - caffieine, aphetamines (>12 microgram/ml for caffeine);

• increase competitiveness
• increased BP and body temp.

• reduce pain especially with injury
• cocaine abuse

II. Prohibited Methods

1. Blood doping*
2. pharmacological, chemical, and physical manipulation of samples
 

III.Classes of Drugs Subject to Restriction
alcohol
marijuana
local anesthetics
corticosteroids
beta-blockers*
 
 

Anabolic Androgenic Steroids (such as testosterone)
 

• over 100 different steroids exist; oral or injection
•  "stacking" and "cycling" are common practices

Mechanism of Action:

• Anabolic steroids bind to androgen receptors on cells, stimulating increased protein synthesis.

Performance-enhancing effects:

• increased strength
• increased muscle mass
• ability to endure intensified training regimens (mood and aggression, recovery)

• weight-lifting
• track and field
• swimming

• cardiovascular disease
• liver dysfunction
• increased aggression
• damage to muscles and tendons
• hypogonadism (infertility)-
• shrunken testes in men (reversed by use of pituitary hormone)

• atrophy of breasts and uterus
• male pattern baldness
• menstrual abnormalities
• teratogenicity
• Hirsutism - the presence of excess hair growth in women
• acne
• deepening of voice
• clitoral hypertrophy

• training aids vs. competition aids; athletes may stop weeks before an event to allow "clearance time"
• "masking", i.e. use of diuretics to increase dilution; spiking with epitestosterone
• Urine Testing: testosterone/epitestosterone ratio  (>6:1)

 rhEPO  - recombinant human Erythropoietin

Mechanism of Action:

• hormone that stimulates the production of red blood cells (erythropoiesis)

• increases production of red blood cells
• increases delivery of oxygen to tissues
• improves endurance
• 10-15% improvements in performance

Sports of Use:

• cycling  (drug of the 1998 Tour de France scandal)
• tennis
• running
• cross country skiing

Adverse Health Outcomes:

• increases blood viscosity (thickness)
• replicates the disease "polycythaemia", which makes blood viscous
• leads to clogging of arteries, stroke, heart attack
•  **exacerbated by dehydrating effects of endurance sports (concomitant decrease in blood volume)

• "Rampant"
• In a study of 102 frozen urine samples from the 1998 Tour de France, 28 samples had elevated EPO levels; researchers analyzed the 14 samples with highest concentrations: all 14 had confirmed recombinant EPO (Nature June 8, 2000)

Differing Effects of Gender:
? unknown

Testing:

• recent introduction of blood test for EPO, in time for the Sydney Olympics
• urine test differentiates between exogenous and endogenous EPO through immunoblotting assay

 Beta Blockers (restricted substance)

Performance-enhancing effects:
calms nerves and steadies hands

Sports of Use:

• archery
• fencing
• bobsled

• luge
• ski-jumping
• diving
• synchronized swimming
• modern pentathalon

• bradycardia (slow heart beat, as seen in AN)
• may constrict blood vessels

• unknown, but available OTC

 Diuretics

Sports of Use:

• weight-lifting
• wrestling
• judo

• reduces weight, through water loss
• increases urine volume
• masks drugs in urine

• severe dehydration
• heart damage
• kidney failure
• cases of pulmonary embolism reported in wrestlers

Testing:

• since 1988

• Reinject your own blood  (previously frozen) to increase red blood cells.

Sports:

•  track and field

•  increases packed-cell volume

• associated with unexplained death in some endurance athletes
• increased blood viscosity (similar to EPO)
• increased blood volume
• logistically complicated; opportunities for infection and contamination

• difficult to detect
• can test packed-cell volume

 Human growth hormone (hGH), Insulin-Like Growth Factor-1 , human chorionic gonadotropin, insulin

Mechanism of Action/Performance-enhancing effects

• peptide hormones that build muscle size and strength (anabolism)
• reduce bodyfat (lipolysis)
• increase bone mass
• increase red-blood cell mass and cardiac function
• effect carbohydrate metabolism

• hCG increases production of natural sex hormones (i.e. testosterone in males)
• hCG is not banned in women

• hGH associated with a fatal neurological disorder
• hGH causes acromegaly (overgrowth of feet, hands, face)
• IGF-1 may cause heart enlargement
• cardiomyopathy
• hypertension
• myopathy
• malignancy
• peripheral neuropathy
• glucose intolerance
• hypoglycemia and coma (insulin)

• no routine tests available for IGF-1 or hGH,

• screening and mass spectrometry tests are available for human chorionic gonadotropin

• banned since 1988