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As the 2024 Paris Summer Olympics unfold, medicine.net continues to provide you with valuable medical insights.

Performance-enhancing drugs (PEDs) are a class of substances that can elevate physical or mental performance. These substances typically work by stimulating the central nervous system, thereby increasing alertness, focus, and physical capabilities in a short period. Many PEDs were initially developed to treat medical conditions. However, the realization that these substances could significantly enhance athletic performance led some athletes to take the risk of using them. While PEDs can boost performance, they often come with serious side effects, including heart disease, addiction, anxiety, and more. Using PEDs to enhance performance is also unfair to other athletes, leading to the establishment of the UNESCO International Convention against Doping in Sport, supported by countries worldwide to protect athletes' physical and mental health and ensure fairness in sports.

According to UNESCO's International Convention against Doping in Sport and the World Anti-Doping Agency's (WADA) Prohibited List, several categories of PEDs are explicitly banned, with the list continually growing. Here, we explore various types of PEDs:

1. Anabolic Agents

Anabolic agents, also known as anabolic steroids, are drugs that promote protein synthesis and reduce protein breakdown, increasing muscle mass and strength. Initially used to treat chronic wasting diseases, malignant tumors, or patients recovering from severe trauma or surgery, anabolic agents have been misused in sports to enhance muscle mass, leading to numerous health problems such as cardiovascular issues, liver dysfunction, reproductive system problems, and psychological abnormalities.

2. Peptide Hormones and Related Substances

Peptide hormones, composed of amino acid chains, play crucial roles in cell communication and hormone regulation. They can enhance athletic performance by regulating metabolism, but their misuse poses significant health risks. For instance, erythropoietin (EPO) increases red blood cell count, improving oxygen transport but can cause cardiovascular issues and thrombosis. Similarly, growth hormone (GH) misuse can lead to acromegaly, characterized by swollen extremities, coarse facial features, joint pain, fluid retention, and increased risks of diabetes and hypertension, potentially leading to premature cardiovascular death.

3. Beta-2 Agonists

Beta-2 agonists relax bronchial smooth muscles by activating adrenaline beta-2 receptors, primarily used clinically to treat asthma and chronic obstructive pulmonary disease (COPD). They can improve cardiopulmonary function but may cause adverse reactions like heart palpitations, muscle tremors, and metabolic disorders when used in large doses. Athletes may falsely claim asthma to evade drug tests.

4. Anti-Estrogenic Agents

Estrogen is crucial for maintaining normal menstrual cycles and female sexual development. However, high estrogen levels can negatively impact athletic performance by affecting fat distribution and muscle quality. Some athletes use anti-estrogenic agents, leading to cardiovascular issues, liver damage, reproductive system problems, and other long-term health risks.

5. Diuretics and Other Masking Agents

Diuretics are unique among PEDs as they do not enhance performance but are banned for their ability to mask other PED use or quickly reduce weight in weight-class sports. Their use can lead to low blood pressure and metabolic disorders.

6. Stimulants

Stimulants enhance performance by affecting the nervous system but may cause severe mental health issues. These drugs are banned in sports and often in everyday life due to their serious health risks.

7. Cannabinoids

Cannabinoids can produce euphoria and hallucinations by acting on the central nervous system. Despite legalization in some countries, such as Canada, they remain banned in sports.

8. Narcotics

Narcotics act on the central nervous system to relieve pain and induce euphoria, increasing an athlete's pain tolerance or psychological performance. However, they carry significant risks, including cardiovascular and respiratory burdens and high addiction potential.

9. Glucocorticoids

Glucocorticoids are used clinically for their anti-inflammatory and pain-relieving properties, as well as their ability to regulate protein, carbohydrate, and lipid metabolism. Athletes may misuse them to speed up recovery or enhance energy and endurance, leading to side effects like hyperglycemia, hyperlipidemia, and potential impacts on the central nervous and digestive systems.

10. Specified Substances and Methods

These substances and methods are listed in the Prohibited List and are banned under certain conditions. They may enhance performance or violate the spirit of sport, though they might be allowed for therapeutic purposes under specific conditions.

Sport is one of the most cost-effective investments in health. While competitive sports strive for faster and stronger performances, the ultimate goal is to foster a fair environment where athletes can compete healthily without relying on drugs. Therefore, we strongly advise against the use of performance-enhancing drugs.

Reference:

  1. https://www.un.org/zh/documents/treaty/UNESCO-2005

  2. https://www.wada-ama.org/en/prohibited-list