Use and Effectiveness of Performance-Enhancing Substances

2003 ◽  
Vol 16 (1) ◽  
pp. 22-36 ◽  
Author(s):  
Eric G. Boyce
Keyword(s):  
High School ◽  
Health Care Providers ◽  
Sports Medicine ◽  
Small Sample ◽  
Anabolic Androgenic Steroids ◽  
Care Providers ◽  
Performance Enhancing Drugs ◽  
Androgenic Steroids ◽  
Performance Enhancing Substances ◽  
Performance Enhancing

The use and effects of selected performance-enhancing drugs and nutritional supplements are reviewed. Recent sports medicine studies are mostly double blind and placebo controlled but contain relatively small sample sizes. Their data appear reliable and are reported in reputable journals. Definitions and methods used in sports medicine are provided to enhance the understanding of this literature. The use of performance-enhancing substances is probably under-reported. Anabolic-androgenic steroids are reportedly used in 0% to 1% of women, 0.5% to 3% of high school girls, 1% to 5% of men, 1% to 12% of high school boys, and up to 67% of some groups of elite athletes. The use of combinations of performance-enhancing substances is common. Carbohydrate loading, adequate protein intake, creatine, blood doping, and erythropoietin (epoetin alfa) appear to enhance performance. Anabolic-androgenic steroids enhance performance, but health risks limit their use. Growth hormones and β2 -selective adrenergic agonists may enhance performance, but additional studies are needed. Androstenedione, caffeine, amphetamines, and nonprescription sympathomimetics do not appear to enhance performance. Performance-enhancing drugs have shown some benefit in diseased patients with malnutrition and/or decreases in physical ability. Pharmacists and other health care providers have opportunities to improve the understanding, use, and monitoring of performance-enhancing substances.

scholarly journals Association Between Legal Performance-Enhancing Substances and Use of Anabolic-Androgenic Steroids in Young Adults

2020 ◽  
Vol 174 (10) ◽  
pp. 992 ◽  
Author(s):  
Jason M. Nagata ◽  
Kyle T. Ganson ◽  
Sasha Gorrell ◽  
Deborah Mitchison ◽  
Stuart B. Murray
Keyword(s):  
Young Adults ◽  
Anabolic Androgenic Steroids ◽  
Androgenic Steroids ◽  
Performance Enhancing Substances ◽  
Performance Enhancing

scholarly journals The Cardiac Effects of Performance-Enhancing Medications: Caffeine vs. Anabolic Androgenic Steroids

Diagnostics ◽  
2021 ◽  
Vol 11 (2) ◽  
pp. 324
Author(s):  
Sanjay Sivalokanathan ◽  
Łukasz A. Małek ◽  
Aneil Malhotra
Keyword(s):  
Cardiovascular Risk ◽  
Muscle Growth ◽  
Cardiovascular Effects ◽  
Anabolic Androgenic Steroids ◽  
The World ◽  
Genetic And Environmental Factors ◽  
Performance Enhancing Drugs ◽  
The Individual ◽  
Androgenic Steroids ◽  
Performance Enhancing

Several performance-enhancing or ergogenic drugs have been linked to both significant adverse cardiovascular effects and increased cardiovascular risk. Even with increased scrutiny on the governance of performance-enhancing drugs (PEDs) in professional sport and heightened awareness of the associated cardiovascular risk, there are some who are prepared to risk their use to gain competitive advantage. Caffeine is the most commonly consumed drug in the world and its ergogenic properties have been reported for decades. Thus, the removal of caffeine from the World Anti-Doping Agency (WADA) list of banned substances, in 2004, has naturally led to an exponential rise in its use amongst athletes. The response to caffeine is complex and influenced by both genetic and environmental factors. Whilst the evidence may be equivocal, the ability of an athlete to train longer or at a greater power output cannot be overlooked. Furthermore, its impact on the myocardium remains unanswered. In contrast, anabolic androgenic steroids are recognised PEDs that improve athletic performance, increase muscle growth and suppress fatigue. Their use, however, comes at a cost, afflicting the individual with several side effects, including those that are detrimental to the cardiovascular system. This review addresses the effects of the two commonest PEDs, one legal, the other prohibited, and their respective effects on the heart, as well as the challenge in defining its long-term implications.

scholarly journals Characteristics and Attitudes of Men Using Anabolic Androgenic Steroids (AAS): A Survey of 2385 Men

2020 ◽  
Vol 14 (6) ◽  
pp. 155798832096653
Author(s):  
Alex K. Bonnecaze ◽  
Thomas O’Connor ◽  
Joseph A. Aloi
Keyword(s):  
Health Care ◽  
Body Image ◽  
Health Care Providers ◽  
Health Care Professionals ◽  
Participation Rate ◽  
The United States ◽  
Anabolic Androgenic Steroids ◽  
Care Providers ◽  
Body Image Disorders ◽  
Androgenic Steroids

Additional characterization of patients using anabolic androgenic steroids (AAS) is needed to improve harm reduction and cessation resources for patients. Our group sought to expand upon the currently limited data regarding AAS use by performing a web-based survey assessing experiences of males using AAS. Participants included men over the age of 18 with history of AAS use within the past 5 years. Data were collected between August 2019 and April 2020. Primary outcome measures included age when starting AAS, dose of AAS, motivations for use, experiences with health-care professionals, and rate of successful cessation. The survey was accessed 3640 times, resulting in 2385 completed surveys meeting the inclusion criteria (68.93% participation rate). Average participant age was 31.69 ± 10.09 years. Over half of respondents were from the United States ( n = 1271, 53.3%). Motives to use AAS included improving appearance ( n = 1959, 82.2%), strength gain ( n = 1192, 50%), and self-esteem/body image issues ( n = 712, 29.87%). Participants rated physicians poorly, regarding knowledge of AAS (4.08 ± 2.23). Most participants did not reveal AAS use to their health-care providers ( n = 1338, 56.1%); of those that did, 55.30% ( n = 579) reported feeling discriminated against for their use. Of 46.16% ( n = 1101) attempting AAS cessation, 60.22% ( n = 663) were unsuccessful. Challenges in the management of AAS use include early onset of use, supraphysiologic doses used, and frequently present body image disorders stress. Distrust of health-care providers, poor cessation rates, and lack of physician training further exacerbate this. These findings should serve to reinforce previous calls to action for further research on the treatment of AAS use disorder.

scholarly journals Cannabis and breastfeeding

2020 ◽  
Vol 25 (Supplement_1) ◽  
pp. S26-S28 ◽  
Author(s):  
Lisa Graves
Keyword(s):  
Health Care Providers ◽  
Small Sample ◽  
Adverse Outcomes ◽  
Care Providers ◽  
High Quality ◽  
High Quality Evidence ◽  
Small Sample Sizes ◽  
The Impact ◽  
Quality Evidence

Abstract Cannabis is one of the most commonly used substances in Canada with 15% of Canadians reporting use in 2019. There is emerging evidence that cannabis is linked to an impact on the developing brain in utero and adverse outcomes in infants, children, and adolescents. The impact of cannabis during breastfeeding has been limited by studies with small sample sizes, follow-up limited to 1 year and the challenge of separating prenatal exposure from that during breastfeeding. In the absence of high-quality evidence, health care providers need to continue to engage women in conversation about the potential concerns related to breastfeeding and cannabis use.

scholarly journals Sports Medicine Staffing Across National Collegiate Athletic Association Division I, II, and III Schools: Evidence for the Medical Model

2020 ◽  
Vol 55 (6) ◽  
pp. 573-579 ◽  
Author(s):  
Christine M. Baugh ◽  
Emily Kroshus ◽  
Bailey L. Lanser ◽  
Tory R. Lindley ◽  
William P. Meehan
Keyword(s):  
Health Care ◽  
Health Outcomes ◽  
Health Care Providers ◽  
Sports Medicine ◽  
National Collegiate Athletic Association ◽  
Athletic Trainers ◽  
Full Time ◽  
Care Providers ◽  
Collegiate Sports ◽  
Financial Oversight

Context The ratio of clinicians to patients has been associated with health outcomes in many medical contexts but has not been explored in collegiate sports medicine. The relationship between administrative and financial oversight models and staffing is also unknown. Objective To (1) evaluate staffing patterns in National Collegiate Athletic Association sports medicine programs and (2) investigate whether staffing was associated with the division of competition, Power 5 conference status, administrative reporting structure (medical or athletic department), or financial structure (medical or athletic department). Design Cross-sectional study. Setting Collegiate sports medicine programs. Patients or Other Participants Representatives of 325 universities. Main Outcome Measure(s) A telephone survey was conducted during June and July 2015. Participants were asked questions regarding the presence and full-time equivalence of the health care providers on their sports medicine staff. The number of athletes per athletic trainer was determined. Results Responding sports medicine programs had 0.5 to 20 full-time equivalent staff athletic trainers (median = 4). Staff athletic trainers at participating schools cared for 21 to 525 athletes per clinician (median = 100). Both administrative and financial oversight from a medical department versus the athletics department was associated with improved staffing across multiple metrics. Staffing levels were associated with the division of competition; athletic trainers at Division I schools cared for fewer athletes than athletic trainers at Division II or III schools, on average. The support of graduate assistant and certified intern athletic trainers varied across the sample as did the contributions of nonphysician, nonathletic trainer health care providers. Conclusions In many health care settings, clinician : patient ratios are associated with patient health outcomes. We found systematic variations in clinician : patient ratios across National Collegiate Athletic Association divisions of competition and across medical versus athletics organizational models, raising the possibility that athletes' health outcomes vary across these contexts. Future researchers should evaluate the relationships between clinician : patient ratios and athletes' access to care, care provision, health care costs, health outcomes, and clinician job satisfaction.

scholarly journals Birth weight and obesity risk at first grade of high school in a non-concurrent cohort of Chilean children

2012 ◽  
Vol 16 (2) ◽  
pp. 228-232 ◽  
Author(s):  
Susana Loaiza ◽  
Eduardo Atalah
Keyword(s):  
High School ◽  
High School Students ◽  
Birth Weight ◽  
Health Care Providers ◽  
Gestational Age ◽  
First Grade ◽  
Ponderal Index ◽  
High Birth Weight ◽  
Care Providers ◽  
Obesity Risk

AbstractObjectiveTo determine the association of birth weight with obesity risk at first grade of high school in Chilean children after accounting for potential confounding factors.DesignNational non-concurrent cohort of newborns. Sociodemographic information, height, weight and anthropometric measurements at first grade of high school were analysed. Birth weight was classified as macrosomia (≥4000 g), by gestational age and by ponderal index. The relationship between birth weight and obesity at first grade of high school (BMI ≥ 95th percentile of the US Centers for Disease Control and Prevention's reference) was assessed using logistic regression models adjusted for sociodemographic information at delivery.SettingFirst grade of public high school of low and middle socio-economic status in the whole country (about 77 % of Chilean children in this age group).SubjectsNewborns (n 119 070) and the same number of high-school students.ResultsA positive relationship of high ponderal index (OR = 1·86, 95 % CI 1·69, 2·03), birth weight ≥4000 g (OR = 1·66, 95 % CI 1·54, 1·78) and large for gestational age (OR = 1·69, 95 % CI 1·58, 1·81) with obesity at adolescence (P < 0·001) was found. Macrosomic children had a higher risk of being obese at first grade of high school after controlling for prenatal confounding variables (OR = 1·63, 95 % CI 1·52, 1·76; P < 0·001).ConclusionsA direct relationship between high birth weight and obesity at first grade of high school was observed in this group of Chilean children. The results highlight the significance of birth weight as a simple tool to be used as an indicator of obesity risk for children by health-care providers.

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