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Doping and drug misuse in leisure sports and sports for all
Abstract
In the past decades fitness centers and mass sport events such as public fun biking or city marathons have become essential elements of recreational and mass sport. When looking at fitness centers and other options in the recreational area, motivations of those participating in physical activities are quite different. Those practicing endurance sport wish to improve their general fitness, to reduce their weight or they do it just for fun. Customers of fitness centers normally aspire to improved strength and rapid muscle increase. In this context, doping and drug abuse in recreational and mass sports represent a problem which should not be underestimated. Prohibited substances are taken with a view to overcome individual limits of performance. Numerous of these substances are on the list of prohibited substances and methods published by the World Anti-Doping Agency (WADA). Depending on the type of the practiced activity prohibited drugs are taken primarily to reduce pain or to achieve rapid muscle growth. To reduce pain, non-prescription, over-the-counter (OTC) medicines are often taken over a prolonged period of time since they are easy to get; in contrast to this, doping agents or substances to achieve rapid muscle increase are more difficult to obtain. Internet-based distribution of substances encourages misuse on the one hand and - like products purchased on the black market - implies a considerable risk to get a product which does not comply with certified quality standards. Potential side effects are underrated completely. Doping and drug abuse impair a healthy organism; physical and psychotropic side effects and in case of prolonged misuse - long-term damages are the logical consequence. Thirty years of experience show that the liver and the kidneys are affected in particular. In the majority of cases, drug abuse in marathon running (normally analgesics) is not identified. We do not criticize the nonrecurrent consumption of analgesics in case of unspecific pains. Repeated consumption, however, should be avoided and, alternatively, a doctor should try to find out the reason for the pains. In the areas of recreational and mass sport this is often not done since people feel they do already know the reason (injuries or overtraining). Consequently, there is a gradual development from repeated consumption to definite misuse. In contrast to this, the consumption of substances with a view to increase performance (to develop strength and to achieve rapid muscle increase) must be strictly classified as doping and misuse. In these cases, it is necessary to identify the misuse in order to take adequate measures. The consumption of anabolic steroids and complementary substances in the area of fitness sports results in distinct changes of the body shape and visible changes of the skin structure. For a doctor, these changes can be an indication of misuse, thus giving him an opportunity to inform his patient about potential health risks.
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Aims: The cross-sectional Epidemiological Survey on Substance Abuse (ESA) which has been conducted in the German adult population since 1980, was continued in 2006, providing current data on the prevalence of, patterns of, and trends in illegal drug use. Method: A representative sample of 7,912 18- to 64-year-old adults was drawn from the general population. The survey used self-administered questionnaires and telephone interviews (mixed-mode design; 45 % response rate). Results: After a continuous increase since the mid-1980s, the prevalence of illegal drug use among young adults decreased between 2003 and 2006. Whereas among 18- to 39-year-olds, the 12-month prevalence rates of other illegal drugs has not changed across time, the proportion of cannabis users decreased significantly from 2003 (11.8 %) to 2006 (9.2 %). However, the proportion of cannabis-use disorders increased somewhat occurring among 1,1 % the adult population (abuse 0.7 %; dependence 0.4 %). Conclusions: The observed trends indicate that the prevalence of illicit drug use has stabilized. The relatively constant prevalence rates of regular cannabis use (last 30-day prevalence) over time indicate that the recent variations in cannabis-use prevalence were due to changes in experimental use.
Gefälschte Arzneimittel gelangen hauptsächlich über den Internethandel auf den Markt. Nach Angaben der Weltgesundheitsorganisation
(WHO) ist jedes zehnte verschickte Medikament eine Fälschung. Um dies wirksam zu bekämpfen, ist enge, auch internationale
Zusammenarbeit zwischen Herstellern, pharmazeutischem Großhandel, Apotheken und Behörden nötig.
Counterfeit drugs are mainly distributed via the internet. On statement of the World Health Organization (WHO), one medicine
out of ten ordered on the internet is counterfeit. Fighting against counterfeits needs close and international cooperation
among manufacturers, wholesalers, pharmacies and agencies.
The use of anabolic supplements and other related drugs for body building and to enhance athletic performance is nowadays widespread and acutely pervasive all around the world. This alarming increase in the use of anabolic and amino acid supplements has been linked to a diverse array of pathologies. As previously reported, the abuse of androgenic steroids is not without severe physiological, psychiatric and physical costs. The case we report here describes multi-organ damage resulting from the abuse and uncontrolled use of anabolic steroid supplements, mainly testosterone.
A 24-year-old white man presented with abdominal pain concomitant with nausea and vomiting. Laboratory analysis revealed hypercalcemia, elevated liver enzymes and high levels of amylase, lipase and creatine protein kinase.
Amino acid as well as anabolic supplements may lead to abnormal functioning of many organs, which could be fatal in some instances. This mandates worldwide and concerted efforts to educate the public, especially the youth, about the dangers of these increasingly abused drugs.
The aim of this paper is to investigate the association between anabolic steroid (AS) use and intensive physical exercise among adolescents.
The 1999 cross-sectional European School Survey Project on Alcohol and Other Drugs (ESPAD). Data collection by standardized methodology using anonymous self-administered questionnaires completed in the classroom.
National probability samples of a total of 18,430 16-year-old high school students from six European countries (Bulgaria, Croatia, Cyprus, Greece, the Slovak Republic, and the U.K.)
Besides AS use and physical exercise, questionnaire items selected for this study included tobacco, alcohol, and illicit drug use, indicators of other deviant behavior (self-harming thoughts and behavior, truancy, aggressive behavior), friends' use of AS, and perceived availability. Backward elimination with likelihood ratio tests was used to select the variables to be retained in a mutlifactorial model. Interactions of other independent variables with country were checked.
Logistic regression analysis of lifetime AS users compared to nonusers showed that the odds of lifetime AS use are 1.4 times higher for students who exercise almost daily and 1.8 times higher for boys compared to girls. Significant associations of AS use were also found with current frequent alcohol use, lifetime use of tranquilizers/sedatives and cannabis, and with the perceptions of friends' use of AS and of easy availability of the substance.
Findings indicate that daily exercising appears to increase the risk of anabolic steroid use in adolescents. However, a more general pattern of closely interlinked deviant types of behavior, such as other drug use and aggressive behavior, is prominent. Preventive interventions are needed targeted towards adolescents involved in intensive exercise and sport. These should take into account both the idiosyncrasy and setting of the sporting culture and the special characteristics of this group.
The differences in beliefs about the effects of anabolic steroid (AS) use between AS users and non-users provides potentially important clues to understanding AS use. Two groups of bodybuilders were used in this comparison: AS users (n = 20) and non-users (n = 27). Subjects completed a 40-item scale measuring their beliefs about the effects of steroids, both physical and psychological (Beliefs About Steroids Scale: BASS). MANOVA comparisons between AS users and non-users on the BASS items indicate that AS-using bodybuilders believe that AS enhance their physical strength, athletic ability, confidence, assertiveness, feelings of sexuality, and feelings of optimism.
To establish whether the symptoms of reverse anorexia continue with the cessation of anabolic-androgenic steroid (AAS) use in male body builders.
To determine whether current and ex-AAS-using body builders score higher on the modified (for reverse anorexia) eating disorders inventory (EDI) than both non-AAS-using body builders and regular aerobic exercisers.
A random sample of regular aerobic exercisers, current, ex-, and non-AAS-using body builders were recruited from four local gyms and a syringe exchange in the Merseyside area. A total of 137 male subjects with an average age of 29 years (range 17-49 years) were recruited. Fifty subjects were classed as aerobic exercisers, 39 subjects were classed as non-AAS-using body builders, 29 subjects were current AAS users and 19 subjects were ex-AAS users. All subjects undertook an anonymous questionnaire consisting of the modified EDI, the severity of dependence scale (SDS) for both exercising and AAS use, and questions about body weight, dieting, and substance use.
AAS-using bodybuilders were striving towards an exaggerated mesomorphic physique. Both current and ex-AAS users had higher scores on all sections of the EDI than both groups of non-AAS users. There was a significant positive correlation between the SDS scores for AAS and scores on the EDI for current AAS users.
AAS use, but not body building per se, was associated with increased symptoms of reverse anorexia, and this symptomatology was higher in those who had higher scores on the SDS for AAS. It remains to be determined whether symptoms of reverse anorexia are either a cause or an effect of AAS use.
We present the case of a 56-year-old man with deep vein thrombosis (DVT) and pulmonary embolism (PE). He had been given intramuscular injections of testosterone and the anabolic-androgenic steroid nandrolone, due to a muscle injury, a total of three times prior to manifestation of the symptoms. An ultrasonographic examination of the right leg revealed a DVT and computed tomography of the pulmonary arteries showed PE. The thromboembolic episodes in this previously healthy patient were in all probability associated with intramuscular injections of testosterone and nandrolone, to which there is a clear correlation in time.
Substances abused for doping may lead to severe cardiac complications such as arrhythmias, myocardial hypertrophy or fibrosis, and myocardial infarction, to only name a few. There is a long list of cardiac deaths in athletes secondary to drug abuse. This is largely due to the poor choice of drugs and or the far too high dosage and combination of drugs that even in hospitals we wouldn't dare to give. With this text, we'd like to raise your awareness of this potent problem, and shed some light on a dark side of sport.
In brief: This study documents the patterns of use of anabolic steroids in 32 body builders and power lifters. These subjects and seven control athletes who had never used steroids were interviewed and underwent a medical examination including 28 diagnostic blood tests and a urinalysis. Gynecomastia was detected in 4 of the 20 current users and 1 of the other 19 subjects. Sixty-seven percent of users reported temporary changes in libido, and 56% reported a temporary increase in irritability or aggressive behavior. Physicians should tell patients about the possible adverse side effects of such agents.
Anabolic steroid abuse is common among athletes and is associated with a number of medical complications. We describe a case of a 27-year-old male bodybuilder with multiple hepatic adenomas induced by anabolic steroids. He initially presented with tumor hemorrhage and was treated with left lateral hepatic segmentectomy. Regression of the remaining tumors was observed with cessation of steroid use. However, 3 years and a half after his initial hepatic segmentectomy, he presented with recurrent tumor enlargement and intraperitoneal hemorrhage in the setting of steroid abuse relapse. Given his limited hepatic reserve, he was conservatively managed with embolization of the right accessory hepatic artery. This is the first reported case of hepatic adenoma re-growth with recidivistic steroid abuse, complicated by life-threatening hemorrhage. While athletes and bodybuilders are often aware of the legal and social ramifications of steroid abuse, they should continue to be counseled about its serious medical risks.
A case of a power weight lifter who is ingesting large doses of anabolic steroids plus other drugs to counter act their short-term side effects is presented.
This type of polydrug abuse phenomenon which is unique to the competitive athlete is widespread despite the lack of convincing evidence that anabolic steroids increase muscular strength. The vast extent of this drug abuse problem is poorly appreciated by the gen eral medical community.
The potential complications of the long-term usage of these drugs such as liver failure, hepatocellular car cinoma, and peliosis hepatitis make these drugs ex tremely dangerous.
The effects of anabolic steroids on the quality of voice have been well documented; however, no study has established significant structural changes in the larynx as a direct result of anabolic steroid use. We report a unique case of a 47-year-old male smoker and professional body builder who presented with progressive stridor and hoarseness following abuse of anabolic steroids over a period of two years. Conservative management failed to resolve his symptoms and a planned tracheostomy was performed to secure his airway. Subsequently he was treated with multiple laser resections and eventually decannulated. No case of severe laryngitis in association with anabolic steroid usage has been reported previously in the literature.
Methasteron is a nutritional supplement used to increase weight or accelerate the build-up of muscle mass. The aim of this study was to describe 5 cases of hepatotoxicity in patients using methasteron seen at tertiary-care medical centers.
A case report design was used.
Five previously healthy patients who used methasteron developed jaundice 2 weeks after discontinuation; they presented to a tertiary-care medical center 2 weeks later. Within another 2 to 3 weeks, bilirubin levels peaked. About 12 weeks after initial presentation, all cases resolved with no identifiable residual hepatic dysfunction.
Methasteron use can result in severe hepatotoxicity. Liver failure can worsen after initial presentation, especially within 2 weeks. With close observation and supportive care, acute hepatic injury should resolve.
Anabolic-androgenic steroids are used worldwide to help athletes gain muscle mass and strength. Their use and abuse is associated with numerous side effects, including acute myocardial infarction (MI). We report a case of MI in a young 31-year-old bodybuilder. Because of the serious cardiovascular complications of anabolic steroids, physicians should be aware of their abuse and consequences.
In the context of house searches in Germany, numerous drugs were confiscated and subjected to chemical analysis, including anabolic agents such as various anabolic-androgenic steroids (stanozolol, testosterone derivatives, trenbolone esters, etc.) and clenbuterol, as well as agents with anti-estrogenic activity (tamoxifen, clomiphene), drugs stimulating virility (sildenafil, tadalafil), and unlabeled plastic bags. Liquid chromatography-tandem mass spectrometry, gas chromatography-mass spectrometry with nitrogen-phosphorus specific detection, gel electrophoresis, and immunological tests were employed to test for the effective content of 70 products. In 18 cases (25.7%), the declared ingredients differed from the actual content, in particular concerning anabolic-androgenic steroids. Nandrolone and trenbolone esters, for instance, were frequently substituted or complemented by various testosterone derivatives, and several testosterone depot formulations originally composed of four different esters were found to contain fewer or wrong components. Except for those drugs supposedly originating from so-called underground labs, fake packings were hardly or not distinguishable from original boxes by visual inspection.