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Understanding of performance-enhancing drug use still evasive in sports medicine
Although cheating may be human, better knowledge needed on the effects of enhancers.
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Performance-enhancing drugs, partially due to their level of media exposure, are more understood than ever. Still, David E. Brown, MD, says questions remain to be answered and areas of research that need to be accessed.
Brown spoke about performance-enhancing drug use and research at the American Orthopedic Society for Sports Medicine annual meeting.
“One of the good things is that we know more now than we did 20 years ago,” he said.
Anabolic steroids have been found to be effective, delivering gains in strength and endurance. Erythropoietin (EPO) is considered one of the best performance enhancers and has significantly boosted the performance of professional cyclists, Brown said. Creatine, though only effective in two-thirds of those who use it, delivers gains in strength. Even caffeine provides a mild endurance improvement in swimming, biking, running and other activities.
Recent media attention on human growth hormone (hGH) has resulted in heightened curiosity regarding its efficacy. Though isolated use of hGH has not been proven to increase athletic performance in 27 separate studies, only three of those studies lasted longer than 30 days — far too short to adequately measure the drug’s impact, Brown said.
Multiple regimens a problem
Brown praised the strides taken in developing further knowledge of performance-enhancing drugs and their use, but added there are obvious holes.
“Unfortunately, the athletes have gotten to a point where they are using multiple drug regimens,” he said. “It is very common to use anabolic steroids, growth hormone, EPO and insulin together as major anabolic agents.
“The trouble with medical studies so far is that it is going to be impossible to study the dosing and duration of dosing that these athletes use these drugs,” he added. “We will probably never get there. We don’t have any studies with athletes using multi-drug regimens.”
Inadequacies in testing
One problem associated with learning more about performance-enhancing drugs, Brown said, is that testing has proven too expensive and ineffective to create strict regulatory standards.
“The bad part is that we still don’t know enough,” he said. “We don’t know enough about growth hormone.”
Although cheating may be “part of human culture,” it is important for researchers to gain greater understanding of the effects of performance-enhancing drug use, he said.
For more information:Reference:
- David E. Brown, MD, can be reached at OrthoWest, 2725 S. 144th St., Suite 212, Omaha, NE, 68144; 402-637-0800; e-mail: dave.brown@orthowest.com. He has no direct financial interest in any product or company mentioned in this article.
- Brown DE. Performance Enhancing Drugs: The Good, the Bad and the Ugly. American Orthopaedic Society for Sports Medicine 2008 Annual Meeting. July 10-13, 2008. Orlando, Fla.