Since the ancient Olympic Games, held in the city of Olympia in 776 B.C, athletes have been competing against one other. The motto ”ciltius, altius, fortius”, Latin for “Faster, Higher, Stronger”, revealed the competitive spirit early on. Beginning with the initial competition, there have been reports of speculated cheating and performance enhancing drug usage. Athletes competing in pankration, a primitive form of wrestling mixed with boxing, consumed bull testicles in order to gain strength. This was thought, at the time, to increase testosterone levels. The athlete would eat the testosterone producing organs of this larger, stronger animal, seeking to obtain its vitality and virility. Later, during the third modern Olympic Games in 1904 and held in Athens, there was speculation a cyclist had used the narcotic strychnine in order to avoid the feeling of pain, and prolong his stamina. The origin of the word ‘doping’ is attributed to the Dutch word ‘doop’, which is a viscous opium juice and was the drug of choice in ancient Greece.
The breakthrough point in modern chemical enhancement took place in Germany, in the 1930’s. A team of scientists was able to create a synthetic form of testosterone to help treat men who were unable to produce enough of the hormone for normal growth, development and sexual function. The basic male androgen, testosterone, was manufactured and a Nobel Prize was awarded to the German scientists for their crowning achievement. In 1954 the American Dr. John Zeigler manufactured the first Androgenic Anabolic Steroid in the form of tablet, methandrostenolone (better known as Dianabol). He successfully pioneered its athletic use as an aid to increase muscle growth in bodybuilders, weightlifters and competitive athletes.
Amphetamines were used widely by soldiers from many countries during the Second World War. These drugs minimize the uncomfortable sensations of fatigue during exercise, and help provide energy and focus. These cognitive and ergogenic benefits are also experienced by athletes, and have ensured this class of drug a place in the drug regimens of many athletes from the early 1950’s to the present day.
Later, during the 60’s, several other testosterone derivatives came to the forefront. Stanozolol (winstrol), methenolone (primobolan), mesterolone (proviron), oxymetholone (anadrol) and drostanolone (masterone) were also synthesized for purely medical purposes. In professional sports, steroid use was also on the rise, especially in football where size and strength are essential to a player’s effectiveness. During the cold war, Eastern bloc countries (DDR, USSR, Bulgaria and China-N.Korea later) specialized in PED doping methods as a means of establishing their superiority. There was a program organized from the communist government in which politicians, physicians, trainers and athletes focused on how to win medals in order to promote communism. Although it was suspected during this period that AAS were being used systematically by athletes, testing methods were insufficiently developed to warrant the inclusion of steroids in the list of banned substances in urine/blood analysis. In 1975, the International Olympic Committee (IOC) finally banned the use of steroids in Olympic competition; while in 1976 steroid testing was conducted for the first time at the Montreal Olympics.
In the 1990’s, during the reunification of Germany, numerous documents from this program were revealed. These documents showed evidence of a vast steroid program used by Olympic athletes. Type of drugs, dosage administered, regularity of administration, and proper timing of pre-competition withdrawal in order to pass the anti-doping control were revealed for roughly 400 athletes. The Ministry for State Security was in charge of overseeing this operation and also providing the drugs. Professors, doctors, scientists performed doping research and administered prescription drugs as well as unapproved experimental drug preparations to thousand athletes, including women and adolescent girls. A study showed that over 68 percent of the athletes at the 1972 Olympics were using or had used steroids. And in 1976, East Germany’s women’s track and swim teams, the Wonder Girls (as they came to be known), were discovered using steroids. Sadly, parents of the young athletes had no idea what the trainers had given to their children. They had assumed it was just basic supplementation with vitamins. Athletes pressed charges against their trainers, as several Olympic champions and world champion athletes have faced serious medical issues as a result of their PED use.
Soon after the fall of the Berlin wall (early 1990’s), many PED gurus left their countries and immigrated West. Many came to the US in particular, asking for political asylum. Afterwards, the anabolic knowledge of Eastern Europe was united with America’s advanced technology, and evolutionary methods of chemical enhancement were developed. Peptides, as well as synthetic form of somatotropin (Human Growth Hormone
It’s been speculated by some that the Olympic Games of 1988 belonged to AAS, while the Olympic Games of 1996 to creatine monohydrate. In the 2000 Olympic Games EPO was on stage and in 2004 HGH was the new undetected weapon of athletes. Tetrahydrogestrinone (THG) was developed at this time, when EPO, HGH and traditional anabolic steroids were high on the radar of testing organizations. The drug has been considered a designer steroid, and was referred to as an unapproved new drug by the Food and Drug Administration (FDA) in 2003, before the subsequent scheduling of it in 2005. THG, the second reported designer AAS, was used to improve athletic performance and was not approved for medical purposes.
Other kinds of PED’s include diuretics, β2-agonists & inhibitors, narcotic analgesics, cannabinoids, a variety of CNS stimulants, corticosteroids, selective androgen receptor modulators (SARM’s), selective estrogen receptor modulators (SERM’s), myostatin inhibitors (MYOi) and aromatase inhibitors (AI’s).
As shown, PED’s are present in numerous sports and often tarnish the spirit of competition by creating what is viewed by many as an unfair playing field. Sports medicine physicians should be aware of the variety of PED’s available, in order to best advise athletes on the risks and benefits of these drugs. At the time of this article, doping and performance enhancing drug use is on the rise, and new drugs are being created.
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