Athletes use drugs for many reasons. Some use drugs for medical need. Some use proscribed drugs inadvertently, while others use drugs deliberately - either on their own initiative or at the behest of coaches or officials - to cheat, to try to improve their performance artificially and to improve their chances of winning. Finally, some sports people use drugs, including illegal drugs, recreationally.

It is possible to take a different view of each of these forms of drug use. For athletes taking a drug for medicinal purposes, it may be important for them to make the medical condition known to testing authorities well in advance of any test being performed. For the inadvertent user, there is a need for more education so that the rules of competition, as they relate to drug use, are well known and understood. For the recreational user, including the use of anabolic steroids by non-competitive body-builders, the issues are those which apply to drug abuse in general.

The person who seeks to cheat faces testing, detection and sanctions. Whether the person initiates the cheating or follows instructions from a coach or from officials does not matter - detection leads to a report to the relevant sporting association and to the imposition of sanctions.

In Australia, the use of certain drugs in sport is prohibited. The independent Australian Sports Drug Agency (ASDA), established in 1989, is charged with conducting testing to identify defaulters. Banned drugs are listed by the International Olympic Committee (IOC) (see box), of which Australia is a member. Testing is conducted randomly in all competitive sports at public expense and, where there is a contract in force between the ASDA and the sport, testing is carried out on a cost-recovery basis.

A number of positive results are found each year and these are reported to the sport concerned. That sport then considers the matter and may impose a sanction on the athlete if it so wishes.

The Agency, in its activities, administers government policy. It operates under an Act of Parliament and regulations made under that Act. Should people wish to change what the Agency does, they need to have the Act and the policy of the government altered - the Agency itself has no discretion in this matter.

Doping classes and methods

Doping classes

  • Stimulants
  • Narcotics
  • Anabolic agents
  • Diuretics
  • Peptide hormones and analogues

Doping methods

  • Blood doping
  • Pharmacological, chemical and physical manipulation

Classes of drugs subject to certain restrictions

  • Alcohol
  • Marijuana
  • local anaesthetics
  • Corticosteroids
  • Beta blockers
The full I0C Guide can be found in the MIMS Annual.

Drug use in sport continues to change. The drugs favoured by coaches and athletes are subject to fashion and to efforts by the unscrupulous and sophisticated to avoid detection. While testing has become more rigorous (including out of competition testing), new forms of undetectable doping have appeared. The use of blood doping and some hormones, e.g. human growth hormone and erythropoietin, is believed to be increasing. Research efforts have intensified to develop tests for these substances.

Blood doping, defined as the administration of blood or related blood products to an athlete for other than legitimate medical treatment, is an area of concern. It usually involves an athlete removing some blood several weeks before a competition and then re-infusing the blood close to the competition (the process of autologous blood transfusion). The resultant increase in oxygen carrying capacity is thought to provide an increase in stamina and endurance. There are moves to conduct blood tests of athletes in order to detect blood doping, but the reality is that analytical procedures do not exist to detect autologous blood transfusion.

Australia is one of a few countries which appears to be serious about detecting the use of banned drugs by athletes. Some countries and organisations appear to be half-hearted about detecting and pursuing drug cheats among their sports people, so some Australian athletes feel at a disadvantage when competing overseas. Working towards a consistent and harmonious approach internationally is a high priority for the ASDA.

Finally, it is becoming obvious that the tightening of doping policies to prevent legal challenges is just as important as the development of new testing and analytical procedures. The cases of Australian cyclist Martin Vinnicombe, German sprinter Katrina Krabbe and American 400m runner Butch Reynolds have demonstrated that positive drug tests can signal the beginning of lengthy legal battles over their interpretation and status. Unfortunately, litigation is a resource-intensive process and one which will increasingly become a problem for sporting organisations and testing agencies. As a matter of urgency, processes must be implemented which minimise the possibility of litigation as a result of positive drug tests and other doping practices.

Many challenges still remain in the drugs in sport area. While success is achieved in one area, new issues and challenges emerge in another. If anti-drug initiatives are to be effective, they will require adequate resourcing, enthusiastic international co-operation and a commitment from all sections of the community to make competitive sport even relatively drug free.

Further reading

Kennedy M. Drugs and sporting performance. Aust Prescr 1989;12:57-9.

Peter Baume

Professor and Head, School of Community Medicine, University Of New South Wales, Sydney

Chair, Australian Sports Drug Agency

Philip Cohen

Research Officer, Australian Sports Drug Agency