Last updated on: 3/17/2010 | Author: ProCon.org

Banned Performance Enhancing Substances and Methods

with Pros & Cons of Their Health Effects

The International Olympic Committee and the US Olympic Committee are among 625 sports organizations worldwide (106 KB) (as of Dec. 19, 2008) that have adopted the World Anti-Doping Agency’s (WADA) “Code” banning 192 performance enhancing substances and methods.

Drugs can be added and removed from this list by WADA annually, although not all of the banned substances are explicitly named. Caroline Hatton, PhD, a sports anti-doping science consultant, told ProCon.org in a Mar. 12, 2010 email that “A key concept in prohibited lists is that they avoid being finite. Instead of listing all banned drugs one by one, they list entire drug classes and name drugs merely as examples. This is to keep users who took designer drugs from claiming that they didn’t break the rules because the drugs they took weren’t listed.”

Each sports organization that adopts the “Code” is also responsible for enforcing it through drug testing and non-compliance penalties. Several sports leagues, including the National Football League (NFL), Major League Baseball (MLB), and the National Basketball Association (NBA), have not adopted WADA’s “Code.”

UPDATED: World Anti-Doping Agency’s 2013 Prohibited List

[Note: Do not rely on this chart for legal or medical advice.]

  1. Anabolic Agents (56)
  2. Hormones & Related Substances (7)
  3. Beta-2 Agonists (1)
  4. Hormone Antagonists & Modulators (13)
  5. Diuretics & Other Masking Agents (16)
  6. Stimulants (62)
  7. Narcotics (11)
  1. Cannabinoids (1)
  2. Glucocorticosteroids (1)
  3. Alcohol (1)
  4. Beta-Blockers (20)
  5. Banned Methods (3)
  6. Notes & Sources
Substance
• method(s) of consumption •		 Health Effects
I. ANABOLIC AGENTS (56)
• oral or intramuscular injection •		 Pro Con
A. Exogenous Anabolic Androgenic Steroids (AAS):

  1. 1-androstendiol
  2. 1-androstendione
  3. bolandiol
  4. bolasterone
  5. boldenone
  6. boldione
  7. calusterone
  8. clostebol
  9. danazol
  10. dehydrochlormethyltestosterone
  11. desoxymethyltestosterone
  12. drostanolone
  13. ethylestrenol
  14. fluoxymesterone
  15. formebolone
  16. furazabol
  17. gestrinone
  18. 4-hydroxytestosterone
  19. mestanolone
  20. mesterolone
  21. metenolone
  22. methandienone
  23. methandriol
  24. methasterone
  25. methyldienolone
  26. methyl-1-testosterone
  27. methylnortestosterone
  28. methyltrienolone
  29. methyltestosterone
  30. mibolerone
  31. nandrolone
  32. 19-norandrostenedione
  33. norboletone
  34. norclostebol
  35. norethandrolone
  36. oxabolone
  37. oxandrolone
  38. oxymesterone
  39. oxymetholone
  40. prostanozol
  41. quinbolone
  42. stanozolol
  43. stenbolone
  44. 1-testosterone
  45. tetrahydrogestrinone
  46. trenbolone

B. Endogenous Anabolic Androgenic Steroids (AAS):

  1. androstenediol
  2. androstenedione
  3. dihydrotestosterone
  4. prasterone
  5. testosterone

C. Other Anabolic Agents:

  1. clenbuterol
  2. selective androgen receptor modulators (SARMs)
  3. tibolone
  4. zeranol
  5. zilpaterol

Enhances athletic performance in the following ways:

  1. endurance increase
  2. fat loss
  3. muscle recovery increase
  4. muscular size and strength increase in combination with exercise

Used medically to treat the following symptoms and diseases:

  1. anemia
  2. asthma
  3. bone pain from osteoporosis
  4. gonadal function descrease or absence (males)  
  5. hereditary angiodema metastatic breast cancer (females)
  6. muscle loss (i.e. burn injury, HIV-infection, muscular dystrophy)
  7. postmenopausal symptoms such as hot flashes and sweating (postmenopausal females)
  8. puberty delay (males)  
  • abnormal menstrual cycles (females)
  • acne
  • aggressiveness  
  • asthenia
  • baldness
  • brain tissue damage
  1. breast enlargement (males)
  2. clitoris enlargement (females)
  3. depression
  4. dizzy spells
  5. fever
  6. hair growth on the face and body (females)
  7. HIV and other disease contraction due to contaminated needles used for injection of steroid  
  8. hypertension  
  9. impotence (males)
  10. kidney tumours
  11. liver dysfunction
  12. mania
  13. masculinization (females)
  14. muscle strains or ruptures  
  15. myalgia
  16. nausea
  17. periorbital pain
  18. prostate gland enlargement (males)
  19. psychiatric dysfunction
  20. sexual appetite increase
  21. sperm production reduction (males)
  22. stunted growth (in adolescents)
  23. tearing of tendons
  24. testicular shrinkage or atrophy (males)
  25. voice deepening (females)
  26. vomiting
    Top
II. HORMONES & RELATED SUBSTANCES (7) Health Effects
Pro Con
  1. Erythropoietin (EPO)
    • oral •

Enhances athletic performance in the following ways:

  1. endurance capabilities enhancement during exercise
  2. muscle recovery increase

Used medically to treat the following symptoms and diseases:

  1. anemia due to kidney failure, HIV, and some cancers
  1. death
  2. deep vein thrombosis
  3. heart attack
  4. hyperviscosity of the blood
  5. myocardial infarction
  6. pulmonary embolism
  7. stroke
  8. thrombosis
  1. Growth Hormone (hGH),
    • oral or intramuscular injection •
  2. Insulin-like Growth Factors (e.g. IGF-1),
    • intramuscular injection •
  3. Mechano Growth Factors (MGFs)
    • intramuscular injection •

Enhances athletic performance in the following ways:

  1. body fat percentage decrease
  2. growth stimulation
  3. muscle definition enhancement
  4. muscle size and srength increase
  5. muscle tissue repair
  6. protein synthesis increase

Used medically to treat the following symptom and diseases:

  1. cosmetic symptoms of aging
  2. growth hormone deficiency in children
  3. growth retardation in children
  4. Turner’s syndrome
  1. abnormal body changes
  2. acromegaly
  3. antibody formation
  4. arthritis
  5. brain swelling
  6. cardiomyopathy
  7. congestive heart failure
  8. coronary artery disease
  9. Cruetzfeldt-Jakob disease development when drug is produced from cadaveric specimens
  10. diabetes mellitus
  11. diabetic (hypoglycemic) coma
  12. facial nerve paralysis
  13. forehead and jaw shape change
  14. hand enlargement
  15. heart enlargement
  16. hypercholesterolemia
  17. hypoglycemia
  18. hypothyroidism
  19. impotence
  20. menstrual irregularities
  21. metabolic dysfunction
  22. myopathies
  23. osteoporosis
  1. Gonadotrophins (e.g. LH, hCG) – prohibited in males
    • intramuscular injection •

Enhances athletic performance in the following ways:

  1. masking agent (for anabolic steroids)
  2. testicular damage (due to anabolic steroid use) counteraction
  3. testosterone and epistestosterone production stimulation

Used medically to treat the following symptom:

  1. infertility (females)
  1. increased risk of gynaecomastia
  2. similar effects as anabolic steroids
  1. Insulins
    • intramuscular injection •

Enhances athletic performance in the following ways:

  1. muscle definition when used in conjunction with other substances
  2. muscle growth when used in conjunction with other substances
  3. protein breakdown reduction

Used medically to treat the following disease:

  1. diabetes
  1. brain damage
  2. breath shortness
  3. coma
  4. death
  5. drowsiness
  6. hypoglycaemia
  7. nausea
  8. shaking
  9. weakness
  1. Corticotrophins (ACTH)
    • intramuscular injection •

Enhances athletic performance in the following ways:

  1. increases adrenal corticosteroid levels
  2. antiinflammatory action aids recovery from injury

Used medically to treat the following symptom:

  1. spasms (infants)
  1. psychological effects such as irritability
  2. softening of connective tissue
  3. stomach irritation and ulcers
  4. weakening of an injured area in muscles, bones, tendons or ligaments, osteoporosis and cataracts
    Top
III. BETA-2 AGONISTS (1)
• intravenous injection •		 Health Effects
Pro Con
  1. All beta-2 agonists including their D- and L- isomers
    (except formoterol, salbutamol, salmeterol and terbutaline when administered by inhalation and Therapeutic Use Exemption is obtained)

Enhances athletic performance in the following ways:

  1. aerobic exercise improvement
  2. fat reduction
  3. muscle growth

Used medically to treat the following symptom and disease:

  1. asthma
  2. chronic obstructive pulmonary disease
  1. anxiety
  2. arrhythmias
  3. dizziness
  4. headache
  5. insomnia
  6. mood disorders
  7. muscle cramps
  8. nausea
  9. palpitations
  10. sweating
  11. tachycardia
  12. tremor (usually of the hands)
    Top
IV. HORMONE ANTAGONISTS & MODULATORS (13)
• intramuscular injection •		 Health Effects
Pro Con
A. Aromatase inhibitors including, but not limited to:

  1. aminoglutethimide
  2. anastrozole
  3. exemestane
  4. formestane
  5. letrozole
  6. testolactone

B. Selective estrogen receptor modulators (SERMs) including, but not limited to:

  1. raloxifene
  2. tamoxifen
  3. toremifene

C. Other anti-estrogenic substances, including but not limited to:

  1. clomiphene
  2. cyclofenil
  3. fulvestrant

D. Agents modifying myostatin function(s) including but not limited to:

  1. myostatin inhibitors

Enhances athletic performance in the following ways:

  1. anabolic effects
  2. strength increase
  3. reduction of anabolic steroid use side effects (i.e. breast tissue growth)

Used medically to treat the following symptom and disease:

  1. breast cancer
  2. infertility (females)
  1. abdominal discomfort
  2. cancer
  3. hot flushes
  4. libido reduction
  5. verbal slurring
    Top
V. DIURETICS & OTHER MASKING AGENTS (16)
• intramuscular injection •		 Health Effects
Pro Con
A. Diuretics:  

  1. acetazolamide
  2. amiloride
  3. bumetanide
  4. canrenone
  5. chlorthalidone
  6. etacrynic acid
  7. furosemide
  8. indapamide
  9. metolazone
  10. spironolactone
  11. thiazides
  12. triamterene

B. Other masking agents:

  1. epitestosterone
  2. probenecid
  3. alpha-reductase inhibitors
  4. plasma expanders

Enhances athletic performance in the following ways:

  1. prevent detection of banned substances
  2. produce urine excretion to reduce concentration of banned substances
  3. weight loss

Used medically to treat the following symptoms:

  1. heart failure from the kidneys
  2. high blood pressure
  1. blood pressure drop
  2. cramps
  3. death
  4. dehydration
  5. dizziness
  6. electrolyte imbalance
  7. headaches
  8. heart failure
  9. kidney failure
  10. muscle cramps
  11. nausea
  12. potassium depletion
  13. volume depletion
    Top
VI. STIMULANTS (62)
• oral, inhalation, intranasal, or intramuscular injection •		 Health Effects
Pro Con
  1. adrafinil
  2. adrenaline
  3. amfepramone
  4. amiphenazole
  5. amphetamine
  6. amphetaminil
  7. benzphetamine
  8. benzylpiperazine
  9. bromantan
  10. cathine
  11. clobenzorex
  12. cocaine
  13. cropropamide
  14. crotetamide
  15. cyclazodone
  16. dimethylamphetamine
  17. ephedrine
  18. etamivan
  19. etilamphetamine
  20. etilefrine
  21. famprofazone
  22. fenbutrazate
  23. fencamfamin
  24. fencamine
  25. fenetylline
  26. fenfluramine
  27. fenproporex
  28. furfenorex
  29. heptaminol
  30. isometheptene
  31. levmethamfetamine
  32. meclofenoxate
  33. mefenorex
  34. mephentermine
  35. mesocarb
  36. methamphetamine (D-)
  37. methylenedioxyamphetamine
  38. methylenedioxymethamphetamine
  39. methylamphetamine
  40. methylephedrine
  41. methylphenidate
  42. modafinil
  43. nikethamide
  44. norfenefrine
  45. norfenfluramine
  46. octopamine
  47. ortetamine
  48. oxilofrine
  49. parahydroxyamphetamine
  50. pemoline
  51. pentetrazol
  52. phendimetrazine
  53. phenmetrazine
  54. phenpromethamine
  55. phentermine
  56. 4-phenylpiracetam (carphedon)
  57. prolintane
  58. propylhexedrine
  59. selegiline
  60. sibutramine
  61. strychnine
  62. tuaminoheptane  

Enhances athletic performance in the following ways:

  1. aggressiveness increase
  2. alertness increase
  3. competitiveness increase
  4. responsiveness increase
  5. tiredness reduction
  6. weight loss

Used medically to treat the following symptoms:

  1. allergies
  2. asthma
  3. attention deficit hyperactivity disorder (ADHD)
  4. cold
  5. headache
  6. nasal congestion
  1. addiction/withdrawal
  2. aggressiveness
  3. alertness
  4. anxiety
  5. blood pressure increase
  6. cardiac arrhythmia
  7. cerebral hemorrhage
  8. coma
  9. convulsions
  10. death
  11. dehydration
  12. hand tremors
  13. heart attack
  14. heart rate increase
  15. heat stroke
  16. inhibited judgment and decision making
  17. insomnia
  18. stroke
  19. sweating
  20. tremor
  21. weight loss
    Top
VII. NARCOTICS (11)
• oral or intramuscular/intravenous injection •		 Health Effects
Pro Con
  1. buprenorphine
  2. dextromoramide
  3. diamorphine (heroin)
  4. fentanyl
  5. hydromorphone
  6. methadone
  7. morphine
  8. oxycodone
  9. oxymorphone
  10. pentazocine
  11. pethidine

Enhances athletic performance in the following ways:

  1. invincibility feeling
  2. pain killer
  3. pain threshold increase
  4. sensation of euphoria

Used medically to treat the following symptoms:

  1. pain
  1. addiction/withdrawal
  2. balance and coordination loss
  3. cardiovascular collapse
  4. concentration ability decrease
  5. death
  6. injury risk
  7. nausea
  8. respiratory depression
  9. sleepiness
  10. vomiting
    Top
VIII. CANNABINOIDS (1)
• oral or inhalation •		 Health Effects
Pro Con
  1. cannabinoids (i.e. hashish, marijuana)

Enhances athletic performance in the following ways:

  1. euphoric sensation
  2. sedative

Used medically to treat the following symptoms:
  1. addiction/withdrawal
  2. anxiety
  3. apathy
  4. appetite increase
  5. balance and coordination impairment
  6. bronchitis
  7. cancer in the lung, throat, mouth, and tongue
  8. concentration loss
  9. drowsiness
  10. hallucinations
  11. heart rate increase
  12. dry mouth
  13. learning ability impairment
  14. memory impairment
  15. mood swings
  16. motivation loss
  17. motor skill impairment
  18. panic attacks
  19. paranoid thinking
  20. reflex loss
  21. weight gain
    Top
IX. GLUCOCORTICOSTEROIDS (1)
• oral, rectal, inhalation, intravenous, or intramuscular injection •		 Health Effects
Pro Con
  1. glucocorticosteroids

Enhances athletic performance in the following ways:

  1. anti-inflammatory agent

Used medically to treat the following symptoms:

  1. arthritis
  2. asthma
  3. inflamed joints
  4. allergic reactions
  1. fluid retention
  2. hyperglycemia
  3. mood alteration
  4. musculoskeletal problems
  5. systemic infections
    Top
X. ALCOHOL (1)
• oral •		 Health Effects
Pro Con
  1. ethanol

Enhances athletic performance in the following ways:

  1. anti-anxiety effect
  2. maximize effects of other drugs taken at the same time
  3. sedative
  1. addiction/withdrawal
  2. cirrhosis of the liver
  3. death
  4. depression
  5. double vision
  6. incontinence
  7. judgment impairment
  8. memory and comprehension loss
  9. reflex and muscular coordination impairment
  10. sleepiness
  11. speech slurring
  12. suicide
  13. vomiting
    Top
XI. BETA-BLOCKERS (20)
• oral •		 Health Effects
Pro Con
  1. acebutolol
  2. alprenolol
  3. atenolol
  4. betaxolol
  5. bisoprolol
  6. bunolol
  7. carteolol
  8. carvedilol
  9. celiprolol
  10. esmolol
  11. labetalol
  12. levobunolol
  13. metipranolol
  14. metoprolol
  15. nadolol
  16. oxprenolol
  17. pindolol
  18. propranolol
  19. sotalol
  20. timolol

Enhances athletic performance in the following ways:

  1. muscle tremor reduction in precision sports
  2. sedative

Used medically to treat the following symptoms:

  1. anxiety
  2. heart problems
  3. high blood pressure
  4. migraine
  1. blood pressure lowering
  2. heart rate decrease
  3. performance capacity decrease in endurance sports
  4. sleep disturbance
  5. tiredness
    Top
XII. BANNED METHODS (3) Health Effects
Pro Con
  1. enhancement of oxygen transfer (i.e. blood doping and artificially enhancing the uptake, transport or delivery of oxygen)

Enhances athletic performance in the following ways:

  1. endurance performance improvement
  2. ability to perform better at higher altitudes
  1. allergic
    reactions if wrong blood type is used
  2. blood poisoning
  3. cardiac output decrease
  4. contraction of infectious diseases such as viral hepatitis, malaria, cytomegalovirus, or HIV
  5. death
  6. heart failure
  7. hypertension
  8. immune system overload
  9. infection
  10. intravascular clotting
  11. iron overload
  12. kidney damage
  13. platelet count reduction
  14. sexual dysfunction
  15. thrombosis
  16. transient fever
  1. chemical and physical manipulation

Chemical and physical manipulation of samples can include tampering with samples, substitution and/or alteration of urine, catheterisation, and intravenous infusion. Such manipulation can allow athletes to benefit from the use of performance enhancing drugs without testing positive for prohibited substances.

Intravenous infusion is also prohibited unless there is an acute medical situation (i.e. acute blood loss) in which the use of this method is necessary.
  1. infection
  2. over hydration
  1. gene doping

Gene doping, when used in sports, can provide a variety of performance enhancing effects depending on the function of the gene.

In terms of medical treatment, there have been cases of doctors using gene therapy to treat patients with chronic or fatal illnesses.

 Effects are unknown due to expertimental phase of gene doping technologies
    Top
XIII. NOTES & SOURCES
Substances and methods that are prohibited by the World Anti-Doping Agency’s (WADA) “2008 Prohibited List International Standard” are not limited to those specifically enumerated above. Please refer to WADA’s Prohibited List for banned related metabolites and isomers of substances, exceptions, classification of drugs and methods as prohibited in and/or out of competition or for specific sports, and the systematic International Union of Pure and Applied Chemistry (IUPAC) names of the substances.

The pros and cons of the health effects provided in our chart were compiled from the following sources unless otherwise noted:

1. Australian Sports Anti-Doping Authority (ASADA), “2008 Anti-Doping Handbook,” ASADA website, 2008

2. US Anti-Doping Agency (USADA), “Guide to Prohibited Substances and Prohibited Methods of Doping,” USADA website, Dec. 2007

3. David R. Mottram, PhD, Drugs in Sport, 2003

4. William D. Knopp, MD, et al., “Ergogenic Drugs in Sports,” Clinics in Sports Medicine, July 1997
Top
 
 

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