The International Olympic Committee and the US Olympic Committee are among almost 700 sports organizations worldwide as of Apr. 9, 2021 that have adopted the World Anti-Doping Agency’s (WADA) Code banning performance enhancing substances and methods.
Drugs can be added and removed from this list by WADA annually and not all of the banned substances are explicitly named. Caroline Hatton, PhD, a sports anti-doping science consultant, told ProCon.org: “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.
Below are examples of banned substances and methods by category, with information about medical uses, performance effects on athletes, and side-effects. For a complete list of banned substances, see the 2021 World Anti-Doping Code International Standard Prohibited List from the World Anti-Doping Agency (WADA).
For medical and/or legal advice, please consult the appropriate legal and medical professionals.
Drinks made from fermented sugars in fruits, berries, grains, and other ingredients.
Medical Uses
- none
Effects on Athletes
- anti-anxiety
- maximize effects of other drugs taken at the same time
- sedative
Side Effects
- addiction and withdrawal
- cirrhosis of the liver
- death
- depression
- double vision
- incontinence
- judgment impairment
- memory and comprehension loss
- reflex and muscular coordination impairment
- sleepiness
- speech slurring
- suicide
- vomiting
Examples
Ethanol: beer, distilled spirits, and wine
Want to know more about alcohol? Visit Britannica.com
Drugs that mimic testosterone and encourage muscle tissue growth.
Medical Uses
- anemia
- asthma
- bone pain from osteoporosis
- gonadal function decrease or absence
- hereditary angiodema metastatic breast cancer
- muscle loss (i.e. burn injury, HIV-infection, muscular dystrophy)
- postmenopausal symptoms such as hot flashes and sweating
- puberty delay
Effects on Athletes
- endurance increase
- fat loss
- muscle recovery increase
- muscular size and strength increase in combination with exercise
Side Effects
- abnormal menstrual cycles
- acne
- aggressiveness
- anemia
- asthenia
- baldness
- brain tissue damage
- breast enlargement
- clitoris enlargement
- depression
- dizzy spells
- fever
- hair growth on the face and body
- HIV and other disease contraction due to contaminated needles used for injection of steroid
- hypertension
- impotence
- kidney tumors
- liver dysfunction
- mania
- masculinization
- muscle strains or ruptures
- myalgia
- nausea
- periorbital pain
- prostate gland enlargement
- psychiatric dysfunction
- sexual appetite increase
- sperm production reduction
- stunted growth in adolescents
- tearing of tendons
- testicular shrinkage or atrophy
- voice deepening
- vomiting
Examples
Endogenous Anabolic Androgenic Steroids (AAS): androstenediol, androstenedione, dihydrotestosterone, prasterone, and testosterone
Exogenous Anabolic Androgenic Steroids (AAS): 1-androstendiol, 1-androstendione, bolandiol, bolasterone, boldenone, boldione, calusterone, clostebol, danazol, dehydrochlormethyltestosterone, desoxymethyltestosterone, drostanolone, ethylestrenol, fluoxymesterone, formebolone, furazabol, gestrinone, 4-hydroxytestosterone, mestanolone, mesterolone, metenolone, methandienone, methandriol, methasterone, methyldienolone, methyl-1-testosterone, methylnortestosterone, methyltrienolone, methyltestosterone, mibolerone, nandrolone, 19-norandrostenedione, norboletone, norclostebol, norethandrolone, oxabolone, oxandrolone, oxymesterone, oxymetholone, prostanozol, quinbolone, stanozolol, stenbolone, 1-testosterone, tetrahydrogestrinone, and trenbolone
Other Anabolic Agents: clenbuterol, selective androgen receptor modulators (SARMs), tibolone, zeranol, and zilpaterol
Want to know more about anabolic steroids? Visit Britannica.com
Bronchodilators (drugs that widen the bronchial tubes to allow more air to move).
Medical Uses
- asthma
- chronic obstructive pulmonary disease
Effects on Athletes
- aerobic exercise improvement
- fat reduction
- muscle growth
Side Effects
- anxiety
- arrhythmias
- dizziness
- headache
- insomnia
- mood disorders
- muscle cramps
- nausea
- palpitations
- sweating
- tachycardia
- tremor, usually of the hands
Examples
Albuterol, metaproterenol, pirbuterol, terbutaline, isoetharine, Levalbuterol, and salmeterol xinafoate
Drugs that reduce excitation of the nervous system.
Medical Uses
- anxiety
- heart problems
- high blood pressure
- migraine
Effects on Athletes
- muscle tremor reduction
- sedative
Side Effects
- blood pressure lowering
- heart rate decrease
- performance capacity decrease in endurance sports
- sleep disturbance
- tiredness
Examples
Acebutolol, alprenolol, atenolol, betaxolol, bisoprolol, bunolol, carteolol, carvedilol, celiprolol, esmolol, labetalol, levobunolol, metipranolol, metoprolol, nadolol, oxprenolol, pindolol, propranolol, sotalol, and timolol
Want to know more about beta-blockers? Visit Britannica.com
Chemical compounds found in the cannabis plant.
Side Effects
- addiction and withdrawal
- anxiety
- apathy
- appetite increase
- balance and coordination impairment
- bronchitis
- cancer of the lung, throat, mouth, and tongue
- concentration loss
- drowsiness
- hallucinations
- heart rate increase
- dry mouth
- learning ability impairment
- memory impairment
- mood swings
- motivation loss
- motor skill impairment
- panic attacks
- paranoid thinking
- reflex loss
- weight gain
Examples
Want to know more about cannabinoids? Visit Britannica.com
Diuretics & Other Masking Agents
Drugs that increase the flow of urine, or otherwise work to diminish the appearance of drugs in someone’s body.
Medical Uses
- heart failure from the kidneys
- high blood pressure
Effects on Athletes
- prevent detection of banned substances
- produce urine excretion to reduce concentration of banned substances
- weight loss
Side Effects
- blood pressure drop
- cramps
- death
- dehydration
- dizziness
- electrolyte imbalance
- headaches
- heart failure
- kidney failure
- muscle cramps
- nausea
- potassium depletion
- volume depletion
Examples
Diuretics: acetazolamide, amiloride, bumetanide, canrenone, chlorthalidone, etacrynic acid, furosemide, indapamide, metolazone, spironolactone, thiazides, and triamterene
Other masking agents: alpha-reductase inhibitors, epitestosterone, plasma expanders, and probenecid
Corticosteroids that prevent and reduce inflammation.
Medical Uses
- asthma
- chronic obstructive pulmonary disease (COPD)
- allergies
- rheumatoid arthritis
- osteoarthritis
- Crohn’s disease and other types of inflammatory bowel disease
- eczema and other skin conditions
- multiple sclerosis
- tendinitis
- lupus
Effects on Athletes
- anti-inflammatory
Side Effects
- acne
- blurred vision
- feeling nervous or restless
- feeling very hungry
- mood swings
- muscle weakness
- trouble sleeping
- stomach irritation
- water retention or swelling
- weight gain
Examples
Budesonide, cortisone, dexamethasone, prednisone, and triamcinolone
Hormone Antagonists & Modulators
Drugs that decrease the amount of estrogen in the body or block estrogen receptors.
Medical Uses
- breast cancer
- infertility
Effects on Athletes
- anabolic effects
- strength increase
- reduction of anabolic steroid use side effects (i.e. breast tissue growth)
Side Effects
- abdominal discomfort
- cancer
- hot flushes
- libido reduction
- verbal slurring
Examples
Aromatase inhibitors: aminoglutethimide, anastrozole, exemestane, formestane, letrozole, and testolactone
Myostatin inhibitors
Other anti-estrogenic substances: clomiphene, cyclofenil, and fulvestrant
Selective estrogen receptor modulators (SERMs): raloxifene, tamoxifen, and toremifene
An organic substance that regulates psychological activities and maintains the body’s homeostasis.
Medical Uses
- anemia due to kidney failure
- cosmetic symptoms of aging
- diabetes
- growth hormone deficiency in children
- growth retardation in children
- HIV
- infertility
- some cancers
- spasms in infants
- Turner’s syndrome
Effects on Athletes
- anti-inflammatory action aids recovery from injury
- body fat percentage decrease
- growth stimulation
- increases adrenal corticosteroid levels
- masking agent for anabolic steroids
- muscle definition when used in conjunction with other substances
- muscle size and growth growth when used in conjunction with other substances
- muscle tissue repair
- protein breakdown reduction
- protein synthesis increase
- testicular damage due to anabolic steroid use counteraction
- testosterone and epistestosterone production stimulation
Side Effects
- abnormal body changes
- acromegaly
- antibody formation
- arthritis
- brain damage
- brain swelling
- cardiomyopathy
- coma
- congestive heart failure
- coronary artery disease
- Cruetzfeldt-Jakob disease
- death
- deep vein thrombosis
- diabetes mellitus
- diabetic (hypoglycemic) coma
- drowsiness
- facial nerve paralysis
- forehead and jaw shape change
- gynaecomastia
- hand enlargement
- heart attack
- heart enlargement
- hypercholesterolemia
- hyperviscosity of the blood
- hypoglycemia
- hypothyroidism
- impotence
- menstrual irregularities
- metabolic dysfunction
- myocardial infarction
- myopathies
- nausea
- osteoporosis
- psychological effects such as irritability
- pulmonary embolism
- shaking
- shortness of breath
- similar effects as anabolic steroids
- softening of connective tissue
- stomach irritation and ulcers
- stroke
- thrombosis
- weakening of an injured area in muscles, bones, tendons or ligaments, osteoporosis and cataracts
- weakness
Examples
Erythropoietin (EPO), growth hormone (hGH), insulin-like growth factors (e.g. IGF-1), mechano growth factors (MGFs), gonadotrophins (e.g. LH, hCG), insulins, and corticotrophins (ACTH)
Drugs that produce pain relief, a state of stupor or relief, and addiction.
Medical Uses
- pain
Effects on Athletes
- feelings of invincibility
- pain killer
- pain threshold increase
- euphoria
Side Effects
- addiction and withdrawal
- balance and coordination loss
- cardiovascular collapse
- concentration ability decrease
- death
- injury risk
- nausea
- respiratory depression
- sleepiness
- vomiting
Examples
Buprenorphine, dextromoramide, diamorphine (diacetylmorphine/heroin), fentanyl, hydromorphone, methadone, morphine, oxycodone, oxymorphone, pentazocine, and pethidine
Want to know more about narcotics? Visit Britannica.com
Any drug that excites any bodily function, but especially those that excite the brain and central nervous system.
Medical Uses
- allergies
- asthma
- ADHD (attention deficit hyperactivity disorder)
- cold
- headache
- nasal congestion
Effects on Athletes
- aggressiveness
- alertness
- competitiveness
- responsiveness
- tiredness reduction
- weight loss
Side Effects
- addiction/withdrawal
- aggressiveness
- alertness
- anxiety
- blood pressure increase
- cardiac arrhythmia
- cerebral hemorrhage
- coma
- convulsions
- death
- dehydration
- hand tremors
- heart attack
- heart rate increase
- heat stroke
- inhibited judgment and decision-making
- insomnia
- stroke
- sweating
- tremor
- weight loss
Examples
Adrafinil, adrenaline, amfepramone, amiphenazole, amphetamine, amphetaminil, benzphetamine, benzylpiperazine, bromantan, cathine, clobenzorex, cocaine, cropropamide, crotetamide, cyclazodone, dimethylamphetamine, ephedrine, etamivan, etilamphetamine, etilefrine, famprofazone, fenbutrazate, fencamfamin, fencamine, fenetylline, fenfluramine, fenproporex, furfenorex, heptaminol, isometheptene, levmethamfetamine, meclofenoxate, mefenorex, mephentermine, mesocarb, methamphetamine (D-), methylenedioxyamphetamine, methylenedioxymethamphetamine, methylamphetamine, methylephedrine, methylphenidate, modafinil, nikethamide, norfenefrine, norfenfluramine, octopamine, ortetamine, oxilofrine, parahydroxyamphetamine, pemoline, pentetrazol, phendimetrazine, phenmetrazine, phenpromethamine, phentermine, 4-phenylpiracetam (carphedon), prolintane, propylhexedrine, selegiline, sibutramine, strychnine, and tuaminoheptane
Want to know more about stimulants? Visit Britannica.com
Blood Doping
Artificially enhancing the uptake, transport, or delivery of oxygen.
Effects on Athletes
- endurance performance improvement
- ability to perform better at higher altitudes
Side Effects
- allergic reaction
- blood poisoning
- cardiac output decrease
- contraction of infectious diseases such as viral hepatitis, malaria, cytomegalovirus, or HIV
- death
- heart failure
- hypertension
- immune system overload
- infection
- intravascular clotting
- iron overload
- kidney damage
- platelet count reduction
- sexual dysfunction
- thrombosis
- transient fever
Want to know more about blood doping? Visit Britannica.com
Chemical and Physical Manipulation of Samples
Can include tampering with samples, substitution and/or alteration of urine, catheterization, and intravenous infusion. Intravenous infusion is prohibited unless there is an acute medical situation (i.e. acute blood loss) for which the use of this method is necessary.
Effects on Athletes
- negative drug tests
Side Effects
- infection
- over-hydration
Gene Doping
Still-experimental manipulation of cells or genes to improve athletic performance.
Effects on Athletes
- unknown
Side Effects
- unknown
Want to know more about gene doping? Visit Britannica.com
Sources:
Australian Sports Anti-Doping Authority (ASADA), “2008 Anti-Doping Handbook,” ASADA website, 2008
David R. Mottram, Drugs in Sport, 2003
William D. Knopp, “Ergogenic Drugs in Sports,” Clinics in Sports Medicine, July 1997
Jennifer Robinson “What Are Glucocorticoids?,” webmd.com, May 30, 2019
US Anti-Doping Agency (USADA), “Guide to Prohibited Substances and Prohibited Methods of Doping,” USADA website, Dec. 2007
Daniel J. DeNoon, “Why Steroids Are Bad for You,” webmd.com, March 16, 2005
WebMD, “Anabolic Steroids,” webmd.com (accessed Apr. 9, 2021)
