The Five Most Effective Types of Performance-Enhancing Drugs. The history of all these substances traces back to the Soviet Union, when many coaches and doctors routinely administered various drugs to athletes throughout their careers. Some of these practices have continued to this day. Over time, a list of the most popular drugs has emerged. We’ve attempted to determine which of these are currently being used in various sports and what effects they actually produce.
Erythropoietin (EPO)
Erythropoietin (EPO) is a hormone that stimulates late-stage progenitor cells to form red blood cells and increases the production of reticulocytes in the bone marrow based on oxygen consumption. Erythropoietin is a replica of a natural hormone produced by the kidneys. Once in the bloodstream, it activates the process of red blood cell maturation.
The History of Erythropoietin (EPO)
The drug appeared in 1983 and was invented by American experts. It found its way into sports almost immediately. However, since EPO essentially replicates a natural hormone, it could not be detected. It wasn’t until the early 21st century that the French laboratory Chateau-Malabry found a way to detect it. Subsequently, old samples were tested, and nearly all of the once-famous cyclists were found to have used EPO. However, new types of EPO then emerged. In particular, CERA was widely used by cyclists, but since 2007, methods have been developed to identify it. This has also led to a large number of cyclists being disqualified.
Physiological Effects
Erythropoietin (EPO) increases the level of hemoglobin in the blood, allowing the blood to carry more oxygen throughout the body and thereby improving endurance.
Sports Affected
Endurance sports: cycling, cross-country skiing, biathlon, swimming, speed skating.
Most Notable Scandals
In 2001, at the World Championships in cross-country skiing—a sport where EPO use was prevalent—nearly the entire star-studded Finnish team was caught: Mika Myllylä, Jari Isometasa, and Virpi Kuitunen.
A year later, at the Salt Lake City Olympics, it was our turn—the victims of the tests were Larissa Lazutina and Olga Danilova.
In 2008, four riders in the Tour de France were caught immediately after a new form of EPO—CERA—was found in their blood. Those disqualified included Bernhard Kohl, as well as stage winners such as Stefan Schumacher, Riccardo Ricco, and Leonardo Piepoli. The race results were revised.
Additionally, Rashid Ramzi, a two-time world champion in the 1,500-meter and 5,000-meter events, was caught using CERA. Just days after becoming an Olympic champion, a sample taken from him at the Beijing Olympics revealed the presence of a blood-doping agent.
Anabolic Steroids (Testosterone, Stanozolol, Nandrolone, Methenolone, Ostarine)
Anabolic drugs are substances that mimic the effects of the male hormones testosterone and dihydrotestosterone. They accelerate protein synthesis within cells, leading to significant muscle hypertrophy (a process generally referred to as anabolism).
History of Steroids
As early as the 1930s, scientists learned to synthesize testosterone artificially. Then, in the 1940s, research into anabolic steroids began to advance in the Soviet Union and Eastern European countries. To this day, it is widely believed that the track and field records set by athletes in the former Soviet Union and East Germany during the 1980s were achieved with the aid of steroids.
Over the years, the American laboratory BALCO attempted to improve anabolic steroids, creating tetrahydrotestosterone.
Physiological Effects
With the use of steroids, muscle mass (5–10 kg per month), strength indicators, and endurance increase significantly; red blood cell production rises; bone tissue strengthens; and fat reserves decrease.
In principle, steroids are still considered the most effective type of performance-enhancing drug, but the problem is that they are easily detected.
Scope of Application
Track and field (sprinting, throwing, jumping), weightlifting, swimming, cross-country skiing.
The Most Notorious Scandals
There are countless scandals related to steroid use. I will list just a few names: Ben Johnson, Carl Lewis, Marion Jones, Tim Montgomery, Frank Luck, Anfisa Ryzhova, Irina Korzhanenko, Nadezhda Ostapchuk, Irina Sergeeva. The list could go on for dozens of pages…
Diuretics (Chlorthalidone, Acetazolamide, Triamterene, Furosemide)
Diuretics are typically used to remove excess fluid from the body to reduce muscle bulk. They are usually taken before competitions because their effects are relatively short-lived. Diuretics can be taken during a steroid cycle because anabolic steroids can cause excessive fluid retention. Increased urination helps remove other substances from the body or masks their use by significantly reducing urine density.
History of Diuretics
In sports, diuretics appeared almost immediately after the introduction of anabolic steroids.
Physiological Effects
They help achieve rapid weight loss and improve an athlete’s appearance. Dehydration helps give muscle tissue a defined, sculpted appearance.
Areas of Application
Rhythmic gymnastics, figure skating, track and field, weightlifting.
Most Notable Scandals
In most cases, diuretics are used to conceal steroid use. At the Seoul Olympics, the Bulgarian national team won four gold medals and one bronze. However, after its representatives Mitko Grablev and Angel Genchev were caught using diuretics, the entire weightlifting team was withdrawn from the Olympics. Two Hungarian weightlifters also used similar diuretics.
Often, athletes manage to prove that their use of diuretics was unintentional, claiming they were taking nutritional supplements. Recently, Olympic champion Cesar Sielo Filho and Jamaican athlete Veronica Campbell-Brown managed to “slip through” disqualification.
Blood Transfusion and Its Components (Transfusion) and Autologous Blood Transfusion
A blood transfusion is the administration of blood or its components from a donor into a recipient’s body.
Autologous transfusion—the transfusion of one’s own blood.
History of Blood Transfusion
It is difficult to say exactly when athletes first began using autologous transfusions, but all blood transfusions were banned in 1985. This occurred after cyclists openly admitted to using blood transfusions at the 1985 Los Angeles Olympics. The first cases of this practice were detected as early as the 2000s following the official ban, after which WADA insisted on the introduction of the biological passport. The blood passport system is based on the analysis of blood parameters and levels of hemoglobin, red blood cells, and reticulocytes collected from athletes at regular intervals. Elevated levels of blood cells and hemoglobin enhance the transport of oxygen from the blood to the muscles, thereby increasing athletic performance.
Typically, elevated levels of red blood cells and hemoglobin are associated with various types of blood transfusions.
Physiological Effects
Autologous blood transfusion accelerates the delivery of oxygen to the muscles, thereby improving their performance.
Scope of Application
Cycling, track and field, cross-country skiing.
Most Notable Scandals
The first blood transfusion scandal occurred during the 2000 Olympic Games, when Vinokurov was caught alongside another American athlete, Tyler Hamilton.
During the 2007 Tour de France, Kazakhstani cyclist Alexander Vinokurov, an Olympic champion, was also caught for blood transfusion and disqualified for two years. According to experts at the Châteaune-Malabry laboratory, analysis of doping tests revealed that Vinokurov’s blood transfusion took place on July 21, the day of his victory in Stage 13. As a result, Alexander and the entire Astana team (at the request of the Tour de France organizers) withdrew from the race.
Psychostimulants (cocaine, ephedrine, ecstasy, and amphetamines)
Under acute conditions, psychostimulants rapidly alter functional indicators of brain activity (such as increasing bioelectric activity and altering conditioned reflexes) and enhance endurance during physical exertion. In clinical settings, they exert a rapid-onset stimulating effect and are widely used in practice to treat conditions accompanied by drowsiness, lethargy, apathy, weakness, and depression. The increase in an athlete’s performance under the influence of stimulants is largely due to the suppression of physiological regulatory mechanisms and the mobilization of functional reserves.
History of Psychostimulants
Different types of stimulants have appeared in sports at various times. In particular, ephedrine emerged on the scene in the late 1970s.
Physiological Effects
These drugs can boost energy, reduce fatigue, and stimulate improvements in training duration or competition results.
Scope of Application
Absolutely any sport—from boxing to rhythmic gymnastics.
The Most Notorious Scandal
During the 1976 Olympics in Innsbruck, ephedrine was detected in Soviet skier Galina Kurakova. Indeed, Kulakova was disqualified from only one event because the use of a nasal spray proved that her system contained ephedrine. This disqualification marked the first time in history that a skier was disqualified for using a banned substance at the Olympics.
In 1994, the famous Diego Maradona was suspended for 15 months from the World Cup for using ephedrine.
Regarding the use of ephedrine and pseudoephedrine, the famous American athlete Carl Lewis faced allegations, but he was never disqualified; he managed to convince everyone that the cough medicine was to blame…
In 2011, Ukrainian biathlete Oksana Khvoshko was caught using ephedrine.