Performance Enhancing Drugs in Sports

Pills with a free weight and towel
Peter Dazeley/Getty Images

Performance enhancing drugs consist of a variety of substances, including medications, procedures, and even devices that are intended to improve athletic sports performance. Some of these substances are naturally occurring, easily available and completely legal while others are manufactured, illegal, or banned by many sporting organizations. Many athletes, coaches, politicians, and fans feel the use of certain substances is unethical in sports.

Determining which substances are regulated, however, is an area of constant debate. Many performance enhancing substances classified as supplements are widely marketed as "health aids" yet have limited research on their safety or effectiveness. Being classified as a supplement means the contents of the product and the claims on the label have not been evaluated by the U.S. Food and Drug Administration and may not have any scientific basis.

In general, performance enhancing drugs and substances (ergogenic aids) can be categorized into the following areas.

Sports Supplements, Vitamins, and Minerals

Athletes often look for alternative nutrition to perform at their best, and sports supplements are one way. The following can be found at your local health food stores. Most are not banned but check with your sports governing body to be sure.

  • Protein is a necessary nutrient that everyone needs to function properly. Both athletes and sedentary individuals need to get adequate protein.
  • Glucosamine has been used to treat osteoarthritis and helps stimulates cartilage, though the results of this are not constant.
  • Ribose is a sugar. There is clear evidence that shows an athletic performance benefit from ribose supplements.
  • Creatine started off as a sports supplement but has been found to work in elderly populations to help maintain muscle mass. For some athletes, creatine supplementation improves repeated bouts of high-intensity exercise, such as sprinting, weightlifting or power sports.
  • Glutamine (L- Glutamine) is an amino acid and classified as a nutritional supplement. Athletes may take it to help them recover from exercise.
  • B-Vitamins are essential for the body to function properly (thiamine, riboflavin, vitamin B-6, B-12, and folate).

Banned or Regulated Performance Enhancing Drugs

  • Amphetamines are central nervous system stimulant drugs that increase alertness and self-confidence, improve concentration, decrease appetite, and create a feeling of increased energy. Amphetamines such as Benzedrine, Adderall, and Dexedrine have a high potential for addiction and are on the banned substance list of most, if not all, sports organizations.
  • Anabolic Steroids (anabolic-androgenic steroids), are synthetic versions of the male hormone testosterone. Non-medical use of anabolic steroids is illegal and banned by most major sports organizations. Still, some athletes continue to use them illegally in an attempt to improve sports performance, despite evidence that using them can cause serious health problems, such as hypertension and heart attack.​ The manufactured version of DHEA (Dehydroepiandrosterone) as well as the designer steroids, Androstenedione (Andro) and Tetrahydrogestrinone (THG) are all precursors to hormones, such as testosterone, and work in a similar manner to anabolic-androgenic steroids. These are all banned substances by nearly all sports organizations.
  • Caffeine is a naturally occurring substance that has been used by endurance athletes for years as a way to stay alert and improve endurance. While generally not harmful, it does have side effects and is banned (in high doses) by many sports organizations.
  • Ephedrine is a substance found in many cold and flu medications. It is also used to treat low blood pressure that may occur because of other medications and can improve breathing. Currently, it is illegal to possess large quantities of it in the US. It once was an ingredient used in diet drugs until it was found to cause headaches, dizziness, heart irregularities, seizures, and possibly death.
  • Erythropoietin (EPO) is a naturally-occurring hormone, produced by the kidneys, that stimulates the production of red blood cells. This hormone can also be manufactured and injected. Most recently EPO has been linked to the professional cycling world. Although EPO is on the banned substance list, some claim cyclists continue to use it to boost performance.
  • HemAssist is a class of drug called a Hemoglobin-based Oxygen Carrier (HBOC). HBOCs are experimental drugs that carry oxygen in the blood for a short period of time. They are designed to act as blood substitutes for trauma patients. HemAssist was in the final stages of clinical trials in 1998 when research was stopped due to safety concerns.
Was this page helpful?
Article Sources
Verywell Fit uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. U.S. Food and Drug Administration. Questions and Answers on Dietary Supplements. Updated July 22, 2019.

  2. Vasiliadis HS, Tsikopoulos K. Glucosamine and chondroitin for the treatment of osteoarthritis. World J Orthop. 2017;8(1):1-11. doi:10.5312/wjo.v8.i1.1

  3. Kerksick CM, Wilborn CD, Roberts MD, et al. ISSN exercise & sports nutrition review update: Research & recommendations. J Int Soc Sports Nutr. 2018;15(1):38. doi:10.1186/s12970-018-0242-y

  4. Maughan RJ, Burke LM, Dvorak J, et al. IOC consensus statement: Dietary supplements and the high-performance athleteBr J Sports Med. 2018;52(7):439-455. doi:10.1136/bjsports-2018-099027

  5. Reardon CL, Creado S. Drug abuse in athletesSubst Abuse Rehabil. 2014;5:95-105. doi:10.2147/SAR.S53784

  6. U.S. Food and Drug Administration. Legal Requirements for the Sale and Purchase of Drug Products Containing Pseudoephedrine, Ephedrine, and Phenylpropanolamine. Updated November 24, 2017.

  7. Mozzarelli A, Ronda L, Faggiano S, Bettati S, Bruno S. Haemoglobin-based oxygen carriers: research and reality towards an alternative to blood transfusionsBlood Transfus. 2010;8 Suppl 3(Suppl 3):s59-s68. doi:10.2450/2010.010S