Illegal Doping Drugs in Sports

Weight lifting

Getty Images / Mel Curtis

Table of Contents
View All
Table of Contents

Doping drugs, also known as performance-enhancing drugs, are prohibited substances designed to improve performance. These substances can be dangerous and lead to negative health consequences for athletes. They can also result in being banned from competition.

What Are Doping Drugs?

Doping drugs are substances that are designed to enhance performance but are banned from use in sports. They may be prohibited from use because they are potentially harmful to the athlete, they degrade the integrity of sport, or both.

Anti-doping programs have been created to protect athlete health and to maintain the integrity of sports competition. These programs aim to keep everyone on a level playing field so one athlete doesn't have an unfair advantage over another.

Sports doping, drugs in sport, illegal steroids, blood doping, and banned supplements are all terms that refer to the illegal use of pharmaceutical and chemical substances prohibited in sports.

Why Athletes Use Doping Drugs

Elite-level athletes—including Olympic weightlifters, bodybuilders, sprinters, marathoners, and even archers and shooters, to name just a few—sometimes use doping drugs in an attempt to gain a competitive advantage.

Training programs are a fundamental tool for the development of high performance. Athletes follow specialized programs designed to help them reach their peak. Even so, some look to increase their advantage over opponents by utilizing illegal substances.

Types of Illegal Doping Drugs

Although testing provides some reassurance of legal competition, invariably, some doping instances will go undetected. Below are the most popular categories of banned performance-enhancing drugs and how they are used.

The World Anti-Doping Agency's 2021 Prohibited List shares all of the illegal performance-enhancing drugs and identifies whether they are prohibited at all times, prohibited only in competition, or prohibited in a particular sport.

Synthetic Anabolic Steroids

Anabolic steroids are popular agents in activities where bulk and strength count for performance. Although natural testosterone can be described as an anabolic agent, various synthetic versions of steroids have been made popular by bodybuilders.

The National Institute on Drug Abuse (NIDA) notes that steroid use is more common among male non-athlete weightlifters in their 20s or 30s. Additionally, those with poor self-esteem, increased depression, and poor knowledge of health are more likely to engage in steroid use.

Examples: anadrol, dianabol, stanozolol

Most steroids are relatively easy to detect and amateur cheating has a low rate of success.

Testosterone and Related Hormones

Testosterone is a natural hormone found in males and females, although men have markedly higher average testosterone than women. Increasing body testosterone provides an anabolic effect. Precursor hormones that lead to increased testosterone are also used.

Drug testers like to rely on 'normal ranges' because testosterone itself is naturally occurring. Laboratory reference ranges categorize normal testosterone levels in males to be 280 ng/dL to 1,100 ng/dL whereas the normal range for females is 15 ng/dL to 70 ng/dL.

Examples: testosterone, DHEA

Amphetamines and Other Stimulants

Various forms of stimulants, like different types of amphetamines, have been used in a variety of sports from football to cycling and weightlifting to sprinting. These chemical and drug agents work by stimulating the nervous system, improving an athlete's reaction time.

Some prescribed medications are also stimulants, such as those for attention-deficit hyperactivity disorder (ADHD). An athlete who is taking this type of stimulant must apply for a Therapeutic Use Exemption (TUE) in order to compete.

Examples: dexedrine, fenfluramine, phentermine


Erythropoietin, or EPO, is a hormone that increases red blood cell (RBC) production, which, in turn, improves oxygen availability to tissues. Increased oxygen improves performance, mainly in endurance events like marathons, triathlons, and endurance cycle racing.

EPO doping is sometimes referred to as gene doping. Because gene therapy has rapid advances, detecting this type of doping has been problematic. But some researchers are working to develop genetic detection tests to better determine if gene doping has occurred.

Examples: EPO, CERA

Blood Doping

Blood doping is the practice of drawing and saving your own blood, allowing the body to replenish its blood supply. The blood is then added back into the bloodstream to provide increased oxygen-carrying capacity, much like with EPO doping.

Diuretics and Other Masking Agents

Steroids and other drugs inevitably leave a trail that testers can find. One way to attempt to avoid this is to use another agent that increases urine output in the hopes of excreting traces of the banned drug. This is where diuretics and masking agents come into play.

However, testers are wise to this approach and look for masking agents as well as banned substances. So, there is no way to escape detection unless the masking agent or diuretic is excreted or metabolized as well.

Examples: acetazolamide, chlorthalidone, desmopressin

Fat Burners

Some athletes use drugs that promote muscle at the expense of fat. These doping drugs can very sophisticated, with compounds like those used in traditional weight-loss treatments acting as a potential performance-enhancing agent.

One example of a fat-burning drug that was also considered a bodybuilding aid is DNP—short for 2,4-dinitrophenol. But it gained the attention of the World Anti-Doping Agency after killing one person and leaving another seriously ill. Now it is on the agency's Prohibited List.

Examples: clenbuterol, oxilofrine

DNP has also sometimes been used in the manufacturing of explosives, highlighting just one of the reasons it is dangerous for human consumption.

Growth Hormones

Human growth hormone or HGH has been used as a supplemental drug for many years by bodybuilders and, more recently, by athletic sprinters. HGH is a naturally occurring substance produced by the body.

Testers look for a range of drugs that stimulate growth hormone production in the body. Among them are fibroblast growth factors (FGFs), hepatocyte growth factor (HGF), insulin-like growth factor 1 (IGF-1), and platelet-derived growth factor (PDGF).

Peptide Hormones

Athletes may use peptides, which are essentially small proteins, for a range of performance targets. These targets include stimulating the production of growth hormone (GH) and enhancing muscle growth.

A majority of peptides used as doping drugs have not been approved for human consumption. This puts the athlete at risk since there is no clear understanding of how that particular substance affects the body.

Examples: chorionic gonadotrophin, corticorelin, luteinizing hormone


Beta-blockers are a class of drugs traditionally used in heart disease and blood pressure treatment. They slow the heart rate down substantially. Competitors such as archers, shooters, and billiards players have used them to steady their shots.

In archery and shooting, beta-blockers are prohibited at all times; in other sports—which include billiards, darts, and golf, for instance—they are only banned during competition.

Examples: acebutolol, celiprolol, propranolol

Other Substances

This group includes chemical agents with somewhat idiosyncratic uses, ranging from hormonal manipulation to metabolic effects. For example, men have used the anti-estrogen drug tamoxifen, prescribed for breast cancer treatment, to oppose the estrogenic effects of anabolic steroids.

Additional banned substances during competition include:

  • Narcotics (fentanyl, morphine, oxycodone)
  • Cannabinoids (except cannabidiol)
  • Glucocorticoids (cortisone, hydrocortisone, methylprednisolone)

Detecting Illegal Doping

Testing for illegal performance enhancing drugs in sports involves taking the athlete's urine or blood, then shipping it to a laboratory accredited by the World Anti-Doping Agency. This process is designed to protect the integrity of the sample taken.

If an athlete tests positive for a banned substance, the consequences can include disqualification, sanctions, and/or suspension. Anti-doping regulations are strict and hold athletes responsible for everything they put in their bodies, whether prescribed or not.

Even seemingly safe dietary supplements can sometimes present an issue for athletes because some have been found to contain banned substances. If these substances are detected, it can cause a positive result.

Drug testing of athletes is very sophisticated in the modern era and basic doping attempts will almost certainly be detected, resulting in the athlete being disqualified. Yet, while testing sophistication has grown, so has the ingenuity of the drug cheats.

Health Risks of Illegal Doping

In addition to risking their sports career, athletes who dope are also risking their own health. Potential health consequences associated with doping drugs include:

  • Heart problems
  • Strokes
  • Mental health effects
  • Kidney or liver damage
  • Reduced fertility in both men and women
  • Brain damage

Frequently Asked Questions

What percentage of athletes use performance-enhancing drugs?

Studies suggest that 14% to 39% of adult elite athletes intentionally use doping. For recreational athletes, the figure is around 18.4%. However, some researchers say that it's hard to know how many athletes use banned substances because of inconsistent data reporting.

Are there any performance-enhancing drugs allowed in sports?

If a performance-enhancing drug is not on the World Anti-Doping Agency's Prohibited List, it is allowed in sports; however, that substance must also be approved by a governmental health authority for use by humans as a therapeutic.

Why is it important to test athletes for performance-enhancing drugs?

Performance-enhancing drugs can be harmful to an athlete's health while also providing an unfair competitive advantage. Testing for these drugs helps to protect the athlete's health while also protecting the integrity of sport.

What are the side effects of performance-enhancing drugs?

Side effects of performance-enhancing drugs vary based on the substance used but can sometimes include:

  • Anabolic steroids: Acne, male pattern baldness, increased aggressiveness, impotence, increased breast size in males, growth of facial and other body hair in females
  • EPO: Hypertension, anemia, stroke, blood cancer
  • Blood doping: Blood clots, stroke
  • Human growth hormone: Thyroid issues, severe headaches, loss of vision, diabetes, tumors, arthritis
  • Beta blockers: Reduced blood pressure, sleep issues, airway spasms
  • Diuretics: Dehydration, muscle cramps, dizziness, poor coordination, and balance
  • Stimulants: Insomnia, anxiety, tremors, increased blood pressure, heart attack, stroke
  • Cannabinoids: Heart rate increases, short-term memory issues, reduced reactivity and coordination
  • Narcotics: Nausea, vomiting, decreased heart rate

A Word From Verywell

While many athletes don't rely on performance-enhancing substances, some do turn to illegal doping. These substances have negative consequences for both individual health and the integrity of sport.

39 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. American College of Medical Toxicology. The history of doping.

  2. World Anti-Doping Agency. World Anti-Doping Code 2021.

  3. National Institute on Drug Abuse. Who uses anabolic steroids?.

  4. Pany S, Panigrahi SK, Rao EV, Patnaik L, Sahu T. Anabolic androgenic steroid abuse and their health impacts: A cross-sectional study among body builders in a city of eastern IndiaInt J Prev Med. 2019;10:178. doi:10.4103/ijpvm.IJPVM_524_17

  5. National Institutes of Health. National Institute on Drug Abuse. How are anabolic steroids tested in athletes? February 2018.

  6. van Anders SM, Steiger J, Goldey KL. Effects of gendered behavior on testosterone in women and men. Proc Natl Acad Sci U S A. 2015;112(45):13805-13810. doi:10.1073/pnas.1509591112

  7. University of Rochester Medical Center. Total testosterone.

  8. Collomp K, Buisson C, Gravisse N, et al. Effects of short-term DHEA intake on hormonal responses in young recreationally trained athletes: modulation by genderEndocrine. 2018;59(3):538-546. doi:10.1007/s12020-017-1514-z

  9. Avois L, Robinson N, Saudan C, Baume N, Mangin P, Saugy M. Central nervous system stimulants and sport practiceBr J Sports Med. 2006;40 Suppl 1(Suppl 1):i16-i20. doi:10.1136/bjsm.2006.027557

  10. UFC Anti-Doping Program. What do athletes with ADHD need to know about TUEs?.

  11. Heal DJ, Smith SL, Gosden J, Nutt DJ. Amphetamine, past and present--a pharmacological and clinical perspectiveJ Psychopharmacol. 2013;27(6):479-496. doi:10.1177/0269881113482532

  12. de Boer E, van der Wouden P, Johansson L, van Diemen C, Haisma H. A next-generation sequencing method for gene doping detection that distinguishes low levels of plasmid DNA against a background of genomic DNA. Gene Ther. 2019;7-8):338-46. doi:1038/s41434-019-0091-6

  13. Leuenberger N, Lamon S, Robinson N, Giraud S, Saugy M. How to confirm C.E.R.A. doping in athletes’ blood?Forensic Sci Int. 2011;213(1-3):101-103. doi:10.1016/j.forsciint.2011.07.053

  14. Barnes KP, Rainbow CR. Update on banned substances 2013Sports Health. 2013;5(5):442-447. doi:10.1177/1941738113478546

  15. World Anti-Doping Agency. INTERPOL issues global alert for potentially lethal illicit diet drug.

  16. Guddat S, Fußhöller G, Geyer H, et al. Clenbuterol - regional food contamination a possible source for inadvertent doping in sportsDrug Test Anal. 2012;4(6):534-538. doi:10.1002/dta.1330

  17. Cohen PA, Avula B, Venhuis B, Travis JC, Wang Y-H, Khan IA. Pharmaceutical doses of the banned stimulant oxilofrine found in dietary supplements sold in the USADrug Test Anal. 2017;9(1):135-142. doi:10.1002/dta.1976

  18. van den Broek I, Blokland M, Nessen M, Sterk S. Current trends in mass spectrometry of peptides and proteins: application to veterinary and sports-doping control. Mass Spectrom Rev. 2013;34(6):571-94. doi:10.1002/mas.21419

  19. Zvereva I, Semenistyaya E, Krotov G, Rodchenkov G. Comparison of various in vitro model systems of the metabolism of synthetic doping peptides: proteolytic enzymes, human blood serum, liver and kidney microsomes and liver S9 fraction. J Proteomics. 2016;149:85-97. doi:10.1016/j.jprot.2016.08.016

  20. Hughes D. The world anti-doping code in sport: update for 2015Aust Prescr. 2015;38(5):167-170. doi:10.18773/austprescr.2015.059

  21. World Anti-Doping Agency. What is prohibited in particular sports.

  22. Čižmáriková R, Habala L, Valentová J, Markuliak M. Survey of pharmacological activity and pharmacokinetics of selected β-adrenergic blockers in regard to their stereochemistryAppl Sci. 2019;9(4):625. doi:10.3390/app9040625

  23. Salvador JP, Vila-Roca E, Monfort N, Ventura R, Marco MP. New approach based on immunochemical techniques for monitoring of selective estrogen receptor modulators (SERMs) in human urine. J Pharmaceut Biomed Analy. 2018;156:147-52. doi:10.1016/j.jpba.2018.04.027

  24. World Anti-Doping Agency. Prohibited In-Competition.

  25. UFC Anti-Doping Program. Sample collection process.

  26. World Anti-Doping Agency. Athletes and medications.

  27. Smith T, Fedoruk M. Performance-enhancing drug use in recreational athletes. Am Fam Physician. 2021;103(4):203-4.

  28. Tlili R, Zayed S, Saoudi W, Azaiez F, Hentati R, Ben Ameur Y. Adverse cardiovascular effects of doping in athletes. Tunis Med. 2019;97(11):1211-1218.

  29. Alexandrino G, Damasio J, Canhao P, et al. Stroke in sports: a case series. J Neurol. 2014;261:1570-4. doi:10.1007/s00415-014-7383-y

  30. Fadlih AM, Idham AF, Nugraha AI, Dongoran MF. Effects of doping on physical and mental health of sports athletes. Enferm Clin. 2020;30 Suppl 4:504-6. doi:10.1016/j.enfcli.2020.03.011

  31. Nieschlag E, Vorona E. Doping with anabolic androgenic steroids (AAS): adverse effects on non-reproductive organs and functions. Rev Endocr Metab Disord. 2015;16:199-211. doi:10.1007/s11154-015-9320-5

  32. Sansone A, Sansone M, Vaamonde D, et al. Sport, doping and male fertility. Reprod Biol Endocrinol. 2018;16:114. doi:10.1186/s12958-018-0435-x

  33. La Vignera S, Condorelli R, Cannarella R, Duca Y, Calogero A. Sport, doping and female fertility. Reprod Biol Endocrinol. 2018;16:108. doi:10.1186/s12958-018-0437-8

  34. National Institute on Drug Abuse. Health consequences of drug misuse, neurological effects.

  35. de Hon O, Kuipers H, van Bottenburg M. Prevalence of doping use in elite sports: a review of numbers and methods. Sports Med. 2015;45:57-69. doi:10.1007/s40279-014-0247-x

  36. de Araujo M. Androgen abuse among recreational athletes. Rev Bras Ginecol Obstet. 2019;41(12). doi:10.1055/s-0039-3401007

  37. Gleaves J, Petroczi A, Folkerts D, et al. Doping prevalence in competitive sport: evidence synthesis with "best practice" recommendations and reporting guidelines from the WADA Working Group on doping prevalence. Sports Med. 2021. doi:10.1007/s40279-021-01477-y

  38. World Anti-Doping Agency. World Anti-Doping Code International Standard Prohibited List 2021.

  39. US Anti-Doping Agency. Effects of performance-enhancing drugs.

Additional Reading

By Christina DeBusk
Christina DeBusk is a personal trainer and nutrition specialist.