Fortnightly Review: Drugs in sport: Table 1

The use of drugs to enhance performance in sport will not go away.Athletes seek every competitive advantage and the rewards of success at top level are great, both financially and in personal glory.Almost all top level competitors are full time and, even if not paid, are to all purposes professional.There is huge pressure to train longer and harder and to take a scientific approach to nutrition and fluid and electrolyte balance, to seek every biomechanical and psychological advantage.It is almost inevitable that some will seek an advantage through drugs.Though there may be little clear objective scientific evidence of a benefit to be gained from drug use, what evidence there is supports the widespread belief among athletes that drugs help.Indeed, many believe that it is impossible to succeed without drugs.Though an athlete's motivation in taking drugs is understand- able, we cannot condone it.Firstly, it can be dangerous to the athlete's health and, secondly, it is against all principles of fair competition. MethodA systematic search ofthe literature is unlikely to tell the complete story in any review of drug abuse in sport.Doping in sport is essentially an underground activity with little formal published research in a topic which should not officially exist.Much of what is common knowledge is cloaked in rumour, suspicion, and suggestion, and the strategies adopted by athletes seem to be founded more on empiricism than published scientific data.The information presented in this review has been identified from several sources.A Medline search from 1966 to 1996 identified 620 references to the term "doping in sports."With the search restricted to humans (504) and to publications in English there were 389 references.Those references were subclassified into publications identfying side effects, prevalence, meth- ods of detection, and a fourth group composed of edito- rials, opinions, and reviews.Further references were identified from a search of the National Sports Medicine Institute database and a hand search of the past five years of the British Journal of Sports Medicine.