Chapter 683 Performance-Enhancing Aids

Performance-enhancing drugs have been used by athletes since at least since 776 BCE. Ergogenic aids are substances used for performance enhancement, most of which are unregulated supplements (Table 683-1). The 1994 Dietary Supplement and Health Education Act limited the ability of the U.S. Food and Drug Administration to regulate any product labeled as a supplement. Many agents have significant side effects without proven ergogenic properties. In 2005, the American Academy of Pediatrics published a policy statement strongly condemning their use in children and adolescents. The US 2004 Controlled Substance Act outlawed the purchase of steroidal supplements such as tetrahydrogestrione (THG), and androstenedione (Andro), with the exception of dehydroepiandrosterone (DHEA).

Table 683-1 ERGOGENIC DRUGS

The prevalence of lifetime steroid use is highest among boys and in the USA (5.1%); The European School Survey Project on Alcohol and Other Drugs found that 1% of European youth reported any use of steroids. Trends indicate that use of steroids declined by half from 2006-2010. Steroids in oral, injectable, and skin cream form are taken in various patterns. Cycling describes taking multiple doses of steroids for a period, ceasing, and then starting again. Stacking refers to the use of different types of steroids in both oral and injectable forms. Pyramiding involves slowly increasing the steroid dose to a peak amount and then gradually tapering down.

Anabolic-androgenic steroids (AAS)

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