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The use of drugs by amateur and professional athletes has received much publicity in recent years. Many athletes believe that drugs are essential for optimum performance. The issue of whether drugs can enhance physical performance remains controversial and unresolved. However, the physiological effects that drugs have on the body can be documented. This section is devoted to examining the most-common drugs used by athletes.

Questions of legality or ethics are best answered by the prevailing view in sports medicine: The use of drugs is generally considered unethical--in some cases illegal--and such use is usually forbidden by organizations that govern competitive athletics.

Some athletes take synthetic male hormones (anabolic steroids) in the hope of increasing strength or muscle mass. The most common synthetic male hormones taken by athletes include testosterone, methandrostenolone, and nandrolone.

Effects in Females -- Muscle mass increases when the hormone is taken for a sufficiently long period of time. However, side effects and adverse reactions include the following:

  • Growth of hair on the face and other body parts.
  • Enlargement of the clitoris.
  • Deepening of the voice.
  • Acne.
  • Baldness.
  • Change in sex drive (usually increased).
  • Irregular menstrual periods.
  • Depression.

    Effects in Males -- Strength and body weight sometimes increase. However, many side effects and adverse reactions are possible. These include:

  • Decreased levels of FSH (follicle-stimulating hormone) and leutenizing hormone. These in turn cause decreased male-hormone production, decreased sperm production, and testicular atrophy.
  • A decrease in high-density lipoprotein, which may increase the likelihood of hardening of the arteries, stroke, and kidney disease.
  • Increased incidence of liver tumors.
  • Increased aggressiveness.
  • Acne.
  • Depression.
  • Change in sex drive (sometimes lessened, sometimes increased).

    The consensus among medical experts is that the use of anabolic steroids by both males and females poses greater risk and danger from adverse effects than is justified by any possible benefit. Physicians uniformly advise against using them. Their use is condemned by the Medical Commission of the International Olympic Committee.

    These drugs are central-nervous-system stimulants. Athletes take them believing they will help performance in competition. Studies show that performance is actually diminished, despite the feeling on the part of the athlete that performance is outstanding. The toxic effects of amphetamines are:

  • Tremor.
  • Confusion.
  • Restlessness.
  • Loss of appetite.
  • Delusions and hallucinations.
  • High blood pressure.
  • Heartbeat irregularities.

    Amphetamines are particularly dangerous if taken with other stimulants such as cocaine, appetite suppressants, and caffeine.

    Caffeine is also a central-nervous-system stimulant. When taken in small, infrequent doses, caffeine seems to have few if any long-lasting ill effects. However, new evidence suggests a correlation between consumption of any coffee--including decaffeinated coffee -- and an increase in low-density lipoproteins. High levels of these fatty elements in the blood are known to increase the likelihood that arteriosclerosis (hardening of the arteries), heart disease, kidney disease and stroke will develop later in your child's life. This effect is noted with the consumption of as little as 2 cups of coffee per day.

    The immediate effects of caffeine consumption vary from person to person, depending on individual factors. Most adults can tolerate 2 cups of caffeine-containing liquid a day, but children should avoid caffeine, which is present in many carbonated soft drinks. Too much caffeine will produce the following:

  • Nervousness, irritability, and rapid heartbeat.
  • Insomnia.
  • Increased urine output.
  • Symptoms of low blood sugar (hypoglycemia), including tremor, weakness, and increased irritability.

    Some people believe caffeine consumption relieves fatigue, but this is an artificial effect. Use of caffeine does not result in increased athletic performance.

    This central-nervous-system stimulant has similar effects to those of amphetamines and caffeine -- except stronger. Cocaine is illegal and addicting. Its use can lead to delusions, psychosocial problems, tremor, restlessness, and damage to nasal tissues (if "snorted"). An overdose of cocaine can be fatal. Its damaging effects on the central nervous system increase greatly when it is taken with other stimulants such as amphetamines, appetite suppressants, or caffeine. Medical experts have documented no benefits from the use of cocaine among athletes.

    This is the addicting factor in tobacco smoke that makes smoking cessation so difficult for many persons. Nicotine causes constriction of peripheral blood vessels. It also causes an increase in heart rate that does not result in increased cardiac output. The result of these two effects is increased fatigue and diminished athletic performance.

    All effective medications have potential side effects for at least some individuals. Your child should not expect to be able to perform at his accustomed level if he is taking any medication.

    Safety precautions for athletes are similar to those for the general population. The most important additional precaution for athletes relates to fluid loss that accompanies heavy sweating. Drugs most likely to become dangerous under these conditions are:

  • Digitalis (a heart medicine).
  • Diuretics (medicine to treat high blood pressure and heart problems).
  • Steroid hormones.

    All the above can cause excessive loss of sodium and potassium from the body. The effect of these drugs may be accelerated by fluid loss, as in heavy sweating, diarrhea, and vomiting, particularly in hot weather. Excessive sweating from any cause may require a dose modification of digitalis, diuretics, or hormones. Let your doctor know if your child exercises vigorously.

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