Performance Enhancing Drugs (Recap and Application)
Why PEDs in This Unit?
Performance-enhancing drugs (PEDs) were introduced in the Physical Training topic because they are a training-related issue — athletes use them to accelerate physical adaptation. In this unit, PEDs return in a different context: as an ethical and socio-cultural issue. Having already encountered the categories and physiological effects, here the focus shifts to why athletes take PEDs, what this means for sporting integrity, and the broader consequences for the sport and society. This dual-context approach mirrors the way PEDs actually function in sport: they are simultaneously a performance question and an ethical question.
Categories of Performance-Enhancing Drugs
Performance-enhancing drugs (PEDs) cover a wide range of substances and methods. The World Anti-Doping Agency (WADA) maintains the prohibited list. The spec identifies the following categories:
Stimulants increase central nervous system activity, raising alertness, reducing fatigue and increasing heart rate. They can improve speed and reaction time in the short term. Examples include amphetamines and cocaine. Side effects include increased risk of heart attack, aggression, addiction and overheating during exercise.
Anabolic steroids (anabolic agents) mimic the effects of testosterone, dramatically increasing protein synthesis in muscle cells. This accelerates muscle hypertrophy and strength gains, enabling athletes in power and strength sports (weightlifting, sprinting, throwing events) to develop far beyond natural limits. Long-term side effects include liver damage, cardiovascular disease, hormonal disruption, mood disorders and, in adolescents, stunted growth. In women, virilisation (development of male characteristics) occurs.
Narcotic analgesics block pain signals, allowing athletes to train or compete through injuries they would otherwise be unable to tolerate. They carry significant risks of addiction, physical dependence and masking of injuries that then worsen undetected. Examples include opioids such as morphine.
Peptide hormones include erythropoietin (EPO) and growth hormone (GH). EPO stimulates bone marrow to produce additional red blood cells, dramatically increasing the blood’s oxygen-carrying capacity and endurance performance. It was widely abused in cycling in the 1990s. Growth hormone increases muscle mass and reduces fat mass. Both are difficult to detect with current testing methods, making them particularly problematic. EPO also significantly increases blood viscosity, raising the risk of stroke and heart attack — particularly dangerous when used by athletes training at altitude who are already dehydrated.
Six PED categories on the spec: stimulants (alertness, reaction time; heart risk), anabolic steroids (muscle growth; liver damage, hormonal disruption), narcotic analgesics (pain blocking; addiction, injury masking), peptide hormones/EPO (red blood cell production; blood viscosity, stroke risk), diuretics (weight loss, mask other drugs; dehydration), beta blockers (reduced heart rate; allowed in some sports, banned in others). Blood doping is a non-drug method with similar effect to EPO.
Diuretics increase urine production. Athletes in weight-class sports (boxing, judo, wrestling) use them to rapidly shed water weight before weigh-in. They are also used to dilute urine samples and mask the presence of other banned substances. Side effects include severe dehydration, electrolyte imbalance and muscle cramps — particularly dangerous for athletes who must then compete shortly after.
Beta blockers reduce heart rate, blood pressure and tremor. They are used in precision sports where a slower, steadier heart rate and reduced muscle tremor improve performance — archery, shooting, snooker and golf. They are banned in these specific sports but permitted in most others, where their use provides no performance benefit. Side effects include bradycardia (excessively low heart rate) and reduced exercise capacity in aerobic sports.
Blood doping involves transfusing extra red blood cells (either from a donor or from the athlete’s own previously stored blood) into the bloodstream before competition. Like EPO, it increases the blood’s oxygen-carrying capacity, boosting endurance performance. Blood doping also increases blood viscosity, raising cardiovascular risk. The method is banned under WADA rules.
Why Do Athletes Take PEDs?
The reasons are primarily economic and competitive. At elite level, the financial gap between winning and placing second is enormous. Sponsorship deals worth millions of pounds depend on results. Career length in professional sport is short, and every season of reduced performance risks being replaced. The pressure to win is compounded by the knowledge or suspicion that opponents may also be using PEDs, creating an “arms race” mentality: if everyone else is doing it, abstaining simply means losing.
Cultural factors also play a role. In some sports, the culture of PED use becomes normalised within training environments — as discussed in the previous lesson on deviance. Coaches, managers or teammates may actively encourage use, or the availability of banned substances through support networks may make access easier than resistance. Psychological factors — body dysmorphia, perfectionism and the desperate desire to perform — also contribute in individual cases.
When doping scandals become public, the consequences for a sport are severe and long-lasting. Public trust in the authenticity of results is damaged — if medals and records were achieved through doping, they become meaningless. Sponsors, fearing reputational contamination, withdraw funding. Media coverage shifts from celebrating performance to reporting scandal, changing the narrative around the sport. Governing bodies must invest heavily in anti-doping infrastructure, diverting resources from athlete development. Clean athletes who competed fairly are disadvantaged and emotionally harmed. In the most serious cases, entire national programmes are banned from international competition. The systematic doping programmes exposed in several countries in recent decades have caused all of these harms simultaneously.
WADA and national anti-doping agencies use urine and blood testing to detect prohibited substances. However, detection is an arms race: as new testing methods are developed, athletes and their support teams adapt their doping strategies to evade them. Microdosing (using very small amounts of EPO that fall below detection thresholds) and transfusing autologous blood (the athlete’s own stored blood, which is biologically indistinguishable from natural blood) are examples of evasion methods. The Biological Passport — which monitors athletes’ blood values over time and flags abnormal fluctuations rather than detecting specific substances — has improved detection but remains imperfect. The challenge of detection is one reason why cultural change within sport, rather than testing alone, is seen as essential for genuinely clean competition.
Three commonly tested PEDs: anabolic steroids (benefit: rapid muscle growth; risk: liver damage, hormonal disruption); EPO (benefit: increased red blood cell count and endurance; risk: increased blood viscosity, stroke); beta blockers (benefit: reduced tremor for precision sports; risk: bradycardia, impaired aerobic capacity in endurance sports).