REVIEWSDrug Use in Sports: A Veritable Arena for Pharmacists
Section snippets
Objectives
This article describes the various opportunities and obligations for pharmacists in counseling, advising, and treating the athlete-patient with regard to doping control. Sports pharmacy is a specialty in pharmacy practice, however, pharmacists may be in a position to provide pharmaceutical care in a variety of settings, and need to consider the special needs of athlete-patients, including doping control issues. Pharmacists can also use their expertise on drugs to participate in education and
Background
The term doping is believed to be a derivative of the Dutch word doop for viscous opium juice, and has evolved to denote the use of performance-enhancing drugs in athletics.14,15 The World Anti-Doping Code, developed by the World Anti-Doping Agency (WADA), defines doping to include one or more of the following: “The presence of a prohibited substance or its metabolites or markers in an athlete's bodily specimen; use or attempted use of a prohibited substance or prohibited method; tampering, or
Patient Counseling
Pharmacists, in a variety of settings including community practice, dispense medications to athletes, and can offer advice on nonprescription products and dietary supplements. Pharmacists should question these patients as to whether they are competitive athletes subject to drug testing by a sports-governing body such as the NCAA, USADA, and professional-sports organizations. If so, pharmacists can help the athlete to avoid banned substances, which are generally considered ergogenic and
Doping Control Programs
Pharmacists are needed to participate in drug testing or doping control programs for the various sports and drug testing organizations (Table 3). Roles for pharmacists in this capacity can include being a resource or a consultant on drugs and other substances regarding whether to prohibit, restrict or permit them. Such categories are based on the potential for unfair or artificial performance-enhancing ergogenic effects, the potential for abuse, safety, efficacy, and therapeutic use of the
Stimulants
The use of stimulants to improve athletic performance is prevalent in both college and Olympic sports, and likely in professional sports as well.14,26–28 In a 2001 study of 21,225 college athletes who responded to a survey, the use of amphetamines and ephedrine was reported to be 3.3% and 3.9%, respectively.26 This is an increase in comparison with similar surveys conducted in prior years. Claims have been made that the majority of Major League Baseball (MLB) players use amphetamines or other
Dietary Supplements Used in Sports
An explosion of dietary supplements has bombarded the American public since the U.S. Congress passed the Dietary Supplement Health and Education Act (DSHEA) in 1994. DSHEA essentially allows substances that are marketed as dietary supplements to be regulated as foods rather than as pharmaceuticals. Dietary supplements under this regulation include vitamins, minerals, herbs and botanicals, amino acids, tissue extracts (e.g., enzymes or tissues from organs or glands), and concentrates,
Other Agents Used in Sports
A multitude of other drugs and supplements have been used by athletes in the hope of obtaining some performance-enhancing benefit. Without a doubt, others will be coming as some athletes will continue to strive for that chemical competitive edge. For example, ribose is a relatively new dietary supplement that is being marketed as an ergogenic aid, supposedly by increasing energy production in a similar fashion as creatine.123,124 Magazines and newspapers are replete with advertisements aimed at
Conclusion
Pharmacists can and should play an important role in doping control, in additional to counseling, advising, and treating athletes. When athletes take drugs for medical conditions, pharmacists can help prevent the inadvertent use of banned substances for those athletes subject to drug testing. Thus, pharmacists need to be familiar with how they can obtain information on banned, restricted, and permitted substances by the various sports-governing organizations. Pharmacists may also be in a
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Continuing education credits: See learning objectives and test questions at the end of this article, which is number 202-000-04-195-H01 in APhA’s educational programs. CEanswer sheets are located inside the back cover of this issue. To take the CE test for this article online, go to www.pharmacist.com/education.cfm, and follow the links to the APhACE center.
Disclosure: The author declares no conflicts of interest in any product or service mentioned in the article. The author receives compensation from the National Center for Drug Free Sport when conducting drug tests for the National Collegiate Athletic Association.
Acknowledgment: The author wishes to thank and acknowledge Frank D. Uryasz and Rachel Olander from the National Center for Drug Free Sport for reviewing the manuscript.