The desire to win at all costs coupled with economic incentives and social pressures have lead athletes to drug taking or doping to enhance their performance. In 1999, an internationally independent organization, the World Anti-Doping Authority (WADA) was established to fight doping in sport and is assisted by various member organizations like the United States Anti-Doping Agency (USADA), National Anti-Doping Agency (NADA) India and many others. Over 190 banned drugs and ‘performance enhancing methods’ (such as blood doping) are registered by WADA, a list which is constantly updated as new drugs emerge. A substance can be considered for inclusion on the World Anti-Doping Code Prohibited List if it meets two of the following three criteria: 1) it is or potentially is performance-enhancing, 2) it is or potentially is harmful to the athlete's health, and 3) it violates the spirit of sport. WADA makes the final determination on whether a substance or method is included on the prohibited list.

This article looks at the different types of performance enhancing drugs.


Stimulants are drugs that directly affect the central nervous system. They work to speed up parts of the brain and body, increasing the heart rate, blood pressure, metabolism and body temperature of the user. They are used by athletes to reduce tiredness and fatigue, and to increase alertness, competitiveness and aggressiveness. The most common stimulants detected in anti-doping tests include amphetamines, cocaine, ecstasy and methylphenidate (Ritalin). The actual effects vary according to the drug and to its method of ingestion—drugs that are snorted or injected will produce more immediate results than those that are taken in pill form. Nicotine and Caffeine are also frequently used as stimulants but they are not banned in sports. However, both substances are currently on the WADA Monitoring Program for 2015. WADA is observing them in order to detect potential patterns of misuse in sport.

Anabolic steroids

Anabolic steroids are drugs derived from testosterone, a hormone which is produced in the testes of males and, to a much lesser extent, in the ovaries of females. Testosterone is partially responsible for the developmental changes that occur during puberty and adolescence and is also involved in controlling the build-up and breakdown of the main biochemical components of all tissues, including muscle.

Human growth hormone

Human growth hormone (HGH; also called somatotrophin or somatotrophic hormone) is a naturally-occurring hormone produced in the human body. It promotes physical development—particularly the growth of bone—during adolescence. It stimulates the synthesis of collagen, which is necessary for strengthening cartilage, bones, tendons and ligaments, and also stimulates the liver to produce growth factors. In adults, HGH increases the number of red blood cells, boosts heart function and makes more energy available by stimulating the breakdown of fat. Other effects attributed to HGH include increase in muscle mass and strength as well as tissue-repairing (recovery). However, as HGH is often used in conjunction with other PEDs its direct role in these benefits is unproven. Still, it is quite easy to see why athletes believe it will enhance their performance. Because HGH is a protein hormone, it is possible to manufacture large amounts of HGH using recombinant DNA technology. 

Blood doping

Blood doping is the use of various methods and substances to increase a person’s red blood cell mass. Higher levels of red blood cells in the blood result in more oxygen being transported to the muscles, resulting in increased stamina and performance. There are three main types of blood doping:

  • erythropoietin (EPO)
  • synthetic oxygen carriers
  • blood transfusions.

All methods of blood doping are prohibited by the WADA.

Blood transfusions

Blood transfusion is an effective and relatively simple method of allowing athletes to boost the number of red blood cells in their blood, improving their aerobic capacity and endurance. Blood transfusions can be classified as autologous, where the athlete receives pre-prepared doses of his/her own blood, or allogenic, where the transfused blood comes from someone else. Athletes who choose to use this method generally begin undergoing blood withdrawals several weeks before a competition, building up a supply of blood between 450 ml and 1800 ml. The plasma is returned to the body during the withdrawal while the corpuscular elements—basically the red blood cells (RBCs)—are stored. These can then be re-infused in the patient directly before or during a high-endurance event.The re-infused blood greatly increases the number of red blood cells in the blood, boosting the blood’s ability to bring oxygen to tired muscles.

Beta Blockers

Beta Blockers work to block the effects of adrenaline. They work to slow the heart rate, thereby reducing blood pressure, anxiety and muscle tremors, and improving the ability to focus. This makes them particularly useful to athletes performing in sports that require a steady hand such as shooting, archery, darts, snooker, even golf. Beta Blockers are prohibited by several sports (darts, racing) during competition, but others (archery, shooting) always prohibit their use .


Diuretics work to promote the production of urine. While putting your hand up for a toilet break may not be deemed professional in modern sport, athletes use diuretics to assist with weight-loss (the loss of water through urination leads to an overall loss of body weight). This is particularly useful in sports where weight is critical such as boxing, rowing or horse-racing. An added benefit of all these toilet breaks is that other drugs present in the system could also more quickly be ‘flushed out’ of the body. The increased urine volume also aids in the dilution of doping agents and their metabolites. All classes of diuretics are considered to be ‘masking agents’ by WADA and are banned both in and out of competition. Diuretics have been banned in sport since 1988.