The use of performance-enhancing drugs (PEDs) and certain medications in sport has significant implications for injury management, performance enhancement, athlete health and the integrity of competition. While some substances are medically necessary for injury treatment, misuse or illegal use of drugs in sport raises serious concerns.

Health Implications

Drug use, particularly without medical supervision, can lead to both short and long-term health consequences. For example,

• Anabolic steroids: Promote muscle repair and growth but may cause liver damage, heart disease, hormonal imbalances and reproductive issues.

• Growth hormone: May accelerate tissue repair but can lead to joint pain, diabetes and organ enlargement.

• Stimulants (e.g. amphetamines): Can improve alertness but increase risk of heart attack, insomnia and anxiety.

• Painkillers and anti-inflammatories: May allow early return from injury but can mask symptoms, leading to further damage.

• Mood swings, aggression (“roid rage”), depression and dependency are associated with long-term use of PEDs and pain-numbing substances.

Ethical Considerations

The use of drugs in sport challenges fundamental ethical values such as fairness, responsibility and integrity. Athletes who use banned substances gain an unfair advantage, violating the principle of equal opportunity in competition. Drug use by elite athletes can send harmful messages to young or impressionable athletes, suggesting that success depends on artificial enhancement. Athletes may also feel coerced into drug use by coaches, sponsors, or peers especially in high-performance environments. Ethically, all medical treatments, including drugs for injury management, should involve informed decision-making, with awareness of risks and alternatives.

Drug Testing

Drug testing is used to detect banned substances, deter misuse and maintain integrity in sport. It is carried out by agencies such as Sport Integrity Australia and World Anti-Doping Agency (WADA). Methods include urine and blood testing, in-competition and out-of-competition. Random and targeted testing, including biological passports are used to monitor long-term markers. Athletes are subject to strict liability; they are responsible for everything in their body, including accidental ingestion of banned substances. Therapeutic Use Exemptions (TUEs) are required when an athlete needs a banned substance for medical reasons (e.g. corticosteroids for inflammation). Consequences of positive tests include suspensions or bans from competition, damage to reputation and career, financial penalties and loss of sponsorships.