Integra

Introduction

Since ancient times till nowadays, doping has been an "evil" ally in the athletic field considered to be a main link in the game of victory. In the 6th century b.C., in Ancient Greece aided by specialists, athletes strived to increase the strength of their muscles by mixing various kinds of meat (e.g. goat with bull). Soon "natural" doping was substituted by "pharmaceutical" doping (first use of p. doping Amsterdam - 1865) by the administration of heroin and cocaine. Health problems appeared in athletes, which were exclusively due to pharmaceutical doping beginning with the first known death from collapsus approximately 120 years ago.

Methods

The two larger classes of p. doping were examined: the steroid anabolics and the psychomotor drugs. Testosterone is the first to be classified in the category of steroid anabolics. Among the many drugs available the most important are nandrolone, methanole, methandienone and northandrolone that are basically used to increase protein metabolism, while recently the steroid THG (tetrahydrogestrinone) has been invented and is under examination by WADA. As regards the psychomotor stimulants and narcotics the most significant are amphetamine (as its derivates ethylamphetamine, benzamphetamine, diethylproprione), caffeine, ephedrine, and cocaine while in the narcotic class is classified the methadone group, which includes methadone and dipipanone (synthetic eptanones). Also the morphine group is classified in this category, which includes morphine, the semisynthetic opiate diamorphine (heroin) and the synthetic opiate derivatives levorphanole, dextromoramide, phenazokine and pentazokine. Finally in this class also belongs the codeine group. Also, a CNS stimulant, which is often found, is strychnine.

Results
In the patients who used either anabolic steroids or psychomotor drugs a multitude of health problems emerged. In particular, the CNS stimulants as amphetamines due to their actions (powerful CNS stimulants and of the a-b sympathetic receptors) cause serious adverse events to the cardiovascular system (circulation) as well as in the CNS. A mental addiction emerges where the athlete often does not realize that he/she is exceeding his/hers limits, which results in exhaustion, which may lead to death. Also at the level of mental health, under the influence of amphetamines and other compounds as ephedrine, caffeine, etc. hostility and aggressiveness appear. Similarly the unwise use of cocaine causes cardiovascular collapsus, arrhythmia, ischemic episodes, myocardial infractions, migraine symptoms and often lung damage. As regards the analgesic narcotics, as are morphine, heroin, codeine, methadone, often in mild toxicity cause euphoria, drowsiness and dilated pupils. A more serious toxicity may cause hypotension, bradycardia, hypothermia and coma. On the other side, steroid anabolics in contrast to the former compounds cause long-term problems, many of which emerge after the athlete’s carrier is over. In men as well as in women acne often develops due to increased secretion of sebum by the sebaceous glands. In men cause azoospermia and disorders in prostate gland function. In women hirsutism, voice changes and menstruation disorders. Also appears hypercalcemia, which often leads to increased blood pressure as well as nephrolith formation (which often leads to kidney destruction) and further, peptic ulcers. Carbohydrate metabolism is affected decreasing serum glucose levels (hypoglycemia), which results in the increase of fatty acid concentration and consequently leads to their conversion to cholesterol and ketone bodies. Steroid administration often leads to hepatic damage due to toxicity with the development of icterous. Due to hepatic function inhibition liver cirrhosis often develops, which results in the intumescence of the liver and the development of portal hypertension. One of the greater risks however, from steroid anabolics is the development of hepatocellular carcinoma, which even in low doses (10-15 mg) for a few months is sufficient for its emergence.

Conclusions

Up to the present, there are many cases of athletes who used doping and suddenly lost their lives (collapsus) due to the use of psychomotor drugs or had to "compromise" with the idea of long-term serious diseases for which the steroid anabolics are responsible. Even the most "innocent" pills such as vitamins may cause problems if not used correctly. Today, efforts are made to create a laboratory monitoring of doping in order to avoid such problems so to ensure the whole result of a victory, but above all to preserve the most valuable asset: the athlete’s health.

References

[1] Doping, A Concise Presentation Of The Problem. Antonis Koutselinis
[2] Clinical Pharmacology (5th Edition). Paul Turner, Alan Richens, Philip Roytledge.
[3] Current Medical Diagnosis & Treatment (42nd Edition). Lawrence M. Tierney Jr., Stephen J. Mcphee, Maxine A. Papadakis