EDUCATION ABOUT PERFORMANCE-ENHANCING SUBSTANCES

To encourage pharmacists to engage in and advise community outreach efforts informing the public on the risks associated with the use of performance-enhancing substances, including but not limited to medications; further,

To educate patients on the importance of disclosing the use of performance-enhancing substances that may or may not be prescribed for legitimate medical indications; further,

To encourage pharmacists to advise athletic authorities, athletes, the community, and healthcare providers on the dangers of performance-enhancing substances and other products that are prohibited in competition; further,

To advocate for the role of the pharmacist in all aspects of performance-enhancing substances control.

Rationale

The risks of using performance-enhancing substances (PES) are well documented in sports medicine journals and other biomedical literature. The U.S. Anti-Doping Agency (USADA) maintains a comprehensive list of performance-enhancing substances that are banned for U.S. athletes competing in the Olympics. In addition to anabolic steroids, the list includes hormones and hormone-like substances (e.g., insulin, tamoxifen); beta-2 agonists; diuretics; red blood cells (RBC) in any form and RBC enhancers; agents that alter genes or genetic expression; stimulants (including caffeine and nicotine); narcotics; cannabinoids; and glucocorticoids. Certain dietary supplements that are known to contain prohibited substances are also banned. The U.S. Food and Drug Administration has also identified dietary supplements that contain pathogens (e.g., Salmonella), contaminants (e.g., lead or mercury), or undeclared prescription drug ingredients (e.g., ephedrine, sildenafil, or dexamethasone).

Although such authorities as the National Collegiate Athletic Association and the USADA have implemented bans on use of these agents and drug testing policies to enforce them, these strategies have been only partially effective in curbing the use of PES. In addition, use of PES has spread beyond professional athletes to military personnel, recreational body builders, professional entertainers, and others wishing to lose weight, increase muscle mass, improve alertness, and increase stamina.

Pharmacists, as medication-use experts and the most-accessible healthcare provider in many communities, can play an important role in community outreach efforts to provide education regarding the use of performance-enhancing substances, including medications, and the importance of disclosing any such use to their healthcare providers.