Use of drugs to enhance performance: types of performance-enhancing drugs (anabolic steroids, EPO, hGH, peptides, stimulants), the rationale for use, consequences (physical, social, legal), drug testing and the role of WADA, Sport Integrity Australia and ASADA

Performance-enhancing drugs (PEDs) have a long history in sport. The HSC syllabus expects you to know the main categories, why athletes use them, the consequences, and the anti-doping framework that responds to them.

Types of performance-enhancing drugs

Anabolic-androgenic steroids

Synthetic analogues of testosterone. Promote muscle growth, strength, and recovery. The most-known category.

Effects

Increased muscle mass, strength, recovery from training, aggressiveness.

Side effects

Cardiovascular damage (left ventricular hypertrophy, hypertension, increased cardiac event risk), liver damage (oral forms), hormonal disruption (testicular atrophy in men, masculinisation in women), psychological effects (mood swings, aggression, dependence).

Use patterns

Concentrated in strength and power sports historically. Significant use in recreational gym contexts in Australia (the AIHW estimates around 2-3% of Australian gym-goers have used anabolic steroids non-medically).

EPO (erythropoietin)

A hormone that stimulates red blood cell production. Synthetic EPO increases haematocrit, raising oxygen-carrying capacity.

Effects

Substantial improvement in aerobic capacity. Most useful for endurance sports.

Side effects

Increased blood viscosity raises stroke and heart attack risk. A wave of unexplained deaths in cyclists in the 1980s and 1990s was linked to EPO use.

Use patterns

Concentrated in endurance sports (cycling, distance running, distance swimming, triathlon). The Lance Armstrong case made EPO the canonical example of high-profile doping.

Human growth hormone (hGH)

A peptide hormone that stimulates growth, muscle development, and recovery. Synthesised forms are used both medically (in growth hormone deficiency) and as PEDs.

Effects

Increased muscle mass, faster recovery, possibly fat loss. Evidence of actual performance benefit is mixed - the marketing exceeds the science.

Side effects

Bone and tissue overgrowth (acromegaly in chronic users), diabetes, cardiovascular issues.

Use patterns

Across many sports, often in combination with steroids and other agents.

Peptides

A broad category of short protein sequences with various effects. Some stimulate growth hormone release, others stimulate IGF-1, others affect specific tissues.

The "Essendon supplements saga" (AFL, 2012-2015) was an Australian case involving alleged use of peptides at an AFL club, resulting in player suspensions and substantial governance reform. The case is a likely HSC exam reference point.

Stimulants

Drugs that increase alertness, energy, and reaction time. Includes amphetamines, methylphenidate, modafinil, and prescription stimulants used recreationally.

Effects

Increased aggression, energy, focus, reduced fatigue perception, improved reaction time.

Side effects

Cardiovascular stress, dependence, mental health effects (anxiety, paranoia, psychosis at high doses), heat illness risk.

Use patterns

Across many sports, particularly those with intense intermittent demands. Caffeine is the legal version and is used by most elite athletes; banned stimulants are the same effect at higher dose with more risk.

Other categories

• Beta-blockers. Reduce heart rate and tremor. Banned in precision sports (shooting, archery).
• Diuretics. Mask other drugs, support weight cutting. Banned across all sports.
• Blood doping (transfusion of own or donor blood). Effect similar to EPO. Detectable through the Athlete Biological Passport.
• Gene doping (theoretical use of gene therapy to enhance performance). Banned but detection is in its early stages.

Rationale for use

Athletes use PEDs for predictable reasons:

• Competitive pressure. "If others are doping, I have to dope to compete."
• Financial incentive. Elite sport pays substantially; doping seems rational if the expected benefit exceeds the expected punishment.
• Recovery from injury. Some athletes start with legitimate medical use and continue beyond clinical necessity.
• Peer and coach influence. Doping cultures within teams or training groups.
• Body image (in recreational contexts).
• Despair. Athletes whose careers are stalling sometimes view PEDs as a last option.

The cost-benefit calculation has shifted over time as anti-doping has tightened. Today the calculation includes substantial career risk.

Consequences

Physical

Covered per drug above. Generic patterns: cardiovascular stress, hormonal disruption, organ damage, dependence, increased injury risk in some cases (steroids can produce tendon weakness as muscle grows faster than connective tissue adapts).

Social

• Suspension or ban from sport. Loss of livelihood.
• Reputation damage. Even after a ban ends, the athlete's career is marked.
• Loss of sponsorships and earnings.
• Family and community relationship damage.
• Mental health consequences from public exposure and shame.

Legal

• WADA Code violations produce 4-year bans (or longer) for serious cases.
• Some PEDs are illegal to possess in Australia (Schedule 4 drugs require prescription; Schedule 8 and S9 drugs are restricted).
• Trafficking PEDs is a criminal offence with substantial penalties.
• Insurance and contractual consequences (loss of payouts, contractual termination clauses).

The anti-doping framework

WADA

The World Anti-Doping Agency, established 1999. Issues the World Anti-Doping Code, the Prohibited List (updated annually), the Therapeutic Use Exemption framework, and accreditation standards for testing labs.

The Code applies across Olympic and most major sports through a network of national anti-doping organisations.

Sport Integrity Australia (SIA)

Established 2020 by merging ASADA (the Australian Sports Anti-Doping Authority), the National Integrity of Sport Unit, and Sport Integrity Hotline. SIA covers anti-doping, match-fixing, sport-related corruption, and athlete welfare.

SIA conducts testing (in-competition, out-of-competition, intelligence-led, target-based), runs education programs, and prosecutes anti-doping rule violations.

Testing

Athletes can be tested:

• At competitions.
• During training.
• At home or away from sport, at any time (out-of-competition testing).
• Through urine, blood, or both.
• For specific substances or through the Athlete Biological Passport (longitudinal biomarker profile).

Elite athletes provide whereabouts information so they can be located for unannounced testing.

Education

Sport Integrity Australia, AIS, and most major sports run mandatory anti-doping education for athletes, coaches, and support staff. School and junior athletes are increasingly targeted as PED awareness rises.

Sanctions

Standard ban for an Anti-Doping Rule Violation is 4 years for intentional violations. Lesser violations (negligence, contamination, specific substances) attract shorter bans. Second violations are typically lifetime.

How this dot point applies in HSC responses

A typical question is "Evaluate the effectiveness of anti-doping in elite sport" or "Discuss the ethical issues raised by PEDs in Australian sport". Strong responses:

1. Name specific drug categories with examples.
2. Cite specific cases (Lance Armstrong, Essendon, Shayna Jack 2019, recent Russian state doping).
3. Cover the anti-doping framework (WADA, SIA, the Code, testing, sanctions).
4. Make an explicit judgment on effectiveness with reasoning.
5. Recognise the ethical complexity (athlete autonomy, competitive pressure, what counts as "fair").