Introduction-The use of performance enhancing drugs (PEDs) has been reported in several sports. There have been no peer-reviewed articles on the use of PEDs in ultramarathon running. This study was to examine the use of PEDs in ultramarathon running and to identify attitudes and beliefs about the usage of PEDs in the sport. Methods-An online survey was developed. The survey was distributed to potential participants through Ultrasignup and the Western States Endurance Run Facebook sites. The survey included 9 demographic questions, 11 PED questions, and a previously validated 17-item performance enhancement attitude scale (PEAS). Results-Six hundred nine self-identified ultramarathon runners completed the survey; 8.4% of respondents reported using PEDs during competition or training. Cannabinoids, narcotics, and stimulants were the PEDs that were most frequently reported. There was no difference between sex, age, country of origin, rank, miles/week of training, or longest race between those that reported using PEDs and those that did not report using PEDs. There was, however, a significant difference in athletes who reported they knew another ultramarathon runner who had used PEDs to have significantly higher years of participation and ranked in the top 20th percentile. There additionally was an increased PEAS score of individuals who reported using a PED or individuals that knew an individual who used PEDs. Conclusion-PEDs are being used in ultramarathon running. The exact extent of the use of PEDs in ultramarathon running is still unknown and challenging to fully investigate without formal, random testing, which is expensive and technically challenging.

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