Use of pharmaceuticals amongst athletes tested by Anti-Doping Norway in a five-year period

Abstract

IntroductionThe aim of the study was to map the use of pharmaceuticals by Norwegian athletes registered on doping control forms (DCFs) in a five-year period to examine general and some class specific use of pharmaceuticals across sports and athlete levels.MethodAnonymous data from DCFs collected in 2015-2019 were manually entered into a database using the Anatomical Therapeutic Chemical (ATC) system for classification of the pharmaceuticals. Variables entered were year of control, gender, age group, athlete level, sport, test type, nationality, and pharmaceuticals (and dietary supplements) used.ResultsPain killers in the ATC groups M01 A (Nonsteroidal anti-inflammatory drugs - NSAIDs) and N02 B (other analgesics), and anti-asthmatics in ATC groups R03 A and R03 B were the most frequently used pharmaceuticals. National level athletes reported more use of pharmaceuticals (1.4 ± 1.7 pharmaceuticals per form) than recreational level athletes (0.9 ± 1.2). The highest proportion of DCFs containing information about at least one pharmaceutical were found in speed skating (79.1%), alpine skiing (74.0%), rowing (72.4%) and cross-country skiing (71.7%). Painkillers were most frequently used in muscular endurance sports (30.4% and 21.2 % for M01A and N02 B, respectively) and ball and team sports (17.9% and 17.0%). Use of hypnotics was reported from ice-hockey players and alpine skiers in around 8% of the cases.CoclusionUse of anti-asthmatics was most often reported amongst athletes specially exposed to cold, chemicals and heavy endurance training. Athletes in specialized sports requiring high levels of strength and/or endurance reported a higher use of pharmaceuticals out-of-competition compared to in-competition, while there was no such difference in complex sports, such as team, gymnastic, aiming and combat sports.

Medicalization of Sport? A Mixed-Method Study on the Use of Medications in Elite Ice Hockey

“…According to the WADA International Standard for Testing and Investigations [ 21 ], all athletes who are selected for doping testing must register on the DCF all medications and supplements taken within the previous seven days before sample collection. These data can be organized and used to obtain an overview of the prevalence and trends in the use of these products among athletes, as has been shown in previous studies by our group [ 5 , 22 ].…”

“…Medications were classified according to the Anatomical Therapeutic Chemical (ATC) Classification System. A detailed description of how the database was developed is provided elsewhere [ 5 ].…”

“…Another study found that young male ice hockey players were more prone to using analgesics compared to the control group [ 4 ]. Recently, a mapping of Norwegian athletes who had participated in doping controls conducted by Anti-Doping Norway (ADNO) in the period of 2015–2019 showed that 56% of all athletes declared current use of at least one medication on the doping control form [ 5 ]. Other studies have reported athletes using analgesics before a competition to avoid pain from possible injuries [ 6 ] and hypnotics to cope with symptoms of jet lag [ 7 ].…”

“…The amount and type of medications used vary significantly between sports (see, e.g., [ 5 ]). Perhaps due to the high-risk potential and culture [ 16 ] and a “tough guy” mentality, ice hockey players may be among the athletes most exposed to using medications to cope with their sport [ 17 ].…”

“…Recently, several articles have shed light on the problematic relationship with medications among professional ice hockey players, most notably in the National Hockey League [ 18 , 19 , 20 ]. Moreover, in a recent study of Norwegian athletes, national-level (NL) ice hockey players more often reported using medications than NL athletes in general and compared to athletes in other ball and team sports [ 5 ]. Ice hockey players also reported the highest use of hypnotics among all sports.…”