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The list of drugs banned from the Olympics is determined by the World Anti-Doping Agency, established in 1999 to deal with the increasing problem of doping in the sports world. The banned substances and techniques fall into the following categories: androgens, blood doping, peptide hormones, stimulants, diuretics, narcotics, and cannabinoids. The use of alcohol (ethanol) is banned in selected sports only during actual competition.
Blood doping is the injection of red blood cells, related blood products that contain red blood cells, or artificial oxygen containers. This is done by extracting and storing one's own blood prior to an athletic competition, well in advance of the competition so that the body can replenish its natural levels of red blood cells, and subsequently injecting the stored blood immediately before competition. The resulting unnatural level of red blood cells improves oxygen transport and athletic endurance; thus, it is prohibited in most events.
Banned androgenic agents are either anabolic steroids, which increase testosterone and epitestosterone, thereby improving muscle strength and endurance, or beta-2 agonists (see adrenergic beta-agonist). Andro, DHEA, stanozolol, testosterone, and nandrolone, or derivates (see below) are banned anabolic steroids. Beta-2 agonists can act as bronchodilators and increase heart rates, in addition to their mild androgenic effects. Other banned androgenic agents include bambuterol, clenbuterol, salbutamol, tibolone, zeranol, zilpaterol, and selective androgen receptor modulators. While a few of the banned drugs are endogenous, that is they are normally produced in the human body, most of the banned drug are exogenous drugs chemically produced.
This is the complete list of exogenous (non-natural) androgenic agents banned as of January 1, 2012:
Metabolites and isomers of endogenous anabolic androgenic steroids, including, but not limited to:
Erythropoiesis-stimulating agents such as erythropoietin (EPO), darbepoetin (dEPO), hypoxia-inducible factor (HIF) stabilizers, methoxy polyethylene glycol-epoetin beta (CERA) and peginesatide (Hematide); growth hormone (hGH), insulin-like growth factors (IGF-1, etc.), fibroblast growth factors (FGFs), hepatocyte growth factors (HGF), mechano growth factors (MGFs), platelet-derived growth factor (PDGF), vascular endothelial growth factor (VEGF), chorionic gonadotropin (banned in men only), somatotrophin (growth hormone), insulins and corticotrophins, corticosteroid mimics, and their releasing factor, are banned.
Also banned are any other growth factor affecting muscle, tendon or ligament protein synthesis/degradation, vascularization, energy utilization, regenerative capacity or fiber type switching; and other substances with similar chemical structure or similar biological effects.
Hormone levels of a particular hormone, like testosterone, can be changed not only by administering it, but also by altering related hormones. For example, the estrogens estrone and estradiol are biosynthetically produced by the enzyme aromatase, respectively, from androstenedione and testosterone, which are both produced from 17-hydroxyprogesterone. Thus, when the body senses low levels of estrogen, the precursor compounds 17-hydroxyprogesterone, androstenedione, and testosterone are up-regulated. Likewise, interfering with a hormone's receptor leads to similar effects. Because of these natural hormone-hormone interdependent biosynthetic pathways and hormone-receptor interactions, all aromatase inhibitors, including but not limited to, anastrozole, letrozole, aminoglutethimide, exemestane, formestane, and testolactone are banned. Selective estrogen receptor modulators, including but not limited to raloxifene, tamoxifen and toremifene are banned. Clomiphene, cyclofenil, fulvestrant, and all other anti-estrogenic substances are banned. Myostatin inhibitors are banned. Metabolic modulators including peroxisome proliferator-activated receptor delta (PPARδ) agonists (e.g. GW 1516), PPARδ-AMP-activated protein kinase (AMPK) axis agonists (e.g. AICAR) are also banned.
Stimulants directly affect the central nervous system, increasing blood flow and heart rate. Stimulants that are banned include amphetamines, beta-2 agonists, ephedrine, pseudoephedrine, fencamfamine, cocaine, methamphetamines, mesocarb, and other substances with similar chemical structures and biological effects, including, but not limited to, the following:
Diuretics, which increase the production of urine, and masking agents, chemical compounds which interfere with drug tests, are banned for two reasons. First, by decreasing water retention and thus decreasing an athlete's weight, an important consideration in many speed sports, they increase the speed of an athlete. Secondly, increased urine production depletes the concentration of both the banned drugs and their metabolites, making their detection more difficult. Masking agents, on the other hand, work by making drug tests ineffective, leading to false-negative results. Desmopressin, plasma expanders (such as glycerol; intravenous administration of albumin, dextran, hydroxyethyl starch and mannitol), probenecid, and other substances with similar biological effects are also banned. Local application of felypressin in dental anesthesia is not prohibited.
The following diuretics, and chemicals with similar structure or biological activity are banned:
Narcotic analgesics decrease the sensation of serious injuries, allowing athletes to continue training for competition after serious injuries. While some painkillers are allowed, including codeine, the following are banned:
Glucocorticoids are a class of corticosteroids that affect the metabolism of carbohydrates, fat, and proteins, and regulate glycogen and blood pressure levels.They possess pronounced anti-inflammatory activity and cause alteration of connective tissue in response to injuries. The anti-inflammatory and connective tissue effects of glucocorticoids might mask injuries, leading to more serious injuries to athletes. Because of this and metabolic regulation effects, the administration of any glucorticoid orally, rectally, intraveniously, or intramuscularly is prohibited and requires a therapeutic use exemption. Topical uses of glucocorticoids does not require an exemption.
Beta blockers are prohibited during competition in a number of sports; out of competition, they are prohibited only in archery and shooting. The prohibited beta blockers include, but are not limited to: