Drugs in sport - the role of the physician

Sportsmen have used anabolic steroids since the 1950s and yet it was not until the 1980s that we, as physicians, admitted that they could improve performance. We now find ourselves in the insidious position of being unable to predict convincingly either safety or major health risks with performance-enhancing drug use. The use of performance-enhancing drugs is no longer limited to the elite athlete. In 1993 the Canadian Center for Drug-free Sport estimated that 83 000 children between the ages of 11 and 18 had used anabolic steroids in the previous 12 months. Recent evidence suggests anabolic steroids are now the third most commonly offered drugs to children in the UK, behind cannabis and amphetamines. The role of the physician of today is to regain our position of impartiality and objectivity within both the sporting and general community. Only then will we be able to pursue a harm minimisation strategy designed to convince the public that it is better to be the best you can be naturally. For the majority, the improvement through the use of performance-enhancing drugs can equally be achieved through dietary and training advice. For the elite athlete, what price a gold medal that is tarnished by deceit? Its value then can only lie with the sponsors and politicians, for they can no longer claim to be sportsmen, only entertainers.