“Substance Abuse: Factors that Influence Young Adult Male Athletes’ Use of Ergogenic drugs” – by Corey Springer
University of the West Indies Cave Hill Campus
Submission Date: 14th May 2007
The history of Ergogenic Substance use is a very extensive and well-documented one, with the first reported incidences being noted as early as the 8th century. Progression in pharmacology has always outstripped the ability of sports federations to implement rigorous testing procedures but since the creation of the World Anti-Doping Agency in 1999 more and more athletes are being caught. The purpose of this study is to determine what factors contribute significantly to the perpetuation of this behaviour by males 18-28. This age-range is specifically targeted because abuse by this age-group is potentially the most physiologically damaging. Implications for this research are with regard to understanding the motivations for ergogenic use in order to develop harm minimization programs.
The purpose of this study is to determine the factors which influence adolescent and young adult, males to use, and abuse, Ergogenic Drugs. Silver (2001) defined ‘ergogenic aid’ as: “any means of enhancing energy utilization, including energy production, control, and efficiency.” For the purpose of this study, ‘Ergogenic drugs’ refer to those substances represented on the list of ‘Performance Enhancing’ substances as banned by the International Olympic Committee (IOC) and the World Anti-doping Agency (WADA). The short-list includes: Stimulants, Anabolic-Androgenic Steroids, Steroid Precursors (Prohormones), Peptide Hormones, Beta-Blockers, Beta-2 Antagonistic Agents, Diuretics, Masking Agents, and ‘Street Drugs’. Appendix I contains WADA’s extended list for 2007.
Ergogenic Drug use by athletes to improve athletic output is not ‘new’ by any stretch. As far back as 776 BC, Greek athletes were reported to use substances to ‘perform better’. However, advances in pharmacology have now generated substances that are much more effective in this regard. In 1889 Dr Brown-Sequard announced to the world that he had found a substance that reversed his 72-year-old body’s ailments. He announced having injected himself with the extract of dog and guinea pig testicles under the assumption that these organs had “internal secretions that acted as physiologic regulators.” His claim was reinforced by the discovery of hormones in 1905 and by the isolation of testosterone in 1935.
It has been suggested that Nazi Germany athletes utilised the first rudimentary testosterone preparations in the 1936 Olympics. Shortly after, Russian weightlifters began to outpace American Olympians through performance-enhancing injections. The multiple gold-medal winning and record-breaking stint at the World Weightlifting Championships of 1954 was an example of such.
In attempting to regain equal competitive footing, the then US Olympic physician teamed with chemists to produce an anabolic steroid for the Americans. This testosterone-derivative was known as Dianabol. In the decades which followed, ergogenic drugs spread throughout sports. In 1959, the first reported case of a high school football player’s taking steroids was reported. This pre-empted that 1960s ban of steroid use by the International Olympic Committee. The IOC also began formal drug testing in the ensuing decade.
During the 1980s, the reported positive test results ranged from 2% to 50%, depending on whether the tests were announced or conducted at random. At the 1988 Seoul Olympics, the first gold metal in track and field was stripped when the Canadian sprinter Ben Johnson lost his 100-meter race victory after failing drug tests. Then, in 1994, an often-referenced survey was conducted by Goldman when aspiring Olympians were asked two simple questions. The first was, “If you were offered a banned performance-enhancing substance that guaranteed that you would win an Olympic medal and you could not be caught, would you take it?” Remarkably, 195 of 198 athletes said yes. The second was, “Would you take a banned performance-enhancing drug with a guarantee that you will not be caught, you will win every competition for the next 5 years, but will then die from adverse effects of the substance?” Still, >50% of the athletes said yes. This survey made it clear that modern athletes often approach their sports with a “win at all costs” mentality. In 2005, information surfaced to suggest that this mentality is becoming more prevalent even in high school athletics, with several highly publicized deaths in teenagers who were on steroids and a recent scandal with 9 students on 1 high school football team admitting to steroid abuse.
The term ‘abuse’ permeates this report as, medically speaking, ‘use’ and ‘abuse’ have been categorically similar: any use outside the immediately medical application constituting ‘abuse’. It is this report’s purpose however to investigate the extreme of the ‘use spectrum’, focusing on use which is correlated to physiological damage. Although the phenomenon, of Ergogenic drug use, indisputably exists in the Caribbean region, it has never been investigated or documented. Rationale for the conduction of this study stemmed from societal disfavour enacted by the abovementioned lack of investigation of the manifestation of Ergogenic drug use.
The research questions addressed in this study were:
- What individual issues contribute to ergogenic drug use? : An investigation of individual characteristics, factors and issues that may influence young adult males to use ergogenic drugs.
- What situational issues contribute to ergogenic drug use? : An investigation of external stressors which may influence young adult males to use erogenic drugs.
- Do males’ attitudes toward ergogenic drugs influence their use of such compounds? : An assessment of the roles which attitudes and perceptions play in the instances of ergogenic drug use.
The variables addressed were: Individual issues and Ergogenic drug use; Situational issues and Ergogenic drug use; Males’ attitudes and perceptions, and Ergogenic drug use.
This project’s researchers created an anonymous internet community, which served as discussion area for ergogenic substance users. This community provided an inlet to the discussion of ergogenics: Information normally deemed socially sensitive. Field research, specifically surveys and informal interviews, was the chosen channel for data collection. Purposive, non-random sampling was used in subject selection for the surveys since the study required specific criteria; and the target population was not the average male in society. Due to the sensitive nature of the discussion, subjects were not informed of the true purpose of the surveys and interviews. This was done so their responses would not be avoidant.
The range of Ergogenic research is expansive, but, at the same time limited. There is a wealth of information on the ‘how’ of sports doping, but little to illustrate the ‘why’. The topic of doping itself is shrouded in controversy. This controversy, and consequent sensitivity, is fuelled by: the magnitude of cash invested in sports, and also by the degree to which public support is important with regard to capitalizing on these investments.
Due to the sensitivity of the topic of sports doping, researchers have been relatively limited in their research. Studies conducted over the past two decades have been plagued by various methodological problems: including the uncovering of potential subjects, and the gaining of their trust. Thus the pitfalls of these preceding studies were used to shape a more feasible methodology
It is suggested that athletes’ beliefs and values may influence whether or not an athlete will use banned drugs, little is known about the athletes’ beliefs and attitudes in different sports. Alaranta A et al. (2006) sought to clarify these beliefs and attitudes of elite athletes towards banned substances and methods in sports. Alaranta A et al. (2006) supplied a total of 446 athletes with a explicitly structured questionnaire during a 2002 Olympic training camp. More than 90 % of the athletes reported to believe that banned substances and methods have performance enhancing effects, and 30 % reported that they personally know an athlete who uses banned substances. Of the male athletes 35 % reported that they personally know an athlete using banned substances. A total of 15 % of the athletes reported that they had been offered banned substances: 21 % of the speed and power athletes, 14 % of the team sport athletes and of the athletes in motor skills demanding events, and 10 % of the endurance athletes. Stimulants were the most often offered substance group (to 7 % of all the athletes) followed by anabolic steroids (4 %). Alaranta A et al. (2006) concluded that Subjects who regarded doping as a minor health risk seemed to be more often associated with doping users than those regarding doping as a significant health risk. Also it was noted that Athletes in different sports have different approaches to, and thoughts on, doping. Risk of doping appears to be highest in speed and power sports and lowest in motor skills demanding sports. Alaranta A et al. (2006) noted that males are at higher risk than females. It was suggested that controlling doping only by tests was not sufficient. Alaranta A et al. (2006) suggested that a profound change in the attitudes is needed, and this change should be monitored repeatedly.
It is generally accepted that ‘Negative affect’ can effect an individual’s perception of body image, and thus the manifestation of eating disorders. A general consensus could not be reached however which outlines definitively whether this relationship also applies to excessive exercise and strategies, including ergogenic drug use, to increase muscle in men. Thus Heywood & McCabe (2006) undertook to investigate whether negative and positive affect mediate the relationship between body dissatisfaction, and these body change strategies. The 2006 Heywood & McCabe study concluded that body dissatisfaction was associated with these strategies to lose weight, dietary restraint and bulimia for both genders. It was concluded that Negative affect mediated the relationship between dissatisfaction with muscles and strategies to lose weight, dietary restraint and bulimia for women only. The results confirm previous findings related to the association between negative affect and disordered eating for women. They also demonstrate the need to further investigate the impact of negative affect on body change strategies, particularly among men, and those strategies related to increasing muscles. Heywood & McCabe (2006) did not discount the possible existence of such.
Coaches are held to be among the main social main within doping prevention campaigns. Realizing this, Laure et. al. (2001) sought to document the attitudes of professional coaches faced with doping so as to evaluate how they related to its manifestation. Upon analysis of the responses it was found that 10.3% of coaches believed that an athlete may use doping with no health hazard with the help of a physician, and 30.0% of the coaches believed that an athlete who declined doping had little chance of succeeding. 5.8% of the coaches had used ergogenic drugs on their athletes within the preceding twelve months: 1 to 6 times. 13.5% of coaches mentioned that athletes, 1 to 5 per coach on average, had told them they had been prompted to use doping drugs during the previous 12 months. 80.7% of coaches considered that the current methods of preventing doping in sport were ineffective. 98.1% of them considered that they had a role to play within this context, but 80.3% considered themselves badly trained in the prevention of doping. Only 10.4% of coaches organized a doping prevention action during the preceding 12 months. The 2001 Laure et. al. study concluded professional coaches do not seem to be efficient in the prevention of doping. Further, they may perpetuate its manifestation.
The study being undertaken was mainly qual itative in nature, but research and findings from quantitative studies were included as well. For the purpose of this study, ‘ergogenic’ drugs referred to banned performance enhancing drugs. Attitudes as a variable in this study referred to beliefs, opinions, and ideas that a person holds about the drug use: both isolated to the drugs themselves, and comparatively to socially acceptable drug-consuming activities. Individual issues as a variable in this study referred to self-perception, pre-dispositions, characteristics, and traits, and their possible effect on an individual’s behaviour with regard to ergogenic drug administration. Situational issues as a variable in this study referred to situation-derived stressors which may influence an individual’s behaviour with regard to ergogenic drug administration.
For the purpose of this study, field research was necessary since literature on the study area was limited. Because of the sensitive nature of the topic, and the subversive nature of the subculture, the creation of a virtual community was necessary. This community was deemed most feasible for the unimpeded investigation of the sensitive subject area. The choice to create this community allowed the researcher to conduct research relatively uninhibited since the role of community contributor was used as a cover while collecting data. This role allowed the researcher and subjects to interact frequently. This role also allowed the researcher to build a rapport with potential subjects of the study. This process was relatively uncomplicated as there were pre-existing relationships and the researcher was aware of all the ‘virtual identities’, as well as some of the actual identities, of the potential subjects. The population from which the sample was chosen consisted of 30 people who interacted within this community on a daily basis. Base criteria were that the applicants be: male, ergogenic drug users, and between 18-28 years old at the time. Information was ascertained, via email, through the administration of a survey. This information was supplemented by informal interviews via instant messenger services, and related chat forums. Appendix II contains the survey instrument used.
The survey participants were not informed of the true nature of this study. This decision was made to facilitate the unclouded relay of this sensitive information. Information was collected over two sittings: one survey, and one interview. The interview was informal: a discussion of the subjects’ perceptions on the phenomenon. The interviews occurred via the instant messenger program of the subject’s preference. On completion of the data collection process, the data collected was grouped in relation to its relevance to each variable being addressed, i.e., under each variable, information ascertained and deemed relevant was grouped. The variables were conceptualised through repeated reference to definitions given by researchers in the field of ergogenics, as well as related literature.
Interviewing involved self-reporting which relies on the subject’s ability to aptly relay information, representative of their experiences, to the researcher. It has been shown that people have the tendency to try to give favourable impressions of themselves, and may at times exaggerate certain experiences. Thus sometimes it may be difficult to ascertain the actuality of the information gleaned: The interviewee being the only person who knows the full extent of their own behaviours.
The sample chosen isn’t representative of any particular population. While the information is of definite importance, due to the comparative size of the societal subgroup, the sample had to be small.
Participant responses, within the interview, were subject to the interpretation of the researcher and therefore could have incurred researcher bias. Overall the method of data collection was subjective with regard to both the researcher and subject as both: each having to interpret questions and responses.
The virtual community, while allowing a neutral territory for users of ergogenic compounds, was somewhat anonymous and impersonal. The observation of non-verbal situational responses, such as body language, was impossible. While this is arguably of benefit, as it could perceivably reduce situational tension, it also allows the subject the opportunity to mislead the interviewer.
Qualitative studies in this topic area were extremely limited and thus it was difficult to formulate the best methodology in terms of research design and procedure.
The three research questions being addressed were:
- “What individual issues contribute to ergogenic drug use?”: An investigation of individual characteristics, factors and issues that may influence young adult males to use ergogenic drugs.
- “What situational issues contribute to ergogenic drug use?” : An investigation of external stressors which may influence young adult males to use ergogenic drugs.
- “Do males’ attitudes toward ergogenic drugs influence their use of such compounds?” : An assessment of the roles which attitudes and perceptions play in the instances of ergogenic drug use.
Thirty surveys and five informal interviews were conducted in an effort to sufficiently answer these questions. Each of the interviews was broken down into three sections, each of which sought to address each of the research questions. The surveys were broken down into four sections. The First section sought to establish the interviewee’s social-economic standing so as to dismiss this as a factor in the likelihood of Ergogenic drug use, by way of illustrating the similarity between motivating factors across socio-economic brackets. The second and third sections sought to address the research questions, while the fourth section served to address a fourth hypothesis which investigated a genetic link.
The first area investigated explored the Individual Issues which contribute to the manifestation of this behaviour. Information acquired from the interviewees were consistent with the idea that a person’s personality and perception of self have a major effect on their decision making process and thus can be an influence on whether a young male will use Ergogenic drugs. Of the 30 males studied, the majority, while indicating a moderate to high level of self-esteem (see Figure 4), indicated a moderate to high need for others’ approval (See Figure 5). Additionally, while the majority reported a Moderate level of Confidence (See: Figure 7) and an above average self-report of physical attractiveness (see Figure 6), it was denoted that two of the most important purposes of Administration were: to improve physical appearance and attractiveness, and to increase confidence. Figure 10, located in appendix III, represents the Athlete’s reported Purposes of Administration.
Those interviewed were split almost equally with regard to their views on the status of sport: source of stress, or an outlet for the release of stress. The majority did concede however that they had been exposed to stressors in the process of training for, or competing in, an event. Based on the responses of the interviewees, it appeared as though Situational Stressors contributed to the manifestation of Ergogenic Use. ‘Stress’ for this purpose was not denoted as ‘positive’ or ‘negative’, but rather a situational friction which pre-empted a change in behaviour. Interviewees noted that stress namely came in the form of their own personal expectations with regard to their physical performance (see Figure 2). Perceived performance, or rather underperformance, pre-empted a need to change and ‘improve’. The above was the most commonly noted response, with alternative response being with regard to situational stress being transposed into a need to improve and change. Thus it can be said that each of the applicants shared this transposition and stress-response, and that situational stress can be considered a contributing factor to the manifestation of this behaviour.
Based on prior knowledge of various studies on substance use, it was hypothesized that men’s attitudes and perceptions of the behaviour often contribute to the manifestation of Ergogenic Use. The majority of the males studied herein viewed Ergogenic use as potentially dangerous (See figure 11). However the potential risk was deemed acceptable by the majority of the interviewees (see figure 12) as the perceived risk outweighed the perceived benefits (see figure 13). The majority of applicants viewed perceived risks as preventable through the monitoring of blood word: lipid profiles etc., and the administration of additional medications to counteract side-effects as they manifested. Additionally the majority of those interviewed agreed that occasional drug use ‘wasn’t bad’, and that they could take drugs as long as they were responsible and careful. The majority disagreed with the belief that all drugs were harmful, and also on the view that all drugs should be freely accessible. The majority also agreed that Drug use should be left up to individual choice, and that Ergogenic use was acceptable provided that no one other than the user is directly affected.
Section 3 also investigated the interviewee’s comparative views on the exhibition of Ergogenic use Behaviour as compared to drug-consuming behaviours deemed socially acceptable. ‘Socially acceptable drug-consuming activities’ for the this purpose, represented the activities of Drinking alcohol, Smoking Tobacco, and the practise of Self-medicating with Non-Prescription Drugs (Also known as OTC Drugs: Over-the-Counter Drugs). The majority of the applicants agreed that the use of Ergogenic Drugs was ‘safer’, ‘less physiologically damaging’, and ‘better’ than each of the above activities. Those interviewed also highlighted the notably lower mortality rate associated with Ergogenic use as compared to each of the above-mentioned socially acceptable drug-consuming behaviours. Thus perception of the behaviour can be considered a contributing factor.
Summary and Conclusions
In conclusion it was determined that in the case of young-adult males, the manifestation of Ergogenic Drug Use tends to be fueled by self-expectations and self-dissatisfaction. It was noted that the applicants used perceived stress as an internal motivator, and the viewed Ergogenic Use as a stress mediator in its ability to change their individual state of being: i.e. to make them stronger, faster, more confident etc.
Implications for future research include more insight into causation as the catalyst to destructive manifestations of this behaviour. Also, further implications are with regard to the investigation of the actual safety or danger of the athletes’ perceptions and beliefs with regard to this behaviour and their preventative measures. More research needs to be done into the latter especially to discount or accept its feasibility, and thus cement the safety of this region’s athletes.
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The World Anti-Doping Association (WADA)
The 2007 Prohibited list
S1. ANABOLIC AGENTS
- Anabolic Androgenic Steroids (AAS)
- Exogenous* AAS, including:
1-androstendiol (5á-androst-1-ene-3â,17â-diol ); 1-androstendione (5á- androst-1-ene-3,17-dione); bolandiol (19-norandrostenediol); bolasterone; boldenone; boldione (androsta-1,4-diene-3,17-dione); calusterone; clostebol; danazol (17á-ethynyl-17â-hydroxyandrost-4-eno[2,3-d]isoxazole); dehydrochlormethyltestosterone (4-chloro-17â-hydroxy-17á-methylandrosta-
1,4-dien-3-one); desoxymethyltestosterone (17á-methyl-5á-androst-2-en- 17â-ol); drostanolone; ethylestrenol (19-nor-17á-pregn-4-en-17-ol); fluoxymesterone; formebolone; furazabol (17â-hydroxy-17á-methyl-5á- androstano[2,3-c]-furazan); gestrinone; 4-hydroxytestosterone (4,17â- dihydroxyandrost-4-en-3-one); mestanolone; mesterolone; metenolone; methandienone (17â-hydroxy-17á-methylandrosta-1,4-dien-3-one); methandriol; methasterone (2á, 17á-dimethyl-5á-androstane-3-one-17â-ol);
methyldienolone (17â-hydroxy-17á-methylestra-4,9-dien-3-one); methyl-1- testosterone (17â-hydroxy-17á-methyl-5á-androst-1-en-3-one); methylnortestosterone (17â-hydroxy-17á-methylestr-4-en-3-one); methyltrienolone (17â-hydroxy-17á-methylestra-4,9,11-trien-3-one); methyltestosterone; mibolerone; nandrolone; 19-norandrostenedione (estr-4-ene-3,17-dione); norboletone; norclostebol; norethandrolone; oxabolone; oxandrolone; oxymesterone; oxymetholone; prostanozol ([3,2-c]pyrazole-5á-etioallocholane-17â-tetrahydropyranol); quinbolone; stanozolol; stenbolone; 1-testosterone (17â-hydroxy-5á-androst-1-en-3- one); tetrahydrogestrinone (18a-homo-pregna-4,9,11-trien-17â-ol-3-one); trenbolone and other substances with a similar chemical structure or similar
- Endogenous** AAS:
Androstenediol (androst-5-ene-3â,17â-diol); androstenedione (androst-4-ene- 3,17-dione); dihydrotestosterone (17â-hydroxy-5á-androstan-3-one); prasterone (dehydroepiandrosterone, DHEA);
Testosterone and the following metabolites and isomers:
5á-androstane-3á,17á-diol; 5á-androstane-3á,17â-diol; 5á-androstane-3â,17á-diol; 5á-androstane-3â,17â-diol; androst-4-ene-3á,17á-diol; androst-4-ene-3á,17â-diol; androst-4-ene-3â,17á-diol; androst-5-ene-3á,17á-diol; androst-5-ene-3á,17â-diol; androst-5-ene-3â,17á-diol; 4-androstenediol (androst-4-ene-3â,17â-diol); 5-androstenedione (androst-5-
ene-3,17-dione); epi-dihydrotestosterone; 3á-hydroxy-5á-androstan-17-one; 3â-hydroxy-5á-androstan-17-one; 19-norandrosterone; 19-noretiocholanolone.
- Other Anabolic Agents, including but not limited to:
Clenbuterol, tibolone, zeranol, zilpaterol.
For purposes of this section:
* “exogenous” refers to a substance which is not ordinarily capable of being
produced by the body naturally.
** “endogenous” refers to a substance which is capable of being produced by the
S2. HORMONES AND RELATED SUBSTANCES
The following substances, including other substances with a similar chemical
structure or similar biological effect(s), and their releasing factors, are prohibited:
- Erythropoietin (EPO);
- Growth Hormone (hGH), Insulin-like Growth Factors (e.g. IGF-1),
Mechano Growth Factors (MGFs);
- Gonadotrophins (LH, hCG), prohibited in males only;
S3. BETA-2 AGONISTS
All beta-2 agonists including their D- and L-isomers are prohibited.
As an exception, formoterol, salbutamol, salmeterol and terbutaline when
administered by inhalation, require an abbreviated Therapeutic Use Exemption.
S4. AGENTS WITH ANTI-ESTROGENIC ACTIVITY
The following classes of anti-estrogenic substances are prohibited:
- Aromatase inhibitors including, but not limited to, anastrozole, letrozole, aminoglutethimide, exemestane, formestane, testolactone.
- Selective Estrogen Receptor Modulators (SERMs) including, but not limited to, raloxifene, tamoxifen, toremifene.
- Other anti-estrogenic substances including, but not limited to, clomiphene, cyclofenil, fulvestrant.
S5. DIURETICS AND OTHER MASKING AGENTS
Masking agents are prohibited. They include:
Diuretics*, epitestosterone, probenecid, alpha-reductase inhibitors (e.g. finasteride, dutasteride), plasma expanders (e.g. albumin, dextran, hydroxyethyl starch) and other substances with similar biological effect(s).
acetazolamide, amiloride, bumetanide, canrenone, chlorthalidone, etacrynic acid, furosemide, indapamide, metolazone, spironolactone, thiazides (e.g. bendroflumethiazide, chlorothiazide, hydrochlorothiazide), triamterene, and other substances with a similar chemical structure or similar biological effect(s) (except for drosperinone, which is not prohibited).
All stimulants (including both their (D- & L-) optical isomers where relevant) are
prohibited. Stimulants include:
Adrafinil, adrenaline, amfepramone, amiphenazole, amphetamine, amphetaminil, benzphetamine, benzylpiperazine, bromantan, cathine, clobenzorex, cocaine, cropropamide, crotetamide, cyclazodone, dimethylamphetamine, ephedrine, etamivan, etilamphetamine, etilefrine, famprofazone, fenbutrazate, fencamfamin, fencamine, fenetylline, fenfluramine, fenproporex, furfenorex, heptaminol, isometheptene, levmethamfetamine, meclofenoxate, mefenorex, mephentermine, mesocarb, methamphetamine (D-),
methylenedioxyamphetamine, methylenedioxymethamphetamine, pmethylamphetamine, methylephedrine, methylphenidate, modafinil, nikethamide, norfenefrine, norfenfluramine, octopamine, ortetamine, oxilofrine, parahydroxyamphetamine, pemoline, pentetrazol, phendimetrazine, phenmetrazine, phenpromethamine, phentermine, 4-phenylpiracetam (carphedon), prolintane, propylhexedrine, selegiline, sibutramine, strychnine, tuaminoheptane and other substances with a similar
chemical structure or similar biological effect(s).
The following narcotics are prohibited:
buprenorphine, dextromoramide, diamorphine (heroin), fentanyl and its derivatives, hydromorphone, methadone, morphine, oxycodone, oxymorphone, pentazocine, pethidine.
Cannabinoids (e.g. hashish, marijuana) are prohibited.
All glucocorticosteroids are prohibited when administered orally, rectally,
intravenously or intramuscularly.
SUBSTANCES PROHIBITED IN PARTICULAR
Beta-blockers include, but are not limited to, the following:
acebutolol, alprenolol, atenolol, betaxolol, bisoprolol, bunolol, carteolol, carvedilol, celiprolol, esmolol, labetalol, levobunolol, metipranolol, metoprolol, nadolol, oxprenolol, pindolol, propranolol, sotalol, timolol.
“Specified Substances”* are listed below:
- Cathine, cropropamide, crotetamide, ephedrine, etamivan, famprofazone, heptaminol, isometheptene, levmethamfetamine, meclofenoxate, p-methylamphetamine, methylephedrine, nikethamide, norfenefrine, octopamine, ortetamine, oxilofrine, phenpromethamine, propylhexedrine, selegiline, sibutramine, tuaminoheptane, and any other stimulant not expressly listed under section S6 for which the Athlete establishes that it fulfils the conditions described in section S6;
- All Glucocorticosteroids;
- All Beta Blockers.
Yours in fitness,
– Corey Springer
Apollo Fitness Barbados