Doping in sport, at least in the elite level athlete, is rarely going to present to primary care due to the prevalence of elite athletes within the general population. However, at a more general level, doping in the context of amateur and semi-pro level is of more relevance to the clinician. Recent news articles have focussed on a disproportionately high level of performance enhancing drug use among the rugby-playing contingent in Wales, which made up 33% of positive doping tests in 2015(48).

What is Doping?

The World Anti-Doping Agency (WADA) define doping as “the presence of a prohibited substance, metabolite or marker in an athletes’ sample, or use/attempted use of a prohibited substance or method. The criteria for what is considered as a prohibited substance or method requires two or more of the following to be met;

  1. Evidence that the substance/method has the potential to enhance sporting performance
  2. Evidence that the substance/method represents risk to the athlete’s health
  3. WADA determines the substance/method violates the spirit of sport
Motivations to Dope

The reasons for doping in sport are multifactorial. The most common reasons for doping in elite athletes include(49,50,51,52):

  • The belief other athletes are doing so
  • Desire to win/succeed
  • Financial incentives
  • Solving weight problems
  • Reducing pain/returning faster from injury



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