Performance-enhancing drugs (PEDs) are medications used to improve physical performance. Many PEDs are illegal to buy when not used to treat an approved medical condition.
There’s no precise definition of which drugs are considered PEDs, but the term is often used specifically to refer to drugs that appear on the World Anti-Doping Agency (WADA)’s banned substance list. Most major sports federations ban medications that appear on this list.
Examples include anabolic steroids, some stimulants, and human growth hormone.
This article looks more at PEDs, including types, who shouldn’t take them, and laws surrounding them.
PEDs have the potential to improve physical performance in one or more ways, such as:
- improving muscle strength or size
- improving endurance
- allowing you to recover faster
The term PED is often used to refer to drugs on WADA’s banned substance list. Hundreds of major sporting organizations use WADA’s list of banned substances in their guidance.
For a drug to be banned by WADA, it has to meet at least two of the three following criteria:
- has the potential to enhance sports performance
- can harm or potentially harm an athlete
- violates the spirit of the sport
Some products may colloquially be referred to as “PEDs” while not technically meeting the definition. For example, creatine monohydrate may sometimes be called a PED. However, it’s sold as a supplement, has an excellent safety profile in adults, and isn’t banned by WADA.
In the United States, the
Some substances are almost universally accepted to be PEDs, while some other substances are more controversial. For example, cannabis products remain banned in-season for athletes.
According to the Canadian Centre for Ethics in Sports, they don’t consider cannabis as particularly performance-enhancing, but they have received anecdotal reports of people using it with the intent to improve performance or recovery by managing pain, stress, or anxiety.
WADA considers the following substances and methods of handling them as performance-enhancing.
Non-approved drugs are not listed in any other section in WADA’s banned substance list and have no approved medical use by any government health authority.
An example is DNP, which is not legal but is sold illegally as a weight loss drug. It is dangerous to take this substance as it is extremely toxic, and you can easily overdose.
Anabolic agents
Substances in this class mimic testosterone or related compounds in your body. They’re also referred to as “anabolic steroids,” and are widely taken for their muscle-building properties.
Peptide hormones, growth factors, and related substances
Many types of drugs fall into this class, including:
- human growth hormone and related molecules, which can help increase muscle and bone development
- testosterone-stimulating hormones such as luteinizing hormone or chorionic gonadotropin
- erythropoietins and related molecules, which athletes sometimes take to increase stamina
Beta-2 agonists
Drugs in this class can potentially increase muscle mass and muscle force as well as reduce body fat.
Beta-2 agonists are typically prescribed for treating asthma and may be long-acting or short-acting.
Hormone and metabolic modulators
Drugs in this class cause changes in your body such as:
- blocking estrogen
- reducing the expression of the gene myostatin, which may help improve muscle mass and decrease fat
- mimicking insulin to help increase muscle growth
Diuretics and masking agents
Diuretics are medications that increase urine output.
People sometimes use diuretics as “masking agents” to hide the presence of other PEDs and manipulate drug tests.
Stimulants
Some stimulants are banned in competition. Examples include:
- cocaine
- ephedrine
- ectasy
Caffeine is not currently banned, but its use is being monitored. It’s well-established that it has benefits for increasing muscle strength and endurance in the short term.
Cannaboids
Cannabis and related substances are banned during the competition period. The use of cannabis products is still under review.
Some people consider these products performance-enhancing due to the potential to relieve anxiety, but other people think they shouldn’t be banned.
Glucocorticoids
Glucocorticoids are banned in competition. They’re widely prescribed for inflammatory conditions, such as many autoimmune conditions. They can help reduce inflammation.
A few examples include:
- prednisolone
- hydrocortisone
- cortisone
Beta-blockers
Beta-blockers are banned during the competition period in all WADA-monitored sports. They are also banned year-round in certain sports that require precise eye-hand coordination due to their anti-tremor effects.
Sports where they’re banned year-round include:
- archery
- billiards
- darts
The following methods are considered unethical by WADA and are also illegal for athletes.
Manipulation of blood and blood components
Manipulation of blood is often called “blood doping.” Blood doping can take many forms, such as storing blood and then reinjecting it later to improve the amount of oxygen that can be carried.
Chemical and physical manipulation
This category includes methods to tamper with urine samples or to hide results of blood tests.
Gene and cell doping
This category involves methods to change sequences of your DNA, such as gene silencing or gene transfer.
Some supplements have research to support their use for improving sports performance, but aren’t banned by WADA and have a low risk of serious health complications. Some common
- Protein. Protein supplements can help make sure you get enough protein to support your muscles. You can also get protein through your regular diet, but protein supplements may be more convenient.
- Creatine monohydrate. Creatine has been widely studied and is linked to improved power and strength.
- Beta-alanine. Beta-alanine is a sports supplement that may help improve endurance by reducing acidity in your muscles.
- Beta-hydroxy-beta-methylbutyrate (HMB). HMB is a substance produced by your body from the breakdown of the amino acid leucine. It may help improve muscle growth for some people, but research is mixed.
- BCAAs. BCAAs are among the most widely taken supplements, but research has not consistently shown a benefit for athletic performance for most people.
Everybody should consult a medical professional before taking any type of PED. Many of these substances have health risks when used for reasons other than what they are prescribed for.
Athletes participating in competitions where drug testing is performed should avoid any PEDs that appear on WADA’s banned substance list. Athletes competing at levels where they don’t undergo regular drug testing may also want to avoid these substances due to ethical or health concerns.
It’s important to note that even taking PEDs unintentionally can lead to a multi-year ban from your sport.
The purchase of prescription medications like testosterone in the United States without a prescription is illegal. Even buying these medications online can land you in jail, especially if you import them from other countries or distribute them.
Dietary supplements are not regulated in the same way as medications, and many that are sold over the counter may still flag positive in a drug test for athletes. If you’re an athlete planning on taking supplements, it’s a good idea to look for products with the Informed Choice stamp.
Products with the Informed Choice stamp meet a high standard of testing to ensure they don’t contain banned or unsafe substances. However, there’s still a small chance that some products with this stamp could be contaminated.
Many products contain other lab testing stamps on the container, but a lot of these are not legitimate.
PEDs are drugs that are thought to increase athletic performance. PEDs that appear on WADA’s banned substance list are illegal to take for competitive athletes who get tested regularly.
Even if you’re not a competitive athlete, it’s a good idea to be careful about taking PEDs since there may be legal and health risks.
If you’re considering taking PEDs for building muscle growth, you may want to try a supplement like creatine monohydrate instead. A large body of research suggests that creatine can be effective and unlikely to cause serious health problems in adults.
If you do decide you want to try any PEDs, speak with your doctor before doing so to make sure they are suitable for you.