Use of performance- and image-enhancing substances among recreational athletes: a quantitative analysis of inquiries submitted to the Danish anti-doping authorities
Journal Title (Medline/Pubmed accepted abbreviation):  Scand. J. Med. Sci. Sports
Year: 2010
Volume: 20
Page numbers: 861-867
doi:  10.1111/j.1600-0838.2009.01023.x

Summary of Background and Research Design

Background:It is difficult to determine what percentage of recreational athletes use performance- and image-enhancing drugs (PIEDs) world-wide, but a few questionnaires have suggested that use is not trivial. Many PIEDs include substances that have been banned by the World Anti Doping Agency (WADA) and are therefore not legal for use in the Olympics but are not necessarily illegal everywhere in the world. Anabolic androgen steroids (AASs), for example, can cause severe health problems and are illegal in many countries including the US, Canada, and Australia. The national anti-doping agency in Denmark offers an anonymous counseling service for PIED-related issues.

Hypothesis/Research Question:What is the profile of the user of the anonymous PIED counseling system? What is the current use of anabolic steroids in this population? What other PIEDs are used in recreational training?

Methods:Internet- (1655) and telephone-based (213) inquiries were collected between January 1, 2006 and June 30, 2007. Information was gathered by investigators for all inquiries for: nature of the question; age; gender; affiliation; use of WADA-banned substances; use of other, non-banned substances; motivation for the query; and main substance in question. Not all information was available from each question. Inquiries from students were discarded, therefore 1398 inquiries were included in the report.

Summary of research findings:
Most of the inquiries came from male recreational athletes in their mid-20’s. Only 12% of inquiries came from those who affiliated themselves with competitive sports and a mere 0.4% identified themselves as elite athletes. This implies that PIEDs may be employed more as image-enhancing agents rather than performance-enhancing agents. 15% of the inquirers used WADA-banned substances and another 15% considered using them. The high volume of inquiries suggests that many Danish recreational athletes are highly interested in pursuing WADA-banned substances. It is unknown whether the counseling provided by this agency reduces drug use by athletes.


The authors attempted to glean information on the habits and practices of the typical recreational gym exerciser, but the profile of anonymous questions to a counseling agency is likely not an accurate reflection of the entire population. For example, athletes may be more inclined to go to other sources of information for answers regarding legal supplements, such as their coach or trainer. There are probably going to be a higher number of questions regarding anabolic steroids and other illegal substances because there is more lay information available regarding hazards of their use.
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