Declared use of medication in sports

Objective: To assess and compare the prevalence of declared medication, such as corticosteroids, nonsteroidal anti-inflammatory drugs (NSAIDs), beta(2)-agonists, narcotic analgesics, anaesthetics, and antidepressant drugs, in time and between different sports among athletes tested for doping control in a 4-year period. Design: Survey study. Setting: Belgium. Participants: This paper reviews the data obtained from 18,645 doping control forms gathered between 2002 and 2005 from national doping organisations in Belgium and The Netherlands, the International Cycling Union (UCI), and the Belgian Cycling Federation. Intervention: All athletes were asked by doping control officers to declare the medication taken in the last 3 days before competition after which the doping control forms were double blinded and handed over to the laboratory. Main Outcome Measurements: Classification of declared medication according to the active ingredient. Results: The overall declared use of medication belonging to one of the monitored categories increased from 19.8% in 2002 to 24.67% in 2005. Differences in use of medication were observed between sports with a higher prevalence of use of NSAIDs in ball sports compared to other sports and a higher use of beta-agonists and corticosteroids in cycling with percentages of declared corticosteroid use in samples from the UCI exceeding 36% in 2005. Conclusion: These results indicate that the current granting of therapeutic use exemption for corticosteroids and beta-agonists needs to be revised and that threshold levels for beta-agonists should be implemented.