Mobile Lesson

All athletes have no doubt asked themselves at some point what the different substances and methods on the Prohibited List actually entail. Swiss Sport Integrity's «Mobile Lesson» is a set of informative modules which explain the different classes of substances and methods on the Prohibited List, what effects and side effects they have on the body and in which sports they are primarily used.

Substances and methods prohibited at all times (in and out of competition)

S1 Anabolics

Anabolics are steroid hormones, such as testosterone and other substances, with effects similar to the male sex hormone. They induce an anabolic metabolic state.

Side effects: Anabolic agents have a range of side effects, some of them dangerous, such as damage to the cardiovascular system, liver disease or even liver cancer, changes to the lipid metabolism leading to hardening of the arteries (arteriosclerosis), water retention in body tissue, mental health problems (depression, aggression, libido, substance dependence), premature skeletal maturation in children or effects on the reproductive system.

S2 Erythropoietin (EPO)

Erythropoietin (EPO) is a hormone produced by the body that stimulates the production of red blood cells. The ultimate effect is an increase in exercise endurance and a reduction of recovery time.

Side effects: An increase the production of red blood cells caused by EPO results in an increase in the packed cell volume of the blood (haematocrit). The blood becomes more viscous and blood pressure rises. Especially when the athlete is dehydrated, after a period of exertion this thickening of the blood can lead to thrombosis, heart attacks, stroke and even death. The risk of developing cancer also rises when EPO is taken.

S2 Human growth hormone (hGH)

Human growth hormone (hGH) is a peptide hormone produced by the body. hGH stimulates cell division and cell growth and therefore has an anabolic (muscle-building) effect.

Side effects: hGH can promote the growth of inner organs (e.g. heart, liver) and cause considerable damage to them. An enlarged heart and increased blood pressure can cause heart attacks. hGH also leads to the disproportionate growth of hands and feet, and also of the chin, nose and ears (acromegaly). These changes are irreversible. Further possible consequences of hGH abuse are intestinal cancer or diabetes.

S3 Beta-2 agonists

Beta-2 agonists widen the bronchi in the lungs. When administered in high doses, they stimulate muscle growth.

Side effects: excessive sweating, restlessness, uncontrollable muscle twitching (tremors) and rapid heartbeat (tachycardia). Due to an increase in oxygen consumption as the result of a rapid heartbeat, there may be an insufficient supply of oxygen to the cells of the heart muscle, resulting in angina pectoris (paroxysmal pain in the chest induced by a circulatory disorder of the heart). Other possible side effects are a reduction in the potassium concentration in the blood serum (possible result: cardiac arrhythmia) or an increase in glucose levels due to a more rapid breakdown of glycogen in the liver.

S4 Hormone and metabolic modulators

Substances classified as 'hormone and metabolic modulators' modify the effects of hormones and accelerate or slow down specific enzyme reactions.

Side effects: hormones and metabolic modulators interfere with the body’s endocrine system and thus enhance the risk of serious diseases.

S4 Insulin

Insulin is a peptide hormone produced by the body and is one of the prohibited doping substances. It lowers blood sugar level and also affects the metabolism of fats and amino acids.

Side effects: Insulin-doping can be fatal! An overdose of artificial insulin leads to heart palpitations, agitation and tremors. If blood sugar levels fall rapidly and the nervous system is therefore no longer supplied with enough energy, serious damage can occur to the brain. In extreme cases this can result in death. In addition, the abuse of insulin carries the risk of developing diabetes.

S5 Diuretics and other masking agents

Masking agents are mainly used to conceal the presence of other prohibited substances or to distort the results of doping controls.

Side effects: Diuretics deprive the body of large amounts of liquids and minerals, thereby disrupting its water and salt balance. This can lead to serious muscle cramps, acute hypotension, cardiac arrhythmia and circulatory shock. Moreover, the risk of thrombosis increases as the blood thickens. Other possible side effects of the abuse of diuretics are gastrointestinal problems and kidney damage.

M1 Manipulation of blood

In addition to prohibited substances, the Prohibited List also lists prohibited methods. These include the manipulation of blood or blood components. It is prohibited because it improves the oxygen supply to the body.

Side effects: Several cases have been documented, for example Tyler Hamilton and Riccardo Riccò, in which athletes have been exposed to major health risks because blood samples were improperly taken, stored, transported or transfused. This can result in a life-threatening case of blood poisoning. In cases of allogeneic doping, more serious complications can occur, for example the transmission of foreign pathogens such as hepatitis viruses or HIV or blood incompatibility resulting in anaphylactic shock, which can lead to death.

M3 Gene and cell doping

The essential difference between gene doping and conventional doping is the fact that instead of doping substances, genetic material is introduced into the body.

Side effects: Changes in genetic material due to gene doping cannot be completely reversed with current medical knowledge. In addition, there are other numerous other risks from gene doping (production risk, transfer risk, genetic risk and others).

Substances and methods prohibited in-competition

S6 Stimulants

Stimulants cause increased physical and mental activity. They suppress the sensation of fatigue and thus increase performance. The group of stimulants also includes illegal drugs such as cocaine and ecstasy.

Side effects: Stimulants put pressure on the cardiovascular system in particular. Blood pressure and body temperature rise due to a narrowing of the blood vessels. This is life-threatening and can cause cardiac arrest. Other possible side effects include cardiac arrhythmia, convulsions and circulatory collapse. These side-effects may lead to life-threatening respiratory paralysis in particular when doing sport.

S7 Narcotics

Narcotics are opoids and potent pain relievers, and are prohibited in sport. They are used to suppress severe pain.

Side effects: The use of narcotics is associated with a high risk of addiction and leads to severe physical and psychological dependence. Narcotics act primarily on the central nervous system, thereby impairing concentration and coordination skills. Overdose may lead to fatal respiratory paralysis.

S8 Cannabinoids

Cannabinoids include natural substances extracted from Indian hemp as well as synthetic analogues of these substances. The principal active substance is tetrahydrocannabinol (THC).

Side effects: Cannabinoids act primarily on the brain and can trigger a variety of side effects. In the short term, they lead to a drop in physical performance and also affect perception and short-term memory. In high doses they can cause psychotic seizures, restlessness, anxiety, panic and confusion.

S9 Glucocorticoids

Glucocorticoids are steroid hormones produced by the body or manufactured synthetically that influence the body's metabolism and have pain-relieving and anti-inflammatory effects.

Side effects: Glucocorticoids affect different areas of the body, so they also have numerous potential side effects such as inhibiting the production of endogenous glucocorticoids via the hypothalamic-pituitary axis, an effect known as «negative feedback»; the suppression of the immune system; or the catabolic effect which leads to a decrease in bone density (osteoporosis) and muscle wasting.

Substances prohibited in particular sports

P1 Beta-blockers

Beta-blockers inhibit the effect of the body's stress hormones adrenaline and noradrenaline. As a result, they have a relaxing effect on the heart and blood circulation and prevent anxiety and muscle trembling.

Side effects: Beta blockers have an inhibitory effect on the sympathetic nervous system (part of the autonomic nervous system, which prepares the body for performance). The reduction in heart rate can cause a cardiac insufficiency in extreme cases. Other possible side effects include asthma attacks, erectile dysfunction, fatigue and a depressed mood.