There are two groups of people who undertake sporting activity while taking drugs. The first are those who require medication for chronic conditions such as hypertension and hyperlipidaemia, in specific circumstances such as paraplegia or organ transplant, or for acute intermittent conditions such as inflamed joints, infections and injuries. The second group comprises healthy people who take drugs to enhance sporting performance. We include bodybuilders in this category.
Doctors are always the prescribers for the first group and are often the prescribers for the second.
In this article, we provide an overview of ethical practice when consulted by individuals in this second category. The use of drugs for enhancing sporting performance is widespread and has been documented in Europe, North America and Australia. 2-5 Some drugs seem to have enduring appeal, while others come and go in fashion. The use of stimulants is still common, although the popularity of amphetamines has decreased since the 1960s. 2,3 and the known connection between some of the drugs and myocardial infarction, stroke and psychiatric episodes in apparently healthy athletes.