The use of drugs in sports is so pervasive
that most athletes must use drugs if they wish to remain competitive
(Di Pasquale, 1992b). AAS use is an extremely secretive behavior
to many, perhaps due to it being thought of as cheating by many
sports federations and much of the public (Yesalis, Wright, &
Bahrke, 1989). In order to make sports competitions fairer, most
sporting federations have instituted drug testing programs (Di
Pasquale, 1992b). Despite these efforts, drug use has not necessarily
declined (Di Pasquale, 1992b; Landry & Primos, 1990). At
present, all that has been achieved is a decrease in the use
of some drugs by some athletes (Di Pasquale, 1992b). Athletes
have learned to avoid detection by various methods and will continue
to do so despite more sophisticated and comprehensive testing.
Many athlete have simply altered what drugs they use and
when they use them (Di Pasquale, 1992 a, b).
One of the most
common methods of escaping detection when using anabolic steroids
is simply discontinuing the use of oral AAS several days prior
to a drug test. Oral AAS, such as Anavar, Winstrol (tablets),
and Dianabol, are usually undetectable 3 to 4 days of after cessation.
Injectable steroids usually have a much longer detection interval.
Metabolites of nandrolone have been found in the urine of some
athletes after 2 years it was reportedly last used. Stanozolol
(Winstrol-V) has been detected in the urine of an athlete 4 months
after cessation of its injection (Di Pasquale, 1992a). Oral AAS
metabolites can be cleared from the body in only fourteen days
after discontinuing use and are therefore more commonly used
when drug testing is a concern (Council on Scientific Affairs,
1988). Incidentally, many oral AAS are more highly associated
with liver abnormalities and adverse psychological changes (Council
on Scientific Affairs, 1988; Bahrke, Yesalis, & Wright, 1990).
Athletes have used various methods before drug testing to
either decrease the excretion of banned drugs or prevent the
detection of these drugs in the urine. Compounds that have been
used to decrease the excretion of unblock steroids and their
metabolites include uricosuric agents (e.g., probenecid, carinamide,
sulfinpyrazone, phenylbutazone, benzbromarone), corticosteroids,
estrogens, oral contraceptives (containing norethindrone), Depo-Provera,
phenytoin, pyrazinamide, dexamethasone, and apple cider vinegar.
Compounds used to prevent the detection of banned drugs in the
urine include various diuretics, Defend, and chemical contaminants
such as sodium hypochlorite, and bacteria. Defend acts by both
decreasing the excretion of the drug and by diluting the the
urine (Di Pasquale, 1992a).
Case studies have been used to study drug detection techniques
on athletes who self-administered anabolic-androgenic steroids
(de Boer, De Jong, van Rossum, & Maes, 1991).