Monday, September 6
Drugs and Sports: Amphetamines
 Editor's note: This is the fourth of an eight-week series of articles examining the effects of commonly abused substances on athletic performance and overall health. Dr. Gary Wadler, a New York University School of Medicine professor and lead author of the book "Drugs and the Athlete", has also won the International Olympic Committee President's Prize for his work in the area of performance-enhancing drugs in competitive sports. He joined us to address the issue of amphetmaine use and sports performance.

What are amphetamines?

"Amphetamines belong to a class of drugs called sympathomimetic amines or stimulants that cause the release of excitatory neurotransmitters, such as dopamine, to stimulate thecentral nervous system (CNS)," says Wadler. They are controlled substances commonly called "uppers" and induce false feelings of power, strength, self-assertion and enhanced motivation. Trade names for amphetamines are Benzedrine, Dexedrene and Methedrine; these drugs have familiarly been referred to as "bennies" or "black beauties."

Amphetamines were synthesized in 1887 and were initially commercially available for over-the-counter use as a nasal decongestant. During World War II, amphetamines were used as a means of delaying the onset of fatigue and increasing alertness in soldiers. Subsequently, amphetamines became prominent as an appetite suppressant and as a drug to ward off sleepiness.

How are amphetamines used?

"Amphetamines are most often taken orally with blood levels peaking in one to two hours and effects appearing in 30 minutes and lasting in excess of three hours," says Wadler. Amphetamines can be injected intravenously or smoked. The smokeable form is a methamphetamine called "Ice," which is very potent, long-lasting and extremely addictive and illegal in most states.. All forms of amphetamines are banned by the International Olympic Committee and the NCAA.

What are the effects of using amphetamines on performance?

Amphetamines share many central nervous system effects with cocaine. However, unlike cocaine, amphetamines are not readily broken down by the body and are eliminated unchanged in the urine. Consequently, the stimulative effects of amphetamines last considerably longer than that of cocaine. The main psychic effects of the amphetamines include wakefulness, alertness, a decreased sense of fatigue, mood elevation, increased self confidence, and a decreased appetite. Amphetamines do not create extra physical and mental energy. Moreover, they are notable for distorting the user's perception of reality and impairing judgment, which may cause an athlete to participate while injured, possibly leading to worse injuries and putting others at risk. "Amphetamines have also been abused by athletes such as gymnasts, wrestlers and ballet dancers to decrease appetite so as to reduce body weight", says Wadler. "Regardless of the sport, the use of amphetamines to enhance athletic performance is illegal and contrary to the spirit of fair play."

What are the adverse effects of amphetamines?

The adverse health effects of amphetamines can be categorized as those that occur acutely and those that occur chronically.

Acute side effects include:

  • Increased heart rate
  • Increased blood pressure
  • Reduced appetite and weight loss
  • Insomnia
  • Headaches
  • Convulsions
  • Hallucinations and paranoia
  • Death may also occur due to ruptured blood vessels in the brain, heart attacks, heart rhythm abnormalities and heatstroke

Chronic Side Effects include:
  • Uncontrollable and abnormal movements of the face and jaw muscles called dyskinesias
  • Compulsive and repetitive behaviors
  • Paranoid delusions similar to schizophrenia
  • Death of blood vessels throughout the body
  • Nerve damage

Can the amphetamines be addictive?

Amphetamines carry a high potential for tolerance and psychological dependency. For example, laboratory animals will self-administer the drug until they die. "Tolerance to the mood-enhancing properties of amphetamines occurs after prolonged usage which, in turn, can lead to a pattern of increased dosing in an attempt to achieve the sought after mood-enhancing effects," says Wadler. "This may lead to progressively compulsive and stereotyped behaviors." Abrupt withdrawal of amphetamines may produce extreme fatigue, lethargy and depression. While there remains a debate on whether amphetamines are physically or psychologically addictive or both, there is no doubt that frequent chronic use of the drug erodes both physical and mental health.

Are amphetamines included in drug testing in sports?

Amphetamines are essentially included in all sport-related drug-testing protocols and are readily detected in the urine. Since amphetamines are primarily abused as performance drugs rather than as training drugs, they are most likely to be detected when drug testing is performed during competition; they can be detected from 2 to 4 days after use by GC/MS technology.