Franques P, Auriacombe M, Tignol J
Unité de Soins d'Addictologie, Consultation d'Addictologie et Psychopathologie dans le Sport, Service Universitaire de Psychiatrie, CHU de Bordeaux et Centre Hospitalier Charles-Perrens, Bordeaux, France.
Ann Med Interne (Paris). 2001 Nov;152 Suppl 7:37-49.
Both the general public and non-sports medicine health professionals have recently been made aware of a large use of performance enhancing drugs among sports practicing subjects. It has been suggested that this behavior is similar to that of substance dependence. Also some have reported that practice of a sport could be in itself an addictive behavior.
The main objective was to address the following question: is performance enhancing drug use in sports an addictive behavior? Methodology. We first reviewed the definition of performance enhancing drug use in sports and the diagnostic criteria of substance dependence as they are currently accepted and attempted to determine a possible common factor. Secondly we reviewed epidemiological data from the literature according to three approaches:
Use of performance enhancing drugs is an important and increasing phenomenon among adolescents. It is sometimes associated to risk taking behaviors for health (syringe use and sharing). Competition participants are at increased risk (up to 20% according to some authors) and some substances (anabolic steroids) are also used by non-sports practicing individuals. It has not been shown that sports practicing subjects were more at risk of using addictive substances compared to non-sports practicing subjects. It is not established that practice of a sport is by itself a risk factor for substance use. However, it could be that a sub-group of individuals that practice certain types of sports in an intensive way, that use both performance enhancing drugs and addictive substances and that engage in health risk taking behaviors have an increased risk for developing a dependence syndrome to both addictive and performance enhancing drugs. This sub-group is even more at risk because some performance enhancing drugs (anabolic steroids) could increase the risk for occurrence of a substance dependence syndrome through neurobiological actions. Yet, the few available clinical studies show that at most only half of regular users actually meet criteria for dependence. Also, one study has reported an overrepresentation of sports professionals among patients seeking treatment for heroin addiction.
The large majority of sports practicing subjects have no dependence to either performance enhancing or addictive drugs. However, a subgroup of individuals that practice sports intensely and makes use of both addictive and performance enhancing drugs appear to be at increased risk for developing a substance dependence syndrome.
公众和非运动医学领域的健康专业人员最近都已意识到，从事体育运动的人群中大量使用提高成绩的药物。有人认为这种行为类似于物质依赖行为。也有一些人报告称，从事一项运动本身可能就是一种成瘾行为。
主要目的是解决以下问题：在体育运动中使用提高成绩的药物是否属于成瘾行为？方法。我们首先回顾了目前公认的体育运动中使用提高成绩的药物的定义以及物质依赖的诊断标准，并试图确定一个可能的共同因素。其次，我们根据三种方法回顾了文献中的流行病学数据：
在青少年中，使用提高成绩的药物是一个重要且呈上升趋势的现象。它有时与健康方面的冒险行为（使用和共用注射器）相关。竞赛参与者面临的风险增加（根据一些作者的数据，高达20%），并且一些物质（合成代谢类固醇）也被不从事体育运动的人使用。尚未表明从事体育运动的人群比不从事体育运动的人群更有使用成瘾物质的风险。尚未确定从事一项运动本身就是物质使用的风险因素。然而，可能有这样一个亚组人群，他们高强度地从事某些类型的运动，使用提高成绩的药物和成瘾物质，并且从事健康冒险行为，他们对成瘾药物和提高成绩的药物产生依赖综合征的风险增加。这个亚组面临的风险更大，因为一些提高成绩的药物（合成代谢类固醇）可能通过神经生物学作用增加发生物质依赖综合征的风险。然而，现有的少数临床研究表明，至多只有一半的经常使用者实际上符合依赖标准。此外，一项研究报告称，在寻求海洛因成瘾治疗的患者中，体育专业人员的比例过高。
绝大多数从事体育运动的人群对提高成绩的药物或成瘾药物都没有依赖。然而，一个高强度从事体育运动且同时使用成瘾药物和提高成绩的药物的亚组人群，似乎发生物质依赖综合征的风险增加。
