Think less like a pharmacist and more like an athlete

When it comes to the use of medications, pharmacists - like all healthcare professionals - focus on the "rights" of the drugs. Right drug, right dose, right route, right time, right person.

Athletes who misuse medications, some with an intention to dope, do not think about the rights. They may think, "What's the biggest dose I can take?" or "If I swallow this instead of inhaling it, will I get a performance benefit since the guidelines say it can only be by inhaler?"

It may surprise some pharmacists that certain medication that do not seem, based on the therapeutic use, to enhance performance can actually do just that if taken at different doses, routes, frequencies or in a certain sport.

One example is beta-blockers, which slow down heart rate. This may be helpful to the shooter who is waiting to pull the trigger between heart beats. It is a hinderance to the cross-country skier who is trying to reach their maximum endurance in a race. So, what would that mean for a bi-athlete? It means, sports pharmacists, consider other options to treat the medication condition for which the beta-blocker was indicated.

While beta-blockers are just one example, for specific sports, there is another class of medications that most pharmacists assume are ergolytic (negatively impact athletic performance), and that is opiates. Dosing and timing of some opiates can improve performance. While opiates are mainly prohibited in sport for athlete health and safety, along with the spirit of sport (e.g., don't mask the pain to return to play), some opiates have enough ergogenic effect to change the outcome of a race/event. When split seconds make a difference between placing on the podium or not, that would change an athlete's chance also of getting sponsorships to continue a sporting career. Small adjustments do matter.

Would you like to know more about opiates effects on performance and the ergolytic effects? Upskill in sports pharmacy by looking into the clinical pearls courses offered here.