Considerations in the Use of Stimulants in Sport
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Medication treatment of adult athletes with attention-deficit/hyperactivity disorder (ADHD) is controversial. Some articles and guidelines support the use of stimulant medications in this population, while others advise against it. We believe that the important issues regarding the use of stimulant medications in athletes include the likelihood of performance enhancement, poor inter-rater reliability of ADHD diagnosis in relation to therapeutic use, policies of sport-governing bodies, psychiatric treatment of mental illness, and dangerous consequences of use. We review the literature on these five issues and conclude by discussing the ethical principle of fairness, and suggest some proposals regarding the use of stimulants by athletes that balance these five issues and fairness. Our ultimate recommendation is that stimulants should not be used by high-level adult athletes.
KeywordsADHD Symptom Atomoxetine Stimulant Medication International Olympic Committee National Collegiate Athletic Association
The authors report no funding for the preparation of this review and no relevant conflicts of interest. We thank Professor Russ Shafer-Landau of the University of Wisconsin-Madison Department of Philosophy (now at the University of North Carolina, Chapel Hill, CA, USA) for helpful conversations regarding the ethical issues we discussed.
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