Citation

Zandonai T, Escorial M, Peiró AM. Front. Pharmacol. 2021; 12: 661781.

Copyright

(Copyright © 2021, Frontiers Media)

DOI

10.3389/fphar.2021.661781

PMID

34177579

Abstract

Analgesic use by athletes is common (Overbye, 2020). It has been observed that athletes used analgesics up to four times more often than their age-matched general population (Holgado et al., 2018a). Notably, codeine and tramadol are not included in the WADA list of prohibited substances in sport (WADA, 2021a). Their use could be an attempt to compensate for fatigue, pain, and inflammation caused by injuries (Hainline et al., 2017) or overtraining (Grandou et al., 2020). It has been described that this abuse can be related to false expectations of performance improvement (Lundberg and Howatson, 2018). A 2017 study reported a small but a significant performance-enhancing benefit of tramadol in 20-min cycling time trial (Holgado et al., 2018b), however, with nonsignificant results being reported in subsequent studies (Experiment 2 of Holgado et al., 2018b; Bejder et al., 2019; Zandonai et al., 2021). To the best of our knowledge, no studies have investigated codeine's effects on exercise performance. Tramadol used by athletes may be linked to its analgesic and mood-enhancing effects (Grond and Sablotzki, 2004; Chaparro et al., 2013; Bastami et al., 2014); the reinforcement of euphoric symptoms may contribute to the onset of addiction. The suppression of pain sensation and increased pain tolerance and improved mood may be sufficient to motivate an athlete to push harder leading to small performance gains. However, tramadol and codeine may have side effects and health risks such as nausea, dizziness, drowsiness, and difficulty in concentrating (Poulsen et al., 1996; Vazzana et al., 2015). Scientific evidence regarding the impact of use and abuse on the sports population's health is scarce (Zideman et al., 2018), much less, with a sex- or gender perspective. We present an overview evidencing the athletes' use of codeine and tramadol and their potential abuse and addiction...

Language: en

Keywords

pain; sports; health; athletes; doping