The rewards of competitive sport, both financial and in personal and national prestige, are the cause of determination to win at (almost) any cost. Drugs are used to enhance performance though efficacy is largely undocumented. Detection can be difficult when the drugs or metabolites are closely related to or identical with endogenous substances, and when the drug can be stopped well before the event without apparent loss of efficacy, e.g. anabolic steroids (but suppression of endogenous trophic hormones can be measured, and can assist).
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