Biochemical Markers of Drug Abuse in Athletics

Review Article

Abstract

Drug abuse in athletics continues to threaten the integrity of competitive sports and the wellbeing of athletes worldwide. The development and validation of biochemical markers have revolutionized anti-doping science, offering objective, quantifiable indicators of illicit substance use that transcend traditional testing limitations. This review provides a comprehensive synthesis of current knowledge on biochemical markers associated with major classes of performance-enhancing drugs, including anabolic steroids, stimulants, peptide hormones, and erythropoietic agents. Emphasis is placed on the mechanistic basis of these markers, their metabolic and molecular signatures, and the analytical technologies such as high-resolution mass spectrometry, immunoassays, and omics-based approaches that enable their precise detection. The review further explores the evolution of the Athlete Biological Passport (ABP) as an individualized, longitudinal monitoring framework that integrates hematological, steroidal, and emerging molecular biomarkers to enhance detection sensitivity. Ethical, regulatory, and practical considerations surrounding biomarker application are discussed, highlighting the delicate balance between athlete privacy and the pursuit of fair competition. Emerging frontiers, including epigenetic, microRNA, and metabolomic signatures, are presented as promising avenues for next-generation doping surveillance. By consolidating recent advances and identifying future directions, this review underscores the pivotal role of biochemical markers in transforming doping control from reactive testing to predictive, evidence-based monitoring, thereby preserving the spirit and credibility of modern athletics.