The article examines doping in endurance sports and the disparity between official test results and what studies and surveys reveal. Starting with the assumption that most athletes shy away from cheating, the text reviews the current landscape across various sports, why athletes continue to dope, and what is necessary to tackle the issue. The conclusion is straightforward: doping is prevalent in endurance sports—often more than test data indicates—and the most important response isn't shortcuts but more knowledge, clear accountability, and stronger preventive actions.

”No sports result is worth so much that doping is ever acceptable.” – Swedish Sports Confederation

Most athletes distance themselves from all forms of cheating, yet doping still occurs in the sports world. Sometimes it's called a "mistake" and blamed on the "coach," "additives in food," "supplements," or ten other explanations. Regardless of what's said, so-called "mistake doping" is unacceptable. It is always the athlete's own responsibility to know what's on WADA's list – a list that is actually easy to follow. To make it even easier, there are apps where you can look up a substance if you're unsure, for instance, when you've bought a new supplement or medication.

Still, doping happens everywhere. Sometimes athletes choose shortcuts, and the statistics speak for themselves. We're not saying that mistake doping doesn't exist – unfortunately, it does – often due to shady manufacturers (see link) or really lousy coaches.

You can read the entire report here:
https://wada-main-prod.s3.amazonaws.com/wada_2014_anti-doping-testing-figures_full-report_en.pdf

These are the official figures from actual tests. Let's also look at what studies and surveys reveal when athletes provide their own responses.

"Throughout the entire questionnaire, the term 'doping' was intentionally omitted. Instead, the phrase 'substances to enhance physical performance that you can only obtain from a pharmacy, a physician, or on the black market (e.g., anabolic steroid hormones, EPO, growth hormones, amphetamines)' was used."

Four characteristics were found to have a strong correlation with the use of pain relievers. These were:

1. Woman
2. English-speaking
3. Continuing to train despite pain
4. More than 12 hours of training volume per week

The association suggests that those who use pain relievers during sports are also more likely to use doping substances. 20.4 percent of the triathletes who answered yes to using pain relievers also reported using doping substances, while the same figure for those who answered no was 12.4 percent.

In summary, the figure landed at 13.0 percent of all respondents. This means that 13 percent of those who responded to the survey reported having used some form of doping substance in the past 12 months. This can be compared to those who actually get caught through testing, where the figure is 0.5 percent (21 convicted out of 4,308 tests; ref WADA's report).

Doping in cycling—especially road cycling—is much more researched compared to triathlon. In recent years, two significant studies have been published, one from 2012 and another from 2013, both focusing on erythropoietin (EPO).

The 2012 study explored elite cyclists' perspectives on health and doping, rather than the link between poor health and doping. It was an interview-based study involving 16 professional cyclists (some recently retired, others active, and some entering professional cycling). The study includes numerous anecdotes about the practices and perceptions of doping. Feel free to read the entire study here.

"You know with a little EPO, it's possible to perform; with a bit more power, you can do it." (Mick, neo-professional).

_"The experienced cyclists often introduced young cyclists to doping. Cyclists from the 'previous generation' gave advice concerning training, performance-enhancing substances or methods, and also taught doping techniques: ‘X (a former cyclist) showed Y (a young cyclist) how to use a syringe. He gave him two or three injections; afterwards, he demonstrated how to inject himself. Obviously, X taught Y everything. And for W (another young cyclist), it was the same, X taught him everything" (Bob, U23).

The first study clearly demonstrated that the health risks associated with doping do not necessarily deter the desire to dope. Those who use doping substances often overlook the long-term negative health consequences. While the study doesn't provide specific percentages, it offers insight into the mindset surrounding doping at the professional level.

The second study, which concentrated on EPO, has sparked debate. It includes tables showing that hematocrit (Hb) increases by 5–17 percent and VO2max by 6–9 percent in both untrained and trained cyclists who received EPO. However, there is controversy over whether this actually improves performance in cycling, which often involves submaximal effort over extended periods.

“Thus, based on the available evidence in the literature, we conclude that it is not proved that EPO has a performance-enhancing effect in elite cyclists.”

There are no large survey studies indicating exact user percentages in cycling, but studies on blood values have highlighted extreme values at the upper end. These extreme values have decreased in recent years, likely due to the implementation of the biological passport.

“In elite cycling, the percentage of ‘extreme’ (and therefore suspect) hematological values has dropped between 2001 and 2009 from 11 to 2 % [30], which can be regarded as an indication that hematological doping (or at least ‘extreme’ doping methods) has decreased during these years.”

This should be compared with those actually caught through testing, where the figure is 1 percent (221 convictions out of 22,471 tests).

Running is not free from cheating. Doping occurs here too, although the figures reported by the Swedish Athletics Federation are partly influenced by tests conducted in activities like Friskis & Svettis. However, doping is present even in elite athletics and running.

The figures are relatively low in athletics, particularly in running events.

Looking at the long-term development of running performance, there has been a gradual improvement. In a mathematical study from 2014 that utilized a performance index based on the top 25 runners each year, some interesting statistics emerged. Since 1948, we've become about 10 percent faster in the 100 meters, but nearly 50 percent faster in the marathon distance. The improvement is due to factors such as enhanced public health, larger populations, better nutrition, and healthcare. However, the index declined on three occasions: when unannounced doping tests began—dropping 1–4 percent; when WADA was established and stepped up anti-doping efforts—dropping 0.5–2.5 percent; and when timing chip technology was introduced (mainly affecting the 100 meters).

Doping also exists in running. In a study from 2007, doping in marathon running was examined, revealing five elite-level cases where medals were later revoked. While five cases may not seem many, it illustrates that the problem exists. Who can forget Abeba Aregawi, who was disqualified in 2016 for the use of meldonium?

WADA's doping figure in athletics stands at 1 percent (261 disqualified out of 25,830 tests). Breaking it down by event, the half marathon is at 3.3 percent, while the marathon is at 2.6 percent of doped participants. Note that this refers to competitions where tests were actually conducted.

The ski season might just be over, but unfortunately, doping is present even here — especially in cross-country skiing.

After the doping scandal in Lahti 2001, the Ski Federation, along with WADA, implemented more tests, stricter guidelines, and tighter thresholds for hematological parameters. In a six-year study between 2001 and 2007, the measured values among skiers were significantly lower than in the late 1990s, i.e., before the increased testing and enhanced thresholds. The study does not provide exact figures for the number of doping cases.

WADA's statistics show the figure 0.7 percent for all skiing disciplines (5,764 tested and 40 positive). Cross-country skiing accounts for the most samples and the most positive results: 2,158 urine samples with 32 positive results, which gives 1.5 percent.

Doping Usage = 1.5%

This question and more are addressed in a review article from 2013. The most common reason athletes use doping is performance enhancement. A full 86 percent of doped athletes in research contexts stated that performance was the main reason. 74 percent cited money as an important motivation. The two factors are linked — better performance increases the chance of podium finishes and prize money.

In a larger German survey conducted for WADA in 2007, 5.1 percent reported that their coaches encouraged them to start using doping, and 6.5 percent said they were encouraged by family and friends.

At both elite and sub-elite levels, most are aware of the risks of doping but often ignore them. The focus is on quick results, and long-term negative effects are seldom discussed among athletes. Here, associations, WADA, and the sports movement have a major responsibility to educate athletes about the risks. Besides being cheating, unethical, and ruining the sport they love, doping also destroys athletes' bodies. Perhaps one must first understand and love one's body enough not to destroy it?

Systematization & Prevention

In one of the larger review articles from 2015, a wide range in estimates of doping use is shown:

”The prevalence of doping in elite sports is likely to be between 14 and 39 %, although this figure can differ widely in various sub-groups of athletes.”

One reason doping is so serious is that some effects can linger long after use has ended. The substances can allow you to train harder and reach a level your body otherwise wouldn't have attained. The body adapts to the higher load, and you gain lasting advantages — a dilemma in the anti-doping debate.

In strength training, using growth hormones, anabolic steroids, and the like often results in lifelong effects (both positive and negative). There is therefore a discussion about whether lifetime bans should be imposed on dopers — something we can fundamentally support, as long as the systems for determining guilt are legally sound so that no innocent people are affected. We leave that part to WADA, research, and doping experts.

It is every athlete's responsibility to keep the sport clean and fair. The idea of the sport is based on fair play — competing without cheating. We have no quick fixes, but it involves continued education about the risks and long-term consequences. The introduction of hormones can increase growth and potentially risk tumor development is one of many risk factors that athletes may not even be aware of. This is where we need to start: with education.

A Doping Story to Highlight the Existence of Doping

Here is an excerpt from a “Letter to the Editors” to a study examining the effects of EPO on athletes. Such a letter is a scientific commentary and shows how researchers debate — text after text with references and respect for each other's work.

”Indeed, it has been a moving sports summer, with the confession by dozens of professional cyclists of the use of, among other substances, erythropoietin, with the public confession of seven-times Tour de France winner Lance Armstrong as the anticlimax.

Erythropoietin use was like taking cups of coffee in the cycling world according to the following quotation:”

‘Hey Dude, you got any Poe I can borrow? Lance pointed casually to the fridge. I opened it and there, on the door, next to a carton of milk, was a carton of EPO, each stoppered vial standing upright, little soldiers in their cardboard cells.’

If you're an athlete: keep track of WADA's list, use verified products, and rather ask a knowledgeable colleague than take a gamble. And if you're a coach: be clear — you win nothing real that is worth losing everything for.

(All references and figures in the text are preserved according to original sources.)