title: Drug misuse in sport: a New Zealand perspective.
abstract: OBJECTIVE
  Drug misuse in elite sport is a world-wide phenomenon. This article explores the culture of contemporary sport, provides estimates of doping prevalence, discusses dietary supplementation and highlights major factors influencing high-performance athletes and their support personnel. The aim is to stimulate discussion, informed by the World Anti-Doping Code (WADC), which is particularly relevant to doctors caring for athletes.
  
  
  METHODS
  Online databases were searched for relevant peer-reviewed research from 2009 to 2015. Comparative New Zealand data have been included.
  
  
  RESULTS
  Estimates of the prevalence of sports doping range from less than 1% to as high as 52%, dependent upon the demographics of the identified cohort. The culture of elite sport, personal stressors, competitive demands, financial reward and the influence of an 'entourage' of support personnel were identified as critical determinants of drug misuse.
  
  
  CONCLUSIONS
  The culture of elite contemporary sport is seductive to many aspiring young athletes. To combat drug misuse, effective education should embody moral, ethical and clinical dangers, recognising the importance of support at times of increased athlete vulnerability. Inadvertent doping from product contamination is a recognised risk of unsupervised dietary supplementation. Doctors responsible for the care of high-performance athletes must be cognisant of these issues and the provisions of the WADC.
authors.forename: Andrew
authors.initials: A
authors.lastname: Curtis
authors.affiliation: Medicine, Dunedin School of Medicine, University of Otago, Dunedin. david.gerrard@otago.ac.nz.
authors.forename: David
authors.initials: D
authors.lastname: Gerrard
authors.forename: Peter
authors.initials: P
authors.lastname: Burt
authors.forename: Hamish
authors.initials: H
authors.lastname: Osborne
mesh_terms: D003163:Competitive Behavior; D003469:Culture; D019587:Dietary Supplements / Q000706:statistics & numerical data; D004300:Doping in Sports / Q000523:psychology / Q000706:statistics & numerical data*; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D009520:New Zealand; D058573:Performance-Enhancing Substances / Q000627:therapeutic use*; D013177:Sports / Q000523:psychology / Q000706:statistics & numerical data*
chemical_list: D058573:Performance-Enhancing Substances