title: Drug Use and Misuse in the Mountains: A UIAA MedCom Consensus Guide for Medical Professionals.
abstract: Donegani, Enrico, Peter Paal, Thomas Küpper, Urs Hefti, Buddha Basnyat, Anna Carceller, Pierre Bouzat, Rianne van der Spek, and David Hillebrandt. Drug use and misuse in the mountains: a UIAA MedCom consensus guide for medical professionals. High Alt Med Biol. 17:157-184, 2016.-Aims: The aim of this review is to inform mountaineers about drugs commonly used in mountains. For many years, drugs have been used to enhance performance in mountaineering. It is the UIAA (International Climbing and Mountaineering Federation-Union International des Associations d'Alpinisme) Medcom's duty to protect mountaineers from possible harm caused by uninformed drug use. The UIAA Medcom assessed relevant articles in scientific literature and peer-reviewed studies, trials, observational studies, and case series to provide information for physicians on drugs commonly used in the mountain environment. Recommendations were graded according to criteria set by the American College of Chest Physicians.
  
  
  RESULTS
  Prophylactic, therapeutic, and recreational uses of drugs relevant to mountaineering are presented with an assessment of their risks and benefits.
  
  
  CONCLUSIONS
  If using drugs not regulated by the World Anti-Doping Agency (WADA), individuals have to determine their own personal standards for enjoyment, challenge, acceptable risk, and ethics. No system of drug testing could ever, or should ever, be policed for recreational climbers. Sponsored climbers or those who climb for status need to carefully consider both the medical and ethical implications if using drugs to aid performance. In some countries (e.g., Switzerland and Germany), administrative systems for mountaineering or medication control dictate a specific stance, but for most recreational mountaineers, any rules would be unenforceable and have to be a personal decision, but should take into account the current best evidence for risk, benefit, and sporting ethics.
authors: 1 Department of Cardiovascular Surgery, Sabah Al-Ahmed Cardiac Center , Al-Amiri Hospital, Kuwait, State of Kuwait.
authors: Enrico
authors: E
authors: Donegani
authors: 2 Department of Anaesthesiology and Critical Care Medicine, Innsbruck University Hospital , Innsbruck, Austria .|3 Department of Perioperative Medicine, Barts Heart Centre, St. Bartholomew's Hospital, Barts Health NHS Trust, Queen Mary University of London, London, United Kingdom .|4 Perioperative Medicine, St. Bartholomew's Hospital , London, United Kingdom .
authors: Peter
authors: P
authors: Paal
authors: 5 Institute of Occupational and Social Medicine, RWTH Aachen University , Aachen, Germany .
authors: Thomas
authors: T
authors: Küpper
authors: 6 Department of Orthopedic and Trauma Surgery, Swiss Sportclinic , Bern, Switzerland .
authors: Urs
authors: U
authors: Hefti
authors: 7 Oxford University Clinical Research Unit-Nepal , Nepal International Clinic, and Himalayan Rescue, Kathmandu, Nepal .
authors: Buddha
authors: B
authors: Basnyat
authors: 8 Sports Medicine School, Instituto de Medicina de Montaña y del Deporte (IMMED), Federació d'Entitats Excursionistes (FEEC), University of Barcelona , Barcelona, Spain .
authors: Anna
authors: A
authors: Carceller
authors: 9 Department of Anesthesiology and Critical Care, University Hospital, INSERM U1236, Neuroscience Institute, Alps University, Grenoble, France .
authors: Pierre
authors: P
authors: Bouzat
authors: 10 Department of Endocrinology and Metabolism, Academic Medical Center Amsterdam, University of Amsterdam , Amsterdam, The Netherlands .
authors: Rianne
authors: R
authors: van der Spek
authors: 11 UIAA Medical Commission, UIAA Office , Bern, Switzerland .
authors: David
authors: D
authors: Hillebrandt
keywords: acclimatization; acute mountain sickness; altitude; doping; exercise; mountain medicine; prevention; sports; training; treatment