WASHINGTON, May 26 (UPI) -- Everyone in sports is looking for an edge to help get stronger, faster and better than the athlete next to them, even outside the world of competitive, professional sports.
Drugs used to treat attention deficit hyperactivity disorder are entering the mainstream workout scene, with trainers and doctors helping people procure them when asked, if not offering them in the first place, researchers, doctors and athletes themselves report.
Students have long used stimulants typically prescribed to patients with ADHD, such as Adderall, to help them study or complete school work. Research has shown this to be a steady, if not growing, habit.
There is no shortage of chemical methods of getting ahead in the gym, with industries dedicated to concocting supplements to help build muscle, lose weight, increase focus and increase the ability to work harder -- easy to find in strip malls across the country.
Athletes have long used coffee in the gym, benefiting from the push of extra caffeine. The method has limits, though, which is where amphetamine-based prescription medications such as Adderall come into play.
"You can see this with people who are trying to maximize their workouts," Dr. Philip Veliz, a researcher at the University of Michigan, told UPI. "It's a way to get additional energy, and it increases focus -- it's that extra bump to motivate."
Adderall, a mixture of amphetamine salts, stimulates the central nervous system by limiting the use of dopamine and norepinephrine in the brain. In children and adults with ADHD, this acts to calm their impulses and help enhance self-control. In people without the condition, however, the drug acts like a strong dose of caffeine, waking them up and improving focus.
The drug is a Schedule II controlled substance, meaning it has potential for abuse and dependency, and is recommended to be used only under the supervision of a medical doctor because of its potential to damage the heart and vascular system, increase blood pressure and cause other gastrointestinal and central nervous system issues, according to the U.S. Food and Drug Administration.
A 2011 study showed concerns about adverse heart events were overblown, however, the agency still cautions people using the drug who have heart conditions or high blood pressure be monitored because of their higher risk for adverse health events, which had been seen in previous studies.
Experts recommend immediately contacting a doctor for side effects including chest pain, weakness or numbness in limbs, dizziness or seizures, among others.
For some sports, though any workout could see benefits, taking a stimulant kills the appetite, allowing athletes such as wrestlers to cut weight, while also providing extra energy for workouts or competition. For lacrosse players, Veliz says the drug could be particularly useful because the sport requires focus on hand-eye coordination at a high speed.
Veliz said the use of Adderall and other stimulants in sports is relatively "understudied," and it is not monitored -- especially in youth sports, where athletes are balancing not only a busy sports schedule but also schoolwork, making the extra focus from the drug attractive.
In a 2013 study, published in the Journal of Studies on Alcohol and Drugs, Veliz analyzed data from the 2010 and 2011 Monitoring the Future study, finding 8th- and 10th-grade participants of both sports were more likely to use the drug as a competitive aid.
Among amateur and recreational athletes, use of the drug has also been documented and is growing, as shown in a 2013 study that found 13 percent of triathletes in three events in Germany admitted to taking the drugs.
The National Football League and Major League Baseball also have had to deal with players testing positive for the drug, which is permitted for patients with a medical exemption for ADHD treatment.
The NFL, MLB and National Basketball Association allow exemptions but overall the drugs are outlawed in professional sports leagues -- the National Hockey League offers no exemption -- under performance enhancing drug bans.
Gregg D'Andrea, a Boston-based personal and corporate trainer, told New York Magazine the drugs are "the quiet performance enhancer no one really talks about." Years ago, he said, he would drink a few espressos and have a harder workout, but athletes are looking for a better, faster kick, which drugs like Adderall provide.
The drugs are reportedly common in gyms, with internet searches for "Adderall" and "gym" turning up page after page of advice on how and when to use the drug, how much to take and anecdotal evidence of its effects on workouts. Adderall was even among the methods offered to participants of The Biggest Loser, the NBC show showing people losing massive amounts of weight very quickly and purportedly improving their health.
A study by the National Institutes of Health about The Biggest Loser suggested the extreme workouts of participants deserved less credit for immediate and sustained weight loss than changes to diet, but makes no mention of Adderall or other performance enhancing drugs participants may have been using.
"Bob Harper was my trainer," Joelle Gwynn, a contestant on the 2008 season of the show, told the New York Post. "He goes away and his assistant comes in. He's got this brown paper bag that's bundled up. He says, 'Take this drug, it'll really help you.'"
Contestants on the show contend that, in addition to the show's doctor, Dr. Robert Huizenga, ignoring their concerns about substances they were strongly urged to use, his involvement with the study calls into question the research because of their experiences.
Huizenga, who said contestants on the show were never offered performance enhancers, and were tested and warned strongly against their use, would not be the only doctor offering substances to help with workouts. Some even endorse the use of Adderall because of its potential to intensify workouts.
"If taken properly and under the supervision of a doctor, and in low dosages and for a short duration, these stimulants are relatively safe," Dr. Ehsan Ali, who practices in Beverly Hills, offering primary medical care, as well as vitamin shots, IV drip therapy and Botox, told New York Magazine, explaining that some patients are looking for an extra edge and consider the drugs a good option -- which is why he has prescribed it for patients, with extra monitoring because of the dangers it can pose.
"Lots of patients do the juicing, they exercise, but it's all for looking good with their shirt off at the beach," Ali said. "They don't mind doing some 'less holistic' things to make themselves look better, and, yes, ADHD medications come up as part of that. They want to be their best, if not the best, in all aspects of life."