Codeine and Tramadol Use in Athletes: A Potential for Abuse
Thomas Zandonai, Mónica Escorial, Ana M. Peiró
Abstract
Analgesic use by athletes is common (Overbye, 2020). It has been observed that athletes used analgesics up to four times more often than their age-matched general population (Holgado et al., 2018a). Notably, codeine and tramadol are not included in the WADA list of prohibited substances in sport Their use could be an attempt to compensate for fatigue, pain, and inflammation caused by injuries It has been described that this abuse can be related to false expectations of performance improvement A 2017 study reported a small but a significant performanceenhancing benefit of tramadol in 20-min cycling time trial (Holgado et al., 2018b), however, with nonsignificant results being reported in subsequent studies (Experiment 2 of Holgado et al., 2018b; To the best of our knowledge, no studies have investigated codeine's effects on exercise performance. Tramadol used by athletes may be linked to its analgesic and mood-enhancing effects The suppression of pain sensation and increased pain tolerance and improved mood may be sufficient to motivate an athlete to push harder leading to small performance gains. However, tramadol and codeine may have side effects and health risks such as nausea, dizziness, drowsiness, and difficulty in concentrating Scientific evidence regarding the impact of use and abuse on the sports population's health is scarce We present an overview evidencing the athletes' use of codeine and tramadol and their potential abuse and addiction.