The organisers of the Enhanced Games are promoting the idea that performance-enhancing drugs (PEDs) can be used safely, and that humanity has a duty to explore their potential to maximise human performance. To advance this agenda, they propose an alternative to the Olympic Games — the Enhanced Games — in which athletes will be actively encouraged to use substances and methods that are prohibited in the Olympics and most professional sports.
They claim athlete safety can be ensured through health monitoring and other support measures, although details on these remain limited.
A major issue with implementing health safeguards for athletes using substances such as anabolic steroids or erythropoietin is the lack of a reliable evidence base to inform these measures. This includes insufficient data on the potential side effects of these drugs and how to mitigate them.
In our recent paper, we argue that such an evidence base does not currently exist, and that crucial information on the effects of commonly used PEDs is missing. For instance, it is known that anabolic steroid use can lead to heart enlargement, often accompanied by stiffening of the heart wall and thickening of the blood. These changes can impair heart function and increase the risk of heart attacks.
However, we lack detailed knowledge about how different types of anabolic steroids, specific dosing regimens, and usage patterns relate to these cardiac effects.
The limited evidence available — mostly observational rather than experimental — suggests that while some individuals experience severe side effects, others do not, and we have little understanding of why. Similarly, some users develop long-term issues that progress slowly, while others experience short-term effects that resolve quickly. Again, we lack sufficient data to predict these outcomes.
The situation is further complicated when athletes use novel substances with minimal human data (e.g., research peptides, selective androgen receptor modulators [SARMs]) or combine multiple PEDs — a common practice among users. As such, there is currently no robust evidence base to support the Enhanced Games’ proposed safety protocols.
Another concern is that the performance-enhancing effects of PEDs take time to develop, requiring use well in advance of competition. If the Enhanced Games are serious about athlete safety, they would need to provide comprehensive medical oversight starting now and continuing well beyond the conclusion of the Games.
It is unclear how they plan to manage this, or how they intend to address serious side effects in athletes to whom they have provided PEDs. As it stands, the Enhanced Games resemble a poorly designed drug trial lacking ethical oversight, rather than a credible alternative to the Olympic Games.
