Most interesting thing I have read on the topic for a long time. https://sports.vice.com/en_us/article/the-drugs-won-the-case-for-ending-the-sports-war-on-doping It's a long article, well worth reading. Here are some of the key points for those who don't like long articles (I am guessing about 80% of my fine Sherbros): Testing has become a large industry but its budget is small even compared to some of the individual athletes who are tested (e.g. the World Anti-Doping Ag (encyWADA) has an annual budget of $30m), meaning that people are always likely to have the resources to evade Testing has a very low hit rate- in 2012 1% of people checked by WADA-accredit tests tested positive; estimates of athletes using PEDs vary from 45% to 90% in some sports (e.g. cycling) Even very draconian testing regimes don't work; athletes simply have too strong a motivation to take PEDs. While failing to catch that many people using PEDs, they do succeed in massively invading the privacy of athletes (e.g. inspecting their genitals during piss-testing and under some regimes requiring them to register their location and movement plans at all times); authorities also engage in capricious and arbitrary behaviour, e.g. banning athletes for substances with no known performance benefit, or banning for things retrospectively. A male tennis player was banned for excess use of Caffeine (yes) and Maria Sharapova was banned for a heart medication that she had been using for several years, which was outlawed only at the beginning of the year Maintenance of prohibition means that people are relying often on counterfeit drugs, frequently administered by people without full knowledge of them; if not prohibited they could be administered more safely. It also means that we have a very small research base around them; most of what is known about the effect on humans is, the article says, known from studies of bodybuilders (I guess in non-clinical settings), who have probably used massive amounts of different drugs, many of questionable quality, and so may not give much information about what a scientifically administered regimen would do The line between PED and a medical procedure is not clear anyway. Growth hormones may be able to stimulate repair of knee cartilage or ligaments. That can allow someone to perform better, or for longer. Baseball players often get Lasik surgery to give them better vision, which also improves performance. There is a sort of moral argument that PEDs mean people are not competing on a "level playing field". But arguably the playing field is not level anyway: in addition to genetic endowment (yes, it usually makes a big difference but that's another story), there is also the luck involved of being born into a family with an interest in exposing a child to sports, or somewhere there is access to coaches and competition. There is another argument that unlimited use of PEDs creates "artificial men" and that is contrary to the spirit of the sport. The counter-argument suggested in the paper, I think, is that this is going on for so long anyway and the line is blurred. The main concern or remaining argument is that without a ban, there would be a PED "arms race", with people free to take as much of they want, no matter how risky. I guess the main issue here is what is the total amount of harm that would be done, compared to the current prohibition regime. That's quite a long tl;dr!