Performance-enhancing drug statistics describe several different measurements: nonmedical anabolic-androgenic steroid use, athlete adoption, laboratory findings, physiological effects and dependence. The figures below identify their populations, periods and limitations so that prevalence estimates are not confused with anti-doping test results or clinical outcomes.
Key Performance Enhancing Drug Statistics
The most broadly useful figures include:
- In global studies published through 2013, 3.3% of study populations reported lifetime nonmedical anabolic-androgenic steroid use (95% CI 2.8%–3.8%).
- In the same global meta-analysis through 2013, 6.4% of males reported lifetime anabolic-androgenic steroid use (95% CI 5.3%–7.7%).
- In global studies through 2013, 1.6% of females reported lifetime anabolic-androgenic steroid use (95% CI 1.3%–1.9%).
- Among Iranian athletes in studies from 1980 through December 2019, 36.2% had estimated anabolic-androgenic steroid misuse prevalence (95% CI 29%–43%).
- Across studies of young athletes, 4% had combined estimated ever-use of anabolic steroids.
- Across included studies, amateur and college athlete performance-enhancing-drug prevalence ranged from 1.1% to 18.3%.
- WADA laboratories analyzed 288,864 samples in the ADAMS-reporting sport system in 2023.
- In 2023, 2,313 adverse analytical findings were recorded across Olympic and non-Olympic sports.
- The overall 2023 adverse analytical finding rate was 0.80% of analyzed samples.
- In 2023, non-Olympic sports had a 1.88% adverse analytical finding rate, compared with 0.57% in Olympic sports.
- From 2018 to 2023, Olympic-sport samples increased from 220,659 to 238,821.
- Across umbrella-review evidence through 2022, anabolic-androgenic steroids were associated with 5%–52% increases in strength.
- The same evidence found a 0.62 standardized mean difference in lean body mass associated with anabolic-androgenic steroids.
- A pooled estimate found 32.5% of anabolic-androgenic steroid users developed dependence (95% CI 25.4%–39.7%).
- In literature through 2022, athlete SARM-use prevalence was estimated at 1%–3%.
- In 2023, 117 erythropoietin-receptor agonist findings were recorded, including 90 urine and 27 blood findings.
Contents
- Global prevalence and anabolic-steroid data
- Athlete and gym-user adoption statistics
- Anti-doping testing and findings
- Performance effects of anabolic steroids, growth hormone and erythropoietin
- Dependence and measured health outcomes
- SARMs and other performance-enhancing drug statistics
Global Performance-Enhancing Drug Prevalence and Anabolic-Steroid Data
The global meta-analysis covered 187 studies and 271 original lifetime-prevalence rates, with studies published through 2013. Its pooled estimate was 3.3%, but the very high heterogeneity (I²=99.7%) means that study populations and methods varied substantially.
| Population or comparison | Estimate | Period and scope |
|---|---|---|
| Global study populations | 3.3% lifetime prevalence | Studies through 2013; 95% CI 2.8%–3.8% |
| Males | 6.4% lifetime prevalence | Global study populations; 95% CI 5.3%–7.7% |
| Females | 1.6% lifetime prevalence | Global study populations; 95% CI 1.3%–1.9% |
| Male–female difference | 4.8 percentage points | Derived comparison of pooled estimates |
Source: The global epidemiology of anabolic-androgenic steroid use: a meta-analysis and meta-regression analysis. The 4.8-point comparison is arithmetic based on the two pooled estimates, not a separate study result; heterogeneity was also high for males (I²=99.2%) and females (I²=96.8%).
A separate systematic review of Iranian athletes, covering studies from 1980 through December 2019, estimated anabolic-androgenic steroid misuse prevalence at 36.2% (95% CI 29%–43%) across 39 articles. The review reported 36.3% among bodybuilding athletes and 30.9% among athletes in other sports, with heterogeneity of I²=99.0%.
Source: The Prevalence of Anabolic-Androgenic Steroid Misuse in Iranian Athletes: A Systematic Review and Meta-Analysis. These subgroup estimates should not be treated as directly comparable with the global pooled estimate because the populations, sport definitions and study designs differ.
Young-athlete research found ever-use estimates ranging from 2% to 6%, with a combined prevalence of 4%. That pooled estimate had substantial heterogeneity (I²=93.2%) and spans studies with differing countries, ages and survey designs.
Source: How Healthy is the Behavior of Young Athletes? A Systematic Literature Review and Meta-Analyses.
Athlete and Gym-User Performance-Enhancing Drug Adoption Statistics
Reported prevalence among amateur and college athletes ranged from 1.1% to 18.3% in the umbrella review. The range combines different substances, sports, competition levels and definitions, so it is not a single estimate for all athletes.
The review searched through April 8, 2022, screened 3,033 imported studies, and identified 27 eligible reviews evaluating five pharmacological interventions. Included evidence averaged 1,736.8 participants per substance, ranging from 453 to 5,912; this is evidence-base context rather than population prevalence.
SARM case reports illustrate why clinical reports cannot be converted into adoption rates:
- Of 15 published SARM-abuse case reports identified through 2022, 8 involved athletes.
- All 15 cases described male patients, whose median age was 32 years, with a range of 19–52.
- Five of the 15 cases explicitly denied illicit drug use.
These are selected clinical cases, not a representative sample of gym users or athletes, and their denominator cannot estimate athlete prevalence. The same umbrella review included creatine among pharmacological interventions; that inclusion does not make creatine an illicit drug or imply that creatine users are performance-enhancing-drug users.
Anti-Doping Testing, Adverse Findings and Sport-Level Trends
WADA’s 2023 figures cover Signatory testing reported into ADAMS and exclude non-signatory results. An adverse analytical finding (AAF) is a laboratory finding, not necessarily a unique athlete, adjudicated violation or sanction; atypical findings can require further investigation, and therapeutic-use exemptions can affect results.
| Measure | Olympic sports | Non-Olympic sports | Overall or comparison |
|---|---|---|---|
| Samples analyzed, 2023 | 238,821 | 50,043 | 288,864 |
| Change from 2022 | 9.2% | 31.7% | Total samples +12.5% |
| AAFs, 2023 | 1,373 | 940 | 2,313 |
| AAF rate, 2023 | 0.57% | 1.88% | 0.80% |
| Total-finding rate, 2023 | 0.73% | 2.07% | 0.96% |
Source: 2023 Anti-Doping Testing Figures: Executive Summary. The total-finding rate combines AAFs and atypical findings and is not a sanctioned-case rate.
Olympic-sport samples rose from 220,659 in 2018 to 238,821 in 2023, while non-Olympic samples rose from 42,860 to 50,043. Total AAFs fell from 2,774 in 2018 to 1,009 in 2020, then reached 2,313 in 2023; pandemic-era testing disruption affects this series.
The overall AAF rate was 1.05% in 2018, 0.67% in 2020 and 0.80% in 2023. These rates reflect changing testing volume and composition, not a direct measure of doping prevalence.
Testing-system expansion also changed across 2022–2023: international federations using Athlete Biological Passport blood testing rose from 25 to 32, while national anti-doping organizations using it rose from 78 to 92.
In 2023, the GC/C/IRMS method had a 2.45% AAF rate, the highest proportion among methods reported by WADA. Method-specific rates do not represent all samples or athletes.
Erythropoietin-receptor agonist testing increased from 51,678 urine tests in 2022 to 58,455 in 2023, and from 3,776 blood tests to 4,323. ERA findings totaled 117 in 2023: 90 urine AAFs and 27 blood AAFs, with findings potentially involving repeat measurements or the same athlete.
Growth-hormone isoform tests numbered 16,952 in 2023 versus 16,680 in 2022, while biomarker tests fell from 4,500 to 4,065. WADA recorded one growth-hormone AAF in 2023 versus five in 2022; GHRF urine tests numbered 58,549 in 2023 versus 56,885 in 2022, and GHRF AAFs rose from 14 to 16.
Performance-Enhancing Drug Performance Effects: Strength, Lean Mass and Oxygen Use
The umbrella review summarized different outcomes rather than one universal performance effect. Across included systematic reviews and meta-analyses through 2022, anabolic-androgenic steroids were associated with strength increases ranging from 5% to 52%, reflecting different interventions and studies.
The pooled association with lean body mass was a 0.62 standardized mean difference. Protocols and populations differed, and evidence quality varied across the reviews.
Evidence for recombinant human erythropoietin showed increases in VO2max and maximal power output, but the umbrella-review conclusion found limited evidence of overall performance benefit. Severe cardiovascular risks were also documented in that evidence synthesis.
The umbrella review’s evidence base included three low-quality reviews, 12 moderate-quality reviews and 12 high-quality reviews. Across substances, the mean number of reviews was 5.4, ranging from 2 to 14; the mean number of primary studies per review was 18.5, ranging from 3 to 96, with possible overlap among primary studies.
Source for the performance and evidence-base findings: Performance-Enhancing Drugs in Healthy Athletes: An Umbrella Review of Systematic Reviews and Meta-analyses.
Performance-Enhancing Drug Dependence and Measured Health Outcomes
A random-effects synthesis of 10 studies estimated that 32.5% of anabolic-androgenic steroid users developed AAS dependence (95% CI 25.4%–39.7%). The scientific statement noted that dependence estimates were largely male and based on modeled survey evidence, with studies predominantly from the United States and international AAS-user populations.
Among 363 reported cases of AAS dependence in the cited pooled studies, only two were female. That case composition reflects the available studies and cannot establish sex-specific risk.
The scientific statement also estimated that about 1 million men in the United States had experienced AAS dependence at some time. This was a model-based estimate reported in a 2014 statement, derived by applying the pooled dependence proportion to prior U.S. AAS-use estimates; it should not be read as a current prevalence count.
SARMs, Cannabis and Other Performance-Enhancing Drug Statistics
SARM statistics require separate treatment from anabolic-steroid statistics because the substance definitions and evidence sources differ. A systematic-review estimate for athlete SARM-use prevalence was 1% to 3% in literature through 2022, while the search identified 72 articles published from 2003 through 2022.
The 72-article count describes the literature, not the number of users. Likewise, the 15 SARM-abuse case reports describe selected patients and cannot establish population prevalence, athlete participation or a rate of adverse outcomes.
Across these categories, the most important interpretive distinction is the measurement type: a survey or meta-analysis estimates use, a laboratory report counts findings, a trial measures physiological outcomes, and a clinical synthesis estimates dependence or harm. Those measures answer different questions and should not be combined into one performance-enhancing-drug prevalence figure.