The first time I was given an out-of-competition drug test, I was teaching. We were in the middle of the Age of Exploration unit, and I was introducing my eighth-grade Medieval History class to Ferdinand Magellan. Like Magellan, I embarked on my own adventure into the unknown when two figures appeared outside my classroom — the Head of School and a doping control officer.
The officer escorted me down the hallway for a drug test in the faculty kitchen. I ground my teeth, worrying — not about the outcome of my drug test but about what my students would tell their parents at the end of the day: “Magellan died before the expedition was complete, and Mrs. Little was tested for drugs.”
A more mature Sabrina Little, having won the 2018 Cayuga Trails 50 Mile. Photo courtesy of Sabrina Little
I am now far removed from the days of World Anti-Doping Agency (WADA) surprise visitations. Retrospectively, I am grateful for the inconvenient, sometimes awkward, intrusions in my days. Clean sport is worth protecting. Because if running is not clean, then what is the point?
Integrity for the Non-Elite Runner
Over the past year, there has been a growing discourse about whether non-elite runners should be subject to the same ethical standards as elite-level and professional runners.
For example, does it matter if runners take performance-enhancing drugs, such as anabolic steroids or amphetamines, if they are unlikely to win a race (1)? This is not an abstract question. A recent U.K. Anti-Doping survey found that one-third of people in the U.K., ages 16 to 25, have purchased performance-enhancing drugs (2), and an estimated three to four million Americans use unregulated, unsupervised performance-enhancing drugs (3). These are significant numbers.
Elite or not, should all runners be subjected to the same standards? Photo: iRunFar/Eszter Horanyi
Banned supplements are nothing new in sports and fitness culture. However, we are currently seeing an increase in certain drugs among athletes. For example, anxieties about appearance, attributed to social media use, have contributed to the rise of anabolic-androgenic steroids in men (4). Also, certain drugs and supplements are advertised on social media as shortcuts to improve body composition, both to support sports performance and to satisfy aesthetic trends. Runners may be susceptible to these trends. According to a 2024 study, 16.3% of anonymous samples given by ultrarunners at an event tested positive for banned substances (5).
For those who care about clean sport, these statistics are worrying. If clean sport matters for runners within a sports culture in which performance-enhancing drugs are increasingly common (6), we should be able to defend its importance.
This is what I intend to do here. Here are five reasons why clean sport matters for the non-elite runner.
The Line Between Professional and Non-Professional Runners is Permeable
Last year, I had the chance to sit courtside at a basketball game. I was close enough that my shoes caught some sweat. When one of the taller players fell to the floor, my body shook with the impact. I felt like I was part of the spectacle, out there with the players. But let’s be clear; I was not.
This is a key difference between elite-level competition in running versus in other sports. In basketball, you don’t just hop onto the court with LeBron James. But in running, the masses line up alongside the professionals. Sure, many are significantly slower, but they run the same races on the same courses.
The start of the 2025 Hardrock 100 where elites line up next to non-elites. Photo: iRunFar/Bryon Powell
Runners receive placings continuous with the professionals, and there is often intermingling between the slowest professionals and the fastest amateurs. The competitive difference is one of degree, rather than kind.
In trail running and ultrarunning — where competitive density is lower, and there are fewer professional contracts — the intermingling of professional and non-professional runners happens all the time. The idea that there are two separate classes — those competing for podiums and those who are not — is absurd. When you line up to compete, you are in the race. Anything can happen.
This is the first case for maintaining consistent ethical norms. Without this consistency, we need separate placement categories, and we should desist comparisons between groups.
Racing is a Game, and Games Have Constraints
My husband and I do not like board games. If we are going to sit still, we would rather read. For this reason (and others), we were pleased to have found each other. We assumed that we would not have to play Monopoly again for the rest of our lives. Unfortunately, our kids are not on the same page. They are games people. So last week, we purchased our first family board game — Candyland.
A few hours later, we found ourselves sitting on the living room floor with our two flustered daughters. “You can’t just move your figurine anywhere you want,” I advised my three-year-old. “The rules are what make Candyland a cooperative social practice.”
Ultrarunning is a game where you get to eat a lot of snacks and follow some other rules. Photo courtesy of Gabe Joyes.
Games are defined in two ways — positive and negative, or in terms of what you can do and what you can’t. In Candyland, you can move your piece to a yellow square if you choose a yellow card. You can’t move your piece to a yellow square if you select a purple card. You can move your own piece. You can’t move your sister’s piece. In the running context, you can race in sneakers, but you can’t wear rollerblades. You can eat a banana, but you can’t take EPO.
Oddly, limitations (or negative rules) are part of what makes games fun. In his 2020 book, “Games: Agency as Art,” C. Thi Nguyen describes limitations as a feature, rather than a bug, of games. Games are often limited by inefficient, narrow constraints or rules, and yes, under certain descriptions, these rules undermine our autonomy (7). We cannot do whatever we wish to do when we participate in a game. However, when we willingly enter a game, the rules can expose us to different forms of agency, or possibilities for exercising our wills.
Rules can also facilitate creativity. We strive and puzzle through how to improve, given our limitations. We honor our constraints, rather than begrudge them.
Banned substance use can take away the essence of the game of running. Photo: iRunFar/Eszter Horanyi
An example in running is that training volume and intensity are limited by the body’s recovery capacity. You can only perform so much work before it becomes unproductive. Often, the life of the runner consists of puzzling through how to accomplish more work in a week without flagging (hence, double thresholds and incorporating speedwork into long runs). If a runner suddenly starts taking EPO or other banned substances — such that her barriers to absorbing work are eliminated — sure, she can run more. However, this ceases to be the same game, involving the same puzzle of how to creatively strive within natural constraints. This runner is no different than the child taking double jumps in Candyland.
Performance-Enhancing Drugs May Pose Health Risks
If you dope, you may become ill. This is one of the reasons why drugs are often banned from sports in the first place (8).
For example, androgenic-anabolic steroids and steroid precursors can cause cancers, cardiovascular issues, psychosis, and liver damage (9). These drugs are often unregulated and taken without supervision, which can be dangerous (10). Many steroids have production issues such as contamination, product dosing inconsistencies, and hygiene concerns (11). EPO can cause heart attacks and strokes, and certain stimulants can cause tremors and heart issues (12).
A common reason why people run is to preserve good health. Doping can undermine this objective.
Runners Come From Somewhere
Before I ran professionally, I ran in local turkey trots and five-kilometer races. I was raised by a community of local runners who welcomed me into the sport and taught me how to compete well — to congratulate the person who beat me, to make new friends on the warm-up and cool down, and to run courses with integrity, rather than cutting corners or otherwise making the playing field unfair.
The Hardblock race at the 2025 Hardrock 100. It’s never too early to teach the ethics of fair competition. Photo: iRunFar/Bryon Powell
This is another reason why we should maintain consistent moral norms across non-professional and professional racing: Professional runners do not just materialize from thin air. They are introduced to the sport and mentored through the running community at large. If that community has a cavalier attitude toward drugs, or is broadly complicit in illicit supplementation, this makes compunctions around drugs less acute at all levels of the sport.
This will impact the posture of elites toward performance-enhancing drug use. Is this really what we want in an era of growing disillusionment with peak performances?
Striving is the Point
Consider why you joined the sport in the first place. Maybe you wanted to see what you were capable of — to do the best you possibly could, overcoming your perceived limitations.
This is the “spirit of sport.” It is an aesthetic value that captures something like the kindergarten spirit of play. You line up at recess and see who is the toughest or quickest, unaided and unenhanced. It is not a measurement of shoe technology or exogenous substances. It’s about people striving honestly together and being edified by the effort.
Incorporating drugs into this process — no matter how fast you are — undermines the process of edification. Cheating makes measures of progress meaningless and diminishes the transformative value of the sport.
Striving is the point. Photo: iRunFar/Eszter Horanyi
Final Thoughts and a Call for Comments
So, if clean sport is worth defending, how should we enforce doping norms among the masses? Honestly, I am not sure we can. Doping control is expensive, and we already do a poor job of testing elites. Also, many people are prescribed banned drugs for therapeutic reasons. For example, a runner may be prescribed an inhaler for asthma or hormone replacement therapy to preserve bone health. It seems unrealistic to require that an amateur athlete submit a therapeutic use exemption to document their prescriptions for banned substances. This is a lot of paperwork, and it is unclear who would be responsible for reviewing it. So, where does this leave us? Should we just give up the idea of clean sport?
I think it is possible to support a norm (competing clean) without policing therapeutic and non-therapeutic drug use in non-elites. This should probably start with education about why doping is a problem — both for personal health and for the sport as a whole. Also, leaders in the running community could publicly advocate for clean sport.
There’s no easy solution to maintaining social norms, but there are steps we can take. Photo: iRunFar/Eszter Horanyi
A few years ago, the Clean Sport Collective invited athletes to pledge to train and compete clean (13). Maybe we could start something like that to instruct runners about which actions are impermissible in competition and to generate enthusiasm and consensus for competing above reproach.
So, this is a modest proposal because I do not know how to fix things. I am thoroughly convinced that doping is not a healthy norm for the sport, but I do not know how we can feasibly defend clean sport. Any ideas?
[Editor’s Note: We know this is a sensitive topic, and we welcome discussion of this story in the comments section. Comments violating our comment policy, designed to foster constructive dialogue, will be removed. Thank you.]
Notes/References
- Another question concerns whether it is acceptable for non-professional runners to race in shoes that violate World Athletics’ 40-millimeter maximum stack height. This is too much to undertake in a short article.
- M. Lawton. 11 May 2026. Third of young people have bought ‘life-threatening’ performance-enhancing drugs. The Times. Web <https://www.thetimes.com/article/uk-anti-doping-young-people-performance-enhancing-drugs> Accessed 12 May 2026.
- M. Hastings. 3 June 2025. Jacked: Rising use of steroids and other performance-enhancing drugs carries risks. University of Colorado Anschutz. Web <https://news.cuanschutz.edu/news-stories/jacked-rising-use-of-steroids-and-other-performance-enhancing-drugs-carries-risks> Accessed 12 May 2026.
- Beos, N., Kemps, E., & Prichard, I. (2025). Relationships between social media, body image, physical activity, and anabolic-androgenic steroid use in men: A systematic review. Psychology of Men & Masculinities, 26(1), 105–128.
- Robach P, Trebes G, Buisson C, Mechin N, Mazzarino M, Garribba F, Roustit M, Quesada JL, Lefèvre B, Giardini G, DE Seigneux S, Botré F, Bouzat P. 2024. Prevalence of Drug Use in Ultraendurance Athletes. Med Sci Sports Exerc. 56(5): 828-838.
- Dandoy, C., & Gereige, R. S. (2012). Performance-enhancing drugs. Pediatrics in review, 33(6), 265–272.
- Nguyen, CT. 2020. Games: Agency as Art. Oxford University Press, 74-5.
- See USADA. Effects of Performance-Enhancing Drugs. Web <https://www.usada.org/substances/effects-of-performance-enhancing-drugs/> Accessed 13 May 2026.
- Dandoy, C., & Gereige, R. S. 2012; A. Al Hamid, L. Alomani, A. Aljuresan, W. Alahmad, Z. Alluwaim. 2025. Steroid and illicit drug abuse in the health and fitness community: A systematic review of evidence. Emerging Trends in Drugs, Addictions, and Health. 5: 100172.
- M. Hastings. 3 June 2025.
- Gibbs N. (2023). #Sponseredathlete: the marketing of image and performance enhancing drugs on Facebook and Instagram. Trends in organized crime, 1–40.
- Mayo Clinic. 2023. Performance-enhancing drugs: Know the risks. The Mayo Clinic. Web <https://www.mayoclinic.org/healthy-lifestyle/fitness/in-depth/performance-enhancing-drugs/art-20046134 > Accessed 12 May 2026.
- USADA. “The Clean Sport Collective.” See https://www.usada.org/spirit-of-sport/five-voices-fighting-for-clean-sport/
