Medicine for the Outdoors
Medicine for the Outdoors

Dr. Paul Auerbach is the world's leading outdoor health expert. His blog offers tips on outdoor safety and advice on how to handle wilderness emergencies.

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Performance Enhancing Drugs and High Altitude

In the current issue of the journal Wilderness & Environmental Medicine, there is an interesting dialogue about the use (and abuse) of performance enhancing drugs (PEDs) to achieve greater heights or to ascend in the mountains at a more rapid rate. In these circumstances the PEDs in question are supplemental oxygen, acetazolamide (to hasten acclimatization), dexamethasone (a steroid medication used to prevent or treat acute mountain sickness and high-altitude cerebral edema, or brain swelling), nifedipine or sildenafil (to prevent or treat high-altitude pulmonary edema [fluid in the lungs]), and so forth.

The argument against using these drugs is logical – in their absence, the maximum height or rate of ascent could not be obtained. The argument for using these drugs is logical – they prevent or treat potentially life-threatening medical conditions.

No conclusion is reached, but the discussion is provocative. It seems valid from an elite climber’s point of view that using any supplement is a crutch and invalidates an “achievement.” It is likewise valid from a doctor’s point of view that prudent administration of drugs and oxygen are wise if they promote clear thinking, strength, and endurance, and minimize illnesses and accidents. The important point to remember is that nothing should be encouraged that promotes ignorance of the basic rules of slow ascent and proper acclimatization. Without adherence to these, the situation is a setup for a failed ascent at best.

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Tags: Climbing High

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About the Author

Dr. Paul S. Auerbach is the world’s leading authority on wilderness medicine.