Recent investigations during the Nordic World Ski Championships in Seefeld drew worldwide attention to the explosive doping issue. The list of banned substances is updated annually by the World Anti-Doping Agency (WADA). Anabolic substances (e.?g. classical anabolic steroids, clenbuterol), certain peptide hormones, and growth factors (e.?g. EPO, GH), beta-2-agonists (except e.?g. salbutamol with defined restrictions), hormone and metabolic modulators (e.?g. tamoxifen), diuretics and masking agents are always prohibited as well as previously unapproved substances. The manipulation of blood and blood components, chemical and physical manipulation as well as gene and cell doping are also always prohibited. In addition, stimulants, narcotics, cannabinoids, and systemically applied glucocorticoids are prohibited in competition. Beta blockers are only banned in certain sports such as shooting. Alcohol is no longer on the prohibition list since January 1st, 2018. While the media interest focuses on the highperformance athletes, from a threatening epidemiological perspective, the real danger can be identified in recreational sports. In a separate survey of 484 recreational athletes in the area of Frankfurt/Main (2013), 12.9 % of men and 3.6 % of women in fitness studios admitted that they used doping substances. Possibly, there is a city-country gap, because further surveys in rural fitness studios in Franconia with 432 athletes (2014) and in the district of Traunstein (2015, n = 206) showed only proportions of 3.2 % and 5 % doping athletes. Various physical symptoms can be summarized as indicia of doping abuse, called doping signs or doping stigmata: e.g. steroid acne, clitoral hypertrophy, or exophthalmus for anabolic steroids, acromegaly or verticis gyrata for GH, speedpimples for amphetamines, or rubeosis faciei for EPO/blood doping. Synthol is a mixture of oil (85 %), lidocaine (7.5 %) for analgesia, and benzyl alcohol (7.5 %) for disinfection, which is injected into the musculature to induce monstrous muscle formation. When boosting in disabled sports, the athlete himself brings nociceptive stimuli, in order to produce an amphetamine-like effect. © 2020 Mediengruppe Oberfranken - Fachverlage GmbH & Co. KG. All rights reserved.