Performance Enhancement in Endurance Sports: OVDO, Caffeine, Coca, and the “Black Drink”

Modern athletes are constantly in the news for doping scandals, from Lance Armstrong’s doping during his Tour de France wins to the allegations of Alberto Salazar doping his Nike Oregon Project athletes. In 1999, the World Anti-Doping Agency was founded to monitor and coordinate anti-doping efforts as well as enforcing the World Anti-Doping Code, which includes a list of all banned and restricted substances for all sports and countries (World Anti-Doping Agency 2018). While some may assume this tendency of elite athletes to try to attain higher levels of performance through the use of banned or illicit substances is a new trend prompted by recent scientific advancements, evidence from prehistoric and historic human societies points to the opposite being true. Athletes have been attempting to improve their performance by ingesting strange and dangerous substances since the dawn of time.In Ancient Greece, around 150 A.D., athletes used a substance known as “Olympic Victor’s Dark Ointment” for pain management and to have an advantage over their opponents (Bartels 2006). In the Andes mountains of Peru, around 800 B.P., the Incas were chewing on coca leaves as a way to prevent altitude sickness and to take advantage of it’s mild stimulant effect, which behaves similarly to the effect of a morning cup of coffee (Stolberg 2011). In North America, around 1050-1250 A.D., Mississippians were ingesting the caffeine-laden “Black Drink” before lacrosse games and religious ceremonies (Hudson 1979). All of these substances were utilized by individuals in these societies to improve their performances in sports or endurance activities, and they are all still in use in today’s society although not necessarily in quite the same forms.

In Ancient Greece, athletes had intense pressure to keep performing at a high level within their sport. Sporting events like the Olympic Games were hugely popular with the populace, and athletes were willing to do whatever it took to stay within the high-ranking athlete social class.Plato was outspoken about the corruption and bribery that was spawned within the athletic circle due to the high level of honors and rewards given to winning athletes(Higgins 2006). One particularly important way to stay ahead was pain management. Being pain-free meant you could train more and stay fit, especially if your competition was injured or could not train. Many athletes turned to some form of substance abuse to stay pain-free, with some going so far as to abuse narcotics to block any pain. One such substances was known as the “Olympic Victor’s Dark Ointment”, or “OVDO”. OVDO has been studied recently and has been found to be composed of three main active ingredients: Frankincense, Saffron, and Poppy. These three substances all have different effects on the human body. Frankincense contains the cannabimimetic compound Incensole Acetate, which binds to CB1 receptors in the brain that are involved in motor function, pain, and mood control (Bartels 2006). Saffron is notable for its saponin content, which is effective against pain and swelling. Poppy is the source of the well-known narcotic opium, and the makers of OVDO specifically extracted what they referred to as the “tears of the poppy”, otherwise known as opium (Bartels 2006). The effect of the “tears of the poppy” on an athlete would have been similar to the effect of modern-day morphine. The scientists who determined the makeup of OVDO also identified multiple possible side effects that an athlete may have experienced after using OVDO: addiction, abnormal thinking, blurred vision, cramps, dizziness, drowsiness, fainting, headaches, rigid muscles, tremor, uncoordinated muscle movements, and weakness (Bartels 2006). While the side effects are numerous, OVDO was likely effective for athletes seeking to reduce their pain to a manageable level, and seems to have been a popular remedy. In modern sports, pain management is still an issue for athletes. Substances like morphine and other narcotics are universally banned by WADA, so cannot be used during competition like they would have been in Ancient Greece. However, they are not banned from use outside of competition, so an athlete who breaks a bone or suffers some other sort of painful injury can still use powerful pain relieving medicines. While the rules surrounding competition may have changed over time, the use of narcotics for pain relief is just as prevalent today as it was back in Ancient Greece.

Another reason that an athlete may turn to substance abuse for performance enhancement is to bring about various physiologic changes within their body that will allow them to perform at a higher level with little or no extra work on their part. One example of this type of substance abuse comes from the Inca, who have been chewing coca leaves (Erythroxylum coca) since 800 B.P (Dillehay 2010). The Inca were (and still are) located in the Andes mountains of Peru, and they tended to spend a great deal of time at high altitude due to living on mountains. Living at high altitudes can cause altitude sickness, as well as cause some beneficial physiologic effects within the human body. Many elite endurance athletes choose to live at high altitude to increase their erythropoietin production (EPO), increase their VO2 max, and increase their mitochondrial volume and lung efficiency. These changes are all beneficial to the athlete when they come down from the high-altitude area to race or play their sport.  Altitude sickness is quite a detrimental side effect of living at high altitudes, however. Being able to avoid the symptoms of altitude sickness while reaping the physiologic benefits of high altitude living would be the ideal setup for an athlete, in modern or ancient times. Coca leaves contain an assortment of various minerals and chemical compounds, the most well-known of which is the alkaloid cocaine (Stolberg 2011). Chewing coca leaves provides a mild stimulant effect that can suppress hunger, pain, and thirst while also preventing the symptoms of altitude sickness (Stolberg 2011). Several studies have been done to assess the impact of coca leaf chewing on athletic performance, beyond the mild stimulant effect. One such study, from the Indian Journal of Biochemistry, found that there did not appear to be any differences in oxygen saturation, blood pressure, pulse rate, or ECG readings between coca chewers and non-chewers (Casikar 2010). There were some VO2 max differences between the chewing and non-chewing groups, but those differences were not determined to be statistically significant. However, there were chances in biochemical parameters, like glucose levels and glycerol values. There was a much higher accumulation of pyruvate and lactate in the coca-chewing subjects. Their findings suggest that chewing coca leaves enhances physical performance at high altitude by blocking the glycolytic pathway of glucose oxidation at the Pyruvate Dehydrogenase level (Casikar 2010). They plan to do further research to determine if this beneficial effect is due to the cocaine content, or the flavonoids. Coca leaves, or more specifically the alkaloid cocaine found within them, are currently banned by WADA just like narcotics are (World Anti-Doping Agency 2018).High altitude training, however, is still an extremely popular (and WADA-approved) technique to enhance athletic performance beyond basic training and practice.

Another ancient performance-enhancing substance that is still widely popular among athletes and non-athletes is caffeine. Caffeine has an ergogenic effect on the body, which means it gives athletes the ability to exercise at a higher absolute intensity for a given rate of exertion (Desbrow 115). Caffeine also raises one’s heart rate, but not to a degree where it is detrimental to the health or athletic performance of the person ingesting it. While many people today associate caffeine with drinks like tea or coffee, the Mississippians of the American Southeast used a different natural source of caffeine in their “Black Drink”: Ilex vomitoria, or yaupon holly. During one study at the site of Cahokia, researchers were able to determine that Black Drink made from Ilex vomitoria was stored in ceramic vessels at the site through organic residue analysis on the potsherds. They found traces of theobromine, caffeine, and ursolic acid on the ceramics recovered from the site. While this alone is not enough to prove that Black Drink alone was the substance stored in those vessels, as there were other things which could have left behind similar residues, they were also able to determine the ratio of theobromine to caffeine. Ilex vomitoria has a distinctive 5:1 ratio of caffeine to theobromine. This ratio, along with historical evidence, which led the researchers to conclude that Black Drink had likely been stored and used at Cahokia (Crown 13948). As one may be able to guess from the name, Ilex vomitoria is an emetic. Black Drink was a popular component of many Native American rituals, and was also associated with various athletic pursuits like lacrosse (Voorhies 290). The effect of the caffeine may have been enough of a benefit to outweigh the detrimental effects of the vomiting for the athletes and non-athletes consuming it.Caffeine’s popularity as a performance-enhancer has endured centuries, but not always without question. Nowadays, some critics are calling for WADA to impose some sort of ban on caffeine due to its performance-enhancing abilities. They point to the World Anti-Doping Code, which states that “the use of a substance before or during sports competition should be banned when, derived from its consumption, individuals meet 2 of the following 3 criteria: benefit from an increase in sports performance; put his/her health at stake; or violate the spirit of the sport” (Del Coso 555).They claim that caffeine use gives an athlete an increase in sports performance, and may also violate the spirit of the sport if done in excess. We all intake mild amounts of caffeine from our standard Western diets (from foods like chocolate or tea, as well as many over the counter medications. However, some athletes may be purposefully ingesting large amounts of caffeine with the sole intent on improving their performance, which goes against the spirit of the sport and would lead to violating the Code. Caffeine was a banned substance from 1984 to 2004, due to concerns of athlete abuse. However, caffeine use among athletes has been unchanged since it was un-banned, which suggests that athletes are not abusing it or violating the Code (Del Coso 2011). Caffeine’s history with endurance sports and athletic performance goes back hundreds of years, and is continuing to be a hot topic amongst those who decide which substances are banned or not banned.

As discussed previously, the practice of ingesting various substances for the purpose of enhancing athletic ability is not new or novel in this day and age. This practice has been around at least since the time of Ancient Greece, and perhaps even longer. The substances themselves cover a wide range of purposes, from helping with pain management to effecting physiologic change within the athlete’s body. As time has passed, many of the active ingredients of these traditional foods or drinks have been identified, extracted, and subsequently banned from use for professional athletes. Some substances, like cocaine and morphine, are also illegal or controlled substances for non-athletes as well. It’s easy to look around at the world today and think that all these substances are modern inventions, but that is clearly untrue. Cultures around the world had identified the powers of these substances and had been using them for hundreds of years before we found them. The desire to succeed at athletic events is not new, and neither is the temptation to “cheat”. Athletes have been using performance-enhancing substances since the original Olympic Games, and probably even earlier. This history of cheating and substance abuse does not justify the practice of it, however. The World Anti-Doping Agency’s work promoting clean sport and setting standards for which substances are allowed and when they are allowed is crucial to the success of modern day athletes.


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Casikar, V., Mujica, E., Mongelli, M., Aliaga, J., Lopez, N., Smith, C., & Bartholomew, F.            (2010). Does Chewing Coca Leaves Influence Physiology at High Altitude?. Indian        Journal of Clinical Biochemistry25(3), 311-314.
Crown, P. L., Emerson, T. E., Gu, J., Hurst, W. J., Pauketat, T. R., & Ward, T. (2012). Ritual       Black Drink consumption at Cahokia. Proceedings of The National Academy Of             Sciences of The United States of America109(35), 13944-13949.
Del Coso, J., Muñoz, G., &Muñoz-Guerra, J. (2011). Prevalence of caffeine use in elite athletes    following its removal from the World Anti-Doping Agency list of banned substances.    Applied Physiology, Nutrition & Metabolism, 36, 555-561.
Desbrow, B., Biddulphi, C., Devlin, B., Grant, G.D., Anoopkumar-Dukie, S., &Leveritti, M.D.    (2012). The Effects of Different Doses of Caffeine on Endurance Cycling Time Trial    Performance. Journal of Sports Sciences, 30(2), 115-120.
Dillehay, T. D., Rossen, J., Ugent, D., Karathanasis, A., Vásquez, V., &Netherly, P. J. (2010).      Early Holocene coca chewing in northern Peru. Antiquity84(326), 939.
Higgins, A. J. (2006). From ancient Greece to modern Athens: 3000 years of doping in competition horses. Journal of Veterinary Pharmacology and Therapeutics, (Supp/1).
Hudson, C. M. (1979). Black drink: a native American tea. Athens: University of Georgia             Press, [1979].
Stolberg, V. B. (2011). The Use of Coca: Prehistory, History, and Ethnography. Journal Of          Ethnicity In Substance Abuse10(2), 126-146.
Voorhies, B. (2017). Prehistoric Games of North American Indians: Subarctic to Mesoamerica.     Salt Lake City: University of Utah Press.
World Anti-Doping Agency. (2018). World Anti-Doping Agency. [online] Available at:




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