The winner of the Copenhagen Marathon 2025 tested positive for EPO, highlighting the ongoing issue of doping in sports. Despite advancements in detection methods, the use of performance-enhancing drugs persists across various athletic disciplines.

According to Wada, in 2023, out of 238,827 tests conducted worldwide, only 1.45 percent yielded positive results. This raises questions about whether the reported figures accurately reflect the true extent of doping, or if they only represent the tip of the iceberg.

Morten Hostrup, a lecturer at the University of Copenhagen, estimates that around 10-15 percent of elite athletes have used illegal substances or methods at some point. The ability to conceal doping practices, the difficulty in tracing certain substances, and the timing of doping controls all contribute to this underestimation.

Athletes continue to use substances like blood doping, EPO, and anabolic steroids. The doping list is updated annually by Anti Doping Denmark, reflecting the pharmaceutical industry’s rapid advancements. One emerging category is peptides, utilized by athletes like swimmer James Magnussen in events like the Enhanced Games.

While some athletes experiment with new and unproven preparations, it is often those outside the highest echelons of elite sport who do so. Many of these substances lack concrete evidence of their effectiveness.

Preparations in the gray area, such as adrenal cortex hormone and bronchodilating asthma medication, also pose challenges. These substances can be used legally under certain circumstances, creating opportunities for exploitation.

The risk of detection serves as a deterrent for top athletes considering doping. Despite potential gains, the consequences of getting caught, including career termination, often outweigh the benefits. Moreover, advancements in laboratory methods have improved detection capabilities.

Morten Hostrup suggests that the doping control system largely functions effectively, deterring many athletes from taking the risk. He finds it surprising when top athletes like Berhane Tesfay are caught using substances like EPO, given the potential consequences.