Although the organizations that regulate sports suggest that sport is largely drug-free and that appropriate detection and control mechanisms are in place. Current policy focuses on detection and severe punishment. However, this policy has been inadequate and misinformed for several years. Far more athletes use performance-enhancing drugs than is officially accepted and recorded. The demand for prohibited drugs is likely to continue. A historically informed analysis also suggests that prevention efforts are unlikely to succeed. Sports are now a major commercial enterprise. The policy of prohibition is inconsistently applied and produces unintentional effects that work against the stated desire to protect the health of the athlete. Athletes who use performance-enhancing drugs have no reliable help or advice, because their activities are underground. Lifting prohibition would enable athletes to seek the kind of assistance for drug use that they currently receive for nutrition and other aspects of training. 32 references