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The Use and (Potential) Abuse of Epinephrine in Boxing


When the corner work of strength-and-conditioning coach Alex Ariza was questioned by boxing fans who began circulating video of his work (via social media) between rounds 11 and 12 of the Marcos Maidana vs. Adrien Broner fight, the Texas Department of Licensing announced it would launch an investigation into the incident. The fight was not drug-tested by the state of Texas but instead by USADA. Along the way in the investigation, the drug “Epinephrine (Adrenaline)” was brought up. The drug is commonly used in the sport by cutmen to stop bleeding from lacerations or a bloody nose suffered during a fight.
The Association of Boxing Commissions rules state, “In the case of a cut, only the topical use of the following is allowed: a. A solution of adrenaline 1/1000 b. Avetine c.Thrombin **All other solutions are prohibited.”

“Topical” meaning only used on the surface of a laceration. It is not to be inhaled or injected.
Epinephrine is also on the Banned Substances List of the World Anti-Doping Agency (WADA), which sets the anti-doping standards for sports all over the world. This is due to the substance also being a powerful stimulant. However, the sport of boxing, which allows practices such as intravenous hydration as well as the use of 1/1000 Epinephrine in the corner of a fight, does not always follow WADA Code.
According to WADA, “a substance or method will be considered for the WADA Prohibited List if the substance or method meets any two of the following three criteria:


1) It has the potential to enhance or enhances sport performance
2) It represents an actual or potential health risk to the athlete
3) It violates the spirit of sport”

Anti-doping expert Victor Conte explained to the dual use of Epinephrine.
“What boxing needs to understand is Adrenaline or the hormone Epinephrine can be used as a powerful PED in sport. In the past, I have personally given Epinephrine to world-class sprinters by injection as well as inhalation. Epinephrine is a central nervous system stimulant. It increases cardiac output of oxygenated blood to muscle tissue and is also a bronchodilator that can open up the air passage ways,” Conte explained. “Cornermen in boxing are allowed to use 1:1000 Epinephrine but only by topical application as a vasoconstrictor to help stop blood flow from cuts and nose bleeds. The use of Epinephrine by injection or inhalation is not allowed in any sport. I’ve observed boxing cornermen place cotton swabs or rolls soaked in Epinephrine into the nostrils of their fighters without any sign of blood and advise them to ‘breathe in!’ I began to realize that the purpose of this practice of inhaling Epinephrine before and/or during fights was, in my opinion, to boost the fighter’s performance.”
In the course of investigating what may have transpired in the corner between the 11th and 12th rounds of Marcos Maidana vs. Adrien Broner (, Epinephrine came up via parties close to the camp of Robert Garcia, who trains Marcos Maidana. Obviously, this corner is now in question. Two of these parties said they were unsure of what may have transpired in the corner but they mentioned that a regular practice of Garcia, dating back to his pro days, was to soak dental gauze rolls in Epinephrine (Adrenaline) and place them inside his own nose or the noses of his fighters 20-to-30 minutes prior to a fight. The reasoning behind this was the drug would constrict the blood vessels in the nose, open the air passages and act as a potential preventive agent for a nose bleed during the fight. Speaking with several people within the industry who wish to remain anonymous, the practice is common in the sport.
When asked about the HBO video, “2 Days with Mikey Garcia,” (, which features Garcia’s fighter and brother, Mikey wearing nose plugs while getting his hands wrapped, Mikey responded on Twitter, “It’s so I won’t sneeze during the fight.” When asked if the plugs were soaked with Epinephrine, he responded, “Adrenaline 1/1000. Ask the Commission about it.”
That fight, against Orlando Salido a year ago, was at the Theater at Madison Square Garden, which is under the New York State Athletic Commission.
Later in the conversation, Mikey Garcia said, “I’m not inhaling it. It’s for my nose bleeds.”
Robert Garcia said in the same exchange, “Dr. Anderson does the same to all my fighters,” referring to chiropractor and cutman Dr. Roger Anderson, who has worked the corner of Garcia fighters for quite some time.
Later, Robert Garcia, a former world champion boxer, added, “I always used that I was fighting. I use it with my amateurs.”
While pro boxing is not governed by WADA and its standards, the United States Anti-Doping Agency (USADA), does have jurisdiction over USA Boxing, which handles the testing for amateur boxers.
When contacted about the use of Epinephrine in fights under its jurisdiction, Laz Benitez of New York State Athletic Commission provided with this statement:
“NYSAC permits the use of Epinephrine/Adrenaline only for the treatment of open lacerations on the face and/or actual nose bleeds through a cotton swab applied into the nose. The drug is applied to constrict the blood vessels and stop bleeding. All other uses of Epinephrine/Adrenaline and/or other applications of the substance are prohibited in the sport of professional boxing in the State of New York, per the policy of the NYSAC.”
Robert Garcia felt he was being specifically targeted because he was working with strength coach Alex Ariza, stating, “They starting this sh*t cuz ariza with me but never said anything when he was with pacquiao. F*ck them all,” and advised me to “Go watch Pac-Barrera 1 Rd 10-11 break. Ask Freddie about that. Go give him sh*t.”
In watching that fight and the sequence in question, Manny Pacquiao’s cutman appears to put in two cotton swabs into his fighter’s nose, then remove them with no blood apparent on the cotton swabs. Then he takes the same swabs and wipes them on Pacquiao’s tongue. It is an odd move that has yet to be explained. In watching another fight, Pacquiao-Joshua Clottey, Clottey’s camp appears to put cotton swabs in Clottey’s nose, instructing him to breathe in several times.
“Is it possible to deliver Epinephrine to a boxer by inhalation from cotton swabs or rolls and have it boost performance?” asked Conte. “I believe it is. I recently conducted a quick experiment by dipping two cotton rolls into some Epinephrine. Each was dipped in half way and allowed to saturate the cotton. Thereafter, I squeezed the liquid out from each cotton roll and measured it. Each contained about three cc of liquid. So both cotton rolls contained a total of six cc (milliliter) of liquid. Each cc of 1:1000 Epinephrine contains 1 milligram of Epinephrine. So six cc’s contains a total of six milligrams of Epinephrine.

“The standard Epinephrine nasal spray dosage is 1 milligram per cc,” continued Conte, who is not a doctor or scientist. However, he is the man who masterminded the BALCO labs scandal, which resulted in athletes he doped winning many awards and breaking world records, all while not being detected by anti-doping tests. If anyone is an expert in the area of creative cheating, it is Conte
( “My quick experiment revealed that two half-saturated cotton rolls contains about six milligrams of Epinephrine. Is it possible that one cc or 1/6th of the amount of liquid contained in two half-saturated cotton rolls could be breathed in by a boxer through his nostrils? I believe the answer is yes. I’ve seen a cornerman stick two large cotton swabs up in a professional boxer’s nose between rounds and loudly instruct him to ‘Breathe in! Breathe in!’ Do I think it is likely that this cornerman was attempting to help his boxer to use Epinephrine as a PED? I do.”
Where does this leave us?
“It’s a slippery slope,” said Greg Sirb, former President of the Association of Boxing Commissions and current head of the Pennsylvania Athletic Commission. Sirb explained that when he was an amateur wrestler, he used to have the inside of his nose coated with Epinephrine to prevent nose bleeds. He had suffered a badly broken nose in the past and as a result, was prone to bleeding. “It worked for me but it doesn’t work for everyone,” said Sirb, who added he did not feel an energy surge from the practice.
Sirb said he agreed with the New York State Athletic Commission’s statement that all uses of Epinephrine besides stopping actual bleeding is prohibited and should be.
“Is it legal for an amateur or professional boxer to place cotton rolls saturated with Epinephrine in their nostrils and inhale this substance for 15-to-20 minutes before fights? I think not yet I have heard that this is common practice for the fighters of some of boxing’s top trainers. My understanding is that this practice is prohibited by the governing bodies of all amateur and professional boxers,” said Conte.
The anti-doping door was opened by Floyd Mayweather Jr. four years ago. It continues to open wider and wider as new situations and thus new questions arise. The Association of Boxing Commissions along with the Association of Ringside Physicians need to further clarify the rule on the use and abuse of Epinephrine among many other issues.
“A couple of professional boxing trainers have even recently said publicly, that they believe the use of Epinephrine-soaked cotton rolls before fights is commonplace,” said Conte. “It’s my opinion that this practice is clearly against the rules and that boxing commissions are either ignorant or looking the other way while this blatant use of a powerful PED is being used right under their noses.”
According to Sirb, uniformity is a much-needed goal.
“My goal in 2014 is to get all the commissions to agree on what drugs we can use, what we should test for and what the threshold for use is for all the commissions,” said Sirb.
You can email Gabriel at, follow him on Twitter at and catch him every Monday on “The Next Round” with Steve Kim, now at its new home, or via iTunes subscription at You can also tune in to hear him and co-host David Duenez live on the BlogTalk radio show, Thursdays at 5-8 p.m., PT.
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