Whereas doping in competitive and popular sport has been the order of the day for years, it is only recently that the DAK Health Report has awakened interest in doping at the workplace in Germany. In line with the definition of the international anti-doping agency (WADA), doping at work may be defined as the attempt to increase occupational performance by taking drugs without a therapeutic indication. Internationally, terms such as “performance enhancement” and “cognitive enhancement” are used in this context. In focus are several prescription drugs with psychotropic and/or neurotropic effects that are registered for the treatment of dementia, depression, attention-deficit or sleep-deficit disorders, and in individual cases it is unclear how to differentiate between so-called “brain doping”, misuse of medicines and addiction. Reliable epidemiological data on the frequency of job performance enhancement is lacking. The few epidemiological studies which have been carried out to date made use of questionnaires (online or by telephone) are very prone to substantial denial bias (socially unacceptable answers) and so probably underestimate the prevalence. The first nationwide representative online survey of 3000 employees between 20 and 50 years of age (performed by the DAK in 2008) showed that 5 % of respondents had already used prescription drugs to enhance professional performance without medical indication, and that 1—2 % were to be classified as “active dopers” because they took neurotropic and/or psychotropic medicines without a doctor’s prescription frequently and/ or regularly. The most frequently used drugs were methylphenidate (28 %) and modafinil (24 %). Presently discussed causes of job doping are diverse and include individual predisposition as well as professional and societal circumstances, whereby changes in values and in the economic and social situation of employees is thought to play an important role. Because of the severe physical and especially mental long-term consequences of prescription drug intake by healthy persons without medical indication, this increasingly prevalent doping at the workplace cannot be tolerated. Because of the complexity of the phenomenon, preventive measures ought to be multi-modal and include intervention in individual behaviour (e.g. adequate coping strategies) as well as modifications of workload and workplace organisation.
