Drug Use on Mont Blanc: A Study Using Automated Urine Collection

Mont Blanc, the summit of Western Europe, is a popular but demanding high-altitude ascent. Drug use is thought to be widespread among climbers attempting this summit, not only to prevent altitude illnesses, but also to boost physical and/or psychological capacities. This practice may be unsafe in this remote alpine environment. However, robust data on medication during the ascent of Mont Blanc are lacking. Individual urine samples from male climbers using urinals in mountain refuges on access routes to Mont Blanc (Goûter and Cosmiques mountain huts) were blindly and anonymously collected using a hidden automatic sampler. Urine samples were screened for a wide range of drugs, including diuretics, glucocorticoids, stimulants, hypnotics and phosphodiesterase 5 (PDE-5) inhibitors. Out of 430 samples analyzed from both huts, 35.8% contained at least one drug. Diuretics (22.7%) and hypnotics (12.9%) were the most frequently detected drugs, while glucocorticoids (3.5%) and stimulants (3.1%) were less commonly detected. None of the samples contained PDE-5 inhibitors. Two substances were predominant: the diuretic acetazolamide (20.6%) and the hypnotic zolpidem (8.4%). Thirty three samples were found positive for at least two substances, the most frequent combination being acetazolamide and a hypnotic (2.1%). Based on a novel sampling technique, we demonstrate that about one third of the urine samples collected from a random sample of male climbers contained one or several drugs, suggesting frequent drug use amongst climbers ascending Mont Blanc. Our data suggest that medication primarily aims at mitigating the symptoms of altitude illnesses, rather than enhancing performance. In this hazardous environment, the relatively high prevalence of hypnotics must be highlighted, since these molecules may alter vigilance.

勃朗峰（Mont Blanc）作为西欧之巅，是一项广受欢迎但难度颇高的高海拔攀登活动。据推测，参与此次登顶的登山者中普遍存在药物使用行为，其目的不仅在于预防高原疾病，还可提升身体与（或）心理机能。在这片偏远的高山环境中，此类行为可能存在安全隐患。然而，目前仍缺乏关于勃朗峰攀登过程中药物使用情况的可靠数据。研究人员通过隐蔽式自动采样器，在通往勃朗峰的古特尔山屋（Goûter mountain hut）与科斯米克斯山屋（Cosmiques mountain huts）的男用小便池处，对男性登山者的尿液样本进行了盲法匿名采集。研究人员对尿液样本进行了多种药物的筛查，涵盖利尿剂、糖皮质激素、兴奋剂、催眠药以及磷酸二酯酶5（PDE-5）抑制剂。在两座山屋采集并分析的430份样本中，35.8%的样本检出至少一种药物。检出率最高的药物为利尿剂（22.7%）与催眠药（12.9%），而糖皮质激素（3.5%）与兴奋剂（3.1%）的检出率相对较低。所有样本均未检出PDE-5抑制剂。占比最高的两种物质分别为利尿剂乙酰唑胺（acetazolamide，20.6%）与催眠药唑吡坦（zolpidem，8.4%）。共有33份样本检出至少两种物质，其中最常见的组合为乙酰唑胺与催眠药联用（2.1%）。依托一种新型采样技术，本研究证实，在随机抽取的男性登山者尿液样本中，约三分之一检出了一种或多种药物，表明参与勃朗峰攀登的登山者中药物使用行为较为普遍。本研究数据显示，登山者使用药物的主要目的在于缓解高原疾病症状，而非提升运动表现。在这种高风险的高山环境中，必须重视催眠药检出率相对偏高的现象，因为此类药物可能会影响登山者的警觉性。