In nearly every sport or olympic event it isn't possible to be competitive without taking some sort of performance enhancing drug. The primary way to get a competitive edge is to have a doctor or other professional figure out how to help an athlete consume as much drugs as possible while still being able to pass the drug test either by masking the use to beat a drug test, taking a new drug that can't be tested for, or taking drugs in between drug tests. This way, only athletes with lots of money/sponsorships can win which helps the elites make sure that there is sufficient diversity in pro sports leagues and that players who have marketable backgrounds and appearances become the big stars. If any athletes don't want to play by the rules, then all of a sudden they don't get signed and they get cut off from the PED's, ending their career.