Doping in sport is nothing new…… perhaps
since ancient times but more particularly in the last 40 years, the spectre of
doping and the “clean or not clean” question has been ever present in global
sport. In the Olympic context, for many, their first real awareness of doping
came with the banning of Ben Johnson following his winning gold in the Olympic
flagship event, the men’s
100m at Seoul in 1988. Stripped of his medal following a positive test for
steroids this led many to start asking questions about all athletics. Over the intervening
years since there have been many high profile drugs related issues in many
sports with athletics, cycling (Lance Armstrong being the most infamous) and swimming being the most
prevalent, but present at some level in many more.
Why to people cheat in sport
Why do sports people and athletes in
particular take drugs? There is no simple single answer to this question.
However, given the
risks, to health, career, lifestyle vs the potential rewards to be gained for
success and victory at the highest level: prestige, money, status etc, this is
most likely at the root of it.
For some, drugs offer faster recovery,
harder training, for others, it’s a way to level the field in the belief that
others are using drugs. Perhaps an athlete has been injured and needs to “catch
up” or maybe simply a lack of knowledge or education regarding drug use or the
mistaken belief that the chances of getting caught are comparatively small.
Whatever the reason, where there is competition, there will always be those
that are prepared to cheat to be the “winner”
Who tries to prevent drugs in sport?
It follows therefore, that where
cheating through doping is present, there must be regulation to try to prevent
and ultimately eliminate it. In
sport today, this role falls to an organisation called WADA (World Anti-Doping
Agency). Formed in 1999, WADA is an
international independent agency funded by sports authorities and governments
with the overriding vision of “a world where all athletes can compete in a
doping-free sporting environment”. Operating across all competitive sports and
geographies, WADA monitor and enforce their World Anti-Doping Code (new 1st
Jan 2015) via the various individual countries sports regulatory authorities,
which in Ireland is the Irish Sports Council.
The “banned list”
WADA also produce “The List” each year.
First produced in 2004, it is the definitive guide to substances or methods
which are prohibited. Compiled and reviewed annually by a panel of 13 experts,
it is issued each January 1st. It was this review that Maria Sharapova
fell foul off in January this year when she tested positive for a substance (Meldonium)
which was a new addition since the 2015 list, although advisory notices had
been issued in September 2015.
This resulted in a two-year ban for the Russian tennis star.
The list is
divided into 9 sections across 7 main classes: -
–
Stimulants
(e.g. caffeine, amphetamines, cocaine)
–
Build
Muscle / Bone (e.g. anabolic steroids, human growth hormone)
–
Relaxants
(e.g. Alcohol, Beta-Blockers, Cannabinoids)
–
Mask
Drug use (e.g. diuretics, epistestosterone)
–
Reduce
Weight (e.g. diuretics)
–
Increase
Oxygen Delivery (e.g. EPO, Blood Doping)
–
Mask
Pain (e.g. Narcotics, Cortisone, local anaesthetics)
The above is purely indicative to show
the differing areas covered. The actual list itself is a comprehensive and
detailed description of exactly what is prohibited and is available for
download or perusal from the WADA website (www.wada-ama.org).
What if an athlete needs a banned
substance for a medical condition?
At some point, it may be necessary for
an athlete, participating at international level or who is part of a registered
testing pool in the Anti-Doping programme, to be treated with a medicinal
product contained within the list, for legitimate medical reasons. In this case
they may apply to WADA (via the Irish Sports Council) for a TUE (Therapeutic
Use Exemption). There are a number of criteria that are used to determine
whether a TUE will be granted. Irish Sports Council (ISC) policy regarding
TUE’s is that the applicant should first consider any alternative treatment or
medication that may be permitted rather than using a prohibited substance. If
no suitable alternative is available, then the applicant should be guided by
ISC policy to ensure compliance with TUE. Worth noting here that with Asthma
being such a common condition, most of the commonly used inhaled medication is
now permitted either in full or up to certain levels. The only time a TUE is
required would be for Terbutaline (Bricanyl® inhaler), which is better known as a “reliever”
or “blue” inhaler to asthmatics. Terbutaline is a similar drug to Salbutamol in
Ventolin® inhalers.
The ISC also lay out a TUE policy for
lower levels sports, (i.e. GAA Senior, national athletes in cycling, swimming,
boxing etc.) that enables them to take the prohibited substance for
genuine medicinal purposes
and then if necessary, complete a “Post Test TUE”.
As you would expect, all TUE
applications must be fully supported with the relevant medical history and
information with details of health professionals involved.
Testing
The key to the success of any Global
Anti-Doping programme is the gathering, storing and sharing of information.
WADA maintains a system known as ADAMS (Anti-Doping Administration &
Management System), a web based database management system which securely
collects data such as an athlete’s whereabouts information, testing history
(blood and / or urine), lab results and TUE management. The Irish Sports
Council use a customised version of this called SIMON. All the information
gathered then creates the athletes’ biological passport within the WADA
infrastructure.
Top level elite athletes, subject to in
or out of competition testing, are required to participate in the programme. Athletes
have to provide a quarterly report of their “whereabouts” (time and place) to
their relevant anti-doping agency, which is the ISC in the case of
Irish Athletes. Once
the information is within the database, the random testing programme is in
place. So, based on the athletes’
whereabouts report, anti-doping authorities can turn up and test. It is vitally
important therefore for any registered athlete to keep their whereabouts
information up to date with changes via web, or even text etc as the penalties
for a “missed test” can be severe, with whereabouts violations bans of up to 12
months can be enforced. There was a
furore over the participation in the Women’s Cycling Road Race event in Rio of
the British cyclist Lizzie Armitstead due to the fact that she was allowed to
participate, despite 3 “missed test” violations last year.
There is an abundance of mis-information
around these days for athletes trying to find out information about or indeed
obtain drugs, supplements etc. From magazines to friends or fellow sports
people or from gyms to coaches, whilst some might be valid, as a general rule
of thumb, it’s always best to check information with the proper authorities.
With nearly every category of
prescription drug available for purchase online without a prescription, as well
as performance-enhancing drugs, taking this route can be a minefield as it is
completely un regulated and you really have no clue what you are buying or any
guarantee of quality. In addition, it is a criminal offence to import
prescription only drugs into Ireland or indeed to be in possession of
prescription only drug without the relevant prescription. Customs and Excise
have ramped up their vigilance on illegal drug imports and convictions are
increasing also.
Dangers of supplements
In addition to drugs, there are many dietary
or nutritional supplements advertised that appear to offer amazing results in
terms of performance improvement, again, many recommended by someone in the gym
or a fellow competitor. In most cases, there is absolutely no actual evidence
to support the claims made. As they are
not medicines, they are not subject to the same rules when it comes to
description of ingredients or labelling. There have been incidences where
supplements have contained an undeclared prohibited substance, which then show
up as an adverse finding in a test.
Allegedly, it was just such an adverse
finding that resulted in the boxer Michael O’Reilly being eliminated and sent
home from the Rio Olympics following a positive test for a prohibited substance
on 4th August. According to him, it was in a supplement he took.
In general, the ISC advise against the use
of supplements believing that correct diet and balanced nutrition should
provide anything a supplement claims to offer.
Creatine
One substance that often comes up in the
“supplement” discussion is Creatine. Widely promoted via health and fitness
publications and websites as a muscle, stamina and power builder, (kidney) it
is not a prohibited substance. General advice would be to view and assess its
use in the same way as supplements. Direct effects of consumption include
weight increase and water retention. There is no evidence that long term use
would have any adverse effect, there is some slight concern on the possible
long term effect on renal function. The Irish Sports Council website offers
comprehensive advice and information regarding the anti-doping programme and
enforcement in Ireland. (www.irishsportscouncil.ie)
No shortcut to success
If you are engaged in sport, at whatever
level, like anything in life, there is no shortcut to success. In general
terms, you get out of it what you put in. If you are in any doubt at all about
what you can and cannot take, it is always best to consult a health
professional, either your GP or your Pharmacist or perhaps a specialist in
Sports Nutrition before you take it!!! or indeed check out any of the online
resources outlined above.
Updated
by Eamonn Brady MPSI in Aug 2016 to coincide with the Rio Olympics.
Whelehans Pharmacy, 38 Pearse St,
Mullingar (Opposite the Greville Arms Hotel). Tel 04493 34591. www.whelehans.ie or info@whelehans.ie. Find us on Facebook
