drugs in sport epo diuretics peptides and more

Drugs in sport has been a hot topic over the last few years, ranging from the multiple Olympic cheats (often steroids) to the Ben Cousins saga (recreational drugs) through to the explosive Lance Armstrong cheating accusations (blood transfusions), and more recently the saturated coverage of the Essendon Football Club Sports Science program (injection of peptides). So what are these substances, how do they actually improve performance, and why do they need to be banned from sport?

There are many different reasons why athletes use drugs: some have a medical reason, some use drugs inadvertently (for example Codral Cold & Flu tablets are banned in some sports) whilst obviously of recent times the big issue has been the deliberate use of drugs to cheat through performance improvement.

The main controlling body for the fight against drugs in sport is WADA (World Anti Doping Agency). The main functions of WADA are to conduct scientific research, provide education, develop anti doping strategies and most importantly to oversee and monitor the World Anti Doping Code, the code by which all athletes must abide.

ASADA (Australian Sports Anti Doping Agency) is Australia’s governing body with the responsibility for ensuring the World Anti Doping Code is implemented and enforced. So in Australia, we tend to hear about ASADA more than WADA, but in effect it is one national body enforcing the rules of an international organisation.

There are many different classes and methods of doping, all listed under the WADA code. A substance can be included on the World Anti-Doping Code Prohibited List if it meets two of the three major criteria defined by WADA, or if it is a potential masking agent. The three criteria are that the substance is performance-enhancing, that there are health risks to the athlete with use of the substance and that use of the substance violates the spirit of sport. The need for two out of the three criteria means that the WADA Code can ban “social drugs” such as marijuana (even though they are not performance-enhancing) but can permit the use of a drug such as caffeine (even though low levels of this drugs are performance-enhancing).

A simple listing of the main substances used, and an explanation of how they enhance performance is below, along with examples of athletes who have paid the price of transgressions:

CLASSES OF DRUGS:

• Stimulants are a class of drugs that stimulate our central nervous system (brain and spinal cord) resulting in an increase in alertness, self confidence and concentration. Stimulants can increase reaction time and decrease fatigue so could be seen as beneficial in events that require instant reactions (eg exploding off swimming or running blocks, or shooting events, or events that have competitions over many days and result in athlete fatigue). Amphetamines, cocaine and ecstasy are all stimulants. Caffeine is also a stimulant which is why athletes must be under a certain level of caffeine if tested. The great Cuban high jumper Javier Sotomayor (who still holds the world record) was found guilty of cocaine abuse in 1999 and banned for two years. He was also found guilty of steroid abuse in 2001, but promptly retired to avoid a lifetime ban. Ex Australian Modern Pentathlete Alex Watson was found guilty of high levels of caffeine during the 1988 Seoul Olympics, despite his protests that he had drunk 15 cups of coffee and 3 cups of cola in the 12 hours prior to his event!
• Narcoticsare substances that cause pain relief and mood alteration, and obviously pain killers have been widely used in sport. Narcotics can also reduce excessive anxiety, which has a detrimental effect on fine motor control, and therefore could be seen as beneficial in sports such as shooting and archery.
• Anabolic Agents or steroids have been amongst the more publicised type of drug used to cheat in sport. Anabolic agents promote growth by promoting production of proteins, which are the one of the basic building blocks within muscle. Steroids have therefore been used widely in track and field events where strength and power are important. It goes without saying that sports such as body building and weight lifting have also had their issues with steroid abuse! The main anabolic steroid produced naturally within the body is testosterone. Ben Johnson is one of the more famous athletes found guilty of use of steroids.
• Diureticsare products that help eliminate fluid from the body, therefore increasing the production of urine. Diuretics are banned because they are considered “masking agents” as they dilute the urine, lowering the concentration levels of the banned substance in the urine. As well as masking agents, diuretics are also considered performance enhancing as they can be used to regulate body mass (beneficial for jockeys and making weight levels in boxing) and also to shape muscle profiles (useful in body building). Our own Shane Warne famously used the defence “diet pill” when found guilty of taking a diuretic – not enough to stop him from getting a one year ban from cricket.
• Peptide Hormones have been quite topical due to the recent Essendon Football club saga. Human Growth Hormone is the most widely known of the peptide hormones, and it acts by stimulating protein synthesis and body growth, playing a key role in bone and muscle growth. HGH also assists muscle to repair itself following strenuous sporting activities.

METHODS OF BLOOD DOPING:

Blood doping is defined as the administration of blood or related blood products to an athlete for purposes other than legitimate medical treatment. It usually involves an athlete removing some blood several weeks before a competition and then re-infusing the blood close to the competition. The resultant increase in red blood cells allows the body to transfer more oxygen to muscles, which in turn provides an increase in stamina and endurance (very useful in an event like The Tour de France!

There are three main substances/methods that athletes use in attempting to dope:

1. Erythropoietin– EPO is produced naturally within the body by the kidneys, and acts on the bone marrow to stimulate red blood cell production. EPO can also buffer lactic acid, therefore not only does it increase endurance ability but it also decreases the burning fatigue of high intensity or long duration exercise. One of the big potential consequences of EPO is increased risk of heart attack or stroke due to the resultant thickening of the blood.
2. Synthetic Oxygen Carriers– these manufactured chemicals can be injected to increase the ability of the blood to carry oxygen, giving a similar effect to EPO. S.O.C’s are used in medical emergencies when human blood is not available but transfusions are necessary.
3. Transfusions– there are two types of transfusions: autologous (transfusion of your own blood) or homologous (transfusion of someone else’s blood). Due to known risks of infection and diseases, autologous transfusion is the main type of transfusion method used.

Whilst there are moves to conduct blood tests of athletes in order to detect blood doping, the reality is that analytical procedures do not exist to detect autologous blood transfusion.

GUILTY?

There are eight ways an athlete can be found to have violated anti-doping laws:

1. Presence of a prohibited substance or markers in an athlete’s sample.
2. Use or attempted use by an athlete of a prohibited substance or prohibited method.
3. Refusing to submit a sample upon request, or evading sample collection.
4. Violation of the requirement to be available for out of competition testing or failing to advise ASADA/WADA of the athletes whereabouts.
5. Tampering or attempted tampering with a part of doping control.
6. Possession of prohibited substances and prohibited methods.
7. Trafficking or attempted trafficking in prohibited substances or prohibited methods.
8. Administration or attempted administration to any athlete in or out of competition of any prohibited method or any prohibited substance.

One of the defences of the Lance Armstrong team is that he has never had a positive drug test, despite being tested regularly. However you can see from the above list that a positive test is only one of eight ways a person can be found guilty of doping.

The burden of proof in doping charges

When an athlete tests positive to the presence of a prohibited substance or its markers in their test specimen, that person is found guilty, irrespective of whether there was a proven or even suspected intention to ingest the substance or cheat. However the WADA Code does allow consideration if an athlete can prove no fault or negligence (in exceptional circumstances, such as a case of proven drink spiking) – in these cases it is possible that suspensions can be downgraded or waived. These exceptional circumstances do not generally include cases where the athlete was given a prohibited substance by his or her personal physician or trainer without disclosure to the athlete. In cases in Australia, even before the adoption of the WADA Code, where an athlete has claimed inadvertent doping and his or her claims were verified, it has been rare to completely vindicate the athlete. This is a critical component of the argument that the Essendon footballers may have if they are proven to have been given peptide hormones without their knowledge.

In summary, Drugs In Sport is a significant issue that faces all levels of sport, particularly as the stakes and monetary gains get higher and higher. The unfortunate reality is that whilst the testing is getting better and better, the cheats tend to be able to stay a step ahead in many cases. With every slight performance gain obtained through the use of these substances and methods, there is usually a much higher potential risk of serious side effect.