Doping in Sport

On 10 October 2016 the Essendon Football Club (EFC) performance-enhancing drugs regulatory saga concluded with the Swiss Federal Tribunal deciding not to " entertain " EFC's appeal of the Court of Arbitration of Sport's (CAS) guilty finding, thus supporting the World Anti-Doping Authority (WADA). The appeal is a unique decision as it is the first time a team (34 players from the one team) has been subject to CAS's jurisdiction for allegations of doping contrary to the World Anti-Doping Code. One significant concern throughout this regulatory saga was that the team-based nature of the infraction denied individual players natural justice. Central to these concerns is the fact that the players were advised by EFC to take part in the program and that its chief architect, sports scientist Stephen Dank, never gave sworn evidence that could be tested in cross-examination. This column investigates whether there are important lessons for team-based anti-doping infractions from the EFC saga.

The number of persons taking part in organized sports in our islands is increasing every year. Many of these athletes and the events that they participate in are subject to doping control tests by the National Anti-Doping Organisation (NADO) or the national federation or association of their particular sport. A small number of these tests record a prohibited substance present in the athlete's sample, which may have serious consequences on the sporting career of the athlete. Many athletes consult their general practitioner (GP) or team doctor regularly for advice when they develop a medical condition. This article is intended to provide the GP with background information regarding drugs that may be used safely and without consequences for the athlete, the procedure to follow when the athlete needs to be treated with drugs which are prohibited to athletes, and the pitfalls of accidental doping.

RESUMEN El dopaje por sustancias u otros medios traen consecuencias catastróficas para el deportista, en su fisiología, en el desempeño deportivo y en la ética deportiva. En estos últimos 10 años después de la primera entrega se ha actualizado la lista de sustancias prohibidas de la WADA, exhibiéndose nuevas sustancias y métodos que han sido utilizados en estos años por algunos deportistas sean profesionales o amateur, con el fin de mejorar su rendimiento físico y obtener mejores resultados a costa de los posibles efectos secundarios que alteran la salud de la persona. En este artículo se define el concepto de dopaje y se presenta la lista de sustancias prohibidas por la WADA actualizada a la fecha con algunos casos famosos en nuestro medio relacionados con deportistas de alto rendimiento. ABSTRACT Doping by substances or other means have catastrophic consequences for the athlete, in his physiology, in sports performance and in sports ethics. In the last 10 years after the first delivery, the list of prohibited substances of the WADA has been updated, exhibiting new substances and methods that have been used in these years by some athletes, whether professional or amateur, in order to improve their physical performance and to get better results at the cost of possible side effects that alter the person's health. This article defines the concept of doping, and presents the list of substances prohibited by the WADA updated

ÖZET: İnsan beden veya zihni üzerinde, tedavinin ötesinde performansı daha da artırmaya yönelik müdahaleler, "insanı geliştirme" olarak adlandırılmaktadır. Doping, en sık başvurulan insanı geliştirme biçimlerinden biridir ve geçmişi antikiteye dek uzanmaktadır. Özellikle 19. yüzyılda modern tıp ve farmakolojinin gelişimini müteakiben sporcular arasında giderek yayılmış, kimi zaman devlet talimatıyla kimi zaman ise bireysel tercihler doğrultusunda varlığını sürdürmüştür. Kaydedilen doping nedenli ciddi sağlık sorunları ve hatta ölümler dahi sporcular üzerinde nadiren caydırıcı bir etki yapabilmiştir. İlgili belirleyici kuruluşların (Uluslararası Olimpiyat Komitesi, Dünya Anti-Doping Ajansı) dopingi yasaklama ve doping yaptığı saptanan sporcuları olimpiyatlardan menetme gibi yaptırımları da yeterince vazgeçirici olamamış, fakat kişileri, kontrollerde saptanamayacak kimyasallar bulmaya sevk etmiştir. Teknoloji ve farmakolojinin insan bedeni üzerinde bu derece yoğun kullanımı, günümüzde ilgili tartışmalarda doping ve dopingle mücadele tarihinde vurgulanan "doğal" ve "doğal olmayan" ayrımına ilaveten, "kimin ya da neyin insan olduğu" gibi temel bir soruyu daha gündeme getirmiştir. Görünen o ki çeşitli insanı geliştirme teknik ve teknolojilerinin yaygınlaşması, sporda ve dolayısıyla doping tarihinde yeni bir dönemin başlangıcına işaret etmektedir.

ABSTRACT: Interventions that go beyond treatment by providing improvement in the physical and mental human performance are commonly referred to as "human enhancement." Doping is one of the most frequently applied forms of human enhancement, its history dating back to antiquity. Particularly after the development of modern medicine and pharmacology in the 19 th century, it became gradually widespread among athletes and has since been maintained occasionally by state mandate or by individual choice. The serious health problems and even deaths observed due to doping could hardly have a deterrent effect on its application. Neither could the leading entities' (International Olympic Committee; World Anti-Doping Agency) sanctions prohibiting doping and disqualifying athletes found doping-positive from participating in the olympics be sufficiently restraining, but instead leading to a search for chemicals undetectable during examinations. Besides the distinction highlighted between the "natural" and "unnatural" in the history of doping and anti-doping, such intense use of technology and pharmacology in the human body has recently brought up in the relevant discussion another basic question as to "who or what is a human." It appears that the proliferation of various human enhancement techniques and technologies has marked a new period in the history of sport and thus that of doping.

This article examines the role of young athletes in the development of the anti-doping movement in sport. In the law and ethics literature, children are considered a vulnerable population in need of special consideration and protection. Yet historically they have not always been treated as such, and in sport many rules apply universally to all competitors regardless of the participants’ ages. This article provides a historical examination of drug testing policies created by the International Olympic Committee and World Anti-Doping Agency as they relate to minors as a means to uncover the ways in which anti-doping organisations have included age as a variable warranting special consideration. Challenges to anti-doping sanctions based on athletes’ ages demonstrate that sport organisations, including the Court of Arbitration for Sport, have not placed much emphasis on the protected status of child athletes. This article situates children and youth in the history of drug testing policies and demonstrates how the unique rights of child athletes have been both managed and neglected.

The concentration of hepcidin, a key regulator of iron metabolism, is suppressed during periods of increased erythropoietic activity. The present study obtained blood samples from 109 elite athletes and examined the correlations between hepcidin and markers of erythropoiesis and iron metabolism (i.e., haemoglobin, erythropoietin (EPO), ferritin, erythroferrone (ERFE), and iron concentration). Furthermore, an administration study was undertaken to examine the effect of recombinant human EPO (rhEPO) delta (Dynepo ™) on hepcidin concentrations in healthy male volunteers. The effects on hepcidin were then compared with those on reticulocyte percentage (Ret%) and ferritin concentration. There was a significant positive correlation between hepcidin and ferritin, iron, and haemoglobin levels in athletes, whereas hepcidin showed an inverse correlation with ERFE. Administration of rhEPO delta reduced hepcidin levels, suggesting that monitoring hepcidin may increase the sensitivity of the Athlete Biological Passport (ABP) for detecting rhEPO abuse.

In this article, we explore if and in what ways doping can be regarded as a challenge to the validity, morality and significance of the sporting test. We start out by examining Kalevi Heinilä's analysis of the logic of elite sport, which shows how the 'spiral of competition' leads to the use of 'dubious means'. As a supplement to Heinilä, we revisit American sports historian John Hoberman's writings on sport and technology. Then we discuss what function equality and fairness have in sport and what separates legitimate form illegitimate ways of enhancing performance. We proceed by discussing the line of argumentation set forth by philosopher Torbjörn Tännsjö on how our admiration of sporting superiority based on natural talent or 'birth luck' is immoral. We analyse his argument in favour of eliminating the significance of meritless luck in sport by lifting the ban on doping and argue that its rationale is incompatible with the purpose of sport. We hereby show that although there certainly are morally problematic features of anti-doping the idea that doping must be banned can be defended by reference to the constitutive function of physical differences in sport. In conclusion we show that although doping will never be eradicated from sport because of its ability to increase the physical differences that serve a constitutive function in sport, those differences are not primary in our fascination with elite sport. Instead, we argue for the sporting competition as a stage where fascinating narratives can unfold in a dramatized manner. The integrity of athletic excellence can thus survive even if doping continues to be a factor in sport.

Background: As far as we are aware, no previous systematic review and synthesis of the qualitative/descriptive literature on polypharmacy in anabolic-androgenic steroid(s) (AAS) users has been published.
Method: We systematically reviewed and synthesized qualitative/descriptive literature gathered from searches in electronic databases and by inspecting reference lists of relevant literature to investigate AAS users’ polypharmacy. We adhered to the recommendations of the UK Economic and Social Research Council’s qualitative research synthesis manual and the PRISMA guidelines.
Results: A total of 50 studies published between 1985 and 2014 were included in the analysis. Studies originated from 10 countries although most originated from United States (n=22), followed by Sweden (n = 7), England only (n = 5), and the United Kingdom (n = 4). It was evident that prior to their debut, AAS users often used other licit and illicit substances. The main ancillary/supplementary substances used were alcohol, and cannabis/cannabinoids followed by cocaine, growth hormone, and human chorionic gonadotropin (hCG), amphetamine/meth, clenbuterol, ephedra/ephedrine, insulin, and thyroxine. Other popular substance classes were analgesics/opioids, dietary/nutritional supplements, and diuretics. Our classification of the various substances used by AAS users resulted in 13 main groups. These non-AAS substances were used mainly to enhance the effects of AAS, combat the side effects of AAS, and for recreational or relaxation purposes, as well as sexual enhancement.
Conclusions: Our findings corroborate previous suggestions of associations between AAS use and the use of other licit and illicit substances. Efforts must be intensified to combat the debilitating effects of AAS-associated polypharmacy.