The Challenges of Drugs in Sport

1
The Challenges of Drugs in Sport
Brendan M Buckley University College
Cork b.buckley_at_ucc.ie
2
The Doping Culture is deeply embedded in our
psyche
3
In a post-religious culture Science /
pseudo-science/ junk science has taken the place
of miracles in trying to shift the odds in our
favour
4
The Doping Culture is deeply embedded in our
psyche

• Sowhy worry about it?
• Because
• It strikes at the roots of sport as a fair
  competition between equals.
• It severely damages the image of sport and
  devalues its legitimate achievements.
• Drug misuse may be harmful to an athletes health.

5
(No Transcript)
6
Expectations Pressure Money Loss of
Perspective Targets
FAIRNESS
Enjoyment Pride Challenge Craic Health Self Esteem
7
Dope testing is conducted to deter athletes
from using performance-enhancing substances and
methods. To detect doping offences which may
lead to the application of a sanction. To
demonstrate that the majority of athletes are
drug free.
8
Anti-Doping Legal Framework. The Sport Rules of
National Governing Body Rules of International
Federation World Anti-Doping Agency (WADA)
Government Anti-Doping Treaties (UNESCO
Council of Europe) Statute (inc. Irish Sports
Council Act, Medicines Acts, Misuse of Drugs
Acts) Application of Constitutional and Common
law rights.
9
How effective ?
How much is needed? Difference between Gold
Medal and the last finisher in Olympic 1500m
Final was about 5 sec. (a performance difference
of 2)
Erythropoietin can increase the V02max by 20
The difference between a competent club runner
and a world class performer.
10
(No Transcript)
11
The Environment

• Gyms a prime supply focus
• Close to 100 of bodybuilders use anabolic
  steroids
• Spins out into sportspeople
• Spins out into insecure adolescent males
• Very sophisticated regimes integrate training and
  diet regimes with complex pharmacology schedules

12
Human Growth Hormone Doping Rogues Gallery

• Track athletics Ben Johnson
• Cycling Tour de
  France team car
• 1992 American Football Lyle Alzado
  80 of players have taken growth hormone
• Swimming Yuan Yuans
  suitcase in Perth
• 1999 Olympiad Theft of
  1,575 hGH vials from Sydney pharmacy warehouse
• Discus Walter
  Reiterers confession
• 2003-- Multiple sports BALCO affair
• 2007 Lookin good ? Sylvester
  Stallone convicted in Sydney for possession

13
Dope Testing

• In-Competition testing
• Out-of-Competition testing
• Specific Targeting

14
The Process
Trained and Certified Independent Sampling
Officer (ISO)
Strict Protocol
Witnessed Sample Production
Athlete Signs Control Form
Chain of Custody
Accredited Laboratory
Blinded Analysis
Reporting
Adjudication
Appeal
15
(No Transcript)
16
Does all this Anti-Doping activity work ?
17
Effect of Out-of-Competition Testing on
Performance
Out-of-Competition tests introduced
18
Effect of Out-of-Competition Testing on
Performance
Out-of-Competition tests introduced
19
(No Transcript)
20
(No Transcript)
21
Mythology about Doping in Ireland

• Drug testing is really only appropriate for
  professional athletes and amateurs should not be
  subjected to it.
• Irish Registered Testing Pool of (mainly
  international) athletes
• 10 are fully professional
• 75 receive some sponsorship and some state
  funding
• 25 receive no state funding.
• Athletes who earn their living from sport are in
  a minority among those tested.
• Is the desire to win solely dependent on whether
  one is paid or not ?
• Do the teams with the most mercenaries win the
  competitions ?

22
Legitimate Drug Use in Sport

• Chronic Diseases
• e.g.
• Asthma
• Diabetes
• Hypertension
• Obsessive-compulsive disorder
• Narcolepsy
• Klinefelters syndrome

23
Legitimate Drug Use in Sport

• Acute Illnesses
• e.g.
• Diarrhoea
• Injury
• Vomiting
• Migraine
• Motion Sickness
• Hay fever

24
Therapeutic Use Exemption (TUE)

• The use of a Prohibited Substance or Method may
  be granted only
• if withholding it could cause a significant
  impairment to health in the course of treating an
  acute or chronic medical condition.
• it would produce no additional enhancement of
  performance other than that which might be
  anticipated by a return to a state of normal
  health following the treatment of a legitimate
  medical condition.
• If no reasonable therapeutic alternative can be
  used
• Its requirement cannot be a consequence, wholly
  or in part, of prior non-therapeutic use of any
  substance from the Prohibited List.

25
TUEs are granted by the Irish Sports Council and
in the case of international athletes by their
international federation

• TUE will only be considered on receipt of a
  completed application form that must include all
  relevant documents (including a comprehensive
  medical history and the results of all
  examinations, laboratory investigations and
  imaging studies relevant to the application).

26
Pitfalls for Athletes

• Over-the counter medicines (especially when
  abroad)

Check OTCs available in Ireland on
www.eirpharm.com
27
Pitfalls for Athletes

• Supplements and Magic Potions

Not regulated Often make false claims Composition
often not declared on label Chemical composition
often not known Drug concentrations often not
standardised 20 contain banned
substances Particularly hazardous in adolescents
28
Responsibilities of Doctors to Athletes

• Know that they compete in sport
• Flag this prominently on their records
• Protect them against inadvertent doping
• Assist in obtaining therapeutic use exemption, if
  needed
• Consider the possibility of doping in
  differential diagnosis

29
Responsibilities of Doctors to Athletes
Protection against inadvertent doping Prescribe
with care and knowledge

• Information sources
• MIMS,
• Irish National Formulary
• www.eirpharm.com
• www.irishsportscouncil.ie
• www.wada-ama.org
• The team doctor