An Evaluation Into The Use Of Performance Enhancing Drugs In Sport

Introduction

Sport throughout the years has changed dramatically with athletes now bigger faster and stronger than ever. Not only that but sport overall is much more competitive with every second, inch and play heavily changing the outcome of competition. In this battle for an edge in competition some resort to the use of drugs in order to increase physical performance in a process now commonly known as doping.

Doping is the illicit use of artificial enhancements and methods to gain an advantage over others in competition, according to UK anti-doping agency. Engaging in such practice is against the spirit of sport and can be deemed as simply cheating.

In this document I will be looking further into the history of doping in sport, the many types of performance enhancing drug and other controversial means of performance enhancement, referencing poignant case studies throughout as well as how drug use is being combated by various organisations from a global to a local level.I will highlight and potetnialkly predict where sports enchancemnt may be going in the future

The history of performance enhancement

The word Doping is believed to originate from the Dutch word “doop” referring to an opium concoction used by Greek Olympians to increase their performance experimented with herbal medications in an effort to enhance their performances. The ancient Greek athletes also drank wine potions, used hallucinogens and ate animal hearts and testicles in search of a physical advantage in competition. This early evidence of doping highlights the eternal motives behind humans through attempts to always one up on each other. While cheating was severely punished in the early Olympics (one penalty was enslavement), enhancing performance by ingesting substances was not considered cheating.

As medicine progressed, we saw the birth of much more conventional doping agents during the 1900s.During the 1950s, the Soviet Union dominated power lifting by providing their wrestlers testosterone injections. In the 1960s, Sports Illustrated documented the use of amphetamines, tranquilizers, cocaine, and other drugs by professional athletes. In 1988, Ben Johnson turned in a record-breaking performance in the 100-m dash but was stripped of his title after he tested positive for the anabolic steroid stanozol

Nowadays there is a plethora of different drugs available and a multitude of cases each year relating to abuse of drugs and cheating in sport.This development of drugs has an ethical conflict

Different drugs and how the work

Stimulants – these are used to stimulate the central nervous system and increase heart rate and blood pressure to increase alertness, improve endurance and reduce fatigue. Stimulants are drugs that directly affect the central nervous system. They work to speed up parts of the brain and body, increasing the heart rate, blood pressure, metabolism and body temperature of the user. They are used by athletes to reduce tiredness and fatigue, and to increase alertness, competitiveness and aggressiveness Common substances used are the most common stimulants detected in anti-doping tests include amphetamines, cocaine and ecstasy – although these are more known to be recreational drugs they’re side effects have positvive physical benefits. The actual effects vary according to the drug and its method of ingestion—drugs that are snorted or injected will produce more immediate results than those that are taken in pill form.

The presence of stimulants in the body can be tested via a variety of procedures, with urine sampling the primary means of testing. Commonly used tests include gas chromatography-mass spectrometry, and immunologic assay.

Anabolic steroids – These are genetically modified drugs derived from the human hormone testosterone they are taken improve endurance and performance and stimulate muscle growth.

The key effects of anabolic steroids include:

• They may help sports players train harder and longer.
• If taken alongside a strenuous exercise regime, they may help with faster recovery times and with the building up of muscle mass.

However, there are often side effects to the misuse of anabolic and they can often make some users feel paranoid, irritable, aggressive or even violent, and they can cause dramatic mood swings.as well as sometimes causing unwanted changes in appearance- in males erection problems can arise, growing of breasts, becoming sterile, loss of hair and development of acne as well as testicle shrinkage are known side effects

Anabolic steroids are utilised and effective through all sports however they are more commonly associated with Bodybuilding, an industry which has become saturated with many variations of anabolic steroids

Erythropoietin is a type of hormone naturally made by the kidneys which can be synthetically made and used to treat anaemia in people with severe kidney disease. It increases production of red blood cells and haemoglobin, which are essential to the movement of oxygen from the lungs to the rest of the body, by the bone marrow. resulting in an improved movement of oxygen to the muscles in non-anaemic athletes. The increase in oxygen capacity that Erythropoetin cretes, is commonly used by endurance athletes to allow more oxygen to be accessible for use in aerobic respiration and oxidative phosphorylation.

EPO has been at the forefront of past and present scandals in the world of cycling, particularly the Festina affair of the 1998 tour de France which prompted the formation of the world anti-doping agency. Several hundred grams of EPO where found in a team car and by December 2000 all members of the 1998 festina cycling team had confessed to using EPO.It was also at the centre of the notorious Lance Armstrong Doping case in which his seven consecutive tour de France wins were stripped off him having been dound to have used EPO in hwat was called “the most sophisticated, professionalised and successful doping programme that sport has ever seen”. [1: https://www.theguardian.com/sport/2015/mar/09/lance-armstrong-cycling-doping-scandal ]

Therapeutic use exemptions (TUEs)

“The Therapeutic Use Exemption (TUE) process is a means by which an athlete can obtain approval to use a prescribed prohibited substance or method for the treatment of a legitimate medical condition”

It is designed to ensure those with a genuine medical condition for which there is no effective alternative treatment are not unfairly penalised. The process for an athlete entails applying for a TUE from their national anti-doping agency or international federation. A TUE committee will review all relevant medical details related to the application and

The process is confidential in deference to an athlete’s right to privacy in relation to their health.

A TUE is only meant to be granted for as long as the medical condition persists, which in some cases can be for an athlete’s entire career. The World Anti-Doping Agency also has the right to review any TUE application at any time.

That has been fuelled by concerns about their prevalence within sport and even fears that some athletes or coaches have manipulated the TUE system.

Mo Farah’s coach, Alberto Salazar, is still under investigation by the United States Anti-Doping Agency over allegations which include TUE abuse. He denies any wrongdoing, while there is no suggestion of wrongdoing by Farah.

The Lance Armstrong scandal also included claims about abuse of the TUE system by the then International Cycling Union president Hein Verbruggen to cover up the disgraced American’s drug-taking. He also strenuously denies any wrongdoing.

Many are unsure on what should be done regarding TUEs as banning them would inhibit the performance of diabetics,asthmatics and others.

Where do legal drugs stand in the industry?

What about…

Atitude training - hypoxic training

red blood cell (RBC) and hemoglobin (Hb) content appear to be major factors contributing to (but probably not solely responsible for) increases in maximal oxygen uptake (VO2max) observed after altitude training increases in erythrocyte volume, maximal aerobic exercise capacity, capillary density, and economy. In the modern era of sport, increasingly sophisticated anti-doping controls, such as the World Anti-Doping Agency (WADA) biological passport program, leave elite athletes with few choices of legal ergogenic aids that have the potential to substantially improve performance, and altitude/hypoxic training is among them. The efficacy of altitude/hypoxic training and the best practices for its use are still being debated in research circles, while athletes congregate in altitude training camps and use altitude simulation devices in the pursuit of improved exercise performance.

Cryotherapy

• Cryotherapy is any treatment that involves the use of freezing or near-freezing temperatures to improve medical health
• Whole Body Cryotherapy lessens the recovery time after a vigorous work-out by delivering oxygen and nutrients to the muscles.
• Regular cryo treatments greatly reduce the recuperation period from the stress of competitive sports and training, enabling a quicker return to the playing field.
• Cryosauna enhances muscular resistance to fatigue, while improving the body’s ability to relax and get better night sleep necessary to endure physical activity.
• Increased strength and endurance, resulting in improved athletic performance.
• Alleviated muscle tension and susceptibility to trauma promoted by cry treatment sessions help build physical endurance.
• Beneficial effects of cryotherapy extend to the improvement of joint functionality, motor capacity, and mobility. The treatment method was originally used for joint pain relief for arthritis and other rheumatoid diseases patients.
• Cryosauna boosts energy levels and the release of endorphins, which in turn promote faster fat reduction and weight loss.
• Regular cryo treatments improve muscular dis-balance.

Although not a banned procedure some may argue that this high tech metyhod of recovery puts others who do not have access to such treatment, at a disadvantage and pushes the boundary of what may be seen as “natural”

Supplementation

While most over-the-counter supplements are considered “legal” within anti-doping codes, some controversies exist because they may enhance athletic performance. While there is no scientific evidence to support the benefits claimed for most products, there is substantial proof that some can enhance specific performance outcomes when used according to specific protocols.14 For instance, certain athletes take creatine and/or caffeine can exercise at higher work rates or for longer before experiencing fatigue this is seen in the cycling industry with a “coffee culture” created as a result of its performance benfits.WADA has taken a back seat when it comes to supplementation as many of the ingredients occur naturally in food they see these manufactured products as a practical way for athletes to consume a desired dose.

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Key players in anti-doping

The world anti-doping agency

The World Anti-Doping Agency (WADA) was established in 1999 as an international independent agency composed and funded equally by the sport movement and governments of the world. Its key activities include scientific research, education, development of anti-doping capacities, and monitoring of the World Anti-Doping Code – the document harmonizing anti-doping policies in all sports and all countries. It is the main enforcer of drug related incidents and possess the ability to give bans from sport to individual or groups of athletes' works with event and tournament organisations to test for drug usage both before and after competing. fulfil that for a product to be banned it must qualify for two of three categories in WADA's own rules:

• Potential to enhance or enhances sports performance
• An actual or potential health risk to the athlete
• Use violated the spirit of sport

Opinions about WADA

There are many different opinions on the effectiveness of WADA in mitigating drug abuse in sport.Recently there have been many cases which have made both public and sporting professionals evaluate the role of WADA

Meldonium affair

The World Anti-Doping Authority (WADA) was embarrassed after admitting that one of its biggest scalps, tennis star Maria Sharapova, might not have broken any rules. The same goes for any number of the 170-odd other athletes who had tested positive to the drug Meldonium.

Last year WADA says it spent months researching Meldonium, a heart medication used to increase blood flow. However, WADA's research only proved that high numbers of athletes were using the product. Without grounds for banning however On January 1 this year Meldonium was added to the World Anti-Doping Code's banned list. In the space of three months more than 170 athletes tested positive with many of them protesting they had stopped using the product before the January 1 deadline. When numerous sports contacted WADA to express such concerns, WADA admitted that perhaps it took longer for Meldonium to leave an athlete's body than their research had predicted. This case represents the lacklustre enforcement of Wada and poor decision making by them The admission has sown doubts about the way anti-doping is prosecuted and the science it is claimed to be built on [2: https://www.abc.net.au/news/2016-04-18/holmes-when-wada-goes-rogue/7334952 ]

WADA have also come under fire over their handling of the recent Froome salbutamol case in which the case was dropped by WADA after stating that it was in rare occasions which an athlete’s urine could possess above the allowed limits even with permitted doses. This aroused many questions as to this “ rare” coincidence in which over 1000 times the permitted levels of salbutamol were found in the urine of Chris Froome during the 2018 Vuelta a espana.Personally I don’t think the whole story has been told by WADA and that some information may have not been told to avoid another Lance Armstrong saga with Chris froome

Travis Tygart, the head of the US Anti-Doping Agency said that he believed that Wada was “doomed to fail – unless it has pretty significant changes that makes it free from the conflict of interest and those who have an interest not to promote clean sport.” [3: https://www.theguardian.com/sport/2018/jul/09/wada-anti-doping ]

NADAs

National anti-doping agencies are government funded organisations who are responsible for the testing of national athletes on behalf of the world anti-doping agency.They test both in competition and out of competition,anyone can be tested for Performance enhancing drugs at any level of sport – this protocol is very useful in my opinion as many assume that at lower levels of sport competition it is much easier to dope,although this may be the case the right to test any individual in the UK helps to deter many from cheating.

They arealso a vital player in education and prevention around doping and public awareness through education partnerships with local sporting bodies.

NADA’s also

It is clear that although both world and national anti doping agencies have still a way to go in order to be completely robust and create a doping free stage in sport however my research has shown the importance of partnerships between the two and other organisations involved and without this co-operation regulation and prevetion of drugs in sport would be much more difficult

Labatories and the pharmaceutical industry

Arguments for/against the use of performance enhancing drugs in sport

The audience has an interest in seeing the best performances possible - Factors making a performance more enjoyable for the audience include many that can be enhanced by drugs - like skill, strength and courage

Opponents argue: if an athlete has cheated we view him or her with less respect, which damages our enjoyment of the performance

• Progressions – athletes could be said to approaching the limit of what can be achieved with the unenhanced human body especially in sports such as athletics and , any further improvement will require performance-enhancers so if we want to progress as a human race in the world of sport new limits must be created
• Admiration of a sport can even be reduced if the competitors could perform better on drugs
• It is misleading to say it disadvantages poorer teams, because they are already disadvantaged by other factors - equipment, expertise and so on
• Evidence shows that people do not lose interest in sports that are known to be tainted by drugs - viewing figures remain as high as ever
• Opponents argue: in many cases there is no 'drug-free' alternative; people may still lose respect for the sport even if they don't want to stop watching altogether
• We should not stop athletes from taking drugs if they are willing and know the health risks: that's being paternalistic
• Drugs testing does not work – some evidence shows that dug tests can sometimes show up wrong or show things that are otherwise not included with many innocent athletes caught on the wrong end
• Opponents argue: this is an argument for better testing, not giving up altogether

The boundary between athletes and their equipment is being blurred -Clothes, and equipment like racquets, are often designed specially for an athlete and customised to his or her body shapeSome people argue that there will soon be no distinction between the equipment and the athlete's body (eg Miah, 2003),It will then be impossible to separate legal enhancements from disallowed ones, and the rules will have to be changed to reflect that

Technology - New technology like genetic engineering will spell the end for drug regulation as well as Genetic engineering potentially helping fair play, by allowing all competitors to create an optimal body type for sport

Genetic lottery - Some could say that People do well at sport as a result of the genetic lottery that happened to deal them a winning hand. The starkest example is the Finnish skier Eero Maentyranta. In 1964, he won three gold medals. Subsequently it was found he had a genetic mutation that meant that he “naturally” had 40–50% more red blood cells than average. Was it fair that he had significant advantage given to him by chance?

Futility - Some people say that it is and always will be part of sports and that we should just stop trying to prohibit it and maybe even set a regulatory framework for it

Against

• It's the taking part that counts, not the winning - Allowing drugs would focus more on winning, not taking part
• Opponents say: but winning already matters to a lot of people, because we celebrate and reward it and this is often said as a way to
• Drugs are against the spirit of sport, even if the rules don't ban them questioning the ethics behind competition and competing
• If the 'spirit of sport' includes the idea of hard work, taking drugs may be seen as a way of succeeding with less effort
• Opponents say: but we allow some enhancements and drugs, so to ban others is hypocritical
• Opponents think previous attempts to draw a line between acceptable enhancements and 'bad' ones have been inadequate and arbitrary
• Many performance-enhancing drugs pose severe health risks
• The risks of the newer drugs aren't even known, and won't be until the long-term effects are studied
• Unless they are informed, athletes cannot properly make their own decisions
• Taking drugs amounts to harming oneself, or risking harm unnecessarily, and for some people that is sufficient reason to say it's unethical
• Allowing drugs promotes unhealthy and dangerous behaviour – we know that Drugs pose severe health risks and the commercialisation of them may lead Amateur sports players to be encouraged to take drugs if professional athletes openly did it and without the medical support,advice and monitoring available to professional athletes,Taking drugs would pose a much greater danger to them
• If drugs are allowed, drug advertising and sponsorship will presumably be allowed
• This poses similar ethical problems to the debate about tobacco advertising in sports like Formula One

The future of sport performance

Battle between drug producers and drug detectors

When the athlete’s blood samples are placed into the biological passport program, they are evaluated for changes in blood components (haemoglobin concentration; reticulocyte percentage; haemoglobin mass; reticulocyte count; red blood cell count; mean corpuscular volume; mean corpuscular haemoglobin; and mean corpuscular haemoglobin concentration) that are collectively used to assess if he or she may have blood doped.

After the athlete’s blood is thoroughly analysed, the data is used to calculate what has been termed the OFF Score (OFF-hr). This variable is calculated from the haemoglobin (a protein responsible for transporting oxygen in the blood) concentration, the reticulocyte (immature blood cells) percentage and an abnormal profile score.

If a suspicious or abnormal profile is determined with this calculation, the data is forwarded to a panel of doping experts who review it to determine if a doping infraction has actually occurred. If the panel deems that it has, WADA initiates a suspension process.

One way athletes appear to be circumventing the biological passports model is by small, frequent use of EPO. In 2011, Australian researchers found frequent micro-dosing allows athletes to use rhEPO without abnormal changes in the blood variables that are currently monitored by the athlete blood passport. aswell as synthetic epo now becoming more and more similar to naturally occurring EPO in humans it may become undistinguishable.

As the fight against doping continues, athletes appear to be continually searching for ways to elevate their performance and evade detection. The biological passport offers a great tool for limiting the practice of doping, but it seems that many athletes have already found ways to circumvent it.

Gene doping

Gene doping is a form of gene therapy where DNA is inserted into a subject for the purpose of physical enhancement. Evidence has shown that this can be done on mice with H. Lee Sweeney, a professor of physiology at the University of Pennsylvania School of Medicine and one of the leading researchers in the field of gene therapy discovering that the protein insulin growth factor-1 could decrease the muscle fibrosis caused by Duchenne muscular dystrophy where the protein, dystrophin slowly loses its functionality and is unable to code for new muscle fibre to be created thus leading to the loss of muscle, increase in muscular fibrosis and eventual loss of function in the muscles affected. The insulin was also found to have increased muscle mass by up to 40% in some mice and increased longevity. This research although greatly encouraging towards a cure for muscular dystrophy can also be potentially exploited as an anabolic steroid.

Another trial by Ronald Evans showed that mice could run nearly twice the distance once injected with a gene that codes for a fat burning protein called PPAR-δ. Although the trial was originally done to test if the protein could protect muscle fibres from type II diabetes and obesity the studies could have brought the gene into the spotlight for potential exploitation by endurance athletes such as runners, swimmers and triathletes.

At the moment there is also research aiming to enable for the gene that codes for the protein erythropoietin (EPO) to be inserted into the human genome thus enabling more red blood cells to be created for those with anaemia without having to administer as a hormone. However, with EPO being a very popular performance enhancing drug this new research could develop a way to gain the benefits of EPO without the detection and consequences These case studies present a modern day ultimatum as we can use the advancements for good in curing and preventing disease but they can also be used for physical exploitation.

The new research into gene alteration and muscular modification could indicate that one day it could be possible to ‘breed’ athletes by using genetic tests and optimal embryos to make an athlete from birth. This to me shows the true nature of humans as a race that are constantly fighting for dominion over one another in a true survival of the fittest almost like animals. I am both excited and weary to see what happens in the not so distant future.

Overall, I would say that the use of performance enhancing drugs in sport is being controlled but not as heavily restricted as it should be and is easily disguisable and may become even harder to detect in the future

Conclusion

This investigation has further widened my knowledge of the expansive and controversial topics that surround performance enhancing drugs in sport. It is clear that a large amount is being done by various organisations to prevent the assimilation of drugs within sport. Doping authorities are further ahead than they have ever been, but awareness that doping is prevalent in sport is also greater than it has ever been. With current antidoping policies, authorities greatly decrease the widespread use of dangerous substances in sport. However the difficulties with enforcing prohibitions lead to many areas of controversy.