Eliminating doping in Sport: An impossible task ?

Eliminating doping in Sport: An impossible task ?

Associate Professor John Fitzgerald

School of Social and Political Sciences

Outline 1. The year that was

a) Notable new celebrities

2. Definitionsa) WADA code / ASADA schedulesb) Different taxonomies

3. Framing anti-doping controls4. Theories of consumption 5. Reasons for testing regimes 6. Preventive approaches7. The context of testing 8. So is this about eliminating doping

Gusfield / durkheim

The year that was

Notable new celebrities Lance Armstrong

Guilty of doping

The weapon Guilty of poor performance

The alchemist Not guilty of anything yet

Hird Guilty of poor governance

The year that was Notable new celebrities AOD-9604

A modified fragment (16aa) of human growth hormone developed in 1990s.

Weight loss, no effect on muscle mass or growth factors Hexarelin

peptide GH secretagogue, structurally similar to GHRP-6 in the growth factor family which stimulates the release of growth hormone (GH)

thymosin beta-4 (TB-4) has a general role in tissue regeneration lowering of the production of pro-inflammatory cytokines.

Source: http://www.abc.net.au/science/articles/2013/07/26/3811053.htm

http://www.abc.net.au/science/articles/2013/07/26/3811053.htm

AOD-9604



AOD-9604



AOD-9604


AOD-9604


WADA/ ASADAUnder the current World Anti-Doping Agency (WADA) Code, a

substance or method is prohibited and considered doping if WADA determines it meets any two of the following three criteria:

Medical or other scientific evidence, pharmacological effect, or experience that the use of the substance or method represents an actual or potential health risk to the athlete.

Medical or other scientific evidence, pharmacological effect, or experience that the substance or method has the potential to enhance or enhances sport performance.

Determination by WADA that the use of the substance or method violates the spirit of sport.

Specific criteriaUnder the current World Anti-Doping Agency (WADA) Code, a

substance or method is prohibited and considered doping if WADA determines it meets any two of the following three criteria:

health risk to the athlete. has the potential to enhance or enhances sport performance. use of the substance or method violates the spirit of sport.

ASADA – Amendments 2013 Australian Sports Anti-Doping Authority Amendment Bill 2013 is to

provide ASADA with the power to issue a ‘disclosure notice’ compelling persons of interest to assist ASADA’s investigations. This will see: individuals required to attend interviews with ASADA investigators individuals required to cooperate with ASADA by answering questions or

providing information; however, individuals will not be required to self-incriminate themselves

individuals required to provide specific documents, materials (including electronic materials and products) and things (such as video cameras, medications and training bags) to ASADA investigators

individuals who fail to comply with a disclosure notice face a civil penalty of 30 penalty units per day (currently equivalent of $5,100 per day).

Source: http://www.asada.gov.au/media/ministerial.html

Anti doping testing

Rationale

Source: http://www.wada-ama.org/Documents/Resources/Testing-Figures/WADA-2012-Anti-Doping-Testing-Figures-Report-EN.pdf

Anti doping testing

Number of tests


Anti doping testing

Drug categories (2006)

Anti doping testing

Drug categories (2012)


Anti doping testing

Drug categories


Anti doping testing

Peptides


Anti doping testing

Stimulants


Anti doping testing

Methylhezaneamine(dimethylpentylamine)(dimethlylamylamine, DMAA)

1944 Eli Lilly Nasal decongestant Dietary supplement

No medical use today 2006 – geranamine ( with caffeine)

single oral dose of about 50-75 mg Dose > 100 mg likely adverse outcome


Anti doping testing

Dimethylamine VFL player Matthew Clark was suspended for two years

after the banned substance dimethylamylamine was detected in his system after a game in 2011.Read more: http://www.theage.com.au/afl/afl-news/st-kildas-ahmed-saad-faces-twoyear-drugs-ban-20130730-2qxha.html#ixzz2lwpB7Yo6


Anti doping testing Clark, 22, is serving a two-year suspension handed down by the Australian Sports

Anti-Doping Authority (ASADA), after he was found guilty of taking a banned substance whilst playing for Frankston in the VFL in 2011.

He accepted a pre-match drink named 'Hemo Rage' from a teammate and afterwards, tested positive to an ingredient named Dimethylamylamine.

Clark says he was aware that he would be drug tested that day, but was assured by his teammate that the product was within the drug code.

Initially handed a nine-month ban, ASADA appealed the decision, and eventually, Clark was given the maximum two years.

The event has completely changed his life.

Source: http://www.afl.com.au/news/2013-07-04/banned-vfl-player-on-road-back

Anti doping testing

Anabolic agents


Taxonomies How the substance effects the body (e.g. stimulants); Chemical identity (e.g. steroids, caffeine); Based on their outcomes (e.g. performance and image enhancing

drugs – PIEDS); Legal or social status (licit/ illicit) Role in relation to sport activity (pre-activity, recovery) (Newland et

al., 2012). Level of interest a substance may have to performance Whether they are approved by sport anti-doping regulators.

Eg what is a supplement ?

What is a supplement ?

Under the World Anti-Doping Code strict liability principle, athletes are ultimately responsible for any substance found in their body, regardless of how it got there. http://www.asada.gov.au/substances/supplements.html

Dietary supplement Also called: 1,3-dimethylamylamine 1,3-dimethylpentylamine 2-amino-4-methylhexane 2-hexanamine, 4-methyl- 2-hexanamine, 4-methyl- (9CI) 4-methyl-2-hexanamine 4-Methylhexan-2-amine DMAA Floradrene Forthan Forthane Geranamine Methylhexanamine Methylhexaneamine Pentylamine, 1, 3-dimethyl-

Source:http://www.asada.gov.au/substances/supplements.html

Methylhexaneamine is classed as a stimulant on the World Anti-Doping Agency’s Prohibited List and it is prohibited in-competition. Generally, stimulants act directly on the central nervous system to speed up parts of the brain and body. They can increase alertness and reduce fatigue.

The prohibited list

Source: http://www.wada-ama.org/en/World-Anti-Doping-Program/Sports-and-Anti-Doping-Organizations/International-Standards/Prohibited-List/

Drug use Theories Cultural beliefs about utility, efficacy and harm associated with

drugs can be powerful determinants of their use. Three cultural theories:

“Edgework” supply-driven consumption and “healthism”.

Edgework Sensations of being on the “edge”, Avoiding disaster Improving performance (Lyng, 1990; Hunt et al., 2007). Competing social forces create a tension that enhances the

likelihood of “edgework” practices (Reith, 2005). The social pressure to be “natural” and drug free A consumerist force to heighten performance through consumption.

Consumers are continually “perched on the boundary between indulgence and the denial of their impulses and desires” (Reith, 2005).

There is both a function and a pleasure to pushing the boundaries of performance, and these boundaries may not necessarily just be found in elite sport performance.

Risk taking among elite sportspeople has been explored extensively from a psychological perspective (Petroczi and Aidman 2008),

Supply-driven consumption Market supply to increase consumption trends for illicit, legal and

therapeutic substances. Supply-induced heroin and amphetamine consumption in Australia

and South East Asia (Dietze and Fitzgerald 2002; UNODC, 2013). Alcohol industry and binge drinking Rise in antidepressant use in the 1990s and“disease mongering”

by the pharmaceutical industry (House of Commons, 2005). Australian Crime Commission (ACC, 2013) - corruption of

professional sport through the illicit supply of psychoactive and performance enhancing drugs (ACC, 2013).

Healthism 1980 the problem of “healthism” was identified (Crawford 1980)

excessive attention to one’s own health and the overmedicalisation of everyday life (Petrie and Wessely, 2001).

Inappropriate level of use of a wide range of substances in order to enhance health and performance in the absence of disease (Greenhalgh and Wessely, 2004).

Cultural trend for articulate, educated, and health-motivated segments of the population,

Prevailing folk models of chronic illness and substance use. “tonic”, “fuel” and “food”, lay people applied to psychotropic drugs

(Helman, 1981). Recent unprecedented rise in population consumption:

enhancement drugs (memory, sexual drive, strength, performance, attention and image)

broader social trends ? (Quintero and Nichter 2011).

How do we frame anti-doping

Role: battle of perspectives Perspective

Focus Theme

Policy options

Role

Role

Role

Role

Role

Role

Role

The U-curve

Level of sporting participation

Alcohol consumption

low highlow

high

Peretti-Watel et al., 2002, Addiction, 97: 707-716

The U-curve

Not for all sports Not for both genders Male contact sports Team sports Not for tobacco Different for age sub-

groups

Peretti-Watel et al., 2002, Addiction, 97: 707-716

Illicit drug use: Professional sportspeople

Source: Dunn et al., (2011)


Source: Dunn et al., (2011)


Source: Dunn et al., (2011) Drug and Alcohol Review, 30, 63–68

Predictors of recent illicit drug use (past year) among elite sportspeople

Having been offered/had the opportunityto use illicit drugs in the past year (14x more likely than not)

Identifying as a ‘full-time athlete’ (4x more likely than not )

Knowing other athletes who use drugs (3x more likely)

Supplements

Where young UK athletes get their information Sources of information about

supplements

Spource: Petroczi et al., 2008 J. Intern. Soc. Sports Nutrition 2008, 5:22

Supplements Age and Gender – likelihood for

supplement use

Reasons for supplement use

Source: UK Sport: Drug-free sport survey. London: UK Sport; 2005

Perceived problem

Continuum of “supplement” use ?

Petroczi et al., 2008

supplements Illicit drugsalcohol

Continuum of “supplement” use ?

Anabolic ergogenic substances provide a gateway for the use of general illicit drugs (Arvary and Pope, 2000),

High school student athletes were four times more likely to dope if they used legal supplements or engaged in risky behaviors Papadopoulos et al. (2006)

Nutritional supplement use may be a “gateway” to doping Backhouse et al (2013) Online sample of competitive sportspeople doping use is 3.5 times

more prevalent in nutritional supplement users compared with non users.

Athletes who engage in legal performance enhancement practices appear to embody an “at-risk” group for transition toward doping. Study has significant limitations.

Information sources

Source: Dunn et al., (2011) Drug and Alcohol Review, 30, 63–68

Key points 1. Where athletes get their information/advice from is

essential– Type/quality of information– Context of the information

Establish the most appropriate conduits to the right information

2. Continuum to supplements use– Each type of supplement will have a role/function

(Strength, weight loss, recovery, performance, emotion management, fun)– Be realistic about drug - alcohol - supplement use Encourage players to see the links between the use of

different substances

Frameworks – Public Health

Organisation

Individual

Community

Society

Context – body surveillance Biological passport The quantified self

Athlete Biological Passport Discussed at WADA 2002, now NRL, ITF, ATP, WTA Looking at the effects of doping Monitoring of selected parameters over time that indirectly reveal the

effect of doping, as opposed to the traditional direct detection of doping by analytical means.

ABP focused on Australia’s elite athletes Complements testing regime May include:

To identify and target athlete for specific analytical testing; and To pursue possible anti-doping rule violations Baseline 4 tests 4 - 10 tests per year

Shift from absolute certainty and perfection to a more defensible empirical and probabilistic foundation (Sottas et al., 2010)

The quantified selfSelf – environment - monitoring Personalized preventive medicine

Continuous Wearable Sensor Patches Continuous Monitoring (smart devices) Biomarkers - risk – wellbeing

Monitoring the bioeme Sensordrone / Air quality egg

Online platforms for personal data streams unified self-tracking, several mobile applications such as Daily Tracker (http://www.thedailytracker.com/) Track and Share (http://www.trackandshareapps.com )

Crowdsensing

Influencing environments

Beyond behaviour change:(Social Practice theory)

Consumption Focus on Health

Source: http://www.rmit.edu.au/cfd/beyondbehaviour

How do we create behaviour changeby changing the environment

Rules Anti-doping

Material infrastructures Supplement programs / mentor programs

Common understandings Performance / balance / health

Practical knowledges Training schedules, recovery schedules

Do we test in order to stop drug use ?

‘We must not say that a criminal action shocks the common conscience because it is criminal. But rather it is criminal because it shocks the common conscience. We do not reprove it because it is a crime, but it is a crime because we reprove it’ - Durkheim

But what do we reprove in doping?

Principles for approaching alcohol and drugs in sporting contexts

Make your frameworks explicit Performance/ financial/ health/education/welfare

Make your framework trusted Shepherd with influential people Take your time /get it right Get good evidence/ precedence / stories

Make your framework feasible People need to see that it is reasonable / do-able

Ensure people own it Make sure everyone is involved Not just players

References Sottas PE, Robinson N, Saugy M. (2010) The athlete's biological passport and indirect markers of blood doping Handb Exp Pharmacol.;(195):305-26. .

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