Doping in Sport

The use of performance enhancing drugs in sport has been a contentious issue for most of the last century. Performance enhancing drugs have been condemned globally by sports organisations as a form of cheating and as an unnecessary health risk to athletes.

There are many notable examples of athletes who have been disqualified or taken early retirement after testing positive to prohibited performance enhancing drugs. In the Olympics, the two most famous cases are track and field athletes Ben Johnson of Canada and Marion Jones of America. Johnson won the 100 meter sprint at the Seoul 1988 in a time of 9.79 seconds which would have seen a new world record. Post-race drug testing revealed that Johnson tested positive for anaboloic steroids and was disqualified. The gold medal was forfeited to Carl Lewis who subsequently also tested positive for small amounts of three banned stimulants but was not disqualified or banned from the Olympics as the concentration levels of the stimulants were considered too small for performance enhancing effects. Interestingly Johnson returned to the track after suspension but received a lifetime ban after failing yet another drug test in 1993.

In 2000, at the Sydney Olympics, Marion Jones won five track and field medals [3 gold and 2 bronze]. Her husband at the time was scheduled to compete in the shot-put event but withdrew before competition stating a knee injury. He was found to test positive for the banned anabolic steriod, nandrolone. By 2007 Jones admitted to using performance enhancing drugs from the year 2000 and the International Olympic Committee disqualified her from all Olympic events and the disgraced Jones returned all five of her medals.

Chapter 66 in the new edition of the Clinical Sport Medicine textbook titled ‘Drugs and the athlete’ provides clinicians with a foundation of knowledge that is essential when working with competitive athletes. The team clinician has an extremely important role in prevention and management of performance enhancing substances both within and outside of sporting competition. The ability to educate others is vital to ensure compliance and continued safety for athletes. The team clinician should be familiar with:

  •  The prohibited list of substances
  •  Prescription drugs
  •  Inadvertent doping
  •  Drug testing protocols
  •  Travel issues (such as to foreign countries)

Adverse effects of anabolic steroids is discussed and featured in table form. Human growth hormone, diuretics, and other drugs are discussed as well as common masking agents which can accelerate the excretion of prohibited substances.

Gene doping is defined by the World Anti-Doping Agency (WADA) as ‘the non-therapeutic use of cells, genes, genetic elements, or of the modulation of gene expression, having the capacity to improve athletic performance.’ This section of the chapter is co-authored by associate professor Malcolm Collins who holds a PhD in Biochemistry and whose research interests include genetic basis of connective tissue overuse injuries, genes associated with obesity and genetic elements that determine the endurance phenotype. Gene delivery, gene therapy and gene doping are discussed. Genes for endurance, genes for tissue repair and risk of gene doping are also discussed

A new podcast has just been added to The British Journal of Sports Medicine website. World Anti-Doping Agency (WADA) expert Dr Alan Vernec  discusses current anti-doping issues with deputy editor Dr Babette Pluim.

Recommended websites:

The World Anti-Doping Agency: established on 1999 to promote, coordinate and monitor the fight against drugs in sport. It also produces an annual list of prohibited substances and methods that sportspersons are not allowed to take or use.

The Australian Sports Anti-Doping Authority: a government statutory authority that is Australia’s driving force for pure performance in sport. It is the organisation with prime responsibility for implementation of the World Anti-Doping Code (the Code) in Australia.

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