Drugs in Sport: The Problems, The Solutions and The Future.

Gemma

The abuse of drugs in sport has become an increasing problem in recent decades, although substance use and abuse to improve sporting performance has been reported as far back in history as ancient Greek and Roman times (Mottram, 2003). With the ongoing advancements in biomedical technology, drugs have become more potent, more effective and more dangerous. Elite athletes are simultaneously being faced with the increasing pressure to perform from a large number of sectors. As a result, many athletes feel the need to abuse substances to relieve this pressure in some way - either through performance enhancement or through perceived escape mechanisms. Drug testing for athletes was introduced in the 1960s as a means of detecting illegal methods of performance enhancement, and as a preventative strategy, aiming to reduce the number of athletes abusing substances, and to reduce the health risks associated with such use (Berlioux, 1969). The ongoing controversial debate regarding the validity of forcing athletes to undergo mandatory drug testing, encompasses moral, legal, ethical and medical arguments for and against, thus an outright solution protecting the rights of all athletes is not likely to be found in the near future.

Historical perspective:

The use of substances to improve performance in sport has been recorded from as early as the third century B.C. – Greek physician Galen used medicinal preparations to treat disease and illness, and noted that many Olympic athletes at the time used stimulants and diet modification methods to enhance their performance.

In more recent times, cyclists in the late 1800s began administering stimulants such as strychnine, a practice that was attributed to several deaths and near-deaths prior to 1920. This instigated the development of the Dangerous Drugs Act.
Amphetamine-like substances were distributed to soldiers in World War Two to improve alertness and decrease fatigue, and it was also at this time that these substances began to be used by athletes (especially cyclists) in both sprint and endurance events. However, the deaths and hospitalisation of several athletes resulting from amphetamine abuse in the 1960s prompted the development of anti-doping legislation and the first use of drug testing procedures at the Olympic Games in 1968.

Since then, there has been ongoing development of a range of performance enhancing drugs.,In response to this, numerous testing procedures have been developed, which not only detect performance enhancers but recreational drugs as well.

Why do Athletes take drugs?

Drugs have a variety of uses amongst athletes and amongst the general population. A large number of preparations exist to treat legitimate medical conditions, including hormone deficiencies or overproduction, diseases ranging from the common cold to cancer and many other conditions. Many of these substances have performance-enhancing benefits, especially when used in quantities above therapeutic doses. It is for this reason that many substances are banned in certain quantities rather than being prohibited altogether. Athletes can receive therapeutic exemptions in the event of requiring treatment with such drugs. For the purposes of this paper, performance-enhancing drugs include those that produce direct ergogenic benefits, and also those which can produce benefits such as hasten recovery from injury, or that allow an athlete to train or compete while injured.

It has been acknowledged that sport has become a business, and winning is no longer just about the glory and knowledge that one is the best – it is now about money, exposure and adulation (Paddick, 1990). It has been hypothesised that the huge incentives such as sponsorships, media exposure, money and prestige that accompany sporting success have corrupted the philosophy of sport – the athlete now has to be the best to satisfy themselves, their club and team mates, their fans, their sponsors and the mass media among others (Bryson, 1990). Athletes are expected to be role models, and maintain this behaviour both on and off the competitive field. The consequences of failing to do so can be huge and take a toll on the athlete’s professional and personal life.

Some athletes simply desire being able to consistently perform at their peak level. Performance can be hindered as a result of uncontrollable situations, such as injury, and a range of drugs have been developed to allow athletes to recover more quickly, or to be able to return to competition while still injured, so that they do not have to face the social, financial and emotional consequences of being unable to perform.

However, many banned substances are taken with the sole aim of improving performance beyond an athlete’s natural capacity, enabling one to gain a competitive advantage over his rivals, or to improve performance in order to be able to successfully compete against other substance-abusing rivals. Alternatively, recreational drugs are often used by athletes in social settings as a means of escaping the pressure., (Bryson, 1990).

A further point of concern is the health risks athletes place themselves in by abusing performance-enhancing substances. Such risks may be manifest as short-term temporary problemsor long-term health problems, reversible and/or irreversible, and in the worst-case scenario, an athlete may die. The fact that athletes are willing to risk their lives in the pursuit of victory has raised a large number of issues, and is one of the key factors in the development of anti-doping codes and a key reason behind the implementation of drug testing.

Drug Testing: The Cases For and Against.

According to Schneider (1992), mandatory drug testing is unethical, as it directly violates an athlete’s rights by deviating from the traditional western notions of “freedom” and “privacy.” Thus it follows that an athlete freely makes the choice to take performance-enhancing substances, with the full understanding of the potential consequences, but is still denied the option of not having to undergo a drug test to detect doping. As a result, athletes who engage in substance-abuse are destined to face disciplinary action, even if they consent to drug testing . However, as Schneider also points out, the fact that mandatory drug testing is considered ethically acceptable in cases where it can serve as a deterrent against harmful use patterns or serve as a course of protection against harm (either of self or others), means that drug testing in sport is actually in all athletes’ best interests, should they freely choose to abide by the anti-doping guidelines.

With regards to the concept of choice, Moorcroft (1985) discusses the moral dilemma facing any athlete. No athlete wants to compete against another athlete who is taking drugs and thus has an unfair and illegal advantage. However, given that every athlete has such a strong drive to win, and given the huge incentives to do so in modern culture, it logically follows that an athlete would take a substance to give them the competitive edge, thus increasing their chances of victory. He also likens the use of performance-enhancing drugs to the implementation of various coaching, training and rehabilitative techniques – it is an athlete’s choice to utilise facilities that will afford them the best chances of victory, be it via new and more effective training techniques, new rehabilitation methods for injury or post-event recovery or other methods. Not every athlete will choose to utilise them, or have access to them, but this should not be a reason to disadvantage those that do. Given that at present, most sports only outlaw doping, and not any other training techniques, it also comes across as a form of hypocrisy to outlaw just one form of competitive advantage.

From a medical viewpoint, the use of substances developed to improve performance is almost moot – although certain drugs, taken in certain quantities and under certain conditions can most certainly improve performance, the fact that such use can produce such life-threatening consequences means that under the stipulations of the Hippocratic Oath, a doctor should not prescribe the drugs, as they would do so, knowing the harmful consequences (Mottram, 2003). However, this has not stopped practitioners prescribing drugs, and it has also not prevented pharmacists, both qualified and unqualified, from producing them with the sole intent of supplying them to athletes. Consequently alternative methods must be developed to try to limit athletes using such harmful drugs. For example, deterrents in the forms of suspensions or permanent exclusions in the event of detection. This supports Schneider’s (1992) assertion that drug-testing for athletes should be considered acceptable.

A side-note of drug use to improve performance concerns the use of drugs to return to competition after injury. Although there are a range of legal treatments that can be, and often are used to reduce rehabilitation time, many of these, if abused, can also be detrimental to the athlete’s health and ability to performance. This also supports the assertion that if drug use can be harmful to an athlete’s health, testing should be encouraged as a means of discouraging adversive behaviour.

These arguments so far are in reference to performance-enhancing drugs, and competitive advantage, but, for the most part, do not take into account recreational substance use. Athletes regularly consume recreational substances such as caffeine and alcohol. Caffeine has been subjected to the World Anti-Doping Association guidelines (2005) that only permits its use within recreational or social limits as caffeine has been shown to improve performance. Alcohol has also been subjected to strict guidelines in certain dangerous sports (such as car racing, archery and shooting), due to its negative effects on performance. Other substances such as marijuana, ecstasy, speed, cocaine and methamphetamines are subject to individual doping control guidelines, but contribute little to improving performance, according to Campos, Yonamine and de Moraes Moreau (2003). Such drugs actually either suppress or overstimulate, which can alter alertness, reaction time, co-ordination, endurance capacity and overall performance, thus their use is more for social benefit, rather than performance enhancement (Campos et al, 2003). For this reason, questions regarding the legality and ethical validity of testing for recreational substances that do not improve performance still arise. Following from Schneider’s (1992) reasoning behind the implementation of drug testing for performance enhancing substances, it could be considered that since these substances do not enhance performance, and are taken for recreational purposes, they should not be tested for, despite the obvious harm they can cause. It is the athlete’s choice to take them after obtaining them illegally (such substances are considered illegal in many countries), and as such, the athlete should be subjected to common law in society rather than anti-doping law in sport.

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Conclusions

Even the briefest investigations into the use and abuse of drugs in sport, and the legal, ethical and medical implications of testing, show that there are many unanswered questions, and many grey areas that can serve to be an advantage for certain athletes, whilst disadvantaging others. Athletes are currently subject to a number of strict guidelines in order to ensure there is a relatively level playing field for all competitors, which, although it may be technically illegal or even immoral in certain circles, can help ensure the health of athletes, thus giving all athletes an opportunity to succeed to the best of their natural abilities. However, as long as capitalism in modern society plays a role in sport, the incentives to perform will most likely be enough to encourage some athletes to go beyond legal boundaries to improve their performance, which can only be ultimately harmful to both the athlete and their sport in the long-term.

References:

Berlioux, M. (1969) Doping, Drugs and Sport Newsletter, October, No. 25, p. 561-564

Bryson, L. Sport, Drugs and the Development of Modern Capitalism. Sporting Traditions, May, No. 2, p. 135-153

Campos, D.R., Yonamine, M. and de Moraes Moreau (2003) Marijuana as Doping in Sports. Sports Medicine, 33(6): 395-399

Moorcroft, D. (1985) Doping: The Athlete’s View: Dilemmas and Choices. Olympic Review, October, No. 216, p. 634-636

Mottram, D.R. (ed.), (2003), Drugs in Sport. 3rd Edition, Human Kinetics, Champaign, Illinois.

Paddick, R.J. (1990) Drugs and Sport: A Review Article Sporting Traditions, May, No. 2, p. 64-72

Schneider, A.J. (1992) Harm, Athletes’ Rights and Doping Control. Proceedings. First International Symposium for Olympic Research, February, 1992, p. 164-175.

World Anti-Doping Agency (2004) The 2005 Prohibited List: International Standard.