Eliminating doping in Sport: An impossible task ?

1. Eliminating doping in Sport: An impossible task ? Associate Professor John Fitzgerald School of Social and Political Sciences

2. Outline • The year that was • Notable new celebrities • Definitions • WADA code / ASADA schedules • Different taxonomies • Framing anti-doping controls • Theories of consumption • Reasons for testing regimes • Preventive approaches • The context of testing • So is this about eliminating doping • Gusfield / durkheim

3. 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

4. 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

5. AOD-9604 Source: http://www.abc.net.au/science/articles/2013/07/26/3811053.htm

6. AOD-9604 Source: http://www.abc.net.au/science/articles/2013/07/26/3811053.htm

7. AOD-9604 Source: http://www.abc.net.au/science/articles/2013/07/26/3811053.htm

8. AOD-9604 Source: http://www.abc.net.au/science/articles/2013/07/26/3811053.htm

9. WADA/ ASADA Under 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.

10. Specific criteria Under 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.

11. 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

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

13. Anti doping testing • Number of tests Source: http://www.wada-ama.org/Documents/Resources/Testing-Figures/WADA-2012-Anti-Doping-Testing-Figures-Report-EN.pdf

14. Anti doping testing • Drug categories (2006)

15. Anti doping testing • Drug categories (2012) Source: http://www.wada-ama.org/Documents/Resources/Testing-Figures/WADA-2012-Anti-Doping-Testing-Figures-Report-EN.pdf

16. Anti doping testing • Drug categories Source: http://www.wada-ama.org/Documents/Resources/Testing-Figures/WADA-2012-Anti-Doping-Testing-Figures-Report-EN.pdf

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

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

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

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

21. 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

22. Anti doping testing • Anabolic agents Source: http://www.wada-ama.org/Documents/Resources/Testing-Figures/WADA-2012-Anti-Doping-Testing-Figures-Report-EN.pdf

23. 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 ?

24. 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

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

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

27. 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”.

28. 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 (Petróczi and Aidman 2008),

29. 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).

30. 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).

31. How do we frame anti-doping Role: battle of perspectives • Perspective • Focus • Theme • Policy options

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39. The U-curve Alcohol consumption high low low high Level of sporting participation Peretti-Watel et al., 2002, Addiction, 97: 707-716

40. 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

41. Illicit drug use: Professional sportspeople Source: Dunn et al., (2011)

42. Illicit drug use: Professional sportspeople Source: Dunn et al., (2011)

43. Illicit drug use: Professional sportspeople 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) Source: Dunn et al., (2011) Drug and Alcohol Review, 30, 63–68

44. Supplements

45. Where young UK athletes get their information • Sources of information about supplements Spource: Petróczi et al., 2008 J. Intern. Soc. Sports Nutrition 2008, 5:22

46. Supplements • Age and Gender – likelihood for supplement use

47. Reasons for supplement use Source: UK Sport: Drug-free sport survey. London: UK Sport; 2005

48. Perceived problem

49. Continuum of “supplement” use ? Petroczi et al., 2008 • supplements • alcohol • Illicit drugs

50. 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.