THERE is widespread shock in the sporting community as one of the world’s most famous cricketers, Shane Warne, tests positive for a banned diuretics hydrochlorothiazide and amiloride — a drug often used to help with weight loss.
The Australian Cricket Board’s anti-doping committee banned Test cricket’s second-leading wicket-taker for 12 months. The 33-year-old leg spinner, one of Wisden’s five Players of the 20th Century, was stunned and immediately branded himself a victim of “anti-doping hysteria” in the biggest doping scandal to hit cricket. In the meantime, Warne has been sent home from the cricket World Cup tournament.
The practice of taking dope by sportsmen is not a new phenomenon — athletes have taken performance-enhancing agents since the beginning of time. The legendary Arthurian knights supposedly drank magical potions from the cup of Merlin. Celtic tales describe the use of strengthening potions to aid valour in battle, and the druids’ use of narcotics is well-documented by historians. The ancient Olympics in Greece were riddled with corruption and doping to the extent that the games had to be dissolved.
In ancient Rome, gladiators drank herbal infusions to gain extra strength before chariot races and going into battle. Almost two millennia later, the first documented report in the medical literature was published in 1865 in the British Medical Journal, citing expulsion of a swimmer from an Amsterdam canal race, for taking an unnamed performance-enhancing drug. The first doping-related death occurred in 1886 in cycling.
In the early 1900s, the most popular doping agent was a cocktail of alcohol and strychnine. The use of strychnine was superseded by amphetamine, following its development in the 1930s. In 1960, the Danish cyclist Kurt Jensen, died after overdosing on amphetamine in an attempt to seek competitive advantage and the search for control measures began. It was, however, the televised death of the British cyclist Tommy Simpson, while under the influence of amphetamine during the 1967 Tour de France that really brought into limelight the seriousness of the issue. Cycling has long since been a harbinger for systematic doping and as one top cyclist explained: “It is impossible to finish in the top five of a Tour de France without doping”.
In the last three decades, a number of names have joined the cheaters’ hall of fame, including Ben Johnson (stanozolol), Dan Mitchell (testosterone), Lind Ford Christie (nandrolone), Olga Yegorova (erythropoietin) and Andrea Raducan (pseudo ephedrine) and many more. Johnson was abusing stanazolol and other agents for years with the help of fringe practitioners, before testing positive at the Seoul Olympics in 1988. In the UK, many were shocked by the Lind Ford Christie saga, however, he first tested positive in 1988, at the start of his career, for the banned stimulant pseudo ephedrine. Not surprisingly he lost his contract.
It is not just athletes who are involved in the doping games — coaches, managers, team doctors and fringe practitioners have all been implicated. Eric Rykaert, medical officer of the Festina cycling team, was prosecuted for possession of erythropoietin in 1999. The Australian swimming team coach for the 2000 Sydney Olympics, Gennadi Touretski, was found in possession of stanozolol; interestingly this discovery was made following the arrest of two heroin addicts who burgled his home. But perhaps the most sinister of all, is the publication of the book Faust’s Gold which takes an in-depth look at the systematic doping machine implemented by the German Democratic Republic in the 1970s.
Doping not only contravenes the spirit of fair competition, it can be seriously detrimental to health. Elite athletes who turn to doping take the greatest risks which seem to pale in contrast to their burning desire for gold. Anabolic steroids affect cardiovascular and mental health and are associated with an increased risk of neoplasms. Dietary supplements containing ephedra alkaloids have been linked to serious health risks including hypertension, tachycardia, stroke, seizures and death. This finding has led to the recall of ephedra containing supplements in the USA and Canada.
Deaths under the influence of drugs and combinations thereof are not uncommon in sport. The peptide hormones or so-called “sports-designer drugs” are thought to be the most dangerous, although the combination of amphetamines, anabolic steroids or anti-hypertensive combined with intense exertion in athletes are just as hazardous.
Doping is not just a symptom of elite competition, but it is also prevalent in amateur sports and school sports. In France, the incidence of deliberate doping in amateur sport is 5 to 15 per cent. In 1993, the Canadian Centre for Drug-Free Sport estimated that 83,000 children between the ages of 11 and 18 years had used anabolic steroids in the previous 12 months. In a more recent American study, prevalence of anabolic steroid use in teenagers was 4 to 12 per cent for boys and 0.5 to 2 per cent for girls. In addition to school sports performance, males used anabolic to enhance physical appearance. In France, the incidence of adolescent doping is estimated at 3 to 5 per cent, males again more commonly implicated. The scale of drug use by body builders is thought to significantly exceed that of the elite athlete.
Body builders use combinations of domestic, foreign and veterinary medicines to create “successful training programmes”. In an American study, 54 per cent of male body builders were abusing anabolic steroids. Androgenic anabolic changes are particularly marked in the female body builder who would otherwise only be exposed to trace levels of testosterone. The most commonly abused group of drugs are stimulants, followed by anabolic steroids. Alcohol is one of the most widely-used drugs in the athletic population as a whole; it is implicated in sports injury and poor physiological performance and should be avoided by the serious athlete.
Despite the development of advanced drug testing systems, doping in sport, both deliberate and inadvertent, is on the increase in elite, amateur and school sports. Whereas some take drugs to seek deliberate advantage, others feel pressurized into considering doping as the only viable option to level the playing field. Others, inadvertently, take prohibited substances due to a lack of awareness. A particular problem is the risk of today’s supplement culture to accidental exposure and a positive drug test. An effective anti-doping programme must incorporate educational components in addition to testing.
Education needs to be collaborative and pro-active and include athletes, coaches, managers, governing bodies, and health-care professionals. The increasing problem of drug abuse in junior sports warrants special attention. Simplification and standardization of procedures, policies and educational strategies is needed at international level. Pharmaceutical legislation needs to change to accommodate safety of medicines in sport.
THERE is widespread shock in the sporting community as one of the world’s most famous cricketers, Shane Warne, tests positive for a banned diuretics hydrochlorothiazide and amiloride — a drug often used to help with weight loss.
