Drug Abuse & Sport - A Basic Intro
The news of a high-profile athlete being caught out for abusing performance enhancing substances never fails to make headlines or trend on twitter (#doping, #cleansport, #hashtag). This is no surprise when you consider the psychology of the issue. When an athlete is in the spot-light for their success, the public become invested in them. When the news that one of these superstars of sport has been caught out and received a ban for abuse of a prohibited substance breaks, it understandably makes waves. Look at the examples of Lance Armstrong and Maria Sharapova. People are still talking about events which have long since been dealt with by the respective governing bodies of the sports involved.
But with the use of prohibited substances making the news with some regularity, it bears talking about how doping is handled in sport, and how doping has even become a thing in the first place. Doping is defined as ‘the use of a substance/method to enhance human performance in an activity’. By that definition, your morning cup of coffee could count as doping. But when we apply it to athletic performance, it becomes a bit more specific. Not all substances a person takes into their body are necessarily going to enhance their performance. So, there is a need to categorise which drugs an athlete is, and isn’t allowed to use (because even athletes get sick). To this end, the World Anti-Doping Agency (WADA) put together their list of prohibited substances. The list focuses on three factors when considering whether a drug should be prohibited:
1) Does the substance enhance the performance of the athlete using it?
This is easy to measure with the scientific method, though it must be said that not all substances on the prohibited list have research behind them guaranteeing that they enhance performance. A substance can be placed on the WADA monitoring list if it suspected there is a potential for performance enhancing effects even before being formally prohibited.
2) Does the substance present a risk to the health and wellbeing of the athlete?
This again can be measured in clinical trials and through long-term data in the form of adverse drug reaction reports. In pharmacy, choosing the right drug for a patient is dependent on the ratio of risk versus benefit. A drug that treats the patient, but also causes immense kidney damage is less likely to be the right choice than one which treats the patient with fewer side effects. On that note, it is important to bear in mind that every drug, at a high enough dose, is associated with toxic effects. It follows that the risk to the athlete is dependent on the dose that is often used for doping. As doses used in doping are often higher than doses used for therapeutic effects, drugs used in doping will often be harmful to the patient in some or other way. Thus this requirement is often the first one to be met.
3) Does the use of the substance contravene the spirit of sport?
Here we hit a bit of a stumbling block. As soon as one deals with an ephemeral topic like ‘spirit’, or even the slightly more straightforward ‘ethics’, it becomes much harder to categorise things, and the potential for debate grows. Still, if we use the fairly simple definition of ‘a user of a drug gaining an advantage over a non-using competitor’ as our baseline, then we have something to work with.
What then is the point?
The point is, for a substance to be prohibited per WADA, it only needs to meet two of the three above mentioned requirements. Thus a substance that boosts performance and does so unfairly, with little to no risk to the athlete can be banned as readily as a substance that provides only a small boost in performance but with a huge risk to the athlete. This is following the assumption that any attempt to unfairly gain an advantage over your opponent contravenes the spirit of sport.
With the knowledge of what makes a substance prohibited we can get to the nitty gritty and talk about the really fun stuff, the drugs themselves. The study of how a drug works is known as ‘pharmacology’. This can be broken up into two aspects: the study of how the drug exerts its effects on the body – ‘pharmacodynamics’; and the study of the effects the body exerts on the drug – ‘pharmacokinetics’. The performance enhancing effects of drugs are often connected to the pharmacodynamic properties of a drug. That is to say, how a drug makes muscles grow, or increases oxygen uptake, and so on, those factors relate to how the drug causes its effect through interaction with different targets in the body. This is also known as the mechanism of action, and it is specific to the drug. When we look at a drug as a masking agent (a drug used to hide the presence of other drugs in the body), this effect is often tied to the pharmacokinetic properties. Given the wide range of effects associated with drugs, these factors can be manipulated in various ways for nefarious purposes. A good understanding of what makes a drug abuseable pharmacodynamically and pharmacokinetically can help a savvy athlete avoid the long arm of the law, and most importantly, uphold the spirit of sport.