Wednesday, July 18, 2012

The Summer Olympics and the “War on Doping”

Time for a change in strategy?

The Summer Olympics are fast approaching, and that can only mean one thing: drugs. After more than a decade, you might wonder, how goes the so-called “War on Doping?”

Not so good, but thanks for asking. The World Anti-Doping Agency, established in 1999 and backed by the UNESCO anti-doping convention, will be operating 24/7 during the games, protecting the “purity” of Sport, trying to ferret out everything from cannabis and cocaine to steroids and arcane metabolites unfamiliar to the world at large. Marijuana as a “performance enhancing” drug? Doesn’t sound likely, but cannabis derivatives are on the banned list anyway. As Bengt Kayser and Barbara Broers of the Institute of Movement Sciences and Sports Medicine at the University of Geneva write in the Harm Reduction Journal, marijuana seems to have been included “largely because of pressure from the ‘war on drugs’ movement, even though there are no known proven performance enhancing effects but rather evidence for the contrary.”

No matter. That’s just for starters. As in life, an athlete can be busted for a banned substance taken days earlier, in some other recreational context, and not intended as a sports enhancer, if the metabolites linger too long in the body. The current policy, Kayser and Broers write, “is still essentially based on repression and surveillance from a zero-tolerance viewpoint.”

Did they say “surveillance?” Top athletes are not like you and me. Jocks operate under a “strict liability” rule: It doesn’t matter how it got in your body, or why. If they find proscribed metabolites, you’re busted. It’s entirely possible to get banned from your sport for life. In 2003, British sprinter Dwain Chambers tested positive for a proscribed substance and was subsequently banned from competition for life by the British Olympic Association. (Chambers recently won an appeal, and continues to compete.)

And to make sure that the Olympic Committee can be diligent about the ever-growing list of banned substances, Olympic-level athletes are subject to something called the “whereabouts” rule, say the authors. Elite athletes must “inform the anti-doping authorities where they will be each day of the year, to allow unannounced out-of (and in)-competition testing…” This requirement is clearly impossible for almost anyone to honor, certainly including globetrotting athletes. But Sebastian Coe, chairman of the London Organizing Committee for the Olympic Games, didn’t let even a ray of ambiguity enter the picture, stating: “I don’t think there is room for drugs cheats in sport.”

However inartfully phrased, this sentiment reflects the Olympic Committee’s desire to increase testing, even though the Geneva sports scientists believe that the “probability for false positives rises with the number of tests performed, as well as with a drop in prevalence of actual doping. Furthermore, for some forms of doping practices, there exist no laboratory tests.” The result? “A greater number of tests would lead to a greater number of false positives, wrongly accusing innocent citizens.”

In fact, you can now be busted even though no trace of a banned drug was found in your blood or urine. Here’s how it works:

Longitudinal testing, looking for fluctuations in certain blood parameters compatible with doping, is now also being introduced. This practice, known as the "athlete biological passport" (ABP), has recently led to the first indictments of athletes, based on indirect indices of presumed doping rather than laboratory tests directly showing the presence of the forbidden substance or their metabolites.

This practice is even shakier, write Kayser and Broers, producing even more false positives “due to analytical variability and outlying individual patterns resulting from the effects of behavior (training, altitude exposure) and genetics.

But the purpose of anti-doping—to celebrate the “clean” and upright athlete as exemplar of everything good and fair—is unrealistic, say the authors. “Doping has always been a part of sports…. Performance enhancement is a logical and essential ingredient of competitive sport. Athletes look for ways to get better, by changing their training paradigm, by eating differently, by taking vitamins, by taking licit medication, by taking supplements.” In short: “The line between licit and illicit fluctuates and has dimensions that can be perceived as arbitrary.”

The essay asks us to consider whether anti-doping tests might one day be logically applied to coaches, trainers, and referees as well—not to mention students studying for a final exam.

So what do we do? Just throw the doors open to any and all drug taking at the Olympics? Since the paper was published in the Harm Reduction Journal, the authors have some thoughts on that. “The argument that it would change sports into an arena akin to Formula 1 where the best engineering team wins is only partly correct,” they write. Which is only partly reassuring. But the authors hasten to argue that “such a scenario is already in place anyway; today well-assisted athletes may engage in complex training regimes and strategic doping while remaining undetected.” They advocate shortening the list of forbidden substances, banning only those with “actually proven performance enhancing effects and major health hazards.” In amateur sports, the authors urge the establishment of so-called steroid clinics, where jocks could get syringes, anonymous service, and professional advice from medical staff.

It would require a major change of heart, and a whole different way of viewing competitive sports. Throttling back the anti-doping program would not sit well with many sports parents of young athletes. The authors are aware of this need, and note that “since athletic careers often start very early, the protection of young talents would be mandatory.”

As a former collegiate athlete, I don’t have an answer to this dilemma. Not even a clue, really. Testing is cumbersome and intrusive and puts the innocent under suspicion. On the other hand, performance-enhancing drugs are unfair and unevenly applied—but so are things like good coaching and state-of-the-art equipment. The answer, perhaps, is to begin viewing anti-doping efforts as wholly distinct from drug war efforts—different rationale, logistics, and deployment.

Kayser B, and Broers B (2012). The Olympics and harm reduction? Harm reduction journal, 9 (1) PMID: 22788912

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