THE problem of drugs in sport is not new. Athletes throughout the ages have sought every competitive advantage and it is almost inevitable that some will step outside the rules and seek an extra benefit through performance enhancing drugs.
Five main categories of drugs are prohibited by the International Olympic Committee and these include stimulants, narcotics, anabolic, agents, diuretics, peptide and glycoprotein hormones or analogues. Blood doping and other attempts to manipulate the sampling procedure through pharmacological, chemical or physical means are also prohibited.
Stimulants are usually used by athletes during competition to increase aggression and reduce tiredness. They have been abused in many sports, including cycling, and indeed the Irish professional cyclist, Paul Kimmage, gives a vivid first hand account in his book, A Rough Ride.
There are many adverse side effects, including changes to the heart rhythm, increased blood pressure and addiction. They were associated with the death of the celebrated English cyclist Tommy Simpson in 1967. Similar medications are present in very small doses in a number of products sold as tonics, cough mixtures, and decongestants, readily available "over the counter" in this country. While the doses present in such products would be insufficient to give any competitive advantage, they could lead to inadvertent positive dope tests.
We are all familiar with another stimulant, caffeine, which, because of its widespread presence in tea, coffee and other beverages, is prohibited only when it exceeds a threshold level of 12 milligrammes per decilitre. Narcotics are banned because they reduce pain sensitivity with potential benefit to performance, but they have well known side effects, and the adverse effect of cocaine abuse has been detected in athletes.
ANABOLIC steroids are the best known of the so called performance enhancement drugs but the greatest benefits are gained by using these drugs during the training period and not during competition. Initially used by power athletes to increase power and strength and by body builders to improve muscle bulk, they are now also used in endurance sports to enable athletes to train longer and harder and to recover more quickly.
The resulting improvement in performance is gained through increased training loads. Because they are essentially training aids, an athlete may stop using the drugs some weeks before an event and pass the competition dope test.
Thus an effective testing programme must include widespread random out of season testing. Testosterone, the male sex hormone, is one example of an anabolic agent but, because it is difficult to determine if a high level is natural or supplemented, the testosterone epitestosterone ratio is used as the clue to detection.
Other drugs with anabolic effect include some beta agonists and these have been used in the livestock industry to increase muscle bulk. Clenbuterol is one such drug which is banned by the IOC. Anabolic steroids have many documented side effects including damage to the muscles and tendons, reduced fertility, adverse effects on blood clotting and cholesterol, liver disease, heart disease, skin conditions, and psychological and psychiatric conditions.
Other prohibited drugs include beta blockers and diuretics. Beta blockers are often used to treat high blood pressure but they also reduce heart rate. Clearly this would harm performance in active sport, but by slowing heart rate and reducing the effects of anxiety, competitors in sports such as shooting and archery may improve performance.
Diuretics may be abused where athletes compete at weight limits, such as boxing or judo, to help shed weight quickly. They also increase urine volume so that detection of small quantities of banned substances may be more difficult.
PEPTIDE hormones are the newer generation of drugs, the so called "designer drugs", and from the athletes perspective, their main attraction is the difficulty of detection. Human Growth Hormone is used to achieve the same effect as anabolic, steroids.
Likewise, Human Chorionic Gonadotrophin stimulates increased production of the body's natural hormones. Eythropoetin, initially developed to treat severe anaemia in kidney failure, increases the red blood cell count. This improves the ability to carry oxygen, which is of particular advantage in endurance sports. These drugs cannot be detected by current testing methods.
Other prohibited methods include blood doping, where blood is removed, stored and retransfused, thereby improving the ability to carry oxygen. Physical manipulation such as catheterisation, urine substitution or tampering with samples is prohibited, as is the use of drugs to mask or prevent the urinary excretion of banned substances.
We can appreciate the great difficulties in preventing the abuse of drugs in sport. Some athletes will deliberately set out to use performance enhancing substances and use every means to avoid detection but there is also the problem of possible inadvertent positive dope tests.
Drug taking can only be controlled if the testing strategy is effective and the penalties act as a sufficient deterrent. At present, some drugs are undetectable and the current programme of random, out of season testing is inadequate. The entire subject of drugs in sport is surrounded by suspicion, gossip and innuendo.
