Performance enhancing drugs in the media

[chicamahomico]

I thought I would share two articles from the Econonmist magazine regarding performance enhancing drugs and sport. It's nice to see an intelligent commentary with no moral bias on the subject.

Drugs and the Olympics

Aug 5th 2004
From The Economist print edition



They are going to mix, whether you like it or not



“WHERE does the power come from, to see the race to its end?” asks Eric Liddell in that cinematic celebration of the Olympian ideal, “Chariots of Fire”. The runner's answer? “From within.” Eighty years after Liddell won his gold medal, for competitors at the Olympic games starting next week in Athens that power may come instead from without—in the form of drugs designed to maximise performance.

There was “doping” in sport even before the days of Liddell; cyclists, boxers, swimmers and others made use of alcohol, strychnine, cocaine and sundry other substances to ease the pain and give them an edge. But by 1988, when a Canadian runner, Ben Johnson, was stripped of his 100m gold at the Seoul Olympics for failing a drugs test, it was clear that doping had become rife—not just in nasty communist regimes such as East Germany and China, with their famously manly female athletes, but in western countries too. If doping may play a lesser role than it might have done this month in Athens, it is only because allegations about the use of the steroid tetrahydrogestrinone by clients of BALCO, a dietary supplements firm in California, have deprived the Olympics of some of its likeliest medallists—as well as highlighting the pervasive use of steroids in some non-Olympic sports such as America's Major League Baseball, now dubbed the “new East Germany”.

The evidence of doping has been greeted with almost universal condemnation, at least from those parts of the media that love a scandal and the chance to bring down a hero, and from politicians. George Bush has added the war on doping to his broader war on drugs, using this year's state-of-the-union address to urge sport to “get rid of steroids now” and bringing high-profile indictments against sporting dope-peddlers. Those in charge of sport are rapidly losing any ambivalence they once had, and joining a crusade against doping led by the redoubtable head of the World Anti-Doping Agency (WADA), Dick Pound (see article). Driving doping out of sport may prove impossible, however—especially as undetectable gene therapies may soon be on the market. But in any case, is it really so obvious that doping is wrong?

Though they come in many forms, there are really two main arguments made against doping. One is that it harms athletes—or, if the argument is made by someone willing to admit that putting athletes in harm's way is an integral part of many sports (boxing, rugby, American football and so on), that it harms them unnecessarily. The other is that it is against the spirit of sport: it is cheating or, at the very least, it destroys the mystical quality that gives sport its appeal. There is something to both arguments, but neither is wholly convincing.

For a start, how harmful are the performance-enhancing drugs used by today's athletes, or likely to be used in the future? Certainly, there have been heavily publicised cases suggesting that excessive use can sometimes have nasty consequences—cyclists suffering heart attacks, perhaps because of the oxygen-storage boosting but blood-thickening steroid EPO, or drug-expanded body-builders who are deeply depressed—though these examples are isolated, and may not be entirely as they appear. Some of the drugs used in East Germany had severe consequences, including gender-bending, but these were often given to the athletes with neither their knowledge nor any concern for the consequences after the gold medal was won. There are grounds to worry about the reportedly widespread use of steroids by children, who may, among other things, lack the maturity (physical and mental) to handle them. But the balance of the medical evidence—which would be harder to gather in an era of outright prohibition—suggests that, used responsibly, today's more popular performance-enhancers mostly have only temporary side-effects, at worst. (“Gene-doping”, done properly, may well prove to have no side-effects at all.) And any such harm pales beside that known to be done by, say, smoking tobacco and drinking alcohol—activities not unknown among athletes, but not likely to be banned anytime soon by the sporting authorities.



Bring me my arrows of desire

Suppose that the only consequence of doping is enhanced performance. Would that really be against the spirit of sport? Cheating is unequivocally against that spirit. Without agreed rules to play by, and strict sanctions against those who break them, sport would soon descend into unsatisfying anarchy. But is not part of the spirit of sport the pursuit of ever greater performance? Athletes do all sorts of things to improve their performance, to give them an edge, including things with similar physiological effects to steroids: training at high altitude, or spending long hours in an altitude chamber (as the iconic soccer star David Beckham did to accelerate the healing of a broken bone before the 2002 World Cup) do much the same as using EPO. If the rules were changed to allow, say, non-harmful performance-enhancing drugs—something that Juan Antonio Samaranch, then head of the International Olympic Committee, once caused outrage by advocating—then surely (that sort of) doping would no longer be cheating.

So, should the rules be changed in that way? There is, in fact, no right or wrong answer to this question—just as there is no right or wrong answer to questions such as what should be the offside rule in soccer (or the LBW rule in cricket, or the size or composition of a baseball bat). Indeed, such questions are wholly ill-suited to being answered with a blanket rule imposed by a single quasi-governmental global body that tends to see complex issues as black and white, and to demonise those who disagree with it—such as WADA. Far better for the question of doping to be addressed— just like, say, the offside rule—sport by sport, by the people who run each sport. Who better than they to judge how much performance-enhancement their athletes, and the fans who worship them, can take?

The development of undetectable gene-doping may soon make this entire debate moot. But if not, sport, with its increasingly shrill, intolerant attitude to doping, will find itself out of kilter with a society in which the use of performance-enhancing drugs—Viagra, Prozac and many more to come—is becoming the norm. We are all “drugs cheats” now.

[chicamahomico]

Ever farther, ever faster, ever higher?

Aug 5th 2004
From The Economist print edition


The Athens Olympics will be a crucial battle in sport's war on drugs



“OLYMPISM seeks to create a way of life based on the joy found in effort, the educational value of a good example and respect for universal fundamental ethical principles.” So said Baron Pierre de Coubertin, the founder of the modern Olympic games. Alas, there is every chance the 28th summer Olympiad, which opens in Athens on August 13th, will make headlines less for the joy of effort—and still less for good example or respect for universal ethics—than for athletes caught cheating with performance-enhancing drugs.

The past year has brought plenty of evidence that “doping” is rife. In June 2003, a syringe containing a hitherto unknown and undetectable steroid, tetrahydrogestrinone (THG), was sent to America's Anti-Doping Agency (USADA), apparently by a disaffected coach. Speedily designed tests, some applied retrospectively to old urine samples, showed that use of THG had been widespread among top athletes. The drug was allegedly made by BALCO (the Bay Area Laboratory Co-operative), in California, as a “nutritional supplement”. BALCO's clients included many top sports stars, such as Tim Montgomery, world champion in the 100m sprint; his partner, Marion Jones, the reigning women's Olympic 100m champion; Shane Mosley, a former boxing world champion; several members of the Oakland Raiders American football team; and Barry Bonds, who holds baseball's record for the most home runs in a season.

Although some of these athletes deny using THG, others have already been banned from their sport for doing so, including Dwain Chambers, a top British sprinter. The USADA is seeking a lifetime ban for Mr Montgomery. After wide investigations, criminal charges have been brought against several people connected with BALCO—though no athletes, as yet—including its boss, Victor Conte, who has been indicted for allegedly supplying illegal drugs and laundering money. A lawyer for Mr Conte has hinted that other well-known athletes, due to compete in the Olympics, have yet to be identified as THG users, and that his client may be prepared to name them as part of a plea-bargain.

But the litany of recent illegal drug use stretches far beyond BALCO. Even cricket, the sport of gentlemen, has been tainted. Shane Warne, an Australian spin bowler, was banned for a year for taking a drug that can be used to mask steroids; on his return, he rivalled the record for the highest number of wickets taken in a Test (a record he shares, ironically, with a Sri Lankan who has been accused of cheating in a more old-fashioned way, by using an illegal bowling action). In soccer, England's top defender, Rio Ferdinand, was banned for eight months for failing to take a mandatory drug test.

Another Briton, Greg Rusedski, escaped a ban this year despite testing positive for nandrolone. The tennis star argued that he had been given the steroid without his knowledge by officials of the sport's governing body, the Association of Tennis Professionals (ATP). In 2003, the ATP let off seven unnamed players who failed drug tests, apparently for the same reason. Drug scandals have erupted in rugby league, ice hockey, orienteering, the triathlon and so on and on.

Cycling has provided many milestones in the history of doping in sport, including the first sportsman allegedly to die as a result of taking drugs, Arthur Linton, in 1896, and the first drug-related death during a televised event, of Tom Simpson, in the 1967 Tour de France. It continues to be rife with drug-taking. David Millar, a British world champion, has admitted taking steroids. Several top cyclists were recently accused of using a room at the Australian Institute of Sport as a “shooting gallery” in which they injected drugs. Even Lance Armstrong, the American cyclist who (inspirationally) recovered from cancer to become a multiple winner of the Tour de France, entered this year's race—the sixth he has won—embroiled in a court battle with the authors of “L.A. Confidential”, a book alleging that his achievements were not wholly above board. Mr Armstrong strenuously denies the allegations, and in 2000 even joked about them in a Nike commercial: “What am I on? I'm on my bike, six hours a day.”

Recent drug scandals have led to much rewriting of the record books, as well as the return of unfairly won medals and trophies. Mr Millar will have to give back his world-champion's rainbow jersey. Michael Johnson, an American runner, may have to return a gold medal because a fellow member of his 4x400m relay team was found guilty of drug-taking. Tragicomically, Anastasiya Kapachinskaya, a Russian runner, had to give back her world indoor 200m gold after failing a drug test, but at the same time was handed the previous year's outdoor 200m gold after the woman who beat her, Kelli White, was banned for taking performance-enhancing drugs.

In such a climate, the validity of almost any outstanding sporting achievement is likely to be questioned. And politicians have got interested. George Bush even referred to the problem in this year's state-of-the-union address, calling on those in charge of sport to “get tough and to get rid of steroids now”. Stopping doping is now at the forefront of Mr Bush's broader war on illegal drugs—not least, cynics say, because it is probably easier to notch up a big success in tackling steroids in sport than to stop cocaine crossing the Mexican border. The BALCO indictments were announced not quietly, by some local prosecutor, but in a blaze of publicity by John Ashcroft, Mr Bush's attorney-general.

Congress has also jumped in. The Senate Commerce, Science and Transportation Committee—sport being commerce—issued a subpoena to obtain documents from the BALCO investigation, which it then handed over to the USADA. In July, a committee of British MPs produced a report that criticised the inconsistent treatment of drug offences by the governing bodies of different sports.



Victorian values

Faced with so much evidence of doping, and with the fact that the discovery of THG was a lucky break and not the result of new detection techniques, you might expect the chief crusaders against drugs in sport to be thoroughly depressed. Yet Dick Pound, a Canadian former Olympic swimmer who now runs the World Anti-Doping Agency (WADA), could hardly be more upbeat. He regards the Athens Olympics as a potential turning point in the war against doping and, though he does not proclaim certain victory, he thinks he has the drug cheats on the run.

Mr Pound is an idealist in the Victorian mould. It was the Victorians who formalised the rules of many of the sports played today, imposing order on what was then anarchy. They saw in sport a way to educate the populace in the importance of the rule of law, and to deepen character by teaching how to play hard but fair: to, as Rudyard Kipling put it, “meet with Triumph and Disaster/And treat those two impostors just the same”. De Coubertin's Olympism was the summit of that Victorian idealism.

In a similar spirit, Mr Pound, as he explains in his new book, “Inside the Olympics” (Wiley), sees sport, and in particular the Olympic movement, as providing young people with the “ethical platform” they need to guide them in a “world that has lost its ethical path”. Sport, he says, “can provide an extraordinary value system for today's and tomorrow's youth”. But only if it can end the “moral decay” in sport itself, of which doping is a big, though not the only, part: Mr Pound also headed an investigation into corruption in Olympic bidding after a scandal before the opening of the Salt Lake City Winter Olympics in 2002.

His old-fashioned idealism, and his readiness to criticise those who do not share his enthusiasm for WADA—created by the International Olympic Committee (IOC) and various member governments in 1999, but very much his baby—has made him a controversial figure. Sepp Blatter, head of FIFA, the governing body of soccer, once described WADA as a “kind of monster”. The saintly cyclist Mr Armstrong even criticised Mr Pound in an open letter in March, after he said that Tour de France cyclists were known to be taking banned substances. “Athletes need to be confident that WADA's programmes are run by fair and straightforward people,” said Mr Armstrong.

None of this seems to worry Mr Pound. WADA today is no longer the six-stone weakling it seemed to be at the 2000 Olympics in Sydney, the first at which the Olympic oath sworn by the athletes included the phrase, “committing ourselves to a sport without doping and without drugs”. It has come up with many new tests. For instance, samples collected in Athens are expected to be subject to new tests for human growth hormone, either at the games or later.

More crucially, in order to take part in Athens, the world governing body of each sport in the games has had to sign up to the world anti-doping code, agreed in 2003. This created, among other things, a single list of banned substances, a standard set of sanctions for offenders and a dispute-resolution mechanism through the Court of Arbitration for Sport. All the governing bodies have now signed up, though some have attached caveats that WADA may not agree to at future Olympics. FIFA, for example, has won an exemption from the code's blanket two-year ban for offenders.



Cold war temptations

Drugs have been part of sport since at least the 1860s, when swimmers in Amsterdam's canal races were doped in various ways, and long before then if alcohol is counted. In the 19th century, alcohol and strychnine were commonly used to ease pain during boxing bouts. The technology of doping has clearly advanced in leaps and bounds since then. But Mr Pound reckons that the failure, at least until now, to tackle the problem owes less to inability to keep pace with science than to lack of will. WADA is the first systematic attempt to test thoroughly for doping, and to punish offenders severely.

Why has it taken so long? One “excusable” factor, says Mr Pound, was that until the “Olympic economic model” changed, sometime in the 1980s, many sports did not have the money to carry out proper tests. Less excusably, he says, many simply turned a blind eye to the health risks of doping. And during the cold war, many communist countries did not hesitate to dope in order to win. Eastern Germany and, more recently, China at times systematically doped their athletes, often without telling them; who can forget the then female, now male, East German shot-putter nicknamed “Hormone Heidi”? Western countries, desperate to hold their own, often ignored drug-taking by their own athletes if it brought them success.

Some of that cold-war mentality still persists, says Mr Pound. Some governments, including America's, have been slow to make promised payments to WADA's budget. Arguably, it took the BALCO scandal to shock America's Olympic Committee into getting serious about doping. This spring Michele Verroken, until this year the head of anti-doping at UK Sport, told a committee of MPs that she may have lost her job because her strong stance on cheating could have damaged Britain's bid to hold the 2012 Olympics in London. Mr Pound thinks that governments will take the problem far more seriously in future, not least because public anger—combined with governments' full adoption of the WADA code, probably in 2005 in the form of a United Nations convention—will force them to do so.

Public outrage about drug-taking, and the widespread consensus that certain substances must be banned from sport, is unlikely to change. As Mr Pound points out in his book, the catalyst for the creation of WADA was the public fury that greeted remarks made in 1998 by the then head of the IOC, Juan Antonio Samaranch. Watching reports of the arrest of cyclists in the Tour de France after police had discovered doping substances, Mr Samaranch commented to a journalist that prohibited drugs, whether performance-enhancing or not, should be limited to those that are dangerous to health, and that the (then) current list of banned substances was too long. At the emergency meeting of the IOC board soon afterwards, WADA was born, with a philosophy of banning that was a long way from Mr Samaranch's.

To be banned by WADA, a drug has to meet at least two of three criteria: it must enhance performance, be harmful to health and (a very Victorian touch) be against the spirit of sport. Clearly, this would allow a drug to be banned if it had no adverse health effects but was, even so, ruled contrary to whatever is deemed to be the spirit of sport. Mr Pound, for one, seems to regard any use of a drug to enhance performance as against that spirit: it is, quite simply, cheating.



A fierce critic of this approach to drugs in sport is Norman Fost, director of the medical-ethics programme at the University of Wisconsin. He calls the claims made about the harmful effects of steroids “incoherent and flat-out wrong”. Mostly, they have small, temporary side-effects, he says, not life-threatening ones. Indeed, the risks are much smaller than those routinely taken by athletes. A man who plays American football professionally for three years has a 90% chance of suffering a permanent physical injury.

If health is the chief concern, surely certain sports should be banned entirely—and athletes should not be allowed to smoke or drink, activities that do far more harm than taking steroids. As for enhancing performance, that is not seen as cheating if it is done by, say, training at high altitude or in a sealed space that simulates high altitude, says Dr Fost, though such training would have exactly the same effect—an increase in oxygen-carrying red blood cells—as the banned steroid EPO, which is especially popular with cyclists.

Gary Wadler of the New York University School of Medicine, who is a member of WADA, dismisses such arguments as “university debating points”, and notes that athletes may have no idea of the risks they are running when they take drugs. He blames the 1994 legal change that exempted many dietary supplements from approval by America's Food and Drug Administration, spawning an $18 billion vitamins industry that is now a powerful lobby against re-regulation.



Setting their own rules

In principle, the best way to decide how much performance-enhancement and health risk is acceptable would be by a vote of those who play the particular sport. Yet Mr Pound directs some of his strongest criticism at so-called “professional sports” (aren't all sports professional nowadays?) that are self-regulated, such as tennis and baseball. WADA currently has no authority over these sports. In major league baseball, with its powerful players' union, the drug-testing regime is part of contract negotiations and is extremely relaxed—last year, 5-7% of drug tests showed positive, but offenders were hardly punished.

Arguably, if all the players agree that using performance-enhancers is not cheating, then it isn't really cheating. But Mr Pound reckons that baseball players are badly led, by people who care more about making money than about the true values of sport. He maintains that baseball's top officials are much more upset by players caught using recreational drugs, such as cannabis, which hurt their brand, than about performance-enhancing drugs, which, after all, may make the game more exciting.

The biggest challenge to WADA is to devise tests to keep up with advances in doping. None will be trickier than the expected emergence of gene therapy, starting with treatments for, say, muscular dystrophy. Hoping to anticipate future doping strategies, WADA held a conference with leading genetic scientists in 2002. Unfortunately, it seems that the likeliest way to detect gene therapy is a muscle biopsy, which, Mr Pound mercifully concedes, is “too invasive”. Instead, WADA is calling for research, to be funded by itself and governments, into how to identify whether gene therapy has been used. Mr Pound hopes that governments will make creating such a test a condition of winning regulatory approval. Alas, this strategy is rather unlikely to work.

And will the public endorse Mr Pound's Olympian idealism? Certainly, parents seem to be warming to his message that “children shouldn't have to become chemical stockpiles to succeed in sport, or be cheated by those who are”—though will they still do so when they think that, with a little help, Junior might become the next Barry Bonds? Surveys suggest that 2.5% of eighth-graders (13-14-year-olds) have used steroids. UK Sport recently launched “Start Clean”, a programme to stop sporty 12-17-year-olds resorting to performance-enhancing drugs. Yet it is hard to see the trend reversing when, outside sport, performance-enhancement seems ever more central to modern life—thanks to Viagra, Prozac, Ritalin and the rest. And, if doping were defeated, would sports fans really be content with the lack of record-breaking feats?

It would be nice to think so. Yet much of this debate may be academic if WADA fails to create tests to spot the use of gene therapy. Watch out for a surge in world-record breaking in the 2012 Olympics. In the meantime, may the best man or woman win (and we don't mean you, Heidi—sorry, Andreas).

[daos]

very interesting read. thanks bro...

[SportsMedVIP]

A very good read, thanks for posting it.

[max-it]

Nice post bo.

Che lives!

[odrorir]

It infuriates me that professional sports, and what they consider fair affects the legality of what I decide to do.

[Russ616]

I just read the entire article at work... Good read...