Linn Goldberg, MD; Diane L. Elliot, MD; Gregory N. Clarke, PhD; David P. MacKinnon, PhD; Leslie Zoref, PhD; Esther Moe, PhD; Christopher Green, MEd; Stephanie L. Wolf
Arch Pediatr Adolesc Med. 1996;150:713-721

Objective: To develop and test a school-based intervention to prevent anabolic androgenic steroid use among high-risk adolescent athletes.

Design: Nonrandom controlled trial.

Setting: Two urban high schools.

Participants: Fifty-six adolescent football players at the experimental school and 24 players at the control school.

Intervention: Eight weekly, 1-hour classroom sessions delivered by the coach and adolescent team leaders, and eight weight-room sessions delivered by research staff. The intervention addressed sports nutrition and strength training as alternatives to steroid
use, drug refusal role play, and antisteroid media campaigns.

Outcome Measures: A preintervention and postintervention questionnaire that assessed attitudes toward and intent to use steroids and other drugs; knowledge of drug effects; and diet, exercise, and related constructs.

Results: Compared with controls, experimental subjects were significantly less interested in trying steroids after the intervention, were less likely to want to use them even if their friends used them, were less likely to believe steroid use was a good idea, believed steroids were more dangerous, had better knowledge of alternatives to steroid use, had improved body image, increased their knowledge ofdiet supplements, and had less beliefin these
supplements as beneficial.

Conclusions: Significant beneficial effects were found despite the sample size, suggesting that the effect of the intervention was large. This outcome trial demonstrates an effective anabolic androgenic steroid prevention program for adolescent athletes, and the potential of team-based interventions to enhance adolescents' health.

Linn Goldberg, MD; Diane Elliot, MD; Gregory N. Clarke, PhD; David P. MacKinnon, PhD; Esther Moe, PhD; Leslie Zoref, PhD; Christopher Green, MEd; Stephanie L. Wolf; Erick Greffrath; Daniel J. Miller, MS; Angela Lapin
JAMA 1996;276:1555-1562
Health Promotion and Sports Medicine, Department of Medicine, Oregon Health Sciences University, 3181 SW Sam Jackson
Park Rd, CB 615, Portland, OR 97201-3098.

Objective.—To test a team-based, educational intervention designed to reduce adolescent athletes' intent to use anabolic androgenic steroids (AAS).

Design.— Randomized prospective trial.

Setting.—Thirty-one high school football teams in the Portland, Ore, area.

Participants.—Seven hundred two adolescent football players at experimental schools; 804 players at control schools.

Intervention.—Seven weekly, 50-minute class sessions were delivered by coaches and student team leaders, addressing AAS effects, sports nutrition and strength-training alternatives to AAS use, drug refusal role play, and anti-AAS media messages. Seven weight-room sessions were taught by research staff. Parents
received written information and were invited to a discussion session.

Main Outcome Measures.—Questionnaires before and after intervention and at 9- or 12-month follow-up, assessing AAS use risk factors, knowledge and attitudes concerning AAS, sports nutrition and exercise knowledge and behaviors, and intentions to use AAS.

Results.—Compared with controls, experimental subjects at the long-term follow-up had increased understanding of AAS effects, greater belief in personal vulnerability to the adverse consequences of AAS, improved drug refusal skills, less
belief in AAS-promoting media messages, increased belief in the team as an information source, improved perception of athletic abilities and strength-training self-efficacy, improved nutrition and exercise behaviors, and reduced intentions to use AAS. Many other beneficial program effects remained significant at the long-term
follow-up.

Conclusions.—This AAS prevention program enhanced healthy behaviors, reduced factors that encourage AAS use, and lowered intent to use AAS. These changes were sustained over the period of 1 year. Team-based interventions appear to be an effective approach to improve adolescent behaviors and reduce drug use risk factors.

Drug and alcohol use by Canadian university athletes : a national survey / J.C. Spence, L. Gauvin. - (Journal of Drug Education 26 (1996) 3 (1 September); p. 275-287)

• PMID: 8952211
• DOI: 10.2190/V8KU-CW0L-WAQH-1D3A

Abstract

To gauge the extent of drug and alcohol use in Canadian university athletes, we estimated the proportion of Canadian university athletes using social and/or ergogenic drugs through survey methods. A secondary purpose was to examine athletes' perceptions of the value of drug testing and drug education programs. Using a stratified random sampling procedure, 754 student athletes were surveyed in eight different sports from eight universities across Canada. Results showed that 17.7 percent of athletes have used major pain medications over the past twelve months, 3 percent reported use of weight loss products, 0.9 percent reported anabolic steroid use, 16.6 percent reported use of smokeless tobacco products, 94.1 percent reported use of alcohol, 65.2 percent reported use of caffeine products, 0.7 percent reported use of amphetamines, 1.0 percent reported use of barbiturates, 19.8 percent reported use of marijuana or hashish, 5.9 percent reported use of psychedelics and 0.8 percent reported use of cocaine/crack.

Melia P, Pipe A, Greenberg L.
Clin J Sport Med. 1996 Jan;6(1):9-14.
Canadian Centre for Drug-free Sport, Gloucester, Ontario, Canada.

OBJECTIVE:
To assess the prevalence of use of anabolic-androgenic steroids and other presumed performance-enhancing drugs and the associated knowledge, attitudes, and behavior of school-aged Canadians.

DESIGN:
A national survey was conducted using a self-report questionnaire distributed randomly to schools within each of five Canadian regions.

SETTING:
Canada.

SUBJECTS:
The subjects were 16,119 Canadian students, in the sixth grade and above, from 107 schools drawn randomly from five Canadian regions.

MAIN OUTCOME MEASUREMENTS:
The number of students reporting the use of anabolic-androgenic steroids and other performance-enhancing drugs in the year before the survey, the nature of such drug-taking activities, and the attitudes underlying the decision to take anabolic-androgenic steroids.

RESULTS:
More than 83,000 young Canadians (2.8% of the respondents) are estimated to have used anabolic-androgenic steroids in the year before the survey. Of those taking such drugs, 29.4% reported that they injected them; of the latter group, 29.2% reported sharing needles in the course of injecting anabolic-androgenic steroids. Significant numbers of respondents reported using other substances (caffeine, 27%; extra protein, 27%; alcohol, 8.6%; painkillers, 9%; stimulants, 3.1%; "doping methods," 2.3%; beta-blockers, 1%) in attempts to improve sport performance.

CONCLUSIONS:
The use of anabolic-androgenic steroids is more widespread than may have been assumed and is often accompanied by high-risk needle-sharing. Anabolic-androgenic steroid use is often intended to alter body build as opposed to accentuating sport performance. Many young Canadians use a variety of other substances in attempts to improve sport performance. Drugtaking of this kind represents a special challenge for educators, health professionals, and sport authorities.

PMID:
8925377
[PubMed - indexed for MEDLINE]

Evolution of serum lipids in two male bodybuilders using anabolic steroids / Francisco Lajarin, Rogelio Zaragozá, Isabel Tovar, Pedro Martinez-Hernandez. - (Clinical Chemistry 42 (1996) 6 (June); p. 970-972).
- PMID: 8665691

Abstract

We followed weekly the evolution of serum lipid concentrations in two bodybuilders undergoing a cycle of treatment with anabolic steroids. These drugs caused maximum depression of high-density lipoprotein cholesterol concentrations by 69.1% in the fifth week after the beginning of the cycle for subject 1, and by 72.4% in the fourth week for subject 2. Maximum increases in low-density lipoprotein cholesterol concentrations were 144% and 156%, respectively. Total cholesterol and apolipoprotein (apo) B were highly increased with anabolic steroid use. We also saw depression of apo A-I by 84% and 91%, and lipoprotein(a) decreased to undetectable amounts in both cases. These effects were reversed 10 weeks after the end of the steroid cycle in subject 1, but subject 2 still presented abnormal concentrations of serum lipids 13 weeks after drug cessation. The periods until reversibility of anabolic steroid effects on lipids were longer than those reported in previous studies.

CAS 95/142 L. / Fédération Internationale de Natation Amateur (FINA)

• Doping of a swimmer (salbutamol)
• Special status of salbutamol in the FINA rules
• Omission to declare the use of such substance to the testing agent
• Damage claim for breach of contract and infringement of personality

1. The FINA Medical Rules provide for the application of the “strict liability” standard as an effective instrument in the fight against doping. The concept of “strict liability”, as it is used in doping cases, does not imply an intentional element. There is no link between sanction and intent.

2. The substance salbutamol has an exceptional status in the FINA doping list: it is not completely banned; its inhalation is explicitly permitted, subject to prior notification to the relevant authorities. Therefore, the mere presence of salbutamol is not conclusive proof of a doping offence.

3. The failure to mention salbutamol in the doping test form may create the assumption that there is a doping offence. In the present case, the swimmer had clearly established that he had suffered from asthma for many years; that from the beginning of his sports career, the relevant medical authorities had been repeatedly informed of his use of medication containing salbutamol; that in prior doping tests, the swimmer had declared his use of salbutamol and been found negative; and that there were no indications that he had taken salbutamol other than by inhalation. These specific and exceptional circumstances justify acceptance of the swimmer's numerous records, reports and notifications about his asthma treatment as a sufficient equivalent to the declaration in the test form. Accordingly, there is no doping offence in this case.

4. Dismissal of the damage claim: FINA did not commit a fault or act in bad faith when it began a doping procedure after salbutamol was identified because no medication containing salbutamol had been declared in the test control form.

In April 1995 the Féderation Internationale de Natation (FINA) has reported an anti-doping rule violation against the Finnish swimmer Petteri Lehtinen after his sample tested positive for the prohibited substance salbutamol.

The Athlete and the Finnish Swimming Association submitted a statement about his asthma, prepared by the doctor who had been treating him, and a copy of the prescription on the basis of which he had purchased his medicine. The national Swimming Association informed FINA that it was not necessary to examine the Athlete's B-sample, because he was regularly taking Ventoline.

Also FINA's Medical Committee stated that the Committee maintained that the use of salbutamol for medicinal purposes was acceptable and it recommended sending the Athlete and the Finnish Swimming Association a “Warning Letter”.
However on 23 June 1995 the FINA Executive decided to impose a 2 year period of ineligibility on the Swimmer.

Hereafter in August 1995 the Swimmer appealed the decision with the Court of Arbitration for Sport (CAS).

The Athlete requested the Panel to set aside the decision taken by the FINA Executive and confirmed by the FINA Bureau and, in addition, that the CAS enjoin FINA to pay him damages for a breach of contract, infringement on his personality and for loss of earnings due to the damage caused to his professional activity.

The CAS Panel concludes that the Athlete has not established that he suffered a financial loss nor that a possible loss was caused by the doping procedure. In addition, FINA has not committed any unlawful act by initiating a doping procedure when the Athlete failed to declare his taking of Ventoline on the doping test form.

Furthermore, the FINA Executive and the FINA Bureau did not act in bad faith or abusively when it decided against the Athlete and imposed the sanction provided in the FINA rules. Therefore, the necessary prerequisites to award damages are not present.

Therefore the Court of Arbitration for Sport decides on 14 February 1996:

1.) The appeal by Petteri Lehtinen of 11 August 1995 against the FINA Bureau's decision of 27 July 1995 is upheld.

2.) The decision taken by the FINA Executive on 23 June 1995 and confirmed by the FINA Bureau on 27 July 1995 imposing a two-year suspension on Petteri Lehtinen is quashed.

3.) The damage claims requested by Petteri Lehtinen are rejected.

(...)

6.) The award is immediately enforceable.

Facts
Andreas Berger, the Athlete, appeals before the Court of Vienna against a decision of the Austrian Athletic Federation (Österreichischer Leichtathletik-Verband, ÖLV) in which he was sanctioned with a period of ineligibility of four years.

History
The athlete had been sanctioned because of the use of metandienone which is a prohibited substance according the World Anti-Doping Agency (WADA) 1993 prohibited list. The International Association of Athletics Federations sanctions this with a 4 year period of ineligibility, a second violation will be a life ban. The sanction of a first violation by the Austrian Sport Federation (Österreichischen Bundessport-organisation, BSO) however is only a 2 year period of ineligibility for national and international games. The athlete had used the prohibited substance to recover from a operations of his Achilles joints. Also it is considered that a 4 year period of ineligibility goes against the principle of the freedom to pursue a trade, it is the end of the career of the athlete. Also it is against the principle of proportionality.

Decision
- The sanction of the ÖLV is inappropriate.
- ÖLV has to pay the legal fee.

Beliefs about steroids : user vs. non-user comparisons / M.J. Schwerin, K.J. Corcoran. - (Drug and Alcohol Dependence 40 (1996) 3 (March); 221-225)

• PMID: 8861400
• DOI: 10.1016/0376-8716(95)01211-7

Abstract

The differences in beliefs about the effects of anabolic steroid (AS) use between AS users and non-users provides potentially important clues to understanding AS use. Two groups of bodybuilders were used in this comparison: AS users (n = 20) and non-users (n = 27). Subjects completed a 40-item scale measuring their beliefs about the effects of steroids, both physical and psychological (Beliefs About Steroids Scale: BASS). MANOVA comparisons between AS users and non-users on the BASS items indicate that AS-using bodybuilders believe that AS enhance their physical strength, athletic ability, confidence, assertiveness, feelings of sexuality, and feelings of optimism.

CAS 95/122 National Wheelchair Basketball Association (NWBA) / International Paralympic Committee (IPC)

• Doping of an athlete member of a team (dextropropoxyphene)
• Disqualification of a national basketball team from the
• Paralympics
• Principle of strict liability

1. Pursuant to the rules applicable in casu, the presence of a drug in the urine is sufficient to constitute an offence, irrespective of the route of administration.

2. If a competitor, member of a team, tests positive for doping during a tournament, does it mean that the match during which the infringement took place must be forfeited by that team or that the team must be disqualified from the entire tournament? Interpretation of a rule, the wording of which is controversial.

The Paralympic Athlete K competed in the USA Wheelchair Basketball Team at the 1992 Barcelona Paralympic Games.

In September 1992 the International Coordinating Committee of World Sports Organizations for the Disabled (ICC) reported an anti-doping rule violation against the Parathlete after his sample tested positive for the prohibited substance dextropropoxyphen.
Due to an injury the Athlete had used the painkiller Darvocet provided to him by his coach who had checked Darvocet on the list of banned drugs. However the coach did not know that one of the components in Darvocet is the prohibited substance dextropropoxyphene.

On 29 September 1992 the ICC decided that K. forfeit any medal with the recommendation to the IWBF to suspend him for six months.
As a consequence of the Athlete’s violation the ICC decided that the USA Basketball Team forfeit the match and to re-allocate their medals.

Hereafter in March 1995 the National Wheelchair Basketball Associaton (NWBA) appealed this decision with the Court of Arbitratio for Sport (CAS) against the International Paralympic Committee (IPC) as successor to the ICC.

The NWBA requested that the disqualification decision be reversed, and, in the alternative, either (a) that the USA wheelchair basketball team retain the 1992 Barcelona Paralympics championship, and that the USA team members retain the gold medals, or (b) that the USA wheelchair basketball team retain the 1992 Barcelona Paralympics championship, and that, with the exception of [K.], the USA team members retain the gold medals”.

The CAS Panel concludes that none of the NWBA’s filed contentions survive the Panel's analysis.
First, the ICC's reliance on Rule 1.1.4 was correct insofar as it declared the USA team to be the loser of the championship and therefore also of the gold medals.
Second, the ICC's conduct in administering its regime of penalties, while hesitant and confused, did not reach a level where it must be characterized as unfair or unreasonable; the result was the perfectly predictable consequence of a strict rule which the Panel can neither annul nor disregard.
That is also why the third contention must fail; as it stands, Rule 1.1.4 creates a regime that does not accommodate considerations of proportionality. Whether more flexible rules are desirable is a matter for debate within the appropriate governing bodies; they cannot be imposed by this Panel.

Therefore on 5 March 1996 the Court of Arbitration for Sport decides:

1.) Rejects each of the NWBA's alternative prayers for relief, and accordingly.
2.) Invites the Secretary General of CAS to dispose of the medals in his custody in accordance with the instructions of the IPC, and to release the cheque in the amount of US$ 2,000 to the IPC upon written certification by the latter that it will apply said amount to the cost of replacing the two missing medals.
3.) Makes no award of costs.

CAS 1995/141 Anne Chagnaud vs FINA
TAS 95/141 C. / Fédération Internationale de Natation Amateur (FINA)

• Dopage d'une nageuse (étiléfrine)
• Disqualification et suspension de deux ans
• Responsabilité objective de la nageuse même en l'absence de faute
• Prise en considération de circonstances atténuantes

1. Selon le règlement de la FINA, la seule présence d'une substance interdite, telle que l'étiléfrine, dans le corps d'une athlète constitue une infraction, entraînant une suspension automatique de deux ans.

2. Le fait que la nageuse n'ait pas eu l'intention de se doper et qu'elle ait été dopée à son insu ne peut remettre en cause sa disqualification.

3. C'est au niveau de la sanction disciplinaire (suspension de l'athlète ayant subi un contrôle positif) que les éléments subjectifs de chaque cas doivent être pris en considération. Le principe de présomption de culpabilité de l'athlète doit demeurer, mais, par contre, l'athlète doit avoir la possibilité de renverser cette présomption en apportant une preuve libératoire.

FACTS
Anne Chagnaud, the athlete, appeals before the Court of Arbitration for Sport (CAS) against the decision, dated July 27, 1995, of the FINA Executive Office.

History
On January 28, 1995, the athlete provided a sample for an in-competition doping test. The sample tested positive for the prohibited substance etilefrine. Her trainer had given her a capsule of effertil which contained the prohibited substance, together with her nourishment. The French Swimming Federation (FFN) disciplinary body didn't sanction the athlete in her decision of July 7, 1995. In their view it had been impossible for the athlete to have known she ingested a prohibited substance.
The International Swimming Federation (FINA) Executive Office didn't agree with this decision and sanctioned the athlete with a period of ineligibility of two years.

On August 10, 1995, the athlete submitted a declaration of appeal before the CAS. But FINA had made a mistake in her decision of July 27, 1995, about where she could appeal. She could appeal to the FINA's Board. On September 1995 the athlete appealed to the FINA's Board against the decision of July 27, 1995, by the FINA Executive Office. The appeal was rejected because the panel regards the positive test as sufficient to establish the violation.

Submissions athlete
The athlete criticizes the system of responsibility without fault. Even though she does not contest the result of the tests, she however argues that the alleged substance was not substantial enough to improve her performance. Besides that she argues that her penalty is unjust, since she was doped without her knowledge by her trainer and she had no intention of consuming capsules of effortil (containing etilefrine), the athlete insists on the disproportionate nature of the penalty.

However the court concludes that the testimonies of her trainer did not permit to establish if he had acted without her knowing consuming the prohibited substance. However, in view of the facts of the brief, the court considers that the penalty pronounced against the appellant is not proportionate to the circumstance of the case. In view of what comes before and in application of the principle of proportionality, the court considers that the fault of the appellant is not sufficiently grave for a period of ineligibility lasting two years. The penalty will last till the day of this hearing, the period from January 28, 1995 through march 12, 1996, which is in corresponds to the guilt of the athlete and is consequently sufficient.

Decision
- The decision in partially upheld.
- The decision of suspension pronounced by FINA against the appellant on October 21, 1995 is terminated immediately.
- The decision is rendered without cost, except for the fee of 500 Swiss francs claimed by CAS.
- FINA will contribute 1,500 Swiss francs to the legal fees of the appellant.

[The attached file contains the French text and an unauthorized English translation]