A Critical Analysis of Article 4.3 of the World Anti Doping Code / Steve Cornelius. – (International Sports Law Journal (2012) 3-4 : p. 3-7)

Content:
1.) Introduction
2.) Prohibited List
3.) Can the Prohibited List be Challenged?
4.) The Way Forward
5.) Conclusion: Proposed Amendments

This article provides a critical analysis of article 4.3 of the Code and questions whether the Prohibited List can be challenged on the grounds that one or more of the substances or methods have been inappropriately classified in terms of article 4.3 and should therefore not be included on the Prohibited List. This article does not address issues relating to the prudence or desirability to include or not to include any particular substance or method on the Prohibited List. It merely highlights flaws in the drafting of article 4.3, warns of a potential basis on which WADA and the Prohibited List can be challenged and proposes ways to deal with this risk.

A Descriptive Study of Adverse Events from Clenbuterol Misuse and Abuse for Weight Loss and Bodybuilding / Henry A. Spiller, Kyla J. James, Steven Scholzen. - (Substance Abuse 34 (2013) 3; p. 306-312).
- PMID: 23844963.
- DOI: 10.1080/08897077.2013.772083

Abstract

BACKGROUND:
Clenbuterol is a β2-agonist approved in the United States for veterinary use in nonfood animals. Clenbuterol use is emerging among bodybuilders and fitness enthusiasts attracted to the hypertrophic and lipolytic effects.

CASES:
This was a retrospective chart review of clenbuterol exposures reported to 2 poison control centers. Misuse of clenbuterol for weight loss and bodybuilding was reported in 11 of 13 clenbuterol users. Reported clinical effects included tachycardia, widened pulse pressure, tachypnea, hypokalemia, hyperglycemia, ST changes on electrocardiogram (ECG), elevated troponin, elevated creatine phosphokinase (CPK), palpitations, chest pain, and tremor. Measured serum clenbuterol concentration was 2983 pg/mL post 4.5 mg ingestion. Co-ingestants included T3 and anabolic steroids. Treatments included activated charcoal, benzodiazepines, β-blockers, potassium replacement, and intravenous (IV) fluid.

CONCLUSIONS:
There is an increasing use of the Internet for illicit drug use for bodybuilding and weight loss purposes. These patients may not present as the stereotype of illicit drug abusers, but as healthy athletic low-risk patients. Clinical effects persisted greater than 24 hours with evidence of myocardial injury in 2 patients. Clenbuterol is increasingly being abused within the bodybuilding subculture. These cases illustrate the hidden dangers of clenbuterol abuse among bodybuilders and fitness enthusiasts.

A false start in the race against doping in sport: concerns with cycling's biological passport / Nicolas Hailey. - (Duke law journal 61 (2011) 2 (November) ; 393-432).

• PMID: 22069854

Abstract:

Professional cycling has suffered from a number of doping scandals. The sport's governing bodies have responded by implementing an aggressive new antidoping program known as the biological passport. Cycling's biological passport marks a departure from traditional antidoping efforts, which have focused on directly detecting prohibited substances in a cyclist's system. Instead, the biological passport tracks biological variables in a cyclist's blood and urine over time, monitoring for fluctuations that are thought to indirectly reveal the effects of doping. Although this method of indirect detection is promising, it also raises serious legal and scientific concerns. Since its introduction, the cycling community has debated the reliability of indirect biological-passport evidence and the clarity, consistency, and transparency of its use in proving doping violations. Such uncertainty undermines the legitimacy of finding cyclists guilty of doping based on this indirect evidence alone. Antidoping authorities should address these important concerns before continuing to pursue doping sanctions against cyclists solely on the basis of their biological passports.

A fast screening method for the detection of CERA in dried blood spots / Angela Rocca, Laurent Martin, Tiia Kuuranne, Magnus Ericsson, Alexandre Marchand, Nicolas Leuenberger. - (Drug Testing and Analysis (2021) 11 August); p. 1-6)

• PMID: 34380180
• DOI: 10.1002/dta.3142

Abstract

Continuous erythropoietin receptor activator (CERA) is a third-generation erythropoiesis-stimulating agent that was developed for the treatment of anemia. However, misuse of CERA for doping in endurance sports has been reported. Previous studies have shown blood as the matrix of choice for the detection of CERA, due to its high molecular weight. The use of dried blood spots (DBSs) for anti-doping purposes constitutes a complementary approach to the standard urine and venous blood matrices and could facilitate sample collection and increase the number of blood samples available for analysis due to reduced costs of sample collection and transport. Here, we investigated whether CERA could be indirectly detected in extracts of single DBSs using an erythropoietin-specific immunoassay that is capable of providing results within approximately 2 h. Reconstituted DBS samples were prepared from mixtures of red blood cell pellets and serum samples. The samples were collected in a previous clinical study in which six healthy volunteers were injected with a single, 200 μg dose of CERA. Using a commercially available ELISA kit, CERA was detected in the DBSs with a detection window of up to 20 days post-injection. Furthermore, in order to demonstrate the fitness-for-purpose, three authentic doping control serum samples, which were identified as containing CERA, were analyzed by the presented methodological approach on DBS. The testing procedure described here could be used as a fast and cost-effective method for the detection of CERA abuse in sport.

A five day treatment with daily subcutaneous injections of growth hormone-releasing peptide-2 causes response attenuation and does not stimulate insulin-like growth factor-I secretion in healthy young men / E.A. Nijland, C.J. Strasburger, C. Popp-Snijders, P.S. van der Wal, E.A. van der Veen

• European Journal of Endocrinology 139 1998 4 (October), p. 395-401
• PMID: 9820615
• DOI: 10.1530/eje.0.1390395

Abstract

The synthetic hexapeptide growth hormone-releasing peptide (GHRP)-2 specifically stimulates GH release in man. To determine the effects of prolonged treatment and whether response attenuation occurs in man, we administered to nine healthy subjects a daily s.c. injection of 100 microg GHRP-2 over 5 days. Every day blood samples were taken to determine GH, IGF-I, IGF-binding protein (IGFBP)-3 and osteocalcin levels. On days 1,3 and 5, GH was measured at -20,0,20,40,60,90,120 and 180 min using an immunometric and an immunofunctional assay. Mean-/+S.D). peak GH concentrations were 83+/-31, 59+/-22 and 51+/-13 microg/l on days 1, 3 and 5 respectively. Mean+/-S.D. areas under the curve for days 1, 3 and 5 were 6366+/-2514, 3987 +/- 1418 and 3392+/-1215 mU/l per min. Despite the maintained GH release, analysis of variance revealed that significant response attenuation occurred (P < 0.01). Mean serum IGF-I concentration did not increase after a 5 day treatment with GHRP-2. Mean basal levels were 22, 25,23,25,23,24 nmol/l measured on days 1 to 6. However, osteocalcin, another serum marker of GH activity in tissue, increased significantly from 3.2+/-1.0 to 4.2+/-0.4 microg/l (mean+S.D.) (P< 0.01).

A focused netnographic study exploring experiences associated with counterfeit and contaminated anabolic-androgenic steroids / Evelyn Frude, Fiona H. McKay, Matthew Dunn

• Harm Reduction Journal 17 (2020) 42 (12 June)
• DOI: 10.1186/s12954-020-00387-y

Abstract

Background

A primary consequence of illicit drug markets and the absence of regulation is the variable quality or purity of the final product. Analysis of anabolic-androgenic steroid seizures shows that these products can contain adulterated products, product not included on the label, or product of unsatisfactory standard. While the potential negative effects of counterfeit anabolic-androgenic steroids (AAS) use is a recognised risk associated with use, no study has explored personal experiences associated with use. The aim of the present study was to use online discussion forums to investigate and explore the experiences associated with the purchase and consumption of counterfeit AAS among consumers.

Methods

An online search was conducted to identify online forums that discussed counterfeit or contaminated AAS; three were deemed suitable for the study. The primary source of data for this study was the ‘threads’ from these online forums, identified using search terms including ‘counterfeit’, ‘tampered’, and ‘fake’. Threads were thematically analysed for overall content, leading to the identification of themes.

Results

Data from 134 threads (2743 posts from 875 unique avatars) was included. Two main themes were identified from the analysis: (1) experiences with counterfeit product and (2) harms and benefits associated with counterfeit product.

Conclusions

The use of counterfeit or contaminated substances represents a public health concern. Those who report using performance and image enhancing drugs such as AAS for non-medical purposes report consuming these substances and experiencing harm as a result. Consumers take steps to limit coming into contact with counterfeit or contaminated product, though recognise that many of these have limitations. The implementation of accessible drug safety checking services may provide an opportunity to provide consumers with information to assist them with making healthier choices.

A high prevalence of abnormal personality traits in chronic users of anabolic-androgenic steroids / C.J. Cooper, T.D. Noakes, T. Dunne, M.I. Lambert, K. Rochford. - (British journal of sports medicine 30 (1996) 3 (1 September); p. 246-250)

• PMID: 8889121
• PMCID: PMC1332342
• DOI: 10.1136/bjsm.30.3.246

Abstract

Objective: (1) To assess the personality profiles of the anabolic androgenic steroid users (AAS) and (2) to determine whether valid premorbid personality traits could be obtained from cross sectional assessment using multisource data.

Methods: The first author became a participant-observer in a group of body builders. An experimental group of body builders who had been using AAS for no more than 18 months (n = 12) was identified. A group of control subjects, each of whom claimed that he did not, and never had, used AAS (n = 12) was also recruited during this period. Key informants played a crucial role in recruiting subjects representative of the AAS and body building communities. An interview schedule based on the Diagnostic and statistical manual of mental disorders (DSM3-R) personality disorder criteria was conducted with each subject. Additional data were obtained from an AAS using informant and significant others including family and friends.

Results: The user group was significantly heavier than the control group and showed abnormal personality traits, in contrast to the control group. Personality traits of AAS users before the onset of AAS use, assessed retrospectively, were not different from personality traits of control subjects. There were significant differences between the before and after personality traits in AAS user group.

Conclusions: The results suggest (1) that AAS use is associated with significant disturbances in personality profile, and (2) that these personality disturbances are possibly the direct result of AAS use.

A level playing field in anti‑doping disputes? The need to scrutinize procedural fairness at first instance hearings / Shaun Star, Sarah Kelly. - (International Sports Law Journal (2020) 28 August; p. 1-24)

• DOI: 10.1007/s40318-020-00176-6

Abstract

The WADA Code upholds the virtues of procedural fairness. Minimum procedural guarantees have been strengthened under the 2021 WADA Code and the International Standard for Results Management. However, implementation of these guarantees by National Anti-Doping Organizations (NADOs) and domestic anti-doping panels are critical in ensuring that athletes are afforded procedural fairness. While some countries have enacted reforms in anti-doping dispute resolution infrastructure, other jurisdictions are arguably lagging behind. Since few doping disputes are heard by the Court of Arbitration for Sport (CAS), a strong domestic dispute resolution framework should encourage independence, efficiency and cost-effectiveness, as well as promote consistency and procedural fairness at all levels of hearing. First instance hearings are particularly significant given that CAS is not considered a practical option for many athletes, especially those from developing countries, predominately due to challenges of access to justice and affordability. Irrespective of procedurally unfair decisions at first instance, CAS has the de novo right of review to correct any such irregularities. However, this approach alone is inadequate, especially given that most athletes do not appeal to CAS. CAS, WADA and NADOs all have significant roles to play in ensuring procedural fairness for athletes. WADA and NADOs need to do more to ensure compliance with procedural guarantees at first instance. This paper advances the debate on the importance of procedural fairness and proposes a research agenda to support future reform, arguing that the current anti-doping model needs to reconsider how these important standards are upheld, from first instance until final appeal.

Keywords Anti-doping · Procedural fairness · Court of Arbitration for Sport (CAS) · National Anti-Doping Organizations (NADOs) · World Anti-Doping Agency (WADA) · Sports law

A Local Study On The Adverse Effects Of Anabolic Androgenic Steroid Abuse On Libyan Male Athletes / Nusieba A. Mohammed Ibrahim, Yahya Saber E. Mansour, Ali A.M. Sulieman. - (International Journal Of Creative and Innovative Research In All Studies 2 (2019) 4 (September); p. 1-9)

Abstract

Anabolic androgenic steroids (AAS) are man-made derivatives of the male sex hormone testosterone, originally designed for therapeutic uses to provide higher anabolic potency with lower androgenic effects. Increasing numbers of young athletes are using these agents illicitly to enhance physical fitness, appearance, and performance despite their numerous side effects and worldwide banning. Today, their use remains one of the main health problems in sports because of their availability and low price. The present study focused on investigating the adverse effects of anabolic androgenic steroid abuse on serum sex hormones, liver and renal function tests, fasting glucose levels, and lipid metabolism in Libyan male recreational bodybuilders. We have recruited fifteen (15) male bodybuilders (age 19-32 years) and an equal number of healthy non-obese, non-AAS-using sedentary controls. Serum sex hormones {luteinizing hormone (LH), follicle-stimulating hormone (FSH), total testosterone, and prolactin (PRL)}, liver function indices {serum alanine aminotransferase (ALT), aspartate aminotransferase (AST), alkaline phosphatase (ALP), total and direct bilirubin}, renal function parameters (serum creatinine and urea), lipid profile {total cholesterol (TC), triglyceride (TG), low density lipoprotein-cholesterol (LDL-C), very low density lipoprotein-cholesterol (VLDL-C), and high density lipoprotein-cholesterol (HDL-C)}, and serum glucose levels were measured. Abuse of AAS was associated with significant decreases (p<0.005) in serum levels of LH (66.9%), FSH (49.8%), and total testosterone (63.7%) together with significant increases (p<0.05) in PRL concentrations (49.8%) in AAS-using bodybuilders compared to sedentary controls. AAS-using athletes had significantly higher (p<0.05) circulating levels of total bilirubin (116.3%), direct bilirubin (127.6%), aspartate (1752.9%) and alanine (263.1%) transaminases than those of sedentary control subjects. Serum ALP levels were not significantly different (p>0.05) between the two groups. Concerning renal functions, AAS-using athletes had significantly higher serum concentrations of creatinine (28.6%) and urea (21.3%) than sedentary controls. Meanwhile, AAS abuse was accompanied by atherogenic lipid profile. AAS-using athletes had significantly higher (p<0.05) serum levels of TG (45.6%), LDL-C (26.0%), and VLDL-C (45.6%) together with significantly lower serum concentrations of HDL-C (31.3%) than sedentary controls. Serum TC and fasting glucose concentrations were not significantly different (p>0.05) between the two groups. The results presented in the study confirm that abuse of AAS induces unfavorable body functions and undesirable side effects. Therefore, efforts should be sought against use of these compounds outside the therapeutic frame.

A methamphetamine analog (N,α-diethyl-phenylethylamine) identified in a mainstream dietary supplement / Cohen, P. A., Travis, J. C. and Venhuis, B. J.. - (Drug Test Analysis (2013 ; 14 October)

• doi: 10.1002/dta.1578)

Pharmaceuticals and banned substances have been detected in hundreds of purportedly natural supplements. Recently, several athletes have been disqualified from competition after testing positive for the methamphetamine analog N,α-diethyl-phenylethylamine (N,α-DEPEA). Athletes have claimed they unknowingly consumed the banned stimulant in workout supplements. Three samples from different lot numbers of Craze, a workout supplement, were analyzed to detect the presence and concentration of N,α-DEPEA. Two labs independently identified N,α-DEPEA in the supplement using ultra high performance liquid chromatography (UHPLC) coupled to an LTQ Orbitrap XL mass spectrometer and UHPLC-quadruple-time-of-flight mass (Q-TOF) spectrometer, respectively. The identity of N,α-DEPEA was confirmed using nuclear magnetic resonance and reference standards. Manufacturer recommended servings were estimated to provide 21 to 35 mg of N,α-DEPEA. N,α-DEPEA has never been studied in humans. N,α-DEPEA is a methamphetamine analog; however, its stimulant, addictive and other adverse effects in humans are entirely unknown. Regulatory agencies should act expeditiously to warn consumers and remove N,α-DEPEA from all dietary supplements.

Copyright © 2013 John Wiley & Sons, Ltd.