Moral disengagement and doping / Maria Kavussanu

• Published in: The psychology of doping in sport / V. Barkoukis, L. Lazuras, H. Tsorbatzoudis (Eds.). - Routledge/Taylor & Francis Group, 2016. - (Part 3: Ethical aspects and implications in doping use and control; p. 151-164)
• ISBN 9781138705197

Abstract

The focus of this chapter is on this construct as applied to doping. The chapter starts by briefly outlining the main tenets of social-cognitive theory as they pertain to moral disengagement and describes the moral disengagement mechanisms. Next, the instruments that measure this construct and have been used in doping research are briefly discussed, followed by a review of quantitative studies examining moral disengagement and doping variables in athletes. Finally, qualitative studies in bodybuilders are reviewed, and the chapter ends with some concluding remarks.

More than unnatural masculinity : Gendered and queer perspectives on human enhancement drugs / Kathryn (Kate) Henne, Bridget Livingstone

Published in: Human Enhancement Drugs. - Routledge, 2019. - (Chapter 2; p. 13-26)

• DOI: 10.4324/9781315148328-2

Description

Popularized discourses surrounding human enhancement drugs often evoke gendered beliefs that frame this form of drug use as an unnatural pursuit of heightened masculinity. Not only is this form of drug use commonly associated with enhanced musculature, but it is also often presented as having aggressive side effects. Accordingly, many portrayals that reflect these embedded beliefs offer reductionist depictions of the diverse practices of human enhancement. This chapter departs from common perceptions to consider critically how gendered and sexualized norms inform understandings of human enhancement drug use in society. It builds upon earlier feminist and queer arguments that the study of gendered issues requires engaging questions of sexuality, as well as other interrelated formations of inequality. To do so, this chapter reflects on empirical research and critical theoretical perspectives, focusing on gendered and queer approaches that can aid in deconstructing the use of such drugs and societal anxieties about them. It contends that widespread concerns about human enhancement drugs being unnatural—and in turn seemingly unhealthy—are inextricably linked to heteronormative ideologies. It also illuminates how different feminist and queer perspectives can aid in destabilizing tacit assumptions about human enhancement drugs and their use.

Motives and Correlates of Anabolic-Androgenic Steroid Use With Stimulant Polypharmacy / Renee Zahnow, Jim McVeigh, Geoff Bates, Adam R. Winstock. - (Contemporary Drug Problems (2020) 22 April). - DOI: 10.1177/0091450920919456

Abstract

Individuals who use anabolic-androgenic steroids (AAS) may engage in concurrent psychoactive drug use recreationally and/or as an additional training aid. Aside from cannabis, individuals who use AAS most commonly report concurrent use of stimulants such as amphetamines and cocaine. In this study, we examine demographic characteristics, frequency of heavy drinking, and nightclubbing in a sample of 993 men from the Global Drug Survey 2015 who reported both AAS and psychoactive drug use before exploring the relationship between motivation for AAS use and the propensity to concurrently engage with stimulant-type substances. Results of a logistic regression analysis suggest that the propensity for concurrent use of AAS and stimulants is greater when AAS use is motivated by weight loss goals, while performance goals are associated with reduced odds of concurrent stimulant use. Identifying individuals who are at risk of polydrug use and associated harms can inform targeted harm reduction strategies.

Motives for illicit use of doping substances among athletes calling a national antidoping phone-help service : an exploratory study / Jean Bilard, Gregory Ninot, Denis Hauw. - (Substance Use & Misuse 46 (2011) 4; p. 359-367)

• PMID: 20735214
• DOI: 10.3109/10826084.2010.502553

Abstract

This study aimed to construct a hierarchy of motives linked to doping behaviors. Between 2000 and 2005, calls to a national antidoping phone-help service by 115 cyclists, 203 bodybuilders, and 40 footballers were analyzed. The results showed that the main motives were preserving health for cyclists, increasing muscular strength for bodybuilders, and personal recreation for footballers. However, in contrast to the literature, group influence was low and health preoccupations were high for cyclists; the influence of body image was relatively low for bodybuilders; and footballers cited muscular strength enhancement as a motive. The study's limitations are noted. The prevention campaigns therefore need to be specific.

Related case:

UKAD 2021 UKAD vs Dr Richard Freeman
July 20, 2023

Dr Richard Freeman is a former sports physician known for his work with British Cycling and Team Sky.

Following investigations United Kingdom Anti-Doping (UKAD) established that Dr Freeman in May 2011 had ordered 30 sachets of Testogel (Testosterone gel). These 30 sachets had been delivered to the National Cycling Centre in Manchester and were addressed to Dr Freeman.

Thereupon UKAD established that Dr Freeman had provided false statements about the purpose of the Testogel. Dr Freeman claimed that the Testogel was used as treatment for a 'non-rider' patient and that the Testogel had been returned to the supplier for destruction.

Consequently in December 2020 UKAD reported two anti-doping rule violations against Dr Freeman for possession of Testogel in 2011 and for Tampering in 2017 by providing false statements to UKAD in respect of ordering the Testogel.

After notification a provisional suspension was ordered. In April 2017 UKAD made a referral to the General Medical Council (GMC) in respect of UKAD's concerns relating to Dr Freeman's conduct and fitness to practise.

On 12 March 2021 the Medical Practitioners Tribunal Service (MPTS) determined that Dr Freeman had ordered Testogel and had lied to UKAD whilst under investigation. As a result the MPTS decided to erase Dr Freeman from the General Medical Council's Medical register.

Taking all these matters into account, the Tribunal considered that Dr Freeman’s behaviour is fundamentally incompatible with continued registration. The Tribunal has therefore determined that erasure is the only sufficient sanction which would protect patients, maintain public confidence in the profession and send a clear message to Dr Freeman, the profession and the public that his misconduct constituted behaviour unbefitting and incompatible with that of a registered doctor.

Hereafter the High Court dismissed on 16 January 2023 Dr Freeman's Appeal and confirmed the Appealed MPTS Decision. Thereupon UKAD could resume its investigations and the National Anti-Doping Panel (NADP) could conclude its proceedings against Dr Freeman.

Multi residue screening of intact testosterone esters and boldenone undecylenate in bovine hair using liquid chromatography electrospray tandem mass spectrometry / Michel W.F. Nielen, Johan J.P. Lasaroms, Patrick P.J. Mulder, Johan Van Hende, J. Hans A. van Rhijn, Maria J. Groot

• Journal of Chromatography B 830 (2006) 1 (2 January), p. 126-134
• PMID: 16301005
• DOI: 10.1016/j.jchromb.2005.10.028

Abstract

The abuse of esters of natural androgenic steroids in cattle fattening and sports is hard to control via routine urine testing. The esters are rapidly hydrolysed in vivo into substances which are also endogenously present in urine. In veterinary control strange findings of 17beta-testosterone and 17alpha-testosterone in urine are often ignored because of the lack of statistically sound reference data of naturally occurring levels. An interesting alternative for inconclusive urine analyses in veterinary control can be provided by the analysis of the administered steroids themselves, i.e. the analysis of intact steroid esters in hair. Unfortunately, the analysis of intact steroid esters is complicated not only by the vulnerability of the esters which precludes alkaline hydrolysis of the hair, but also by the wide polarity range of short and long-chain esters yielding very poor recoveries for either the one or the other. In this study, a multi-steroid esters LC/MS/MS screening method is presented for trace analysis of the synthetic intact esters of 17beta-testosterone and the undecylenate ester of 17beta-boldenone in bovine hair. The method, requiring only 200 mg of pulverised hair, features a mild digestion procedure using tris(2-carboxyethyl)phosphine hydrochloride (TCEP) and the use of four deuterium-labelled steroid esters as internal standards covering the wide polarity range of the analytes. In spiked hair samples for most of the analytes the limit of detection and the accuracy using isotope dilution were 2-5 ng/g and 97-105%, respectively. The applicability was demonstrated using hair samples from a controlled experiment in which six bovines were injected intramuscularly with two different doses of two commercial mixtures of testosterone esters, and with two different doses of boldenone undecylenate. Depending on the dose all administered testosterone- and boldenone esters were found to be incorporated in bovine hair following a single intramuscular injection, except testosterone propionate which dose might have been too low.

Multidimensional Separations of Intact Phase II Steroid Metabolites Utilizing LC-Ion Mobility-HRMS / Don E. Davis Jr, Katrina L. Leaptrot, David C. Koomen, Jody C. May, Gustavo de A. Cavalcanti, Monica C. Padilha, Henrique M.G. Pereira, John A. McLean. - (Analytical Chemistry 93 (2021) 31 (10 August); p. 10990-10998)

• PMID: 34319704
• DOI: 10.1021/acs.analchem.1c02163

Abstract

The detection and unambiguous identification of anabolic-androgenic steroid metabolites are essential in clinical, forensic, and antidoping analyses. Recently, sulfate phase II steroid metabolites have received increased attention in steroid metabolism and drug testing. In large part, this is because phase II steroid metabolites are excreted for an extended time, making them a potential long-term chemical marker of choice for tracking steroid misuse in sports. Comprehensive analytical methods, such as liquid chromatography-tandem mass spectrometry (LC-MS/MS), have been used to detect and identify glucuronide and sulfate steroids in human urine with high sensitivity and reliability. However, LC-MS/MS identification strategies can be hindered by the fact that phase II steroid metabolites generate nonselective ion fragments across the different metabolite markers, limiting the confidence in metabolite identifications that rely on exact mass measurement and MS/MS information. Additionally, liquid chromatography-high-resolution mass spectrometry (LC-HRMS) is sometimes insufficient at fully resolving the analyte peaks from the sample matrix (commonly urine) chemical noise, further complicating accurate identification efforts. Therefore, we developed a liquid chromatography-ion mobility-high resolution mass spectrometry (LC-IM-HRMS) method to increase the peak capacity and utilize the IM-derived collision cross section (CCS) values as an additional molecular descriptor for increased selectivity and to improve identifications of intact steroid analyses at low concentrations.

Множественные гепатоцеллюлярные аденомы и почечноклеточный рак, ассоциированные с приемом бодибилдером анаболических андрогенных стероидов [Multiple hepatocellular adenomas and renal cell carcinoma associated with anabolic androgenic steroids] / M.M. Morozova, E.I. Ivanova, N.K. Chardarov, O.V. Dolzhanskiy, G.A. Shatveryan, Yu.R. Kamalov. - (Khirurgiya (2021) 10; p. 105-109

• PMID: 34608788
• DOI: 10.17116/hirurgia2021101105
• Article in Russian

Abstract in English

The authors report a rare case of combination of chromophobe renal cell carcinoma Grade 2 pT2aN0 with multiple hepatocellular adenomas in a 31-year-old bodybuilder who received anabolic androgenic steroids at high doses for 8 years. According to MRI data, over 15 liver adenomas and tumor in the lower segment of the right kidney were detected. The patients underwent laparascopic resection of the right kidney and liver segments 2, 3 and 4 with large adenomas. Histological study and immunohistochemistry revealed no malignancy signs in hepatocellular adenomas. Nuclear β-catenin expression was absent. Kidney tumor had a structure of chromophobe renal cell carcinoma. The patient is currently being followed-up due to residual small liver adenomas. In our opinion, liver adenomatosis and renal cancer have the same cause in this case (chronic toxic effect of androgens).

Abstract in Russian

Приведен редкий случай сочетания хромофобного рака почки Grade 2 (pT2aN0 по системе TMN) со множественными гепатоцеллюлярными аденомами печени у 31-летнего бодибилдера, который на протяжении 8 лет в больших дозах принимал анаболические андрогенные стероиды. При МРТ выявлено более 15 аденом печени, а также образование в нижнем сегменте правой почки. Больному проведена одномоментная операция: лапараскопическая резекция правой почки и резекция II, III и IV сегментов печени с наиболее крупными образованиями. При гистологическом и иммуногистохимическом исследованиях гепатоцеллюлярные аденомы не имели признаков малигнизации, ядерная β-катениновая экспрессия отсутствовала, образование почки расценено как хромофобный почечноклеточный рак. В настоящее время пациент находится под динамическим контролем онколога и хирурга в связи с необходимостью наблюдения за сохранившимися в паренхиме печени аденомами. Сочетанное поражение печени в виде аденоматоза и рака почки у данного пациента следует рассматривать как единый этиопатологический процесс, обусловленный хроническим токсическим влиянием андрогенов.

Multiple incidence of the prescription diuretic hydrochlorothiazide in compounded nutritional supplements / Donata Favretto, Sindi Visentin Salvatore Scrivano, Emanuele Roselli, Fabio Mattiazzi, Roberto Pertile, Susanna Vogliardi, Marianna Tucci, Massimo Montisci. - (Drug Testing and Analysis 11(2018) 3 (March) ; 512-522)

• PMID: 30194914.
• DOI: 10.1002/dta.2499

Abstract

Diuretic agents are prohibited in sports in- and out-of-competition according to the regulations of the World Anti-Doping Agency (WADA) because of their possible masking effects on other doping agents in urine samples, and their ability to produce fast acute weight losses. Despite previous studies reported adverse analytical findings (AAFs) resulting from contaminations at ppm level (μg/g) of medicinal products, and recommended to introduce reporting limits for diuretics in doping controls, these are not adopted in analyses performed by WADA-accredited laboratories. We report the case of an athlete with two AAFs for hydrochlorothiazide (HCTZ) at low urinary concentrations (<10 ng/mL), who declared the use of nutritional supplements prepared in a compounding pharmacy. His nutritional supplements were analyzed revealing HCTZ presence in different concentrations, at the ppm level (μg/g and ng/mL). With the aim of testing the plausibility of the observed urinary HCTZ concentrations with the nutritional supplement ingestion, a urinary excretion study with three healthy volunteers was performed. HCTZ-contaminated powder (6.4 μg/g of HCTZ) was administered to each subject in different dosages, reproducing the possible ingestion pattern occurred. Urine specimens were collected before and after ingestion of the powder, up to 24 hours, and underwent liquid-liquid extraction and liquid chromatography-tandem mass spectrometry determination. Post-administration specimens were found to contain HCTZ at concentrations of 5-230 ng/mL, which supported the accidental inadvertent intake of the prohibited substance by the athlete. This study makes the argument that the introduction of reporting limits for diuretics are warranted in doping control samples, in order to protect against inadvertent AAFs due to contaminated products.

Multivariate interpretation of the urinary steroid profile and training-induced modifications : The case study of a Marathon runner / Eleonora Amante, Serena Pruner, Eugenio Alladio, Alberto Salomone, Marco Vincenti, Rasmus Bro. - (Drug Testing and Analysis 11 (2019) 10 (October); p. 1556-1565).

• PMID: 31307117.
• DOI: 10.1002/dta.2676

Abstract

The steroidal module of the athlete biological passport (ABP) introduced by the World Anti-Doping Agency (WADA) in 2014 includes six endogenous androgenic steroids and five of their concentration ratios, monitored in urine samples collected repeatedly from the same athlete, whose values are interpreted by a Bayesian model on the basis of intra-individual variability. The same steroid profile, plus dihydrotestosterone (DHT) and DHEA, was determined in 198 urine samples collected from an amateur marathon runner monitored over three months preceding an international competition. Two to three samples were collected each day and subsequently analyzed by a fully validated gas chromatography-mass spectrometry protocol. The objective of the study was to identify the potential effects of physical activity at different intensity levels on the physiological steroid profile of the athlete. The results were interpreted using principal component analysis and Hotelling's T2 vs Q residuals plots, and were compared with a profile model based on the samples collected after rest. The urine samples collected after activity of moderate or high intensity, in terms of cardiac frequency and/or distance run, proved to modify the basal steroid profile, with particular enhancement of testosterone, epitestosterone, and 5α-androstane-3α,17β-diol. In contrast, all steroid concentration ratios were apparently not modified by intense exercise. The alteration of steroid profiles seemingly lasted for few hours, as most of the samples collected 6 or more hours after training showed profiles compatible with the "after rest" model. These observations issue a warning about the ABP results obtained immediately post-competition.