Proportionality in the World Anti-Doping Code: Is There Enough Room for Flexibility? / Jannica Houben. – (International Sports Law Journal (2007) 1-2 : p. 10-18)

Content:
1.) Stict Liability
2.) Proof and Sanctions
2.1.) Proof of an Anti-Doping Violation
2.2.) Sanctions
2.3.) The limited impact of the question of guilt
3.) Proportionality
3.1.) The principle of proportionality
3.2.) Proportionality cases
3.2.1.) Pre WADC cases
3.2.2.) Post WADC cases
4.) Conclusion

The biggest advantage of the introduction of the World Anti-Doping Code in 2004 is the harmonization, but a disadvantage is that there are still some unclear matters left. The drafters of the WADC opted for a system of strict liability with mandatory (tough) penalties and a possibility of sanction reduction in the case of exceptional circumstances.
The question of fault or negligence only plays a role in the determination of the sanction. In this article, the Author will evaluate this system and the rulings by the CAS. Are the sanctions imposed proportionate to the offenses? Does the Code leave room for the use of the principle of proportionality? If yes, does the CAS use the flexibility in the Code?
In this contribution it is argued that the CAS does not interpret the Code in a correct way. Although the Code can be seen as well drafted, the CAS does not use the flexibility that is incorporated therein.
But there is hope: recently a CAS Panel held in the Puerta case that “in those very rare cases in which Articles 10.5.1 and 10.5.2 of the WADC do not provide a just and proportionate sanction, i.e., when there is a gap or lacuna in the WADC, that gap or lacuna must be filled by the Panel.”

Everyday Memory Deficits Associated with Anabolic-Androgenic Steroid Use in Regular Gymnasium Users / Thomas Heffernan, Lisa Battersby, Patricia Bishop and Terence O’Neill. - (Open Psychiatry Journal 9 (2015); p. 1-6)

Background:

This study compared a group of 47 regular gym users who take androgenic-anabolic steroids (the AAS group) as part of their recreational sport, with a group of 48 regular gym users who do not use AAS (the Non-AAS group) on self-reports of Retrospective memory (RM), executive function (EF) and prospective memory (PM), which are all critical to everyday remembering.

Methods:

All participants were tested using an on-line Survey Monkey method. The Prospective and Retrospective Memory Questionnaire (PRMQ) assessed everyday RM and PM deficits and the Executive Function Questionnaire (EFQ) assessed self-reported problems in EF. A drug-use questionnaire and a mood questionnaire were also administered Results: After observing no between-group differences on alcohol or mood, omitting anyone who drank excessively or had drank recently, smoked or reported using any illegal drug, three one-way ANCOVAs (controlling for age) revealed that the ASS group reported significantly more RM deficits, EF deficits, and PM deficits, when compared with the Non ASS group.

Conclusion:

It was concluded that AAS use in a recreational sports context is associated with RM, EF and PM deficits, indicating that AAS use may damage everyday remembering.

Antonino Bianco, Caterina Mammina, Antonio Paoli, Marianna Bellafiore, Giuseppe Battaglia, Giovanni Caramazza, Antonio Palma, and Monèm Jemni
J Int Soc Sports Nutr. 2011; 8: 25.

Background: It is known that supplement use is a widespread and accepted practice by athletes and people who attend commercial gyms. Little is known about protein supplement amongst people undertaking strength trainingin commercial gyms in Italy when compared to the US.

Objective: The purpose of this study was to examine the use of protein supplementation, alone or in association with other supplements, and dietary behavior amongst regular fitness center attendees in Palermo, Italy.

Design: Resistance training information have been collected from 800 regular fitness center attendees for the initial analysis. A specific questionnaire was generated for the experimentation. Data were collected using a face-toface interview method. Supplement users were then compared to the non users and analyzed using a one-way ANOVA, Kruskall-Wallis, chi-square test or exact test of Fisher when appropriate.

Results: 30.1% of the respondents use dietary supplements during their training as a believe it is the “way to gain muscles and strength”. Whey protein shakes (50.0%) mixed with creatine and amino-acids (48.3%) were the most frequent choices amongst the users. A majority of the subjects (34.0%) appeared to rely on their gym instructors’ advice for their intake; a lower proportion (13.0%) consulted physicians, while none of them consulted nutritionists.
A high consumption of milk has been noticed in both users (67,7%) and non-users (52,8%); supplement non-users consumed significantly more snacks and bakery products than users per week (P < 0.001), while users consumed significantly more protein-rich foods (P < 0.01) with a particular preference for meat (48.0%).

Conclusions: A considerable number of regular strength training adepts consume protein supplements mixed with other products (mainly creatine and amino-acids). Limited numbers consult “dietary specialists” and rely mainly on their instructors. We emphasize on the importance of the dissemination of scientifically based
information about supplementation in this environment and the promotion of updated educational programs for the instructors.

Pseudoephedrine enhances performance in 1500-m runners / Kate Hodges, Sarah Hancock, Kevin Currell, Bruce Hamilton, Asker E. Jeukendrup. - (Medicine & Science in Sports & Exercise 38 (2006) 2 (February); p. 329-333)

• PMID: 16531903
• DOI: 10.1249/01.mss.0000183201.79330.9c

Abstract

Pseudoephedrine is an over-the-counter drug to relieve nasal and sinus congestion. Although it has been suggested that pseudoephedrine could be a stimulant and ergogenic aid, pseudoephedrine was recently removed from the banned substance list by the International Olympic Committee and placed on the monitoring program (from January 2004). It was felt that evidence was lacking for an ergogenic effect, although few studies have investigated the effects of pseudoephedrine on exercise performance. This study, therefore, aimed to investigate the effects of pseudoephedrine on 1500-m running performance.

Methods: In a double-blind, randomized crossover design, seven male athletes completed two 1500-m running trials on an outdoor track after having completed a familiarization trial. All trials were 7 d apart. After a 12-h overnight fast, subjects reported to the laboratory and received a standardized breakfast (energy asymptotically equal to 500 kcal 50% CHO). Subjects were given either 2.5 mg.kg(-1) bw pseudoephedrine or 2.5 mg.kg(-1) bw maltodextrins (placebo) in gelatin capsules 70 min before the start of the warm-up, which started 20 min before they ran 1500 m all-out. Pre- and postexercise blood samples were collected and analyzed for lactate and glucose concentrations, partial pressure of oxygen (PO2) and carbon dioxide (PCO2), and percent oxygen saturation.

Results: Pseudoephedrine significantly decreased time to completion of 1500-m time trials in the present study by 2.1% (from 279.65 +/- 4.36 s with placebo to 273.86 +/- 4.36 s with pseudoephedrine) with no reported side effects. No changes in the measured blood parameters were found, suggesting a central effect of pseudoephedrine rather than a metabolic effect.

Conclusion: The finding was that 2.5 mg.kg(-1) bw pseudoephedrine ingested 90 min preexercise improves 1500-m running performance.

Psychiatric and hostility factors related to use of anabolic steroids in monozygotic twins / Thomas A. Pagonis, Nikiforos V. Angelopoulos, George N. Koukoulis, Christos S. Hadjichristodoulou, Paraskevi N. Toli

• European Psychiatry 21 (2006) 8 (December); p. 563-569
• PMID: 16529916
• DOI: 10.1016/j.eurpsy.2005.11.002

Abstract

Introduction: Anabolic androgenic steroids (AAS) are derived by chemical manipulation of the testosterone molecule. The specified category of drugs produces anabolic, androgenic and psycho-active effects including elevated aggressive, hostile, violent and anti social behavior.

Objective: The objective of this case report observational study was to evaluate the possible psychological consequences of AS use in the twin user of each pair, compared with the non-user twin.

Methodology: We studied two pairs of male monozygotic twins: one pair 24 years old and the other 31 years old, with absolute genome and phenotype similarity. One of the twins of each pair used AAS while the other did not. Both pairs lived in Hellenic provincial towns and followed a common training and nutrition regime. The psychometric instruments used were the Symptoms Check List-90 (SCL-90) and the Hostility and Direction of Hostility Questionnaire (HDHQ). The psychometric evaluations took place within a time interval of 6 months.

Results: The study found high levels of aggressiveness, hostility, anxiety and paranoid ideation in the twins who used AS. The non-user twins showed no deviation from their initial status.

Conclusion: The use of AAS induced several important psychiatric changes in monozygotic twins which were not present in the twin who did not use AAS.

Psychiatric and medical effects of anabolic-androgenic steroid use. A controlled study of 160 athletes / Harrison G. Pope Jr, David L. Katz. - (Archives of general psychiatry 51 (1994) 5 (May); p. 375-382)

• PMID: 8179461
• DOI: 10.1001/archpsyc.1994.03950050035004

Abstract

Background: We sought to expand on preliminary findings suggesting that anabolic-androgenic steroids produce psychiatric effects in some athletes who use them.

Methods: We compared 88 athletes who were using steroids with 68 nonusers, using the Structured Clinical Interview for DSM-III-R to diagnose psychiatric syndromes occurring in association with steroid use (if applicable) and in the absence of steroid use. Demographic, medical, and laboratory measures were also performed.

Results: Steroid users displayed more frequent gynecomastia, decreased mean testicular length, and higher cholesterol-high-density lipoprotein ratios than nonusers. Most strikingly, 23% of steroid users reported major mood syndromes--mania, hypomania, or major depression--in association with steroid use. Steroid users displayed mood disorders during steroid exposure significantly more frequently than in the absence of steroid exposure (P < .001) and significantly more frequently than nonusers (P < .01). Users rarely abused other drugs simultaneously with steroids.

Conclusion: Major mood disturbances associated with anabolic-androgenic steroids may represent an important public health problem for athletes using steroids and sometimes for the victims of their irritability and aggression.

Psychological and behavioural effects of endogenous testosterone and anabolic-androgenic steroids. An update M.S. Bahrke, C.E. Yesalis 3rd, J.E. Wright. - (Sports Medicine 22 (1996) 6 (December) ; p. 367-390)

• PMID: 8969015
• DOI: 10.2165/00007256-199622060-00005

Abstract

Endogenous testosterone levels have been linked to aggressive behaviour in both animals and humans. Studies administering moderate doses of exogenous testosterone for contraceptive and clinical purposes reveal essentially no adverse effects on male sexual and aggressive behaviour. However, investigations and case reports of athletes, usually involving higher doses, demonstrate an association between anabolic-androgenic steroid use and affective and psychotic syndromes and psychological dependence. Efforts to study the psychological and behavioural effects of anabolic-androgenic steroids are complicated by a variety of methodological limitations. Only 3 prospective, blinded studies demonstrating aggression or adverse overt behaviour resulting from anabolic-androgenic steroid use have been reported. With estimates of over 1 million past or current users in the US, an extremely small percentage of individuals using anabolic-androgenic steroids appear to experience mental disturbances severe enough to result in clinical treatment and medical case reports. Even among those so affected, the roles of previous psychiatric history, genetic susceptibility to addictions or mental disorders, environmental and peer influences, and individual expectations remain unclear.

Psychological and Physical Impact of Anabolic-Androgenic Steroid Dependence / Eric J. Ip, Debbie H. Lu, M.P.H. Mitchell, J. Barnett, Michael, J. Tenerowicz, Justin, C. Vo, Paul, J. Perry. - Pharmacotherapy 32 (2011) 10 (October); p. 910-919).

• PMID: 23033230.
• DOI: 10.1002/j.1875-9114.2012.01123

Abstract

STUDY OBJECTIVE:
To contrast the characteristics of two groups of anabolic-androgenic steroid (AAS) users-those with versus those without AAS dependence.

DESIGN:
Subanalysis of data from the Anabolic 500, a cross-sectional survey.

PARTICIPANTS:
One hundred twelve male AAS-dependent users and 367 AAS-nondependent users who completed an online survey between February 19 and June 30, 2009.

MEASUREMENTS AND MAIN RESULTS:
Respondents were recruited from the Internet discussion boards of 38 fitness, bodybuilding, weightlifting, and steroid Web sites. The respondents provided online informed consent and completed the Anabolic 500, a 99-item Web-based survey. Self-reported data included demographics, exercise patterns, use of AAS and other performance-enhancing agents, adverse effects of AAS use, behavior consistent with Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision (DSM-IV-TR) criteria for AAS dependence, history of illicit drug and alcohol use, history of sexual or physical abuse, and psychiatric conditions diagnosed according to the DSM-IV-TR. Behavior consistent with AAS dependence was identified in 23.4% of the survey participants. These AAS-dependent users were more excessive in their AAS use (e.g., higher doses, higher quantity of agents, longer duration of use), more likely to report a history of illicit heroin use in the last 12 months (5.4% vs 1.9%, p=0.049), and more likely to report a diagnosis of an anxiety disorder (16.1 vs 8.4%, p=0.020) or major depressive disorder (15.2% vs 7.4%, p=0.012) than AAS-nondependent users.

CONCLUSION:
Data from the Anabolic 500 survey showed that almost one quarter of AAS users were dependent on these drugs. These AAS-dependent users had a higher rate of heroin use as well as anxiety and major depressive disorders compared with AAS-nondependent users. These findings can help clinicians and researchers better understand and address the potential illicit drug use and psychiatric comorbidities that may be present among AAS-dependent users.

Psychological characteristics of adolescent steroid users / K.F. Burnett, M.E. Kleiman. - (Adolescence 29 (1994) 113; p. 81-89)

• PMID: 8036984

Abstract

The Millon Adolescent Personality Inventory and the Profile of Mood States were used to assess a broad range of psychological characteristics in 24 adolescent athletes who reported steroid use. In addition, a steroid knowledge questionnaire was administered and an evaluation of physical symptoms of steroid use was conducted. Corresponding data were obtained from 24 adolescent athletes who did not use steroids, and 24 nonathletic adolescents. Although some personality variables differentiated between athletes and nonathletes, no personality variables significantly differentiated between athletes who used steroids and athletes who did not use steroids. Steroid users, however, had significantly higher levels of muscular density and hardness, bloating, gynecomastia, and acne than did athletes who did not use steroids; steroid users who were currently on a steroid use cycle had significantly more depression, anger, vigor, and total mood disturbance than those who were not on a cycle. Prospective longitudinal studies are needed to develop our understanding of psychological issues related to adolescent steroid use.

The Millon Adolescent Personality Inventory and the Profile of Mood States were used to assess a broad range of psychological characteristics in 24 adolescent athletes who reported steroid use. In addition, a steroid knowledge questionnaire was administered and an evaluation of physical symptoms of steroid use was conducted.

Corresponding data were obtained from 24 adolescent athletes who did not use steroids, and 24 nonathletic adolescents.
Although some personality variables differentiated between athletes and nonathletes, no personality variables significantly differentiated between athletes who used steroids and athletes who did not use steroids. Steroid users, however, had significantly higher levels of muscular density and hardness, bloating, gynecomastia, and acne than did athletes who did not use steroids; steroid users who were currently on a steroid use cycle had significantly more depression, anger, vigor, and total mood disturbance than those who were not on a cycle.

Psychological determinants of doping behaviour through the testimony of sanctioned athletes / Mattia Piffaretti

Objectives:
A) The main objective of the study is to gain knowledge about the psychological and psycho-social determinants of their doping behaviour, by interviewing sanctioned athletes.

B) Moreover, the investigation aims to assess how athletes experience the banning period, while identifying their specific needs. With such intelligence, the study aims to launch a new project encompassing:
1) PRIMARY PREVENTION: to enrich the prevention campaigns for young athletes with the testimonials of experienced athletes
2) SECUNDARY PREVENTION: to improve detection of psychological attitudes and risky behaviours in young athletes
3) TERTIARY PREVENTION: to contribute to the set-up of a prevention programme to decrease sanctioned athletes‟ relapse risk and to improve their chances for a sport and/or professional relocation

Summary: Current research indicates motivational orientations (Kleinert and Jüngling, 2007; Donahue et al., 2006), perception of sport‟s culture and attitude towards substance abuse (Ohl et Buissonneau, 2009) and obsessive passion (Vallerand et al., 2003) as possible psychological determinants of deviant behaviour in sports, and more particularly of athletes‟ substance abuse. In this study, 11 athletes who were condemned for their substance abuse by their national or international Federation, and were willing to speak out about their deviant behaviour, were interviewed through a theory-based interview guide. In particular, questions focused on the motivational orientations of the athletes, the perception they have about their environment, and the perception of the challenges like career transitions, injury or competitive pressure. Interview data were analysed sound qualitative research methods.

Main results: First of all, the study allowed to clarify the role of the athletes‟ awareness, sport transition, motivations, stress level and perception of anti-doping and ethical norms in their sporting environment, on the risk to violate the anti-dopoing code. Secundarily, it shed a light on the psychological and emotional reactions of the athletes who are banned from their sport for a long period, while throwing a light on their specific needs, to minimise risks of relapse or psychological distress.