The Spirit of Sport and the Medicalisation of Anti-Doping: Empirical and Normative Ethics / Michael McNamee. - (Asian Bioethics Review 4 (2012) 4; p. 374-392)

In this article, I argue to the contrary — that Cannabinoids should be retained on the Prohibited List; that its use may be thought of as doping; and that the Spirit of Sport criterion, though vague, is still a defensible criterion for the demarcation of “doping”. To achieve this, I critically discuss the legitimacy of Cannabinoid inclusion in the light of contemporary literature on “enhancement”, and introduce the findings of a recent empirical investigation into anti-doping policy with a sample of international key actors in antidoping policy.

In the first section, I describe the definition of doping and the current state of policy flux in anti-doping, then I set out the extant and the proposed criteria for a method or substance to be considered doping (i.e., for inclusion on the Prohibited List). I review then one bioethical critique of the Spirit of Sport criterion (Foddy and Savulescu 2010), and a recent challenge by an internationally recognised group of scholars and scientists working in the field of anti-doping (the International Network of Humanistic Doping Research) to remove the criterion. I then included narrative data from key actors on the international scene of anti-doping such as Heads of National Anti-Doping Organisations, Heads of Medicine and Science in Anti-Doping Organisations, and senior members of the World-Anti Doping Agency (WADA), before arguing against their position and for the status quo.

The status quo before the International Standard for Education : Elite adolescent athletes’ perceptions of anti-doping education / Katharina Gatterer, Bernhard Streicher, Andrea Petróczic, Marie Overbye, Wolfgang Schobersberger, Matthias Gumpenberger, Kathrin Weber, Karsten Königstein, Cornelia Blank

• Performance Enhancement & Health 9 (2021) 3-4 (October), 100200
• DOI: 10.1016/j.peh.2021.100200

ABSTRACT

Education is a fundamental pillar of anti-doping. With the International Standard for Education (ISE) coming into effect in 2021, understanding the status quo of anti-doping education is paramount. This study aimed to evaluate young elite athletes’ perceptions of the anti-doping education they receive. A total of 2,232 athletes, participating at any of four Youth Olympic events between 2018 and 2020 (representing 49 sport disciplines and 124 countries) were surveyed using an online questionnaire, including questions about the anti-doping education received, athletes’ views about its usefulness and trust in its content. Additionally, anti-doping education programmes of the countries’ National Anti-Doping Organisations (NADOs) were assessed in terms of scope and extent, and categorised as ‘comprehensive’, ‘selective’, ‘limited’ or ‘information-only’. Perceived usefulness and trust were compared between these groups. Three-quarters (73.3%) of the athletes received anti-doping education, its usefulness and trust were rated as ‘good’ (> 4 out of 5). Based on NADO's anti-doping education, athletes in the ‘information-only’ category had significantly lower values for usefulness and trust, while those in the ‘selective’ category had the highest values. Results confirm the importance of a multifaceted education, recommending the implementation of at least one educational approach above information provision as they were perceived to be more useful and trusted, and could facilitate Code compliance via developing skills as well as knowledge for informed decision making.

The Stigma of Anabolic Steroid Use / Scott Griffiths, Stuart B. Murray, Jonathan M. Mond. - (Journal of Drug Issues 46 (2016) 4 (October); p. 1-11)

• DOI: 10.1177%2F0022042616661837

Abstract

Little is known about the stigma of anabolic steroid use despite clear implications for treatment-seekers and for public policy development. We investigated the predictors of steroid stigma and contextualized the results by comparing steroids with marijuana. Undergraduates (N = 304) completed measures of drug stigma, exposure to drug users, and history of drug use. Participants stigmatized steroid use more than marijuana use—a very large effect. Participants reported less exposure to steroid users. Nevertheless, 15% of participants reported having a steroid-using friend. History of drug use, but not exposure to steroid users, predicted lower steroid stigma. Drug use and exposure both predicted lower marijuana use stigma. The amount of stigma expressed toward steroids is commensurate with that of “hard” drugs, such as heroin, likely constituting a formidable barrier to treatment. The public’s difficulty empathizing with male body image insecurities may partially explain why exposure to steroid users did not predict lower stigmatization.

The stimulant higenamine in weight loss and sports supplements / Pieter A. Cohen, John C. Travis, Peter H.J. Keizers, Frederick E. Boyer, Bastiaan J. Venhuis. - (Clinical Toxicology 57 (2019) 2 (February); 125-130)

• PMID: 30188222
• DOI: 10.1080/15563650.2018.1497171

Abstract

Background: Higenamine is a stimulant with cardiovascular properties recently prohibited in sport by the World Anti-Doping Agency (WADA). Higenamine is also a natural constituent of several traditional botanical remedies and is listed as an ingredient in weight loss and sports supplements sold over-the-counter in the United States.

Objectives: We analyzed dietary supplements available for sale in the United States prior to WADA's prohibition of higenamine in sport for the presence and quantity of higenamine.

Methods: All supplements labeled as containing higenamine or a synonym (i.e., norcoclaurine or demethylcoclaurine) available for sale in the United States were identified. For each brand, one sample was analyzed by NSF International (Ann Arbor, MI) and one sample by the Netherland's National Institute for Public Health and the Environment (RIVM). NSF International carried out qualitative and quantitative analyses using ultra high performance liquid chromatography (UHPLC) with tandem mass spectrometry. RIVM carried out qualitative analysis using UHPLC quadrupole time of flight mass spectrometry for an independent confirmation of identity.

Results: Twenty-four products were analyzed. The majority of supplements were marketed as either weight loss (11/24; 46%) or sports/energy supplements (11/24; 46%); two brands did not list a labeled indication. The quantity of higenamine (±95% CI) ranged from trace amounts to 62 ± 6.0 mg per serving. Consumers could be exposed to up to 110 ± 11 mg of higenamine per day when following recommended serving sizes provided on the label. Five products (5/24; 21%) listed an amount of higenamine, but none were accurately labeled; the quantity in these supplements ranged from <0.01% to 200% of the quantity listed on the label.

Conclusion: Dosages of up to 62 ± 6.0 mg per serving of the stimulant higenamine were found in dietary supplements sold in the United States.

by Soek, Jan Willem
Doctoral Thesis
Erasmus University Rotterdam: Erasmus School of Law (ESL)

Athletes who achieve extraordinary feats on the pitch stir up the imagination and enjoy a unique position within society. However, laurels received one day, may be just as quickly snatched back the next if it becomes known that the athlete achieved his or her exceptional performance with the aid of doping. Manipulating the body by the use of substances and methods that unnaturally enhance athletic performance is considered a violation of several fundamental principles related to sport. The arguments by which sports organisations have sought to justify their fight against doping have been discussed in Chapter 1. Doping is considered a health risk, but also a threat to both athlete’s integrity and that of sport as a whole, and consequently, given the position in society occupied by sport, of that of society itself. None of these arguments, however, is entirely convincing. Perhaps this is why many sports organisations have declined to state reasons for their anti-doping policies in their anti-doping regulations. The fight against doping in sport is considered self-evident and the arguments which are advanced in its favour merely serve to illustrate this fact. It was only a relatively short time ago that the systematic fight against doping in sport through legal rules began. As a separate body of disciplinary law besides their regular disciplinary rules the sports organisations established special anti-doping regulations for the prosecution and punishment of doping offences. As opposed to under general disciplinary law where unwritten minimum standards usually apply, the disciplinary law of doping uses detailed material rules which define the act of doping and the way in which it is to be punished. As such, the disciplinary law concerning doping resembles the statutory disciplinary rules that exist for certain professions, but is also comparable to public punitive law. What sets disciplinary doping law apart however is that the material rules do not aim to regulate the actual exercise of a profession, but are based on the ideological aspects which prevail in the environment where an athlete's activities take place. In disciplinary doping law, for example, there are hardly any examples of professional error, but rather of acts which undermine the image and ethics of the sport. This is an aspect which it has in common with criminal law. Disciplinary doping law which mainly aims to regulate the relevant offences and their prosecution and punishment should therefore be organised along the same lines as criminal law and entitle athletes to certain rights to counter the demands of the collective. This is necessary, as in sport the interests of the collective are often valued above those of the individual.

The Sturm und Drang of anabolic steroid use: angst, anxiety, and aggression / , Leslie P. Henderson

• Trends in Neurosciences 35 (2012) 6 (1 June); p. 382-392
• PMID: 22516619
• PMCID: PMC4127319
• DOI: 10.1016/j.tins.2012.03.001

Abstract

Anabolic androgenic steroids (AAS) are illicitly administered to enhance athletic performance and body image. Although conferring positive actions on performance, steroid abuse is associated with changes in anxiety and aggression. AAS users are often keenly invested in understanding the biological actions of these drugs. Thus, mechanistic information on AAS actions is important not only for the biomedical community, but also for steroid users. Here we review findings from animal studies on the impact of AAS exposure on neural systems that are crucial for the production of anxiety and aggression, and compare the effects of the different classes of AAS and their potential signaling mechanisms, as well as context-, age- and sex-dependent aspects of their actions.

The supply of doping products and the potential of criminal law enforcement in anti-doping : an examination of Italy's experience : executive summary / Letizia Paoli, Alessandro Donati. - KU Leuven, 2013

Motivation and Aims of the Study:

The present study draws its main motivation from the growing dissatisfaction of World Anti-Doping Agency (WADA) and numerous international and national policy-makers with the traditional anti-doping approach. This has developed since the 1960s through the interaction of the International Olympic Committee (IOC), international sports federations, and national governments, and since 2001, WADA, “focus[ing] squarely on the athlete[s]” (WADA, 2010b) and their testing. The 2012 London Olympics again demonstrated the limits of athletes’ testing: despite the 6,000 tests conducted, only two athletes tested positive during the Olympics, whereas seven others were “caught” in the preceding two weeks, which also belong to the official testing period for the games (Associated Press, 2012; Niggli, 2013, personal communication).
Today, there is a growing consensus among national and international policy-makers and many scholars (e.g., Bannenberg and Rössner, 2006; Rössner, 2011; Howman, 2011; Houlihan and García, 2012; see also AFP, 2011) that a broader approach is needed, including the use of criminal law instruments and, specifically, the repression of “trafficking.” According to the WADA (2010), for example, “it is imperative that additional strategies be combined with testing, research and education to ensure an efficient and effective anti-doping fight.” Testing alone cannot tackle five of the eight core violations listed in the WADA Anti-Doping Code, which constitutes the cornerstone of the current international drug 3 control regime and is implemented by national governments through the ratification of the 2005 UNESCO International Convention against Doping in Sport.

In this study, we have examined Italy’s anti-doping criminal law experience with the two main aims:
1) analyzing the production and distribution (collectively referred to as trade or supply) of doping products—an expression that includes both doping substances and methods and
2) understanding how anti-doping criminal provisions and their enforcement can contribute to improve the fight against doping within and outside the sports world. Since the late 1990s, in fact, Italy has played a pioneering role in the criminal law control of doping, and numerous investigations have shed light in Italy on different facets of the problem of doping and specifically of the supply of doping products.

By implementing a multi-method research design (see below), we have mapped the distribution system of doping products from producers to final users in Italy and built a typology of suppliers, identifying their motivations, modus operandi and mutual relationships and assessing their revenues and profits. On the basis of the same and other secondary sources, we have also evaluated the legislative bases, actors and outcomes of Italy’s anti-doping criminal law action, identifying a series of challenges that this action faces. To provide necessary context for assessing the supply of doping products, we have also estimated the size and financial dimensions of the Italian market for doping products—to our knowledge our study constitutes the first attempt to estimate these aspects of a national market for doping products.

The symbiotic evolution of anti-doping and supply chains of doping substances: how criminal networks may benefit from anti-doping policy / Bertrand Fincoeur, Katinka van de Ven, Kyle J.D. Mulrooney. - (Trends in Organised Crime 18 (2015) 3 (September) p. 229-250)

• Doi: 10.1007/s12117-014-9235-7

Abstract:

Doping in sport has been explored predominantly from a user-perspective, widely neglecting an analysis of the supply-side of the market for doping products. In this article, we aim to fill a gap in the existing literature by demonstrating that the supply chains of doping substances have evolved over the course of the past two decades, not least due to the zero tolerance approach of anti-doping policy. Specifically, adopting the case studies of (elite) cycling and recreational weight-training (RWT) and bodybuilding (BB), we outline how the supply chains for performance and image enhancing drugs (PIEDs) have shifted away from “culturally embedded dealers” and into new organizational structures independent from these sub-cultures. We maintain that the evolution of doping supply mirrors the evolution of doping use; whereas doping was previously the result of a socialization process, and PIED suppliers were a cultural product, consumption is now often a secretive practice and “social suppliers” are no longer prepared to take risks in (openly) supplying doping products. Consequently, the increasingly clandestine nature of doping practices has led consumers to increasingly consider the “black market” as a potential source for PIEDs. Most importantly, this shift in doping supply chains has led to greater inequality among athletes, increased health risks and the rise of suppliers devoid of sociocultural characteristics. We suggest that as the current anti-doping regime, focused predominantly on punishment and control, continues unabated these unintended negative consequences are likely to increase. As several countries have begun to rethink their position on the criminalization of drugs and drug users, it is time to rethink our approach to curbing the problem of doping in sports.

The trade in doping products and the challenges of supply reduction : an examinatio of Italy's experience / Letizia Paoli, Alessandro Donati. - KU Leuven, 2012. - 289 p.

Content:

- 1.) Wat is known about doping and what can this study add to it?
- 2.) Doping products and their demand
- 3.) The (illegal) suppliers of doping products
- 4.) Distribution chains and market relationships
- 5.) The role of sports bodies and organized crime
- 6.) Revenues and profits
- 7.) Anti-Doping law enforcement: legislation, actors, outcomes, and the callenges ahead
- 8.) Synthesis of findings and lessons for policy-making

The uncertainties of enhancement : A mixed-methods study on the use of substances for cognitive enhancement and it’s unintended consequences / Margit Anne Petersen, Oskar Enghoff, Jakob Demant

• Performance Enhancement & Health 6 (July 2019) 3-4, p. 111-120
• DOI: 10.1016/j.peh.2018.09.001

Abstract

Aims

The use of substances for cognitive enhancement has become a relatively well-studied phenomenon in recent years. However, few studies deal with the negative and unintended consequences of such practices. This article uses two data sets to explore and discuss the doubt and negative consequences that affect people using substances in the pursuit of enhancing cognition.

Methods

Data for the study are drawn from an online discussion forum on substances for enhancement and from ethnographic fieldwork carried out among university students in New York City. Taking a quali-quantitative approach, we combine digital text analytic tools with qualitative analysis and readings.

Findings

Using prescription stimulants and other substances for cognitive enhancement generates considerable uncertainty in terms of unclear effects, varying practices and ambivalent ethics. While the negative effects are not something easily discussed in person, references to them are very common in the online discussion forum.

Conclusions

People who use substances for enhancement have developed a ‘folk pharmacology’ that seems to play an important role in how they perceive the negative effects. This may make people who engage in these kinds of enhancement practices less able to make informed choices about their use of these substances.