Use of substances among professionals and students of professional programs : a review of the literature / Niki Kiepek, Jonnie-Lyn Baron

• Drugs: Education, Prevention and Policy 26 (2019) 1, p. 6-31)
• DOI: 10.1080/09687637.2017.1375080

Abstract

Background and aims: This literature review investigates the scope of information regarding self-reported substance use by professionals and students in professional programs, with a focus on anticipated and actual effects of substances.

Methods: A review of English, peer-reviewed journals and professional journals was conducted. Articles were included if they reported empirical findings of original research and specifically described an aspect of substance use (e.g. type of substance used, patterns of use, reasons for use) by professionals or students.

Results: Of the 130 articles ultimately included, 105 involved anonymous self-administered survey methodology. Self-reported data about the effects of substance use or reasons for use were reported in 35 articles. Reasons for use included positive impact on performance and experience, such as fun, pleasure, sleep, enhanced work performance, improved attention and concentration, and relaxation. Predictive associations were analysed regarding demographic factors, mental health, type of profession, and area of specialisation.

Conclusions: Little is known about the effects of substance use on the performance or experience of professionals or students in professional programs. Research is required that incorporates qualitative methodologies, elicits anticipated and actual effects of substance use, including controlled and beneficial patterns of use. Minimisation of research bias is key to future study of the effects of substance use by professionals or students in professional programs.

Using complementary mass spectrometric approaches for the determination of methylprednisolone metabolites in human urine / Oscar J. Pozo, Josep Marcos, Xavier Matabosch, Rosa Ventura, Jordi Segura. - (Rapid Communcations in Mass Spectrometry 26 (2012) 5 (15 March); p. 541-553)

• PMID: 22302494
• DOI: 10.1002/rcm.6129

Abstract

Rationale: The metabolism of methylprednisolone is revisited in order to find new metabolites that could be important for distinguishing between different routes of administration. Recently developed liquid chromatography/tandem mass spectrometry (LC/MS/MS) strategies for the detection of corticosteroid metabolites have been applied to the study of methylprednisolone metabolism.

Methods: The structures of these metabolites were studied using two complementary mass spectrometric techniques: LC/MS/MS in product ion scan mode with electrospray ionization and gas chromatography/mass spectrometry (GC/MS) in full scan mode with electron ionization. Metabolites were also isolated by semipreparative liquid chromatography fractionation. Each fraction was divided into two aliquots; one was studied by LC/MS/MS and the other by GC/MS after methoxyamine-trimethylsilyl derivatization.

Results: The combination of all the structural information allowed us to propose a comprehensive picture of methylprednisolone metabolism in humans. Overall, 15 metabolites including five previously unreported compounds have been detected. Specifically, 16β,17α,21-trihydroxy-6α-methylpregna-1,4-diene-3,11,20-trione, 17α,20β,21-trihydroxy-6α-methylpregna-1,4-diene-3, 11-dione, 11β,17α,21-trihydroxy-6α-hydroxymethylpregna-1,4-diene-3,20-dione, 11β,17α,20ξ,21-tetrahydroxy-6α-hydroxymethylpregna-1,4-diene-3-one, and 17α,21-dihydroxy-6α-hydroxymethylpregna-1,4-diene-3,11,20-trione are proposed as feasible structures for the novel metabolites. In addition to the expected biotransformations: reduction of the C20 carbonyl, oxidation of the C11 hydroxy group, and further 6β-hydroxylation, we propose that hydroxylation of the 6α-methyl group can also take place.

Conclusions: New metabolites have been identified in urine samples collected after oral administration of 40 mg of methylprednisolone. All identified metabolites were found in all samples collected up to 36 h after oral administration. However, after topical administration of 5 g of methylprednisolone aceponate, neither the parent compound nor any of the metabolites were detected.

Who this guidance is for
This guidance has been commissioned by the World Anti-Doping Agency (WADA) for use by organisations interested in engaging young athletes in communications around the issue of anti-doping.

How this guidance has been developed
This guidance has been developed following a review of the research literature and interviews with academics, campaign managers, a selection of National and Regional Anti-Doping Organisations, and young athletes themselves. We have attempted to incorporate the perspectives of stakeholders from around the world within this review2. In particular we would like to thank Dr Brian Cugelman and UK Anti-Doping for their detailed feedback on this guidance.

Contents:

• What is social media?
• How do people use social media?
• How can I use social media?
• A 10-step programme for using social media successfully
• Further reading

On 4 December 2017 the Disciplinary Commission of the Olympic Council of Asia (OCA) decided to disqualify the results of the Iraqi wrestler Ahmed Salah Al-Jamie after his sample tested positive for the prohibited substance Methasterone. Previously when notified in November 2017 a provional suspension was ordered and the Athlete denied the intentional use of any prohibited substance.

Hereafter in January 2018 the case was transferred to United World Wrestling (UWW) and proceedings were opened against the Athlete. After notification the Athlete failed to respond to any of the communications from UWW.

Without the Athlete’s response the UWW Anti-Doping Panel deems that the Athlete has admitted the charge, to have waived his right for a hearing and /or file a statement in his defence, and to have accepted the consequences. Without any ground for a reduction of the sanction the UWW Anti-Doping Panel decides on 9 February 2018 to impose a 4 year period of ineligibility on the Athlete starting on 12 January 2018.

In September 2017 United World Wrestling (UWW) has reported an anti-doping rule violation against the Russian Athlete Aleksandr Chekhirkin after his A and B samples tested positive for the prohibited substance Triamcinolone. After notification a provisional suspension was ordered and the Athlete filed a statement with medical evidence in his defence.

At the same time the Paris Lab was provionally suspended by WADA for technical reasons. The Athlete’s samples were transferred to the Rome Lab in order to reanalyse the A sample, to analyse his B sample and to provide the Athlete the sample documentation package.

The Athlete explained in his submissions that the positive result was due to an out-of-competition injection of triamcinolone for his articular pain. His last treatment on his left knee was dated 14 August 2017, seven days before the test that resulted in the adverse analytical finding. The Athlete provided a certificate of medical consultation with his defence statement.

Although the injection of glucocorticoids was intra-articular and thus permitted according to the Prohibited List, the Athlete asserted the injection might have reached a muscle or tendon tissues, resulting in the substance being found in urine in small quantities. The Athlete based this assertion on a report prepared by an external analytical chemist who analysed the metabolism of triamcinolone acetonide in a human body and the influence of different factors on excretion.

The UWW Anti-Doping Panel finds that the Athlete’s explanation and evidence is plausible and meet the burden of proof to establish how the prohibited substance entered his system. The Panel considers the circumstances in this case and holds that the Athlete’s degree of fault is light with grounds for a reduced sanction.

Therefore the UWW Anti-Doping Panel decides on 27 February 2018 to impose a 4 month period of ineligibility on the Athlete starting on 29 September 2017.

In July 2017 United World Wrestling (UWW) has reported an anti-doping rule violation against the Kyrgyz Athlete Anarbek Sydykbekov after his sample tested positive for the prohibited substance Furosemide. After notification the Athlete filed a statement in his defence and he waived his right to be heard for the UWW Anti-Doping Panel.

The Athlete denied the intentional use of the substance and asserted that the positive test was caused by a bottle of water which was allegedly already opened and provided to him during the sample collection procedure.

The NADO in question responded that there were no recorded irregularities with the sample collection procedure, no open bottle could have been provided to the Athlete and that there were no complaints from any other tested wrestler.

The Panel concludes that the Athlete failed to establish how the substance enterend his system and dismiss his vague allegations. Further it holds that there is no evidence that the anti-doping violation was intentional.

Therefore the UWW Anti-Doping Panel decides on 2 October 2017 to impose a 2 year period of ineligibility on the Athlete starting on the date of the decision. In addition the Panel decides to impose a CHF 20’000 fine on the Kyrgyzstan Wrestling Federation.

Related case:

CAS 2018_A_5619 WADA vs UWW & Anzor Boltukaev
October 3, 2018

In June 2017 United World Wrestling (UWW) has reported an anti-doping rule violation against the Russian Athlete Anzor Boltukaev after his sample tested positive for the prohibited substance Higenamine. After notification a provisional suspension was ordered. The Athlete filed a statement in his defence and was heard for the UWW Anti-Doping Panel.

The Athlete asserted that it was probably caused through contamination of the nutritional supplements he used while he was told that they were safe and none of these products mention the substance in question on their label. With evidence he argued that the substance can be found in a large variety of plants en in coffee and coffee bases products.

The Panel accepts the Athlete’s explanation and finds that it is probable that the substance was ingested through a contaminated product consumed by the athlete considering the substance and the probability that the substance may be found in a variety of plants and, hence in nutritional supplements without clear indication on the label, the panel.

The panel also finds that the Athlete had been careful when consulting his team doctor about his supplements and that he could not reasonably suspect that he had used the specified substance Higenamine, whether through his consumption of coffee or nutritional supplements. The Panel concludes that the violation was not intentional and that he establish No Significant Fault or Negligence.

Therefore the UWW Anti-Doping Panel decides on 2 February 2018 to impose a 10 month period of ineligibility on the Athlete starting on the date of the provisional suspension, i.e. on 6 June 2017.

In April 2017 United World Wrestling (UWW) has reported an anti-doping rule violation against the Russian Athlete Aslan Visaitov after his sample tested positive for the prohibited substance GW1516 (Peroxisome Proliferator Activated Receptor δ (PPARδ) agonists). After notification the Athlete failed to respond to any of the communications from UWW.

Without the Athlete’s response the UWW Anti-Doping Panel deems that the Athlete has admitted the charge, to have waived his right for a hearing and /or file a statement in his defence, and to have accepted the consequences.

Therefore the UWW Anti-Doping Panel decides on 30 May 2017 to impose a 4 year period of ineligibility on the Athlete starting on 24 April 2017. Further the Panel decides to impose a CHF 20’000 fine on the Russian Wresting Federation.

On 19 December 2017 the Disciplinary Commission of the Olympic Council of Asia (OCA) decided to disqualify the results of the Turkmen wrestler Dinara Hallyyeva after her sample tested positive for the prohibited substance Meldonium. Previously at a hearing in November 2017 the Athlete could not explain how the substance entered her system.

Hereafter the case was transferred to United World Wrestling (UWW) and proceedings were opened in February 2018 against the Athlete. After notification a provisional suspension was ordered and the Athlete failed to respond to any of the communications from UWW.

Without the Athlete’s response the UWW Anti-Doping Panel deems that the Athlete has admitted the charge, to have waived her right for a hearing and /or file a statement in her defence, and to have accepted the consequences. Therefore the UWW Anti-Doping Panel decides on 7 March 2018 to impose a 4 year period of ineligibility on the Athlete starting on 9 February 2018.

In June 2017 United World Wrestling (UWW) has reported an anti-doping rule violation against the Algerian Athlete Iftene Zohier after his sample tested positive for the prohibited substance Stanozolol. After notification a provisional suspension was ordered and the Athlete filed a statement in his defence.

The Athlete argued that the positive test was probably caused by contaminated supplements he had used and he asserted that several testing departures occurred of the applicable rules and standards at the Doping Control Station.

The Africa Zone Regional Anti-Doping Organization (RADO) submitted that the space used for the Doping Control was acceptable, at all times there was supervision and no comments were received neither from the athletes nor from the coaches or managers. Also the UWW Medical deligate reported that the conditions were adequate and that there were no irregularities that could undermine the validity of the Doping Control Process.

The UWW Anti-Doping Panel finds that the Athlete failed to establish with evidence that there were departures from testing standards and holds that the testing conditions were acceptable and in accordance with the standards. Also the Athlete failed to demonstrate with evidence that one of the supplements he used was contaminated.

Therefore the UWW Anti-Doping Panel decides on 25 July 2017 to impose a 4 year period of ineligibility on the Athlete starting on 1 June 2017. Further the Panel decides to impose a CHF 20’000 fine on the Algerian Wresting Federation.