The farce of legalised doping

This article is scientifically illiterate. Everything you put in your body is a chemical. Athletes can consume coffee beans but not cannabis leaves? Why? It seems completely arbitrary. At the end of the day anti-doping rules just allow you to discriminate against people who consume substances you don't like.

Over the past 6 odd months since this scandal broke have taken a casual interest and read up on some of the effects and after effects these stimulants have on someone's body. It seems to feed the insulin growth protein which causes you to grow, muscle growth, cell repair, but also grows cancer cells in some cases. Limiting the IGF-1 protein in a person's body reduces these effects and makes the body concentrate on repairing cells which is what you want to do with an adult body. End of the day, Essendon tried to get a performance edge on it's opponents. Draw your own conclusions.

That's fine for now but what about in the future with 'Gene' babies who are created by being given the the best possible traits to succeed in sport?

Ben, Thanks for your thought provoking comments. I do agree that medicine today is no longer about treating the sick only and that the biopsychosocial aspects of health are also important. But if we all want to benefit from this aspect of healthcare, whether we want be more intelligent (smart drugs like ritalin) or 'better' lovers (Viagara) then who will make the call that athletes should not be afforded the opportunity to perform better also through controlled doping. Its a long slippery slope and one we are probably not quite ready for at this time but I can see the moral and ethical debate shifting to this side in the future. When it does how and who will control it is the question. For example, Professor Andy Miah who wrote Genetically Modified Athletes (Google it) posits a very strong argument for allowing gene doping for instance (and for administrators to stay out of the medical and ethical debate on the matter). While the debate has certainly started in some quarters few are listening and like you mentioned even fewer are adding anything of value to this debate. Robin

Jason, I won't enter too much into the philosophical sides of things and leave that to much better qualified people such as yourself. Perhaps if the testing was made much simpler and more clarity on what is and what is not performance enhancing then at least there could be gains made on the anti-doping side of the argument. For the average punter you are either pro-doping or anti-doping but as you point out the problems are much more complex when arguing either position. It is obvious that testing for banned drugs is failing miserably and I agree with you that if ALL stakeholders are involved (they all buy into anti-doping programs and therefore the costs) then there is a much better chance of success. While any sport is beholden to corporate sponsors anti-doping efforts are bound to err on the side of 'image/brand protection' rather than outing cheats. Many years ago I wrote to sporting officials, government ministers and media outlets on a possible case of the doping of a Melbourne Cup horse and had the proverbial door slammed in my face. Obviously it was too controversial for the regulators of the sport of racing to face the questions and for the media outlets to compromise a paying relationship for coverage of their sport. That said perhaps one way for the sports to ‘put-up or shut-up’ is to examine the Banned Drug List itself. We all accept that any drug is dangerous when used inappropriately and when used in excess. What we don't know (and I would guess that the WADA and the like) don't know or have not proven which drugs actually improve performance either, so we have a banned list that is arguably based on assumptions that if drug A works then any related drug must also work to improve performance. For example there is no clear-cut empirical evidence that human growth hormone actually improves performance nor provides any anabolic effect (there is some evidence suggesting that growth hormone may work synergistically when 'stacked' with steroids though - so why not just test for steroids reducing the costs considerably!). How many 'headache' pills have been proven to be performance enhancing? Ironically caffeine has been proven in many studies to improve performance yet is no longer banned; no wonder the public are confused. As far as supplements are concerned I believe that any oral form (which comprises most of the internet sources) is a waste of time as most if not all would be metabolised in the gut and excreted in the urine before there was any measurable physiological effect. That’s not to say though that one could not over-dose if they were using excessive amounts but in such cases it is more likely to have a detrimental effect rather than a beneficial one. And to think that all banned drugs apply to all sports is ridiculous in the extreme. I fail to see how blood doping and/or steroid abuse would be of benefit to any high-jumper for instance and in this sport perhaps it would be better to concentrate on the stimulant type drugs. A certain amount of pragmatism would certainly help testing authorities to be more strategic with their meagre resources. If the WADA and other sporting federations are going to be the gatekeepers of an athlete’s health as well as the 'police' for drug infractions then all sports should consider adopting the biological passport concept. A hormonal and blood profile would go a long way in achieving both aims. Instead of seeking known drugs (that do improve performance) like EPO, anabolic steroids and prohibited methods such as blood transfusions you can easily detect who has been manipulating their physiology and who is displaying a healthy profile. For those that may be 'micro-doping' to minimise disturbances in their blood profiles in order to fly under the radar they would have to question the benefit of their drug taking regime. I am sure that if any athlete does not notice any effect then they are not going to continue and waste money. This way you don't have to be searching for every known (and unknown) drug to man and limit the expensive urine testing to 'un-natural' substances such as the stimulants and peptides KNOWN to improve performance. The beauty of the biological passport is that it would work in detecting gene doping also. I do believe though that if any drug is found that has not been approved for human use then these should be banned period. The argument for either side requires more lengthy and eloquent debating and is probably not for this forum. In this context my response for reader’s thoughts are purposely narrow and simplistic. Robin

Dean I've always had a degree of cynicism about the original press conference. It seemed to me that they had an investigation that had gone cold, and they went public with overstated claims in order to try and get players to come clean or dob someone in in the hope of receiving a lighter sanction. Worked a treat, didn't it? And you are dead right about what happens when you politicize it.

I don't know exactly which ones are banned, but my nephew plays in the AFL, and he had a quite debilitating headache one day, and had to go to the club to get medicated. He would not take what was offered at home.

There needs to be a better way. The treatment of sports people as if they were criminals or second class citizens needs to stop. The crude attempts by ASADA to intimidate sports people is quite nauseating, really. These so called investigations by ASADA have been a media and public circus. This is the outcome we should expect when such investigations are politicised from the very beginning. It has been an unseemly business, with constant leaks of information and accusations, with prosecutions being played out in the media. Indeed, the media have taken an active role in the whole sordid business. Is that how justice is supposed to work. Surely it can't be? I'd like to see an investigation to find the sources for these leaks. I even heard Fahey blame NRL players for the leaks, while he was sucking up to the AFL and praising them for their co-operation!!

Just a query on headache painkillers Graham, are you saying panadol is banned?

At last an article where the "dead heads" don't want to come out and play.

Robin, Thank you for bringing the issue into the public consciousness and the opportunity to engage in further discourse. In my view, there are no perfect solution or a binary "right"/"wrong" to the issue. As in most social phenomena, things occur on a continuum. I would like to offer an alternative view to your comments on the ‘Hippocratic oath’; allegedly taken by all doctors. Firstly, the original 'Hippocratic oath' has actually been modified numerous times over the course of history. Different countries have also modified it to suit their particular social context. There is currently no legal obligation in most countries around the world for any medical students to swear upon an oath, and many medical schools have also dispensed with such traditions. Secondly, most doctors abide by an “ethical code” rather than the “Hippocratic oath”. Nonetheless, both the code and oath reflect the prevailing Zeitgeist. For example, in some countries, the oath/code have been modified to reflect contemporary society’s view on abortion and the self-determined role of women in society. In my view, I think that the idea that doctors only treat sick people to get better oversimplifies the role that Medicine plays in modern society. Most doctors have replaced such biomedical perspectives with biopsychosocial models. Medicine is today as much about treating disease, as it is about prevention of ailments and optimisation of biopsychosocial health (including both quantity AND quality of life). For example, 1. We prescribe cognitive behavioural therapy, beta-blockers and anxiolytics to help big business CEOs cope better with their jobs. 2. We advise on the use of diuretics for recreational mountain climbers to prevent the onset of high altitude disease, thereby optimising their performance. 3. We offer patients going on a sea cruise preventive anti-emetics to prevent sea-sickness. 4. We offer laser eye therapy to help improve the vision of patients who may not be able to wear contact lens or glasses for their occupation. 5. We use surgery and various hormonal manipulations to either assist in reproduction or the prevention of pregnancies. And the list goes on. So do we translate what we advocate for athletes in their occupation into other social context? For example, 1. Asking a CEO to quit his job if cannot handle the stress of competition 2. Telling patients not to go mountain climbing or on sea voyages if their bodies are not designed for it, 3. Advising individuals to quit their jobs if they have to wear glasses, 4. Preaching to those who do not want to be pregnant to adopt sexual abstinence, while lecturing to those who fail to conceive to simply accept their fate? Medical science, either in sport or outside of it, is essentially morally neutral. Every “scientific” intervention has a benefit and a price. Social acceptance, public policies (including anti-doping and sports rules) are, however, subjective. The question is what society wants, and what is our ultimate purpose/objective for any policy? Who has a say in that debate: only sports administrators? I concur with Jason’s point that those who simply bleat about the failing of anti-doping or fear monger drug use do not help address the issue. For those that have a genuine interest about sports and athletes’ health, all options should be explored in order to figure out a better way forward. I would also add that any debate needs to go beyond slogans and rhetoric in order for social change to occur. Respectfully, Ben

Robin: Thank you for your thoughts. As always, the articles I write are intended to ask people to consider an alternative to anti-doping. I get frustrated that I am constantly misrepresented as "supporting doping". My position is and always has been that sport needs drug control. The issue I have is with anti-doping as a policy experiment that has clearly failed. John Fahey admitted as much. This says we need to find alternatives. Your list of questions implies that an alternative to anti-doping should be denied because it is too complex. Yet anti-doping is so horrendously complex that it defies the best legal and medical minds. In terms of a level playing field there is no meaningful difference. As a result, exchanging one complex system with another that prioritises the integrity of athlete health and welfare above the integrity of sporting competition is surely more humane and enlightened than one that sees punishment as the only way to control people. What I am advocating is a system that offers a way forward rather than constant moralising crusade that is anti-doping. The extant hypocrisies of a system that allows caffeine but bans marijuana indicates something is needed to break out of the malaise. As I argued in the Senate Inquiry into drugs in sport, the biggest problem we face is that there are so many conflicting version of what is "right" in sport. Some people see drug use as a sin. Others see it a necessary evil. Others see it as a necessary element to their survival. Yet others think it is all a waste of time and energy. I agree that the problem lies with the way Australians consume sport. If Australia wanted drug free sport then they should pay for it. The AFL and NRL should impose rigorous drug testing that is reflected in broadcast rights, sponsorship, merchandising and ticket prices. Then we could get away from the speculative arguments and get concrete "revealed preference" data. Put simply, the failure to experiment with alternatives to anti-doping will see investment in a system doomed to failure. We have reached the 'put up or shut up' phase. Those who simply bleat about the failing of anti-doping or fear monger drug use should get out of the way while the rest of us try to figure out a way out of this mess. Best wishes, Jason

I think the best way to try and put a stop to all this sports science is to introduce Blood Passports, However its prob to late and i for one am starting to lose interest in professional footy of any code. Its hard to appreciate the athletes when they could/prob are doing some form of performance enhancing to get to the top.

that article by Dr Mazanov was a good read. But I unable to spot where he suggested doping should be legalised.

1. The rules of sport were compiled by people who participated in that sport and trialed over a long period of time to enable the benefits of that sport to be enjoyed by all. There should be overwhelming and compelling reasons to alter those rules. 2. Embracing the increased use of pharmacological substances fails to consider the fact that of the hundreds of thousands of drugs available today in the world there is not one which is known to make a healthy person unconditionally better. See Taleb - Nonlinearity of Iatrogenics 3. Every human responds in a vastly different way to pharmaceuticals (two people drink one cup of coffee at night, one can sleep and the other cannot) should a sporting contest be determined or influenced by this human variable? 4. From a historical perspective we are currently experiencing the progressive commercialisation of sport. This is presenting many positive and negative challenges. At Clean Protocol (www.cleanprotocol.org) we hope to influence clean sport to provide benefits for the greater majority of clean athletes, their supporters and families.

WHat about the concept of having 2 events, like in bodybuilding has. Drug assisted body building, and non-drug protein assisted body building.

I hope they're officially sanctioned oranges you're talking about. I will not stand for rogue oranges in sport! That said, I do have a bit of a problem with pain killing injections as a regular occurrence, calf's blood injections and so on. It just doesn't sit right with me, regardless of how legal it might be. As for Essendon*, throw the bloody book at them! Although, I wouldn't mind some of their heart injected into my spineless handbags at Carlton.

No one wants to see sport reduced to a "drugs race", but I'm not sure that an environment where everybody lives on a knife edge about what is, and what is not legal, is the perfect answer. Let's face it, we will never be able to stop those who want to obtain a better response by using what is "legal" on a particular day. To me, there are three reasons for having strong controls over what is administered to athletes bodies. Firstly, the obvious one. Obtaining an advantage over an opponent in a contest, by using drugs is clearly unfair. Secondly, increasing strength, stamina, etc by any means other than hard work, I think is questionable. In an environment of professional sport, where a player's livelihood is dependant on his ability to be fit to perform, I think he or she should have access to "out of competition" substances that aid in the repair of their bodies, as long as it is under strict medical supervision. Thirdly, and by far the most important is safety. No one should feel pressured in any way into using non natural means to improve their body shape, or performance, ESPECIALLY when many of the products have not been tested for long term effects. I think we do need to reassess the idea of what is performance enhancing. I find absolutely ludicrous, the concept that an athlete can be a vociferous campaigner against performance enhancing drugs, while being perfectly willing to be injected with something that will allow him to play out a game after he's been injured. If that is not performance enhancement, what is? And what about "Therapeutic Use"? If a drug allows you to play a sport that you would not normally be able to play, how is it not performance enhancing. Isn't it ridiculous that an athlete can't take a painkiller for a headache, even on a non match day? And then we come to Caffeine, where it is not the substance itself, but the amount of it, at a given time. As an aside, isn't it odd that every one abhors the use of drugs to gain an advantage, but relishes the use of technology to achieve the same result? The system is out of control. I am not suggesting that these be outlawed, by any means. I just think we need to take a long hard look at exactly what we want to achieve, and how best to go about it. Simply creating an endlessly growing list of banned, sometimes banned, and "okay for now", substances, will never solve the problem.

Right then, back we go to an orange at half time. No pain killing injections, they enhance performance. No hyperbaric chambers. No altitude training. The list goes on, unfortunately I can't offer any realistic alternatives to this mess.