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Drugs in sport: Doping development and ethical analysis
Abstract
Doping is a complex and ancient phenomenon considering the vast variety of substances, supplied through both legal and illegal trading routes, and the extensive connections between the people involved in the network. It occurs in elite athletes but also affects amateur athletes. Furthermore, it involves athletes’ friends and relatives, medical staff, managers, chemists, biologists and pharmacists, pharmaceutical industries, clandestine laboratories and criminal organizations. Over time, doping has shown a great ability to discover and always use new substances and appropriated the new scientific discoveries. Unfortunately, new discoveries for the human health have been used in distorted way by the athletes. In fact, the athletes may be able to use gene therapy to re-engineer their bodies for better performances. Drug dependence depends on several factors: the socio-environmental context of the subject and what effects have the substance in the body. The drug dependence could be connected to the indirect gratification.We will agree that sport is essentially under the current anti-doping campaign executed by a coordinated alliance between the World Anti-Doping Agency (WADA), law enforcement authorities, sports organizers and the media. Therefore, doping is a public health issue and not simply a problem inside the professional sports community. © 2019, DPTZK (Physical Education Pedagogues Association). All rights reserved.
... Sporcular tarafından kullanımı yasak ilaç etkin maddelerine örnek olarak; buprenorfin, dekstromoramid, hidrokodon, morfin, pentazosin ve benzer bileşikler verilebilir. 7 Tramadol ve kodein, potansiyel kötüye kullanma modellerini tespit etmek amacıyla, 2012'den 2017'ye kadar WADA'nın izleme programına yerleştirilmiştir. 7 Morfin ve türevleri, ağrı giderici etkisinin yanında öfori hissi, artmış kendine güven gibi etkiler TABLO 2: Sporcularda kullanımı yasak olan narkotik analjezikler ve özellikleri. ...
... 7 Tramadol ve kodein, potansiyel kötüye kullanma modellerini tespit etmek amacıyla, 2012'den 2017'ye kadar WADA'nın izleme programına yerleştirilmiştir. 7 Morfin ve türevleri, ağrı giderici etkisinin yanında öfori hissi, artmış kendine güven gibi etkiler TABLO 2: Sporcularda kullanımı yasak olan narkotik analjezikler ve özellikleri. 6 verdiği için mücadele sporlarında performansı artırmak amacıyla kullanılmaktadır. ...
... Yan etkilerinden en kötüsü bağımlılık oluşturması olup, kesildiğinde yoksunluk belirtileri görülebilir. 7 Sporcular hızlı bir şekilde iyileşmek, olimpiyat oyunları ile dünya şampiyonluğu gibi sınırlı bir süre içinde sürekli katılım ve çaba gerektiren turnuvalarda, yaralanma veya yorgunluktan kaynaklanan ağrı ile başa çıkmak için narkotik analjeziklere başvurabilirler. ...
... People have attempted to develop their bodies' in a fake manner by using legitimate, illegitimate, healthful and unhealthful methods (Mazzeo, D'Elia & Raiola, 2018). ...
The yearning to win sports competitions has led some athletes to dope. Doping in sports is a real threat to the 'Spirit of Sport' and fairness. The pharmacokinetics of performance-enhancing drugs differ, as do their effects and purposes of use. As one of the most effective and decisive solutions, the idea to issue a prohibited list came to raise the legal awareness level among athletes about the types of prohibited substances and methods they have to avoid and in which time specifically. In addition, for the sake of broader and more comprehensive cooperation between the law, medicine, and pharmacology, to confront the phenomenon, and limit it to the narrowest possible scope on the other hand. The idea to issue the prohibited list came. Historical, descriptive, and legal approaches are employed in conducting this review. Additionally, the method of conceptual analysis is used to discover the exact normative terminology. The most significant finding for this review is that the issuance of the Prohibited List brought greater stability to sporting events. Its annual issuance is legal proof in front of everyone (countries, international sports organisations, and athletes).
... CVD is entrusted by Law 376/2000 with the development and update of Italy's own-prohibited list, the organization of anti-doping controls and the maintenance of operative contacts with the European Union and the international bodies. WADA Accredited Laboratories are absorbed by the constant and significant flow of blood and urine analyses required by National and Regional Anti-doping Organizations (NADO and RADO), National and International Sports Federations and the International Olympic Committee (IOC) and the regular demands for case support (Arioli & Bellini 2005;Mazzeo, D'Elia et al., 2018). ...
The knowledge of using performance-enhancing drugs and supplements is caused by psychological and social dynamics. Moreover, athletes used pharmaceuticals to improve their performance, which is commonly known as doping. Doping in sports is the “use of prohibited techniques and/or the assumption of prohibited substances by athletes in order to increase physical performances”. If an individual believes that capacity is not related to commitment, then they are more exposed to the use of performance-enhancing drugs. This misuse is ethically and legally incorrect. We will agree that sport is essentially under the current anti-doping campaign executed by a coordinated alliance between the World Anti-Doping Agency (WADA), law enforcement authorities and sports organizers. Doping is a public health issue and not simply a problem inside the professional sports community. Opinions are spreading in support of liberalization of doping. Some are based on the circumstances that currently the values of equality and health are not protected and, therefore, the liberalization of doping doesn’t result in a change in the current situation. Indeed, the prohibitionist attitude involves the search for substances and methods of administration increasingly dangerous. This review is a portrait of this issue and explores some arguments concerning various aspects of the problem.
Islam recommends its followers to protect the body, to enjoy full health and also prohibits them from endangering their own soul (an-Nafs) which is within their body. This study attempts to present the perspective of Islamic Shari‘ah regarding performance enhancing drugs (PEDs) used in sports. This is achieved by showing that using prohibited substances and methods constitutes fraud. Moreover, it also has a detrimental effect on the right to life and the right of bodily integrity.
The Problem: The problem states that some sports practitioners accept the idea of taking banned items and consider it to be inevitable in line with the sweeping trend of globalization. However, it is a fact that such behaviour contradicts Islamic ethics and rules which forbid cheating. Methodology: This study employed descriptive, analytical, and inferential methods as these methods suit the objectives and hypotheses of the study.
Authenticity and Value: The originality and value of this study appears in its ethical presentation and treatment of the phenomenon which has been stripped of any moral determinant.
Findings: The most important finding of this study is that cheating in sports, particularly doping in sports, is a serious problem that needs a radical solution. Furthermore, any respected athlete (male or female) who is taking PEDs should abstain from taking such drugs because it is considered as cheating that harms the body and endangers life. Accordingly, a person who takes prohibited and banned drugs contravenes both the Islamic Shari‘ah and the secular law. Moreover, that person deserves punishment suggested by both of these codes of law.
Moral Disengagement is a collection of socio-cognitive mechanisms by which individuals detach themselves from ethical actions and participate in inhumane, abusive, damaging, or horrifying acts toward others without showing remorse and self-censure. Previous studies revealed the significant role of moral disengagement between individuals’ moral standards and their unethical actions. Moral disengagement mechanisms allow people to perform unethical behaviors they normally do not approve or are against their moral standards, however consumer perspective in previous studies are either omitted or quite limited. Therefore, in this study, a general outlook to consumer behavior studies is presented to understand the role of moral disengagement in varying contexts. A general discussion and future research avenues are also presented at the end.
Research purpose. The present study aims to examine the changes in physical activity levels during the lockdown due to COVID-19 in Italy. In particular, it aims to evaluate the impact of physical exercise on psychological health, how much the home environment influences the desire to train and what people think about Smart-fitness and sport in general.
Materials and methods. A sample of 268 people from the province of Salerno participated in the study, with an average age of 26 years. To achieve the tasks set, the study relied on the following methods: analysis of scientific literature, formulation and administration of a questionnaire and data analysis through methods of mathematical statistics. A structured questionnaire was prepared, disseminated through social networks. To analyze the data, the Social Sciences Statistical Package (SPSS) and descriptive statistics were used to calculate the demographic variables. The factor analysis was also calculated to verify the characteristics of the sport considered important by the participants.
Results. The results obtained made it possible to understand the main type of physical activity carried out during the quarantine (aerobic activity 35%, functional training 27%, anaerobic activity 19%), the time dedicated to each session (52.8% practice for 1 hour) and the weekly frequency of the same (42.9% practice physical activity continuously more than ¾ times a week). It was also understood the reasons that prompted the interviewees to train, the way they planned their session and the equipment used. Finally, it was shown that the majority of the sample (64.17%) knew smart fitness considering it an interesting activity, and the influence attributed to the home environment by a scale of values from 1 to 5. Furthermore, the factor analysis shows us the most relevant aspects wich respondents attributed to sport. More frequently, respondents place greater importance on being loyal and correct, on the contrary, lower values are attributed to the importance of earning money, and not to disappoint others.
Conclusions. The study found that COVID-19 did not stop athletes, who quickly adapted to the new situation. The home environment has proved to be very influential on the desire to train, despite this, they hope to return to the gym as soon as possible.
It is generally believed, especially among athletes and practicing sports people, that the use of performance-enhancing drugs, besides improving performance, leads to the obtainment of easy results accompanied by glory and money gain. Unfortunately, the misuse and abuse of pharmacologically active substances have become so widespread in present day sports that the safety, the health and the longevity of far too many athletes are now compromised. More recently, athletes began the use pharmacological practices by assuming a stimulant of popular diffusion called strychnine. With the years gone by and the pharmacological progress, the use of drugs by athletes became more intense reaching a point of international phenomenon known as “doping”. The restless evolution and multiplication of doping methods and substances, the fear by athletes of harsh sports and legal sanctions as well as the inadequacy of the identification techniques for illegal substances, contribute to make a not accurate evaluation of the prevalence of the Doping phenomenon. In the course of the time, the results obtained in genetics have been used in the field of sport, creating a new form of doping, called “gene doping”. The athletes may be able to use gene therapy to re-engineer their bodies for better performances. One of the primary reasons for having a list of prohibited substances and methods is to protect athlete health. However, the International Olympic Committee (IOC) prohibited drugs, as beta2 agonists or glucocorticosteroids and some athletes with genuine medical conditions, were denied legitimate medical therapy. The use of drugs that have the potential to improve physical performance is restricted by anti-doping regulation. Therefore, act 376/2000 establishes three distinct types of doping offenses.
“Globesity” is a word used by the World Health Organization (WHO) to describe the global epidemic of overweight and obesity. The gain weight is due to numerous factors such as an unhealthy lifestyle, a wrong diet, a lack of exercise, the change in way to live and genetic factors. It is reported that the accumulation of fat in the body starts in childhood and changes depending on sex, age and ethnicity. The illness linked to high body fat are obesity, type 2 diabetes, osteoporosis, depression, and cancer of the breast and colon. There are different tests that measure the quantity of body fat but the most used is the Body Mass Index. According to it, a person is obese when his BMI is equal or superior to 30 points. Researchers showed that diet and exercise play an important role in the treatment and prevention of obesity in patients with obesity as useful variables to predict CVD risk beyond adiposity and emerging evidence showed also the importance of cardiorespiratory fitness, skeletal muscle mass and strength. Regular exercise (and proper nutrition) can help reduce body fat as well as protect against chronic diseases associated with obesity. The (WHO), with Health 2020, is engaging all Countries to develop an efficient approach in order to resolve health diseases. The aim of this review is to discuss on obesity: epidemiology etiology, different methods to measure it, the role of physical activity and governments to solve it. Additional research may foster understanding about how and what sport to can help promote energy balance and healthy body weight. Moreover, a new pharmacological target to fight obesity and its associated diseases are represented by Endocannabinoid system.
The results obtained in the field of genetic engineering applied to the sport have created a new form of doping: “gene doping”. It’s very difficult to identify athletes who have resorted to gene doping because many of treatment based on gene technologies are unlikely to be detected by urine or blood tests and the new technologies are often too invasive and not easily achievable. To fight gene doping in 2009 the World Anti-Doping Agency (WADA) had published “the Athlete Biological Passport” (ABP), the new standard in testing, based on the personalized monitoring of biomarkers of doping. It is an individual electronic document, in which are enclosed biological data of the athlete. Through the marking variation of this biological parameters is possible detect use of gene doping. This document is actually the most important to detect gene doping in every sport’s practice. This article correlated gene doping, that represents a threat to the integrity of sport and the health of athletes, with ABP this new element of innovative strategies against doping.
Recent biotechnological advances have permitted the manipulation of genetic sequences to treat several diseases in a process called gene therapy. However, the advance of gene therapy has opened the door to the possibility of using genetic manipulation (GM) to enhance athletic performance. In such ‘gene doping’, exogenous genetic sequences are inserted into a specific tissue, altering cellular gene activity or leading to the expression of a protein product. The exogenous genes most likely to be utilized for gene doping include erythropoietin (EPO), vascular endothelial growth factor (VEGF), insulin-like growth factor type 1 (IGF-1), myostatin antagonists, and endorphin. However, many other genes could also be used, such as those involved in glucose metabolic pathways. Because gene doping would be very difficult to detect, it is inherently very attractive for those involved in sports who are prepared to cheat. Moreover, the field of gene therapy is constantly and rapidly progressing, and this is likely to generate many new possibilities for gene doping. Thus, as part of the general fight against all forms of doping, it will be necessary to develop and continually improve means of detecting exogenous gene sequences (or their products) in athletes. Nevertheless, some bioethicists have argued for a liberal approach to gene doping.
Running has been defined as a product of integrated movement activities performed by different joints and body segments. Thus, an analysis of each joint and segment of motion, in addition to their relationships seems to be useful in order to assess the entire body movement trying aid to achieve a proper running technique. For this reason, understanding how the runner's foot makes contact with the ground during takeoff and stance phases has special importance because the foot is the only body segment to directly supply force to the ground during the running movement. The aim of this review is to summarise the current literature on foot-strike patterns in running. Secondly, we discussthe influence of foot-strike patterns on various aspects related to running performance. In conclusio, the implementation of a " Running technique-specific training " seems to be crucial for improving performance in middle-and long-distance runners, as well Propriocetive and Plyometric training.
The elite players are constantly being exposed to multiple high physiological demands due to elevated number of training sessions and matches played in national and international competitions held several times during a week. The aim is to assess oxidative stress variation throughout pre-season and the first half of the season by comparing month-by-month free radicals. Secondly, we aimed to compare overall pre-oxidative stress to in season one. The methods is experimental. Blood samples were obtained per month from twenty-three elite football players, during seven-months season (2 months pre-season and five-months in-season). The results show a large negative correlation was observed between July and August and between November and December (p=0.02; r=-0.54; p=0.03; r=-0.45 respectively). Significant interaction was observed in ROS over the whole analysed period (p<0.01; ž2=0.19) in function of the monthly analysis. Monthly ROS increased (p<0.05) from November to October, and then decreased (p<0.05) from October to November. In conclusion the Oxidative stress vary over the season. Thus, a certain risk of non-contact injury and illness must be considered at a given seasonal stage, particularly in September, when competitive season is beginning. Further research may relate training load to oxidative stress over a given period to better explain the present results.
Intensity training, talent, and an adequate diet represent the crucial factors for the success of athletes. Unfortunately, athletes prefer intaking substances to quicker and easier increase their performance compared to traditional training. For this reason there has been a significant spread of enhancing substances drugs and dietary supplements (DS), although, as already broadly evidenced, the abuse of those substances could seriously damage athletes' health. Indeed, DS could contain substances that are not declared on the label, which are banned by the World Anti-Doping Agency (WADA). This exploratory study aims to investigate DS phenomenon, specifically, we want to describe this phenomenon among boxers, analyzing typologies of DS intaken, knowledge about DS, main reasons for justifying DS abuse, and places where boxers buy them and potential consultants about suggesting their consumption. Data were collected through a total of 214 anonymous self-report questionnaires administered to boxers in Campania (Italy), 169 questionnaires were considered valid. The study collects data exclusively for male athletes. Indeed, the results demonstrate that boxers, mainly men (88.4% of the sample), practice sport mostly for fun and they intake DS for balancing out nutritional deficiencies and having more energy. Mineral salts (N=88) and vitamins (N=85) are broadly intaken compared to other substances. The consumption of DSis recommended by coach in the competitive athletes (N=33), against non-competitive boxer whom consultant is the doctor (N=25). Boxers mostly buy the supplements in the drugstore. In summary, the results demonstrate that boxers widely intake DS for improving their performance. Also, implications for research and practice are discussed.
Aim: Doping affects the sport. Its explosive spread has triggered the response of sports' and government's institutions. The aims of this study were to know the spread of doping in Italy, what were the most used substances and/or method and in which sports it was more common. Moreover, what instruments were used to contrast it. Methods: We have analysed the doping's spread in Italy since 2003. The data come from the databases of government and sports Italians institutions. We have compared those data and focused our attention on substances and/or methods discovered in athletes. Furthermore, data's combination showed the reason of drug addiction. Results: In Italy, only 3% of checked athletes are doped, many of them are men and young athletes dope less than the older ones. Doped athletes play mainly cycling, athletics, swimming and football. The prominent peak of them is in the Central and Southern Italy in 2008 and 2010. Moreover, the analysis of data relating to galenic preparations declared during the year 2012, shows that 75% of the prescribed substances are diuretics and masking agents, anabolic steroids and stimulant. Regarding the substances, cannabinoids and stimulants have recorded the highest consumption. Conclusion: The data show only the tip of the iceberg due to doping's secrecy. Every substance that give pleasant sensations or help the subject in his activity will bring him to repeat the consumption. Frequently, new substances and methods are discovered. For this reason, to contrast this phenomenon, there are legislation instruments together with various funded projects.
Previous research had evaluated the training football effect in adolescence on postural control through the use of a platform of strength for the detection of the COP; however This research showed just how football compared to other sports or compared to sedentary individuals would improve postural stability in adolescence before the normal maturation of man. However the significance of this potential can be given by the skills developed through this sport or its exercises/situations that facilitate the learning. This further research on the influence of football training on postural control will have to show the specific factors that lead to a greater postural control; Therefore, the project deals with two different methodologies in experiencing different workout on two groups of children aged between 6-7 years, which will be offered its training program for five years, and the beginning and end of each year/cycle training will be conducted surveys through a platform of strength of the COP to assess postural stability of children. Teaching applications will be either prescriptive or ecological - dynamic and the final goal of this study is to highlight precisely what kind of methodological approach in football will lead to a greater postural control in adolescence, in order to get additional data that can contribute looking for the Peterson search done in 2006 on the variables that influence the postural control in adolescence.
This study is a systematic review on the use of prohibited substances and their effects on sports performance. The use of banned substances, in order to increase the performance capacity, constitutes a problem worldwide. The research is based on the analysis of the most relevant studies on the issues addressed published in the last 5 years in the PubMed database. From the 78 results of the screening, we analyzed a total of 14 scientific studies and summarized the latest findings in this field.
The purpose of this study was to investigate the reliability and validity of wheelchair basketball as motor difference performance of 20 disabled athletes practising wheelchair basketball. They resulted with variable classifications-point between 1 and 4.5 and had different positions. Pre-requisites were the different disabilities of the athletes, due to mobility impairment by traumatic injuries, polio, mutilations, and others, resulted compatible with the basketball practice. Aims were improving the percentage of shooting and passing by strengthening the upper limbs through specific exercises and the use of competition balls, medicine balls, and elastics fitband. The data were collected during two academic years at the Faculty of Sport Sciences (now the Department of Sport Sciences and Wellness) of the University of Naples Parthenope to evaluate the conditional and coordinative abilities used in passing and shooting in wheelchair basketball. The research carried out using an observation method and handwriting reporting-was made on a sample of 20 disabled athletes who already had experienced national wheelchair basket leagues and who belonged to the "CISS Basket Napoli" team, including athletes of the junior team. The study included initial, intermediate and final tests. The final output, recorded at the end of the second agonistic season, showed the improvement percentage of about 6, 5% validating a methodology based on supplementary training. The athletes of group B showed an incremented percentage and even some athletes of group A, determined to train with greater concentration, showed improvements in their performances reaching higher points of percentage.
Opioid addiction is a chronic disease with a relapsing trend including unpredictably-long periods of remission and complete well-being, but at high risk of relapse. Selective antagonists of mu, kappa and lambda receptors of the opioid system are among the commonest therapeutic means to prevent relapses and include naltrexone. Therefore, the aim of this report was to evaluate different administration regimens for naltrexone in a 12-month follow-up to keep a drug-free condition with respect to the different therapeutic requirements and compliance of the treated patients. Seventy-two patients (64 males and 8 females) were enrolled. Patients were divided in three groups of 24. In the 1st group a member of the family was in charge for daily administration of the antagonist (50 mg tabs). Due to personal reasons, no psychological support could be given to patients in this group; these patients only underwent a weekly test to rule out narcotics intake. The 2(nd) group received a daily administration (50 mg tabs) by a member of their families, psychological support and toxicological tests twice a week. The 3rd group received a daily administration (50 mg tabs) by a member of their families, psychological support, toxicological tests twice a week and antagonist administration by healthcare professionals of the Therapeutic Services every 10 days. The following results were obtained at the end of the study: in the first group, 9 patients withdrew from treatment within the first three months, 7 withdrew after 6 to 12 months, resuming heroin use, 8 of the treated patients are currently drug-free. In the second group, 6 patients withdrew from treatment within the first three months and 6 of them after 6 to 12 months resuming their opioid habits; 12 patients are drug-free. Finally, follow-up of the third group showed 2 and 3 patients to have withdrawn from the trial within the first three months and after 6 to 12 months, respectively, resuming their heroin habits; 19 patients of this group are currently still drug-free. The results obtained in this trial confirm that treatment with an opioid antagonist allowed us to keep a large number of patients drug-free.
The desire to increase their own physical performances in order to obtain better results in sports led athletes to seek alternative methods to train hard. In the time, the results obtained in genetics have been used in the field of sport, creating anew form of doping: "gene doping". The athletes may be able to use gene therapy to re-engineer their bodies for better performances. In the sport, leading authorities predict that the genetic engineering of athletes will be widespread by the 2004 Olympics. This new type of doping can be dangerous and detrimental to health as with it, gene transfer vectors may be produced in non-controlled laboratories. It is really difficult to identify athletes who have resorted to gene doping because many of the muscle based gene technologies are unlikely to be detected by urine or blood tests. Various options have been advanced to detect the use of genes for the purpose of doping but they turn out to be too invasive and not easily achievable. Athletes are not fully aware of the physical problems associated with the use of gene doping and they and their supporting staff will be educated on this subject in order to prevent the use.
The intentional activation of autonomic dysreflexia (AD, also called "boosting"), a practice sometimes used by athletes affected by spinal cord injury (SCI), is banned by the International Paralympic Committee (IPC). Although various studies have addressed doping and AD as separate issues, studies evaluating AD as a doping method are lacking. The aim of this brief review is to contribute to better understanding of the relationship between doping and AD. We conducted a literature search of the PubMed database (from 1994 onwards). The key search terms "autonomic dysreflexia" and "boosting" were crossreferenced with "sport performance". The official Paralympic website was also viewed. AD is a potent sympathetic reflex, due to a massive release of noradrenaline, that results in marked vasoconstriction distal to the level of the lesion. Athletes with SCI often self-inflict physical suffering in order to induce this phenomenon, which carries high health risks (i.e., hypertension, cerebral hemorrhage, stroke and sudden death). Boosting is a practice that can be compared to doping methods and the IPC expressly prohibits it. Any deliberate attempt to induce AD, if detected, will lead to disqualification from the sporting event and subsequent investigation by the IPC Legal and Ethics Committee.
The use of performance-enhancing and social drugs by athletes raises a number of ethical and health concerns. The World Anti-Doping Agency was constituted to address both of these issues as well as publishing a list of, and testing for, banned substances in athletes. Despite continuing methodological developments to detect drug use and associated punishments for positive dope tests, there are still many athletes who choose to use performance and image enhancing drugs. Of primary concern to this review are the health consequences of drug use by athletes. For such a large topic we must put in place delimitations. Specifically, we will address current knowledge, controversies and emerging evidence in relation to cardiovascular (CV) health of athletes taking drugs. Further, we delimit our discussion to the CV consequences of anabolic steroids and stimulant (including amphetamines and cocaine) use. These drugs are reported in the majority of adverse findings in athlete drug screenings and thus are more likely to be relevant to the healthcare professionals responsible for the wellbeing of athletes. In detailing CV health issues related to anabolic steroid and stimulant abuse by athletes we critique current research evidence, present exemplar case studies and suggest important avenues for on-going research. Specifically we prompt the need for awareness of clinical staff when assessing the potential CV consequences of drug use in athletes.
We will argue that sport is essentially deteriorating under the current anti-doping campaign executed by an un-coordinated alliance between the World Anti-Doping Agency (WADA), law enforcement authorities, sports organizers and the media. We will develop our argument in three steps. We begin with a brief consideration of the fundamental characteristics that define the kind of sport WADA was established to protect. After this, we use the case of cycling to demonstrate the unplanned consequences of the current sanction system and show how it diminishes the meaning of sport before we finish the article by calling for a more rational and level-headed approach which is urgently needed to bring sport out of its current mess.
Drug abuse occurs in all sports and at most levels of competition. Athletic life may lead to drug abuse for a number of reasons, including for performance enhancement, to self-treat otherwise untreated mental illness, and to deal with stressors, such as pressure to perform, injuries, physical pain, and retirement from sport. This review examines the history of doping in athletes, the effects of different classes of substances used for doping, side effects of doping, the role of anti-doping organizations, and treatment of affected athletes. Doping goes back to ancient times, prior to the development of organized sports. Performance-enhancing drugs have continued to evolve, with "advances" in doping strategies driven by improved drug testing detection methods and advances in scientific research that can lead to the discovery and use of substances that may later be banned. Many sports organizations have come to ban the use of performance-enhancing drugs and have very strict consequences for people caught using them. There is variable evidence for the performance-enhancing effects and side effects of the various substances that are used for doping. Drug abuse in athletes should be addressed with preventive measures, education, motivational interviewing, and, when indicated, pharmacologic interventions.
A medical and scientific multidisciplinary consensus meeting was held from 29 to 30 November 2013 on Anti-Doping in Sport at the Home of FIFA in Zurich, Switzerland, to create a roadmap for the implementation of the 2015 World Anti-Doping Code. The consensus statement and accompanying papers set out the priorities for the antidoping community in research, science and medicine. The participants achieved consensus on a strategy for the implementation of the 2015 World Anti-Doping Code. Key components of this strategy include: (1) sport-specific risk assessment, (2) prevalence measurement, (3) sport-specific test distribution plans, (4) storage and reanalysis, (5) analytical challenges, (6) forensic intelligence, (7) psychological approach to optimise the most deterrent effect, (8) the Athlete Biological Passport (ABP) and confounding factors, (9) data management system (Anti-Doping Administration & Management System (ADAMS), (10) education, (11) research needs and necessary advances, (12) inadvertent doping and (13) management and ethics: biological data. True implementation of the 2015 World Anti-Doping Code will depend largely on the ability to align thinking around these core concepts and strategies. FIFA, jointly with all other engaged International Federations of sports (Ifs), the International Olympic Committee (IOC) and World Anti-Doping Agency (WADA), are ideally placed to lead transformational change with the unwavering support of the wider antidoping community. The outcome of the consensus meeting was the creation of the ad hoc Working Group charged with the responsibility of moving this agenda forward.
It is generally known that talent and hard training are the main factors contributing to the success of an athlete; nevertheless athletes make use of various substances in an attempt to improve their performance. The aim of this study is: 1) the evaluation of diet supplements used by the students attending courses at the faculty of Motor Sciences in a southern Italian University. 2) the evaluation of the precise knowledge about nutritional supplements and risks related to their utilization. An anonymous questionnaire was distributed to 562 students attending the last year of the university course. This questionnaire focused on information regarding demographic characteristics, sporting activities and the use of nutritional supplements (frequency, types of substances and suppliers). A significant percentage (28.6%) of students admitted using nutritional supplements (absolute values: elite-n = 84; non-elite-n = 76). Among the 160 athletes using nutritional supplements: 34% practised bodybuilding and 32% football; 40% used minerals, 36.3% vitamins and 23.7% proteins; 20.1% took nutritional supplements regularly (>5 times per week), 35.3% occasionally (2-4 times per week), 44.6% seldom (<2 times per week); 45% bought supplements from a pharmacy and 21.9% from a sports coach; 41% of the athletes used nutritional agents at the suggestion of a sport coach trainer while only 19% and 6% on recommendation of a medical or nutritional consultant respectively. No adverse drug reactions have been reported. Among young people, and particularly sports students, it is important to provide accurate information on the correct use of supplements and their potential damage.
During the last 2 decades, progress in deciphering the human gene map as well as the discovery of specific defective genes encoding particular proteins in some serious human diseases have resulted in attempts to treat sick patients with gene therapy. There has been considerable focus on human recombinant proteins which were gene-engineered and produced in vitro (insulin, growth hormone, insulin-like growth factor-1, erythropoietin). Unfortunately, these substances and methods also became improper tools for unscrupulous athletes. Biomedical research has focused on the possible direct insertion of gene material into the body, in order to replace some defective genes in vivo and/or to promote long-lasting endogenous synthesis of deficient proteins. Theoretically, diabetes, anaemia, muscular dystrophies, immune deficiency, cardiovascular diseases and numerous other illnesses could benefit from such innovative biomedical research, though much work remains to be done. Considering recent findings linking specific genotypes and physical performance, it is tempting to submit the young athletic population to genetic screening or, alternatively, to artificial gene expression modulation. Much research is already being conducted in order to achieve a safe transfer of genetic material to humans. This is of critical importance since uncontrolled production of the specifically coded protein, with serious secondary adverse effects (polycythaemia, acute cardiovascular problems, cancer, etc.), could occur. Other unpredictable reactions (immunogenicity of vectors or DNA-vector complex, autoimmune anaemia, production of wild genetic material) also remain possible at the individual level. Some new substances (myostatin blockers or anti-myostatin antibodies), although not gene material, might represent a useful and well-tolerated treatment to prevent progression of muscular dystrophies. Similarly, other molecules, in the roles of gene or metabolic activators [5-aminoimidazole-4-carboxamide 1-β-D-ribofuranoside (AICAR), GW1516], might concomitantly improve endurance exercise capacity in ischaemic conditions but also in normal conditions. Undoubtedly, some athletes will attempt to take advantage of these new molecules to increase strength or endurance. Antidoping laboratories are improving detection methods. These are based both on direct identification of new substances or their metabolites and on indirect evaluation of changes in gene, protein or metabolite patterns (genomics, proteomics or metabolomics).
This study examined young adult sequelae of participation in high school activities and identity group for 900 participants from the Michigan Study of Life Transitions.Participation at Grade 10 in high school activities predicted later substance use, psychological adjustment, and educational and occupational outcomes.Prosocial activity participation predicted lower substance use and higher self-esteem and an increased likelihood of college graduation.Performing arts participation predicted more years of education as well as increases in drinking between ages 18 and 21 and higher rates of suicide attempts and psychologist visits by the age of 24.Sports participation predicted positive educational and occupational outcomes and lower levels of social isolation but also higher rates of drinking. Breakfast Club identity categories were predictive of both levels and longitudinal patterns in substance use, education and work outcomes, and psychological adjustment.In general, Jocks and Brains showed the most positive adjustment and Criminals the least.
Background: Use of genetic doping or gene transfer technology will be the newest and the lethal method of doping in future
and have some unpleasant consequences for sports, athletes, and outcomes of competitions. The World Anti-Doping
Agency (WADA) defines genetic doping as "the non-therapeutic use of genes, genetic elements, and/or cells that have the
capacity to enhance athletic performance". The purpose of this review is to consider genetic doping, health damages and
risks of new genes if delivered in athletes.
Methods: This review, which is carried out by reviewing relevant publications, is primarily based on the journals available
in GOOGLE, ELSEVIER, PUBMED in fields of genetic technology, and health using a combination of keywords (e.g., genetic
doping, genes, exercise, performance, athletes) until July 2010.
Conclusion: There are several genes related to sport performance and if they are used, they will have health risks and sever
damages such as cancer, autoimmunization, and heart attack.
In Italy, naltrexone for the treatment of opioid dependence is frequently administered to opiate‐dependent patients sent for treatment via special treatment facilities, the Public Services for Treatment of Drug Addition (SERT). In the region Campania, prescription data showed that the use of naltrexone outside SERT is higher compared to the other regions of Italy. This study was carried out in order to identify factors that influence the higher utilization of naltrexone outside SERT in Campania. Three‐hundred and fifty patients followed by 13 SERTs have been evaluated. Twenty per cent of patients withdrew from the trial in the very first months. At the beginning of the study, 63% of the patients received naltrexone at SERT, while 37% were treated at home with the support of their families. Later during treatment, the majority of patients were treated at home. Families showed a high degree of participation and cooperation in the rehabilitation of patients (75%). These data suggest that the support of families was especially important for motivation of retention treatment and integration with psychosocial programmes. Naltrexone treatment can be continued at home after a short period of treatment from the public service if families intensively participate in the therapeutic programme.
The focus of this paper is on the theoretical and empirical interdependencies between goal perspectives, or ways of judging one's competence and subjectively defining success, and intrinsic motivation in the sport domain. First, the conceptual links between goal perspective theory (Nicholls, 1989) and Deci and Ryan's cognitive evaluation theory (1985) are outlined. Drawing from both of these frameworks, it is presumed that a task-involved goal perspective should foster intrinsic motivation while an ego-involved goal perspective is more likely to lead to decreased intrinsic motivation. Second, recent investigations which have examined the relationship of situationally-induced task and/or ego involvement and intrinsic motivation in the classroom and, in particular, sport are reviewed. Finally, research across two samples is presented which determined the association between dispositional goal perspectives (as measured by the Task and Ego Orientation in Sport Questionnaire) and indices of intrinsic motivation (as measured by the Intrinsic Motivation Inventory). The results were consistent with theoretical predictions and provide converging evidence for the construct validity of the TEOSQ. The paper concludes with future directions for work on goal perspectives and intrinsic motivation in sport.
Recent biotechnological advances have permitted the manipulation of genetic sequences to treat several diseases in a process called gene therapy. However, the advance of gene therapy has opened the door to the possibility of using genetic manipulation (GM) to enhance athletic performance. In such 'gene doping', exogenous genetic sequences are inserted into a specific tissue, altering cellular gene activity or leading to the expression of a protein product. The exogenous genes most likely to be utilized for gene doping include erythropoietin (EPO), vascular endothelial growth factor (VEGF), insulin-like growth factor type 1 (IGF-1), myostatin antagonists, and endorphin. However, many other genes could also be used, such as those involved in glucose metabolic pathways. Because gene doping would be very difficult to detect, it is inherently very attractive for those involved in sports who are prepared to cheat. Moreover, the field of gene therapy is constantly and rapidly progressing, and this is likely to generate many new possibilities for gene doping. Thus, as part of the general fight against all forms of doping, it will be necessary to develop and continually improve means of detecting exogenous gene sequences (or their products) in athletes. Nevertheless, some bioethicists have argued for a liberal approach to gene doping.
Current anti-doping in competitive sports is advocated for reasons of fair-play and concern for the athlete's health. With the inception of the World Anti Doping Agency (WADA), anti-doping effort has been considerably intensified. Resources invested in anti-doping are rising steeply and increasingly involve public funding. Most of the effort concerns elite athletes with much less impact on amateur sports and the general public.
We review this recent development of increasingly severe anti-doping control measures and find them based on questionable ethical grounds. The ethical foundation of the war on doping consists of largely unsubstantiated assumptions about fairness in sports and the concept of a "level playing field". Moreover, it relies on dubious claims about the protection of an athlete's health and the value of the essentialist view that sports achievements reflect natural capacities. In addition, costly antidoping efforts in elite competitive sports concern only a small fraction of the population. From a public health perspective this is problematic since the high prevalence of uncontrolled, medically unsupervised doping practiced in amateur sports and doping-like behaviour in the general population (substance use for performance enhancement outside sport) exposes greater numbers of people to potential harm. In addition, anti-doping has pushed doping and doping-like behaviour underground, thus fostering dangerous practices such as sharing needles for injection. Finally, we argue that the involvement of the medical profession in doping and anti-doping challenges the principles of non-maleficience and of privacy protection. As such, current anti-doping measures potentially introduce problems of greater impact than are solved, and place physicians working with athletes or in anti-doping settings in an ethically difficult position. In response, we argue on behalf of enhancement practices in sports within a framework of medical supervision.
Current anti-doping strategy is aimed at eradication of doping in elite sports by means of all-out repression, buttressed by a war-like ideology similar to the public discourse sustaining international efforts against illicit drugs. Rather than striving for eradication of doping in sports, which appears to be an unattainable goal, a more pragmatic approach aimed at controlled use and harm reduction may be a viable alternative to cope with doping and doping-like behaviour.
Autonomic dysreflexia (AD) is unique to individuals with spinal injuries (SCI) at T6 or above and can be voluntarily induced. Although AD improves wheelchair racing performance in some athletes, it also elicits exaggerated blood pressure, which could be dangerous. The International Paralympic Committee considers AD doping and banned its use.
The purpose of this study is to evaluate AD knowledge, incidence and attitudes (KIA) of Paralympians with SCI.
An existing questionnaire was modified to include questions of AD KIA, validated by three experts and piloted with a small sample. It was administered on-line, mailed to members of a scientific network and distributed during the Beijing Paralympic Games. Fisher Exact test was used to evaluate differences across gender, injury and education.
Of 99 participants, 54.5% had previously heard of AD while 39.4% were unaware; 16.7%, all males, had used AD to enhance performance. Participants reported that AD was (1) useful for middle (78.6%) and long distance (71.4%), marathon (64.3%) and wheelchair rugby (64.3%); (2) somewhat dangerous (48.9%), dangerous (21.3%) or very dangerous (25.5%) to health. Results were not influenced by age, injury level or injury duration.
Findings indicate the need for educational programmes directed towards enhancing the AD knowledge of rehabilitation professionals, coaches and trainers working with SCI individuals.
The increasing levels of physical inactivity and availability of food high in calories are bringing an increasing number of people developing pathological conditions such as obesity, type 2 diabetes, osteoporosis, cardiovascular disease, respiratory disease, colon cancer and breast cancer. In this review, it became evident that the lack of physical activity can contribute negatively to various diseases, and, what are the possible strategies recommended to promote changes in lifestyle to maintain acceptable levels of physical activity and to ensure a durable psychological and physical well-being. A key challenge for all those working in the health and physical-sportive and undoubtedly capable to identify strategies that facilitate physical activity participation in adequate amounts, in relation to the possibilities and age, in order to produce benefits for all, in terms of learning, participation and inclusion.
From a study previously published on the occasion of the scientific meeting of the International Conference on Sports Science and Disability held in Naples at the University Naval February 15, 2014, be clear that "It is appropriate to the study of a process for the effective implementation of these activities and connected to an objective evaluation tool."This work illustrates a practice used for a pilot project currently underway. Analysis of the practices used. Administering tests validated (FPS, POMS, tests Rockfort, measurement bmi) to an experimental group and a control group. They were also used additional assessment instruments calibrated for the specific use. Graphical representation of the data obtained. The analysis of currently available data is positive, this data will be compared with the final data to get a picture more complete. In Conclusions the data collected if confirmed by the end of the pilot project to encourage the creation of an experimental project in which they are involved more patients and more facilities in order to evaluate the results.
Autonomic dysreflexia is a common response to painful stimuli following high level spinal injuries. Loss of normal control of sympathetic reflexes leads to large increases in blood pressure, accompanied by headache and occasional more dangerous sequelae. Although now officially banned, intentional dysreflexia ("boosting") is still exploited by some competitors to gain an unfair advantage. It is thus important to consider physiological mechanisms, consequences for health and performance, and methods of controlling this abuse. Boosters perceive the practice as frequent, performance enhancing, and of low immediate risk. Effective methods of eliminating the practice may include more stringent control of competitors, evaluating and publicizing short- and long-term risks, and countering arguments that boosting is an ethically acceptable method of restoring a normal physiological response.
Background: data on the prevalence of use, beliefs and attitude towards doping substances and practices among Italian athletes are scarce. Methods: in 2006 we interviewed 508 Italian athletes in sports facilities, using an anonymous structured questionnaire to collect information on the athletes' beliefs about the role in performance and side effects of selected doping practices and substances, the reasons for use, obstacles in obtaining drugs, responsibility in the decision, changes in use in recent years, and anti-doping controls. Results: among the athletes, 88.2% believed that supplements were effective to improve performance and 4.8% that they were potentially dangerous. They believed that 87.0% of top-level athletes frequently use supplements, namely 69.1% anti-inflammatory drugs and 56.9% creatine. Doping was widespread in the opinion of 87.4% of athletes, and 45.3% thought it was used at all competition levels. Among those interviewed, 43.9% reported that athletes and coaches together were responsible for use, and 25.2% that it was easy to obtain substances. Lastly, 34.8% believed that doping use increased during 2002-05, and 54.7% thought that anti-doping controls should be more frequent. ConclusionS: this survey indicates that athletes believe that doping (mainly supplement use) is widespread at all competition levels, that athletes are aware of the seriousness of adverse effects and ask for more severe control and emphasis on potential dangers in the press.
Both sport and academic work play large roles in school life, yet there is little comparative evidence on the nature or generality of achievement motivation across these domains. In this study, beliefs about the causes of success in school and sport of 207 high school students were found to be related in a logical fashion to their personal goals. The ego-involved goal of superiority was associated with the belief that success requires high ability, whereas task orientation (the goal of gaining knowledge) was associated with beliefs that success requires interest, effort, and collaboration with peers. These goal-belief dimensions, or theories about success, cut across sport and schoolwork. However, little cross-domain generality was found for perceptions of ability and intrinsic satisfaction. Intrinsic satisfaction in sport primarily related to perceived ability in that setting. Task orientation, not perceived ability, was the major predictor of satisfaction in schoolwork.
We examined the potential benefits and risks associated with participation in five types of activities: prosocial (church and volunteer activities), team sports, school involvement, performing arts, and academic clubs. Our sample included 1,259 mostly European American adolescents (approximately equal numbers of males and females). First, we explore the link between involvement in these activities and our indicators of positive and negative development. Involvement in prosocial activities was linked to positive educational trajectories and low rates of involvement in risky behaviors. In contrast, participation in team sports was linked to positive educational trajectories and to high rates of involvement in one risky behavior, drinking alcohol. Then, we explore two possible mediators of these associations: peer associations and activity-based identity formation. The evidence supported our hypothesis that group differences in peer associations and activity-based identities help explain activity group differences.
Aim
This study aims to examine the circumstances which athletes say affect their (hypothetical) considerations of whether to dope or not and explore the differences between athletes of different gender, age and sport type.
Methods
645 elite athletes (mean age: 22.12; response rate: 43%) representing 40 sports completed a web-based questionnaire. Participants were asked to imagine themselves in a situation in which they had to decide whether to dope or not to dope and then evaluate how different circumstances would affect their decisions.
Results
Multiple circumstances had an effect on athletes’ hypothetical decisions. The most effective deterrents were related to legal and social sanctions, side-effects and moral considerations. Female athletes and younger athletes evaluated more reasons as deterrents than older, male athletes. When confronted with incentives to dope, the type of sport was often a more decisive factor. Top incentives were related to qualified medical assistance, improved health or faster recovery from injury, the low risk of being caught and the threat posed to an elite career.
Conclusions
Our results reveal that numerous circumstances affect athletes’ thoughts on doping and athletes of different gender, age and sport type reacted differently to a variety of circumstances that may potentially deter or trigger doping. Particularly notable findings were the potential role of doctors in athletes’ doping and that the current punitive anti-doping approach seems to deter athletes, although the fear of social sanctions was almost as great a deterrent.
Implications
Anti-doping prevention strategies should be diversified to target specific groups of athletes.
Today's approach to anti-doping is mostly centered on the judicial process, despite pursuing a further goal in the detection, reduction, solving and/or prevention of doping. Similarly to decision-making in the area of law enforcement feeding on Forensic Intelligence, anti-doping might significantly benefit from a more extensive gathering of knowledge. Forensic Intelligence might bring a broader logical dimension to the interpretation of data on doping activities for a more future-oriented and comprehensive approach instead of the traditional case-based and reactive process. Information coming from a variety of sources related to doping, whether directly or potentially, would feed an organized memory to provide real time intelligence on the size, seriousness and evolution of the phenomenon. Due to the complexity of doping, integrating analytical chemical results and longitudinal monitoring of biomarkers with physiological, epidemiological, sociological or circumstantial information might provide a logical framework enabling fit for purpose decision-making. Therefore, Anti-Doping Intelligence might prove efficient at providing a more proactive response to any potential or emerging doping phenomenon or to address existing problems with innovative actions or/and policies. This approach might prove useful to detect, neutralize, disrupt and/or prevent organized doping or the trafficking of doping agents, as well as helping to refine the targeting of athletes or teams. In addition, such an intelligence-led methodology would serve to address doping offenses in the absence of adverse analytical chemical evidence.
Doping in sport is a well-known phenomenon that has been studied mainly from a biomedical point of view, even though psychosocial approaches are also key factors in the fight against doping. This phenomenon has evolved greatly in recent years, and greater understanding of it is essential for developing efficient prevention programmes. In the psychosocial approach, attitudes are considered an index of doping behaviour, relating the use of banned substances to greater leniency towards doping. The aim of this review is to gather and critically analyse the most recent publications describing elite athletes' attitudes, beliefs and knowledge of doping in sport, to better understand the foundations provided by the previous work, and to help develop practical strategies to efficiently combat doping. For this purpose, we performed a literature search using combinations of the terms "doping", "sport", "elite athletes", "attitudes", "beliefs", "knowledge", "drugs", and "performance-enhancing substances" (PES). A total of 33 studies were subjected to comprehensive assessment using articles published between 2000 and 2011. All of the reports focused on elite athletes and described their attitudes, beliefs and knowledge of doping in sport. The initial reasons given for using banned substances included achievement of athletic success by improving performance, financial gain, improving recovery and prevention of nutritional deficiencies, as well as the idea that others use them, or the "false consensus effect". Although most athletes acknowledge that doping is cheating, unhealthy and risky because of sanctions, its effectiveness is also widely recognized. There is a general belief about the inefficacy of anti-doping programmes, and athletes criticise the way tests are carried out. Most athletes consider the severity of punishment is appropriate or not severe enough. There are some differences between sports, as team-based sports and sports requiring motor skills could be less influenced by doping practices than individual self-paced sports. However, anti-doping controls are less exhaustive in team sports. The use of banned substance also differs according to the demand of the specific sport. Coaches appear to be the main influence and source of information for athletes, whereas doctors and other specialists do not seem to act as principal advisors. Athletes are becoming increasingly familiar with anti-doping rules, but there is still a lack of knowledge that should be remedied using appropriate educational programmes. There is also a lack of information on dietary supplements and the side effects of PES. Therefore, information and prevention are necessary, and should cater to the athletes and associated stakeholders. This will allow us to establish and maintain correct attitudes towards doping. Psychosocial programmes must be carefully planned and developed, and should include middle- to long-term objectives (e.g. changing attitudes towards doping and the doping culture). Some institutions have developed or started prevention or educational programmes without the necessary resources, while the majority of the budget is spent on anti-doping testing. Controls are obviously needed, as well as more efficient educational strategies. Therefore, we encourage sporting institutions to invest in educational programmes aimed at discouraging the use of banned substances. Event organizers and sport federations should work together to adapt the rules of each competition to disincentivize dopers. Current research methods are weak, especially questionnaires. A combination of qualitative and quantitative measurements are recommended, using interviews, questionnaires and, ideally, biomedical tests. Studies should also examine possible geographical and cultural differences in attitudes towards doping.
Participation in high school sports had positive effects on many Grade 12 and postsecondary outcomes (e.g., school grades, coursework selection, homework, educational and occupational aspirations, self-esteem, university applications, subsequent college enrollment, and eventual educational attainment) after controlling background variables and parallel outcomes from Grades 8 and 10 in a large, nationally representative, 6-year longitudinal study. In contrast to Zero-Sum and Threshold Models, these positive effects generalized across academic and nonacademic outcomes, across the entire range of athletic participation levels, and across different subgroups of students (e.g., SES, gender, ethnicity, ability levels, educational aspirations). Sport participation is hypothesized to increase identification/commitment to school and school values which mediate the participation effects, particularly for narrowly defined academic outcomes not directly related to sport participation. Consistent with this Identification/Commitment Model, extramural sport, and to a lesser extent team sport, had more positive effects than intramural and individual sports.
Sport celebrates differences in competitors that lead to the often razor-thin margins between victory and defeat. The source of this variation is the interaction between the environment in which the athletes develop and compete and their genetic make-up. However, a darker side of sports may also be genetically influenced: some anti-doping tests are affected by the athlete's genotype. Genetic variation is an issue that anti-doping authorities must address as more is learned about the interaction between genotype and the responses to prohibited practices. To differentiate between naturally occurring deviations in indirect blood and urine markers from those potentially caused by doping, the "biological-passport" program uses intra-individual variability rather than population values to establish an athlete's expected physiological range. The next step in "personalized" doping control may be the inclusion of genetic data, both for the purposes of documenting an athlete's responses to doping agents and doping-control assays as well facilitating athlete and sample identification. Such applications could benefit "clean" athletes but will come at the expense of risks to privacy. This article reviews the instances where genetics has intersected with doping control, and briefly discusses the potential role, and ethical implications, of genotyping in the struggle to eliminate illicit ergogenic practices.
Since the first anti-doping tests in the 1960s, the analytical aspects of the testing remain challenging. The evolution of the analytical process in doping control is discussed in this paper with a particular emphasis on separation techniques, such as gas chromatography and liquid chromatography. These approaches are improving in parallel with the requirements of increasing sensitivity and selectivity for detecting prohibited substances in biological samples from athletes. Moreover, fast analyses are mandatory to deal with the growing number of doping control samples and the short response time required during particular sport events. Recent developments in mass spectrometry and the expansion of accurate mass determination has improved anti-doping strategies with the possibility of using elemental composition and isotope patterns for structural identification. These techniques must be able to distinguish equivocally between negative and suspicious samples with no false-negative or false-positive results. Therefore, high degree of reliability must be reached for the identification of major metabolites corresponding to suspected analytes. Along with current trends in pharmaceutical industry the analysis of proteins and peptides remains an important issue in doping control. Sophisticated analytical tools are still mandatory to improve their distinction from endogenous analogs. Finally, indirect approaches will be discussed in the context of anti-doping, in which recent advances are aimed to examine the biological response of a doping agent in a holistic way.
The objective of this study was to assess the prevalence of illicit drugs use among young adults, in particular elite athletes. This study considers the data obtained from anti-doping analyses performed on nearly 100,000 urine samples from 2000 to 2009 by the World Anti-Doping Agency accredited Italian Anti-Doping Laboratory. The percentage of adverse analytical findings varies on a yearly basis, but it is in the range 1.0-1.8% (not considering atypical findings, such as an altered endogenous steroid profile). Among positive results, there is a high prevalence of stimulants and drugs of abuse. The drug of abuse found most frequently is the tetrahydrocannabinol (cannabis) metabolite, accounting for 0.2-0.4% of the total samples analysed (18% of the positive results). The second most frequently encountered drug is cocaine, as detected from cocaine metabolites, accounting for 0.1% of the total samples analysed (7% of positive results). Other stimulants found included amphetamines, ephedrines, carphedon, modafinil, and anorexic compounds. No amphetamine-like designer drugs were detected. These data are indicative of the widespread prevalence of cocaine and cannabis use among the young adult population. However, due to the particular population studied, it must be considered an underestimation of the phenomenon among elite athletes with respect to the general population.
This review examines the question of whether performance-enhancing drugs should be permitted in sport under the control of physicians, and evaluates the expected outcomes of such a scenario. Such a change in regulation would need to be tightly controlled because of the risks involved. The results of legalizing performance-enhancing drugs in competitive sport would be either unhelpful or negative, and the unwanted aspects of doping control would not disappear. Athletes, including children and adolescents who wanted to pursue competitive sports, would be forced to take additional, avoidable health risks. The 'natural lottery' of athletic talents would be compensated for only partially by use of performance-enhancing agents. It would also be complemented by another 'natural lottery' of variable responses to doping measures, combined with the inventiveness of doping doctors. There would be no gain in 'justice' (i.e. fairer results that reflected efforts made) for athletes as a result of legalizing doping. Legalization would not reduce restrictions on athletes' freedom; the control effort would remain the same, if not increased. Extremely complicated international regulations would have to be adopted. The game of the 'tortoise and the hare' between doping athletes and inspectors would remain because prohibited but not identifiable practices could still provide additional benefits from use of permissible drugs. Audience mistrust, particularly toward athletes who achieved outstanding feats, would remain because it would still be possible that these athletes were reliant on illegal doping practices. Doping entails exposing the athletes to avoidable risks that do not need to be taken to increase the appeal of a sport. Most importantly, the function of sport as a role model would definitely be damaged. It is not necessary to clarify the question of what constitutes the 'spirit of sport' and whether this may be changed. From a practical point of view, a legalization of performance-enhancing drugs in sport should not be considered for the simple reason that it has no advantages but many disadvantages.
To date, there are estimates for the percentage of unknown cases of doping and illicit drug use in fitness sports, but not for elite sports. This can be attributed to the problem of implementing questionnaires and surveys to get reliable epidemiological estimates of deviant or illicit behaviour.
All athletes questioned were subject to doping controls as members or junior members of the national teams. In order to estimate the prevalence of doping and illicit drug abuse, the athletes were either issued an anonymous standardized questionnaire (SQ; n=1394) or were interviewed using randomized response technique (RRT; n=480). We used a two-sided z-test to compare the SQ and RRT results with the respective official German NADA data on the prevalence of doping.
Official doping tests only reveal 0.81% (n=25,437; 95% CI: 0.70-0.92%) of positive test results, while according to RRT 6.8% (n=480; 95% CI: 2.7-10.9%) of our athletes confessed to having practiced doping (z=2.91, p=0.004). SQ and RRT both revealed a prevalence of about 7% for illicit drug use, but SQ failed to indicate a realistic prevalence of doping (0.20%; 95% CI: 0.02-0.74%).
We demonstrate for the first time that data from official doping tests underestimate the true prevalence of doping in elite sports by more than a factor of eight. Our results indicate that implementing RRT before and after anti-doping measures could be a promising method for evaluating the effectiveness of anti-doping programs.
A general procedure for the analysis in urine of basic drugs (and their metabolites), some of which may be misused as stimulants in sport, has been developed. The techniques used include gas-liquid and thin-layer chromatography and linked gas-liquid chromatography—mass spectroscopy. It is recommended that international control of drug-taking in sport be based primarily upon urine analysis by gas-liquid chromatography systems and also derivative formation followed by gas-liquid chromatography. The principles outlined in the procedure can be applied in a much wider forensic context.
Autonomic dysreflexia (AD) may complicate spinal cord injured (SCI) subjects with a lesion level above the sixth thoracic level. There are several ways to remove triggering factors and, furthermore, new trigger mechanisms may be added by the introduction of new treatments. New data about the pathogenic mechanisms have been suggested in recent years as well as signs of metabolic effects associated with the reaction. This review of the syndrome includes clinical aspects of the AD reaction; the known pathogenic mechanisms, the incidence and prevalence and triggering factors. AD is associated with some cases of severe morbidity, including cerebral haemorrhage, seizures and pulmonary oedema. Symptomatic as well as specific treatments are discussed. Finally, some further questions are raised by the necessity of a proper definition of the syndrome, the revealing of the underlying pathophysiology, and new investigations concerning incidence and prevalence.