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Clean Olympians? Doping and anti-doping: The views of talented young British athletes

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Background: Review articles suggest a small but significant proportion (between 3 and 12%) of male adolescents have used anabolic-androgenic steroids (AAS) at some point (Yesalis and Bahrke, 2000; Calfee and Fadale, 2006). In sport, the use of prohibited substances or processes to enhance performance, collectively referred to as 'doping', is banned by both sports' National and International Governing Bodies, and by the World Anti-Doping Agency (WADA) who run an extensive testing programme and educational initiatives designed to foster anti-doping attitudes. Method: A total of 40 talented male and female athletes (mean average age 19.6 years) from 13 different sports attended 12 focus groups held over the UK intended to investigate athletes' attitudes toward doping. Focus group transcriptions were analysed and coded with the use of QSR NVivo 8. Results: Athletes in general did not report a significant national doping problem in their sport, but exhibited sporting xenophobia with regard to both doping practices and the stringency of testing procedures outside of the UK. Athletes often viewed doping as 'unnatural' and considered the shame associated with doping to be a significant deterrent. Athletes perceived no external pressure to use performance enhancing drugs. In response to hypothetical questions, however, various factors were acknowledged as potential 'pressure' points: most notably injury recovery and the economic pressures of elite sport. Finally, a significant minority of athletes entertained the possibility of taking a banned hypothetical performance enhancing drug under conditions of guaranteed success and undetectability. Conclusions: The athletes in this study generally embraced those values promoted in anti-doping educational programmes, although there were some notable exceptions. That the social emotion of shame was considered a significant deterrent suggests anti-doping efforts that cultivate a shared sense of responsibility to remain 'clean' and emphasise the social sanctions associated with being deemed a 'drugs cheat', resonate with this atypical social group.
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International Journal of Drug Policy 21 (2010) 276–282
Contents lists available at ScienceDirect
International Journal of Drug Policy
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Research paper
Clean Olympians? Doping and anti-doping: The views of talented
young British athletes
Andrew Bloodworth, Michael McNamee
Department of Philosophy, History and Law, School of Health Science, Vivian Tower, Swansea University, Singleton Park, Swansea, SA2 8PP, United Kingdom
article info
Article history:
Received 2 September 2009
Received in revised form
29 November 2009
Accepted 30 November 2009
Keywords:
Performance enhancing substances
Doping
Health
Sport
abstract
Background: Review articles suggest a small but significant proportion (between 3 and 12%) of male ado-
lescents have used anabolic-androgenic steroids (AAS) at some point (Yesalis and Bahrke, 2000; Calfee
and Fadale, 2006). In sport, the use of prohibited substances or processes to enhance performance, collec-
tively referred to as ‘doping’, is banned by both sports’ National and International Governing Bodies, and
by the World Anti-Doping Agency (WADA) who run an extensive testing programme and educational
initiatives designed to foster anti-doping attitudes.
Method: A total of 40 talented male and female athletes (mean average age 19.6 years) from 13 different
sports attended 12 focus groups held over the UK intended to investigate athletes’ attitudes toward
doping. Focus group transcriptions were analysed and coded with the use of QSR NVivo 8.
Results: Athletes in general did not report a significant national doping problem in their sport, but exhib-
ited sporting xenophobia with regard to both doping practices and the stringency of testing procedures
outside of the UK. Athletes often viewed doping as ‘unnatural’ and considered the shame associated
with doping to be a significant deterrent. Athletes perceived no external pressure to use performance
enhancing drugs. In response to hypothetical questions, however, various factors were acknowledged as
potential ‘pressure’ points: most notably injury recovery and the economic pressures of elite sport. Finally,
a significant minority of athletes entertained the possibility of taking a banned hypothetical performance
enhancing drug under conditions of guaranteed success and undetectability.
Conclusions: The athletes in this study generally embraced those values promoted in anti-doping educa-
tional programmes, although there were some notable exceptions. That the social emotion of shame was
considered a significant deterrent suggests anti-doping efforts that cultivate a shared sense of responsi-
bility to remain ‘clean’ and emphasise the social sanctions associated with being deemed a ‘drugs cheat’,
resonate with this atypical social group.
© 2009 Elsevier B.V. All rights reserved.
Background
The use of substances to enhance performance is not a new
sporting phenomenon. Hoberman (2004) cites the use of doping
substances in cycling in the 1890s, where riders were given extra
caffeine, cocaine and even strychnine. Beckett and Cowan (1979)
consider the origin of relevant legislation (such as the 1965 French
Senate’s anti-doping law), and the establishment of the Interna-
tional Olympic Committee Medical Commission, to have arisen
from deaths in sport associated with substance use. A more recent
catalyst (Vest Christiansen, 2005) arose out of the Tour De France
of 1998, when it became clear that doping practices were systemic.
Subsequently, the World Anti-Doping Agency (WADA) was estab-
lished in 1999.
Corresponding author. Tel.: +44 01792 295611; fax: +44 01792 295769.
E-mail address: A.J.Bloodworth@swansea.ac.uk (A. Bloodworth).
UK Sport is the QUANGO charged with the responsibility for
managing and distributing public investment and state lottery
funding for selected athletes in all but the highly commercialised
elite sports. This organisation is also currently responsible for
national anti-doping policy and its implementation, although in
January 2010 this responsibility will transfer to a stand-alone
National Anti-Doping Organisation. UK Sport defines doping as
when athletes ‘use prohibited substances or methods to unfairly
improve their sporting performance’ (UK Sport, 2009). A substance
or process may be banned on the basis of its being a masking agent
or if it fulfils at least two of the following three criteria: that it (i)
enhances or has the potential to enhance performance (ii) threat-
ens health or has the potential to do so; and (iii) is ‘contrary to
the spirit of sport’ (WADA, 2009a, p. 33). The ban on doping in
sport has been subject to strong critique from many quarters. Critics
have questioned whether doping is contrary to the ‘spirit of sport’
and whether so vague a notion is operationalisable in policy terms
(Foddy & Savulescu, 2007; Møller, 2009). Others have suggested
0955-3959/$ – see front matter © 2009 Elsevier B.V. All rights reserved.
doi:10.1016/j.drugpo.2009.11.009
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A. Bloodworth, M. McNamee / International Journal of Drug Policy 21 (2010) 276–282 277
that elite sport is an inherently unhealthy activity, and that a harm-
based ban on health grounds is inconsistent (Foddy & Savulescu,
2007; Kayser & Smith, 2008). The growing cost of administering
anti-doping programmes (Lippi, Banfi, Franchini, & Cesare Guidi,
2008) and the infringement upon athlete privacy of year round
random drugs testing (Kayser & Smith, 2008; Kreft, 2009; Slater,
2009) have also been raised in order to undermine the legitimacy
of WADA.
Review articles, though predominantly North American, suggest
between 3 and 12% of male adolescents (Calfee & Fadale, 2006;
Yesalis & Bahrke, 2000, 4–11%; American Academy of Pediatrics,
1997, 5–11%) have reported using anabolic-androgenic steroids
(AAS) at some point. Female use is typically lower: 1–2% admit-
ting using steroids (Yesalis & Bahrke, 2000). Of adolescents who
reported using AAS, review articles suggest that between 30
and 40% were not engaged in competitive sport (Bahrke, Yesalis,
Kopstein, & Stephens, 2000; Calfee & Fadale, 2006). Indeed, the use
of substances in the pursuit of a body ideal appears an increasingly
accepted practice. Baker, Graham, and Davies (2006) reported AAS
prevalence rates of 70% in adult users of selected fitness gyms in
South Wales (UK). This represents a challenge for anti-doping edu-
cational initiatives. Beyond recreational or cosmetic drug usage,
recent research in neuroethics has suggested significant use of
cognitive enhancement by academics (Sahakian & Morein-Zamir,
2007) and argued that it is a desirable trend (Greely et al., 2008).
Moreover, some critics note that the zero-tolerance attitude of
anti-doping authorities in sport is sharply at odds with acquies-
cence towards drug usage elsewhere in society (Kayser & Smith,
2008; Laure, 2009). Danish authorities have responded to this per-
ceived schism by enforcing the same anti-doping regulations to
recreational users but this move has been criticised on paternalistic
grounds (Vest Christiansen, 2009). Recreational gyms are required
to post a visible sign with a smiley face along with the text ‘We
test for doping in collaboration with Anti Doping Denmark’ in a
prominent place within the gym. Those gyms that do not comply
equally must display a along with the statement ‘We do not test
in collaboration with Anti Doping Denmark.’ Although not legally
enforced, political pressure has been brought to bear to ensure com-
pliance (Vest Christiansen, 2009). No other countries have adopted
this strategy.
Zero-tolerance approaches toward doping reflected in anti-
doping policy may be at odds with some attitudes held in society
more broadly. There has however, been little research investigat-
ing athletes’ attitudes toward doping, despite their centrality to the
issue. The present study sought to better understand the attitudes
of (UK based) talented young athletes toward doping and the sorts
of pressures and temptations they may perceive with respect to
engaging in doping at elite levels of sporting competition. A richer
understanding of athletes’ attitudes and their origins should have
the potential to inform more effective anti-doping educational pro-
grammes. While testing and research play a central and high profile
role in WADA’s anti-doping strategy, their education programme
is deemed central to fostering a lasting anti-doping culture in elite
sports (WADA, 2009b).
Method
The present qualitative study followed the distribution of a
questionnaire to 2000 UK athletes (McNamee et al., 2007). Twelve
focus groups of talented young athletes (by athlete we mean
sportsmen or sportswomen from a variety of sports, not merely
track and field athletes) were held across the UK. The desig-
nation ‘Talented’ refers to the level of expertise or potential
expertise. Most participants were either from the ‘Talented Ath-
lete Scholarship Scheme’ (providing services to those athletes in
further or higher education), or UK Sport’s own ‘World Class Path-
ways’, where funding levels correspond to anticipated success at
major international competitions, with particular reference to the
Olympic Games. Other participants not receiving state funding
were in the main rugby or football players already attached to
a professional club. The sample included young players who had
already made professional appearances and an Olympic medal-
list.
We sought to invite only those athletes between 16 and 21 years.
Ethical approval was granted by the Research Ethics Committee of
the School of Health Science, Swansea University. Participants were
provided with a full explanation of the project and information
sheet, and all gave written consent. Groups were held in univer-
sities, or at the training site (in a suitably private room) in order to
facilitate ease of participation. The population is notoriously diffi-
cult to recruit since they are highly focused on self-chosen goals and
are not typically pre-disposed to participate in research that does
not directly contribute to performance enhancement. Focus groups
enabled in-depth discussion of issues identified as key from the
questionnaire study, and allowed for interaction between athletes,
as they compared and contrasted their attitudes towards perfor-
mance enhancing substances in sport.
Our first method of recruiting athletes entailed contacting them
directly to ascertain interest in the project and possible attendance
at the group. This was possible only after some negotiation with
research contractor: UK Sport. Considerable discussion was had
in order to assure compliance with UK Data Protection legisla-
tion. The research team felt that any approach to athletes to solicit
participation by the research contractor – who at the same time
were responsible for both funding and anti-doping testing would
have had the likely effect of producing very low participation. The
research team felt it necessary that they were perceived to be work-
ing at arm’s length from UK Sport or there would be a fear of leakage
of the data that might compromise confidentiality. Groups organ-
ised in this fashion often included athletes from different sports
within the same geographical area. Due to low initial response rates
an alternative method was employed. Via personal contacts and
snowballing techniques to garner appropriate gatekeepers, such
as coaches, sport performance directors or others in authority at
a squad/club/governing body, access and participation was facili-
tated though it was made clear to both athletes and those assisting
in their recruitment that no information would be ‘leaked’ from
the focus groups back to the relevant gatekeepers. A list of names
from each gatekeeper, greater than the number needed for the focus
groups, was ascertained so that we could select randomly those
who would be invited to attend. In most cases this meant that the
coach or gatekeeper did not know who finally attended the focus
group.
40 athletes participated in groups held from October 2007 to
January 2009. Group average size was just 3.33, group size ranged
from 2 to 5, athletes at times withdrawing due to illness or other
commitments (often in the hour before the scheduled time). The
same research team (two male researchers) conducted all focus
groups. Discussions ranged from 30 to 60 min. The group began
with an ‘ice breaker’, asking athletes the extent to which they con-
sidered doping to be a problem in their sport. Researchers then
loosely followed a schedule of questions but did so in a fairly open
manner allowing the conversation to be dictated by the athletes.
Discussions centred upon a range of themes concerning willing-
ness to dope in hypothetical situations and the range of reasons
offered against doping practices.
Methodological and research ethical challenges
Enabling a frank discussion of these issues required great effort
to establish a trusting rapport, in light of the sensitivity of the topic.
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278 A. Bloodworth, M. McNamee / International Journal of Drug Policy 21 (2010) 276–282
Focus groups can be useful in attracting participants who would
be reluctant to take part in a potentially intimidating formal one-
one interview and facilitate interaction between members of the
group. Kitzinger (1995) illustrates how focus groups can be suitable
for the study of sensitive issues in the context of health research.
Certain confident group members more willing to discuss ‘taboo’
issues, can pave the way for other group members to contribute
(Kitzinger, 1994, 1995). This proved to be the case in the present
study.
More generally the support and reinforcement of other ath-
letes was intended to facilitate more relaxed and open discussion
than might be the case in face-to-face or one-to-one interviews.
A number of telephone interviews were also conducted with ath-
letes as part of the project but elicited less detailed responses, and
are not reported here. Athletes appeared happy to discuss their
careers, and other peripheral issues, but discussion over willingness
or pressures to dope, either hypothetically or non-hypothetically
were more limited. One-to-one interviews failed to elicit anything
other than staunchly anti-doping attitudes. Indeed the more varied
and considered attitudes reported below can be viewed as pro-
viding tentative methodological justification for our use of focus
groups.
Prior to the focus groups the interviewers went to considerable
lengths to gain both the confidence and trust of the participants
by establishing rapport which displayed their familiarity with the
sports and their own credentials as researchers of sports. In some
groups participants knew all members of the group, in others they
did not. With respect to the latter, developing an atmosphere of
trust was particularly critical. Moreover, in all focus groups particu-
lar emphasis was put upon the understanding of, and agreement to,
Chatham House rules where the contents of the discussion would
not be divulged by participants after the study or by the researchers
except in an appropriately anonymised form. Although athletes
signed an agreement to leave whatever was said in the room there,
it had no legal force. Nevertheless, following Bringer (2002) it was
hoped the athletes would feel obliged to do so by signing their
agreement in addition to providing verbal assent. Athletes were
also encouraged to use aliases when speaking of other coaches or
athletes in their contributions.
While participants were aware that the research contractor
was UK Sport, the interviewers assured participants that their
responses would remain anonymous, and that the research con-
tractor would not be aware of who attended the focus groups.
This was of particular importance as most athletes were funded
directly by UK Sport. The participants were assured any identi-
fying characteristics would be removed from any quotations that
figured in reports, further safeguarding their anonymity. Thus, in
the results section below the specific sport of the participants
is not identified. We refer only to whether the participant per-
formed in a team or individual sports. There are, however, limits
to the promise of anonymity and confidentiality in any research
on so sensitive a topic (Lee, 1993). Failure to make this plain to
the researched may undermine the validity of consent (McNamee,
Olivier, & Wainwright, 2006). Thus participants were told that in
the event of participants’ reporting of illegal activity, such as pos-
session or trafficking of controlled substances, researchers may
be obliged to pass this on to the relevant authorities. Researchers
utilised a ‘light-hearted’ method in stating this obligation, often
saying ‘so don’t tell us!’ in order to undercut any potential reti-
cence. While the use of certain performance enhancing substances
such as human growth hormone (see Evans-Brown & McVeigh,
2009) is a criminal act in France, Italy, Slovenia, and Sweden,
the British Government has so far resisted pressure to criminalise
doping. Importantly, it was made clear that if participant’s them-
selves admitted doping, this information would not be passed
on.
Analysis
Focus group discussions were recorded and transcribed. Tran-
scriptions were analysed and coded with the use of QSR NVivo 8.
Both researchers, present at all focus groups, were involved in the
coding process.
Results
22 male and 18 female athletes from 13 sports participated in
the research (mean average age =19.6 years). The sample included
eight swimmers; six football (soccer) players; five rugby union
players; five wrestlers; four canoeists; three rowers; two athletes
from gymnastics and two from athletics; with one athlete from each
of the following sports – netball, modern pentathlon, diving, rugby
league and cricket. The sample was, in the main, comprised of young
athletes at the beginning of the elite stage of their sports careers.
Due to the use of gatekeepers to stimulate initial interest, however,
the pool from which athletes were selected occasionally included
older athletes. Our sample included a 26-year old, a 29-year old
and a 30-year old. Their international experience, however, helped
stimulate discussion and provided a useful point of comparison.
The majority of athletes (21) were from UK Sport’s World Class
Pathways. This group included some with senior international
experience, including the Olympic Games, although the majority
were competing at junior international competition. Seven full-
time club football or rugby players participated, some of which
had international experience, representing their country within an
age group. The sample included nine individuals on the ‘Talented
Athlete Scholarship Scheme’, and a further three athletes whose
funding level was unknown, or who were unclear as to their fund-
ing. Salient themes resulting from the discussions are presented
below.
The extent to which athletes perceived there to be a doping
problem
The athletes in general did not perceive the use of performance
enhancing drugs to be a widespread problem on a national scale
within their sport. There was, however, extensive reference to what
was perceived to be a greater problem in some other countries,
often associated with the perception that testing procedures were
less stringent there than in the UK:
when we asked them [fellow athletes from other countries]
where they’ve been they said like ‘the mountains’ and we said
do you not have to give whereabouts forms? Cos, like we’ve all
been tested these last few weeks and um they were like ‘no ...
no whereabouts forms.’ (female athlete individual sport).
This scepticism as to practices abroad, a form of sporting xeno-
phobia, is not unique to British athletes and has been reported in
interviews with elite Danish cyclists (Vest Christiansen & Møller,
2007). In light of a perceived disparity in doping regulations and
practices one British athlete even went so far as to question whether
it was possible to win ‘clean’: ‘it is hard in [their sport] cos you think
can you win a medal without drugs?’ (female athlete individual
sport).
Ethical reasons not to engage in doping practices
As expected in discussions of this kind a range of explanations
were given as to why athletes would not use performance enhanc-
ing drugs:
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A. Bloodworth, M. McNamee / International Journal of Drug Policy 21 (2010) 276–282 279
like seeing stuff in the papers about people getting a medal
stripped because they’ve done it and it’s just not worth it, if you
can’t get there naturally then it’s not, why do it? (male athlete
individual sport).
Personal reasons against doping were often associated with
ideas of ‘natural ability’, seeing the benefits of one’s own hard work
and the guilt that would be associated with success having doped.
Shame
Given that doping is widely perceived as contrary to the ethics of
sports, unnatural, or inequitable, it would follow that being caught
doping would be associated with social stigma and not merely
sanctions restricted to sporting contexts. Athletes were not solely
against doping because of their own attitudes about how success
ought to be achieved. It is typically the case that guilt is conceived of
as a moral emotion experienced after an act of rule breaking where
one holds oneself responsible (Eisenberg, 2000; Hoffman, 2000;
Tangney, Stuewig, & Mashek, 2007). Shame, by contrast, is typically
understood not in terms of transgression but rather as the failure
to live up to agreed social norms. It is thought historically to be
a widespread moral norm in honour-based societies or communi-
ties (Morris, 1971). The relations between the two are dynamic and
contested (Bear, Uribe-Zarain, Manning, & Shiomi, 2009). Shame is
typically viewed by psychologists in a more negative light because
of its more destructive force (Murphy, 1999; Tangney et al., 2007)
while guilt is correlated with less reactive anger and aggression
(Tangney & Dearing, 2002). Shame is thought by some to be partic-
ularly problematic when it is experienced without guilt. However,
McAlinden (2005), in the context of rehabilitation with sexual
offenders, argues that negative associations with shame may arise
because of a failure to distinguish two varieties. Closely associated
with retributive justice, disintegrative shaming is associated with
ostracism and stigmatisation. By contrast, re-integrative shame
may be valued positively as it affirms membership to a commu-
nity who share the ideal that was fallen short of and is more closely
associated with restorative justice (McAlinden, 2005).
Some of our participants felt the external pressures of social and
moral expectation as an especially significant deterrent. It is clear
that the shame they report, in anticipation of doping, belongs to
McAlinden’s re-integrative shame:
I wouldn’t do it because, as I said looking on the podium and
looking at other people and knowing that I’d beaten them
because I’d done drugs. I couldn’t do it, and it’d be letting down
my family, it’d be letting down other people, I don’t know, I’d just
feel like a disgrace to my country and everything to be honest
with you, I just wouldn’t do it (male athlete individual sport).
For the athlete below the shameful nature of the act was mag-
nified by the closeness felt to team mates and squad members, and
by an understanding of the wider ramifications of a positive test:
there’s a lot of pride in [sport] about um being as good as you
are because of the effort you’ve put in through a very difficult
technical sport, to kind of ya know cloud that effort in any way,
um I think would be great shame to the athlete as well as to
the whole team. I think cos it’s such a close-knit community
within [the sport] ya know if you found one of your heroes had
been using performance enhancing drugs even within training
you’d be very, you’d be very upset and it would damage the
community a lot (male athlete individual sport).
One counter, however, to the idealised close-knit sporting
environment portrayed above was reported as a response to a
commonly used question, asking what an athlete might think if
hypothetically their friend or team mate was caught doping.
Male athlete individual sport 1: I would be disappointed with
him but I’d still talk to him
Interviewer: that’s it?
Male athlete individual sport 2: you wouldn’t be like really
(interrupted)
Male athlete individual sport 3: I’ve not killed your mum – ‘I’d
still talk to him’
Interviewer: that’s really funny that is ‘cos some people do feel
like that. Some people feel like you’ve just shot their dog or
something you know, they wouldn’t talk to you, ‘you’ve let us
down’
Male athlete individual sport 4: it’s an individual sport, I don’t
believe in that at all, definitely, it’s completely individual. You’d
only be letting yourself down though innit, when you get caught
Their response reveals no hint of powerful social mediators such
as ostracisation or stigmatisation: the use of the vernacular – ‘you’d
be letting yourself down’ – reveals an attitude that invokes neither
shame nor guilt. These differences in view may be connected to the
extent to which doping is stigmatised within the sport, or the sub-
cultural variances of particular sports. A few athletes even appeared
convinced that their role models were engaged in doping prac-
tices, and indicated evidence of doping practices at international
competition. Such attitudes and experiences may contribute to the
extent to which the doping of another is condemned. Clearly fur-
ther research is required to disentangle the complex of guilt and the
varieties of shame felt by elite sportspersons in relation to doping.
Pressure points in the decision to dope
Athletes did not consider themselves under any real pressure
to dope, thus discussions as to potential pressure points were of
a hypothetical nature. When asked about the extent of a doping
problem in their sport, some athletes (without prompting) referred
to a lack of financial incentive as a reason for there being little
to no problem. Nevertheless, the motivation to dope may refer to
the maintenance of current living standard, applicable for all those
receiving some substantial form of funding:
I’ll give an example, say for example a team says to a player,
look you’re a good player you’re too small we’re gonna have to
release you out of a contract or whatever, obviously that con-
tract’s paying your mortgage everything else all your outgoings.
I think that’s probably ...and er, if ever I did, you know, it’s hard
to say until you are actually in that position (male athlete team
sport).
Injury was also acknowledged as a potential pressure point in
hypothetical discussion. Participants responded to a hypothetical
scenario proposed by the interviewer regarding the possible use
of steroids to speed up recovery times, enabling participation at a
major sporting event:
Male athlete individual sport 1: if you were two months away
from the Olympic Games?
Male athlete individual sport 2: two months away from one of
the biggest competitions in the world?
Male athlete individual sport 1: and you were like podium stan-
dard?
Interviewer: yep
Male athlete individual sport 1: and you tear your ligaments?
Definitely be thinking about that
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280 A. Bloodworth, M. McNamee / International Journal of Drug Policy 21 (2010) 276–282
Interviewer: yep?
Male athlete individual sport 1: I would, I dunno about you guys,
you can lie all you want, but I know all you lot would say ‘yeah’
This athlete indicated a hypothetical willingness to dope in order
to speed up recovery from an injury; if this allowed him to compete
in the Olympic Games – ‘I’m thinking about getting on the podium,
d’ya know what I mean’. An important methodological point is also
evident here. In the passage quoted above, an individual whom we
perceived to be the most vocal athlete in the focus group, with a
dominant personality, suggested that all athletes would be like-
minded, and many did concur. His forthrightness effectively may
have paved the way for other ‘honest’ responses. Alternatively ath-
letes may have felt some pressure to concur. Thus while this degree
of honesty could be interpreted as support for the research method
employed, a degree of caution remains.
Hypothetical scenario: guaranteed success from anonymised
doping
In an oft-cited example, Bob Goldman invited world class ath-
letes (American weightlifters and competitors in field athletics)
to consider whether they would take a ‘magic drug’ that would
guarantee success for the next five years, but would cause death
immediately thereafter. Goldman (see Goldman, Bush, & Klatz,
1984) reports that 52% (103/198) of the athletes asked stated that
they would take the drug. We conducted a variant of this question
asking if athletes would (a) take an illicit performance enhanc-
ing drug if it were undetectable and guaranteed success; and (b)
whether they would do so under the same conditions with the addi-
tion that the drug would reduce their lifespan by 10 years. All focus
group participants were invited to respond individually to these
questions at the end of their session.
It is noteworthy that a significant minority, just under a third
of respondents, expressed a willingness to take the hypothetical
banned and undetectable substance that would guarantee suc-
cess. Responses were at times difficult to pin down; some unsure,
some said ‘yes’ at one point and ‘no’ subsequently. When the
hypothetical scenario was revised to the effect that the substance
would result in a 10-year lifespan reduction, almost all athletes
rejected it outright. In their responses they prioritised the lat-
ter 10 years of their life over guaranteed sporting success and
the associated rewards that Goldman’s (American) respondents
favoured. Contrary to the stereotype of the ‘dumb jock’, many ath-
letes demonstrated a notable level of reflection and prudential
projection on this matter. Some even referred to the value of seeing
grandchildren grown up.
Athletes’ concerns with the health implications of doping were
not limited to this hypothetical scenario. Harms to health asso-
ciated with doping were cited as a significant reason not to.
Symbolism notwithstanding, elite sport is scarcely conducive to
good health (Howe, 2004; Møller, 2008), though this fact did not
impinge upon their perceptions;
But personally for me I don’t think I would, um for health rea-
sons more than anything. Um most things which you’re putting
inside your body which are illegal are either bad, are usually bad
for you, for your body in general (male athlete team sport).
Some were quite clear on the health consequences that elite
sport entailed and acknowledged their prioritisation of sporting
success over health. Some simply pointed to ethical reasons for not
doping as trumping concerns over harms to health. Others were less
willing to acknowledge the health risks of their sport, suggesting
that their level of expertise in body management helped protect
against harm.
Discussion
There is limited research on attitudes and values of athletes
toward performance enhancing drugs. The majority of studies in
this field utilise questionnaire methods that negate ‘rich’ data.
The use of focus groups fostered a willingness to speak candidly.
Researchers made considerable efforts to emphasise the anonymity
of athlete responses. While we have noted the need to interpret
data with some caution, in case of athlete ‘leading’ of focus groups,
and in light of the sensitive topic area, the reflective and diverse
responses indicate potential for the development of this method
in similar research. Themes such as the importance athletes attach
to shame as a deterrent, the presence of economic temptations, or
their willingness to utilise banned methods in certain hypothet-
ical scenarios, are important findings that would not have been
achieved via survey methods. Moreover, in phone interview data
– conducted as a wider part of this project but not included in this
report – not one athlete expressed a hypothetical willingness to
take the ‘magic’ undetectable drug (McNamee & Bloodworth, 2009).
Focus groups certainly elicited more diverse and at times con-
flicting responses, yet the majority of athletes still reported a
staunchly anti-doping stance. This may be of some comfort to sports
governing bodies and international federations and agencies such
as WADA. It may also reassure UK politicians anxious that drugs
scandals do not mar the development of Olympic sports and their
closely associated commercial sponsors. The suggestion that ath-
letes some of whom are already competing at an international
level have their doubts over the means some fellow competitors
are using to improve performance brings an element of realism to
this view. Our data were less stark than those reported by Laure
et al. (2004) in a survey of French school athletes where 21% con-
sidered that the decision not to dope effectively relinquished all
chances of ‘becoming a great champion’. Nevertheless, scepticism
as to the practices of other elite athletes, and the associated per-
ceived inequity in anti-doping practices is a problematical trend
for anti-doping authorities. The perception that competitors dope
presents a potential pressure point for ‘clean’ athletes. This is sup-
ported by Petróczi (2007) who found that those who dope need
not necessarily view the practice favourably and may consider it
something of a necessary evil.
Many participants acknowledged enhanced injury-recovery and
the economic rewards attached to elite sports as potential pressure
points in hypothetical discussion. That these discussions remained
hypothetical reflects that the majority of the sample had not expe-
rienced the greatest pressures such as career threatening injuries.
Petróczi and Aidman’s (2008) reference to ‘exit points’, at which
an individual might contemplate doping, appears pertinent here.
At certain stages of a career hypothetical possibilities become gen-
uine tipping points; career-elongation, enhanced injury-recovery
to secure a new contract. Some athletes were unwilling to con-
sider that any future situation would impact upon their anti-doping
attitudes. Others however, were more willing to acknowledge a
possibility or temptation to use banned methods. For some this
might reflect a more permissive attitude toward doping. Others
continued to indicate that until one is placed under such a level of
strain, it is difficult to predict one’s choices.
Athletes offered a range of reasons against the use of perfor-
mance enhancing drugs. Some centred upon personal feelings of
guilt, shame and the wrongness of doping as both an unnatural
and unfair enhancement of performance. Reasons against dop-
ing founded in concepts of ‘natural’ performance and the ‘natural’
human being have been criticised on the basis that ‘natural’ is a
contested concept (Miah, 2004) and that a vast array of sports are
dependent upon technological developments (Magdalinski, 2009)
and supplementation for example. It is questionable, however, that
we should reject altogether the role that concepts of ‘natural per-
Author's personal copy
A. Bloodworth, M. McNamee / International Journal of Drug Policy 21 (2010) 276–282 281
formance’ and the ‘natural human being’ might play as constructs
in athlete’s thinking, purely on the grounds of their contestedness
by scholars.
In general athletes communicated a strong anti-doping stance.
Nevertheless, a significant minority of participants at least
entertained the hypothetical possibility of doping in a thought
experiment where the drug was guaranteed to ensure success and
remain undetectable. Athletes were willing to admit to tempta-
tion, despite conflicting or ambiguous ethical standpoints in their
own minds. No doubt the financial incentives associated with elite
sporting success, cited as a potential tipping point by some, would
also have weighed in this decision. In contrast to Goldman et al.’s
(1984) polls, our athletes were very concerned about any reduc-
tion in life span arising from doping. Those willing to take the drug
were dissuaded by the added caveat that this undetectable doping
would reduce lifespan by 10 years. Perhaps most interesting was
the ability and willingness to project their life stories forward to
older age.
The salience of social sanctions and in particular the antici-
pated shame associated with doping and a positive drug test was
a theme evident in focus group discussions. Re-integrative shame
(McAlinden, 2005) could be an effective emotion to cultivate for
those engaged in anti-doping policy and practice, relying as it does
on the perception that moral opprobrium attaches to an action that
fails to live up to a widely shared rule or norm. Clearly the effective-
ness of such a stance would be compromised by salient sub-cultural
norms where doping was not viewed negatively.
Classroom-based efforts to educate on anti-doping matters may
hold significant potential. Such an environment may help to fos-
ter and mutually reinforce anti-doping attitudes. This face-to-face
contact is more likely to be reinforced if an athlete can see other
athletes engaging with and supporting anti-doping stances. Strong
role models, in the form of high profile, successful ‘clean’ athletes,
clearly already being used, may help to strengthen the force of the
message.
Conclusion
There is a dearth of studies that address the attitudes of athletes
toward performance enhancing drugs. One reason is that access to
the population is extremely difficult. Another is the difficulty in get-
ting athletes to open up to discussion with researchers on such a
taboo topic. The majority of studies utilise questionnaire methods
not conducive to ‘thick’ or ‘rich’ data. This study sought to extend
beyond the common focus on doping prevalence to explore ath-
letes’ attitudes toward doping, their bodies, and the reasons offered
against doping. This research provides a platform for academics
and policymakers alike to investigate points of interest, in partic-
ular how the cultivation of shame might be a useful weapon in
the fight against doping, and how the perceived inequities in dop-
ing testing might impact upon athletes’ attitudes. More generally,
this type of research has the potential to both inform and eval-
uate educational initiatives. Future research should consider the
attitudes and values of athletes within a developmental context
observing how these views and values evolve as an elite sporting
career progresses.
Acknowledgements
The project was funded by UK Sport, at the time of the study the
body responsible for anti-doping in the UK. This research is part of
the wider ‘Drug Free Sport Project’ that included both a quantita-
tive (McNamee et al., 2007) and qualitative phase (see McNamee &
Bloodworth, 2009; McNamee et al., 2008 although the research is
ongoing).
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