By Sports Science Institute
The NCAA Sport Science Institute convened a Doping, Drug Education and Drug Testing Task Force in July 2013 (for a list of task force members click here). The purpose of the task force was to provide a broad overview of doping, drug education and drug testing and to address collegiate-specific concerns. A series of three articles published via the Sport Science Institute Newsletter will summarize key task force findings. The first article will cover the historical background of doping and drug testing in sport, and include an overview of performance-enhancing drugs. A second article will review alcohol and recreational drug abuse. The final article will review the drug testing process and future considerations.
Doping refers to the use of performance-enhancing drugs, and has always been a part of sport; whenever there is a combination of competition and rules of engagement, there are competitors who seek a competitive advantage. In the 3rd century BC, Greeks ingested mushrooms to improve athletic performance. In the famed Circus Maximus, gladiators used stimulants to fight despite fatigue and injury. Modern day drug testing was first introduced in the 1968 Olympic Games. The World Anti-Doping Agency (WADA) was established in 1999 to promote, coordinate and monitor the fight against doping in sports.
The NCAA has been part of the modern day drug testing movement. Due to concern about the possibility of increasing drug abuse among college student-athletes, the NCAA established the Drug Education Committee in August 1970. At the 1971 Annual Convention, NCAA members passed a resolution condemning the use of nontherapeutic drugs in college sport, stating that such use was a violation of the NCAA’s principles of ethical conduct. In 1984, NCAA Convention delegates approved a resolution from the Pacific-10 Conference directing the NCAA Executive Committee to develop a testing program for NCAA Championships. The first postseason drug testing program for Divisions I, II and III was approved in 1986. This included testing for marijuana and allowed for medical exceptions for therapeutic drugs. In 1988, the Committee on Competitive Safeguards and Medical Aspects of Sports (CSMAS) assumed responsibility for NCAA drug education and testing programs. Year-round drug testing was introduced in 1989, and initially only included Division I football. With the intent of providing independent administration and transparency, the NCAA transferred the administration of drug testing programs to The National Center for Drug Free Sport, Inc. (Drug Free Sport) in 1999. Since then, Drug Free Sport has administered drug testing for all NCAA sports, with year-round (including summer) and championship drug testing.
Although it might seem self-evident to have a drug testing program in sport, we might take a step back and ask: “What’s wrong with drug use in sport?” Once we ask this question, we delve into practical ethics; good ethics begin with good facts, and must be within the conceptual framework of values and meaning in sport. With this in mind, the U.S. Anti-Doping Agency (USADA) conducted a survey across a large cross-section of America. As noted in Table 1, the top five values reinforced through sport are: honesty; fair play; respect for others; doing your best; and teamwork.
Table 1. Importance of Values to Reinforce Through Sport
Table 2 demonstrates that the top five perceptions of values most reinforced through sport are: competitiveness; winning; hard work; teamwork; and doing your best.
Table 2. Perceptions of Values Most Reinforced Through Sport
Interestingly, “fun” is the primary motivator for becoming involved in sport, for both the general population and for national governing body (NGB) sport participants (See Table 3).
Table 3. Top Motivators for Becoming Involved in Sport
And perhaps most importantly, the USADA survey found that the use of performance-enhancing substances is the most serious ethical issue facing sport today (See Table 4).
Table 4. Values & Ethics: Seriousness of Issues Facing Sport Today
How do we bring this back to doping in sport? Consider the many reasons we play sport:
We must always balance values and ethics in sport with the fact that sport is also inherently and relentlessly competitive. At the margins of competition, some athletes, coaches or parents will do anything to gain a competitive advantage. With regard to doping in sport, there exists the possibility that a small advantage from performance-enhancing drug use may be greater than a slightly smaller advantage from talent and hard work alone. This means that when performance-enhancing drugs make a difference – and they can – clean athletes must choose among a few possibilities:
The point of doping control is to provide clean athletes a fair contest. Without doping control, there is the possibility that performance-enhancing drug use will not be contained, with never-ending pressure to use more drugs, higher dosages, and bizarre and dangerous combinations. This leads to an inevitable contagion to our youth. Just as we make decisions about the rules and equipment of sport to preserve a sport’s meaning, we also make decisions to deter doping in sport. Rules changes, equipment recommendations and doping control share the same common intent:
In addition to doping control having an ethics-based foundation, we might also consider that doping control in sport is a public health issue. Because of the relentlessly competitive structure of sport, without doping control there could exist an uncontrolled, massive pharmaceutical experiment that would indeed be a public health risk. If some athletes are willing to resort to anything to win at all costs, then the intrinsic value of sport is undermined, with potential serious health and social costs. Doping control allows athletes to compete while celebrating excellence in mind, body and spirit. For doping control to be truly successful, we must enlist all of our athletes in the cause.
Performance-enhancing drugs (PEDs) are drugs that allow an athlete to attain an otherwise unreachable level of performance. PEDs work through some combination of:
PEDs also include drugs that may mask the detection of other PEDs.
PEDs include the following:
Stimulants are the most unique of the performance-enhancing drugs because they are also commonly used to treat ADHD, and they are used in a widespread manner as recreational drugs of abuse. ADHD is a disorder that comprises inattention, hyperactivity and impulsiveness. A common medical treatment for ADHD is prescription stimulants. In 2013, it was estimated that ADHD affects between 8 to 20 percent of the adolescent and young adult population. However, ADHD often co-exists with other psychiatric conditions, as noted in Figure 1.
Figure 1: ADHD and Other Psychiatric Conditions
In addition, stimulants are increasingly used as cognitive enhancement medications in individuals who do not suffer with ADHD or other psychiatric conditions, as noted in Figure 2.
Figure 2: The Spectrum of Stimulant Use
Thus, there are often imprecise boundaries between the use of stimulants as therapy and wellness enhancement.
Commonly used stimulants include:
Both classes of drugs act in the brain in a similar fashion by enhancing the effects of norepinephrine and dopamine.
Stimulants may be used as PEDs because they increase alertness, attention and energy, and may also increase aggressiveness. Performance-enhancing stimulant use has been documented in a wide variety of sports, including baseball, cycling, football and track and field. Stimulants may be used as recreational drugs to help increase wakefulness and energy in the setting of a long party, and often as a counter-medication to alcohol or narcotic use. Stimulants may be used “off-label,” meaning that they have not been prescribed to the individual for ADHD or another legitimate medical condition, for cognitive enhancement. In this setting, stimulants are most often utilized in colleges with competitive academic standards. Indeed, surveys indicate that 16 to 60 percent of college students use stimulants for non-medical/cognitive enhancement use.
Despite the widespread use of stimulants as “neuroenhancing” drugs (e.g., drugs taken to improve cognition), scientific evidence does not support the conclusion that stimulants are cognitive enhancers. However, the effects of stimulants on the user’s emotions and feelings are an important contributor to the user’s perceptions of improved academic performance. For example, if you take a stimulant for the purposes of studying, and you feel more awake and ‘stimulated’ during the study process, you are likely to believe that your cognitive performance will be improved.
Although many stimulant users do not believe they are involved in criminal activity through non-prescription use, it is important to note that stimulants are Schedule II medications, which is the same schedule as narcotics. Stimulants are Schedule II drugs because there is a considerable potential for abuse and addiction. Distributing stimulants illegally is a felony. Because of the potential for stimulant abuse, many institutions are tightening rules on the diagnosis of ADHD and subsequent stimulant prescriptions.
In addition to addiction, there are several potential side effects of stimulants, including:
Caffeine doses vary, depending on the drink or food (See NCAA Caffeine/Energy Drink Poster for more details). When used in a ‘societal’ dose (e.g., a cup of coffee or tea) caffeine has a mild stimulant effect and is usually well tolerated. Caffeine is regulated in sport when taken in large doses, and in such a setting is considered a doping agent. However, large doses of caffeine, especially over 500mg, can cause heart palpitations, restlessness, insomnia, irritability, anxiety and reduced cognitive and physical performance.
Blood doping and erythropoietin are used as PEDs by athletes who wish to improve their endurance. By increasing the amount of red blood cells available to transport oxygen to the contracting muscle, such doping improves aerobic power. This means that in long distance events such as cycling, running and cross-country skiing, the athlete has more capacity to utilize oxygen.
Side effects of homologous blood transfusions include serious immune reactions and the transfer of viral diseases such as hepatitis and HIV. Autologous blood doping and erythropoietin use carries with it the potential for too many red blood cells in the body, which can cause hypertension, congestive heart failure and stroke.Last Updated: Oct 11, 2013