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Performance Enhancing Drugs in Sports

Maxwell J. Mehlman, J.D.
 
The report in the popular media(1) that some track-and-field athletes have been using a so-called "designer steroid" created to thwart drug testing regimens is the latest installment in the ongoing battle against doping, or the use of performance-enhancing technologies, in sports. Are sports organizations responding appropriately to these challenges, and what is the proper role of physicians in this controversy?

Background
According to the World Anti-Doping Agency,(2) the term "doping" probably comes from the Afrikaans word "dop," a concoction made from grape leaves that Zulu warriors drank before going into battle. In sports, the term was first used to describe the illegal drugging of race horses at the beginning of the 20th century.

Doping in sport now includes a range of practices, including "blood doping" (the practice of autologous or homologous hemoglobin transfusions) and the use of synthetic erythropoeitin (EPO) to increase the number of red blood cells; anabolic steroids and human growth hormone to grow skeletal muscle; stimulants to improve cognitive function and reduce fatigue; and nitrogen tents and "houses" to simulate the effects of sleeping at high altitude. The future holds the promise of more powerful and exotic interventions.

At a recent meeting of the American Society for Gene Therapy, for example, Barry Byrne, Professor of Molecular Genetics and Microbiology at the University of Florida, described a considerable amount of research currently underway to identify biological determinants of athletic performance, including vascular endothelial growth factor (VEGF) to increase vascularization; leptin as a fat metabolizer; myostatin to increase the number of muscle cells; and therapeutic antibodies and cytokines to reduce susceptibility to athletic injuries.

Additional enhancement interventions are expected from the knowledge gained by the Human Genome Project. In July 2003, for example, researchers reported finding that different versions of the alpha-actinin gene were associated with sprinting and endurance running,3 opening the door to genetic testing at an early age to identify promising athletes, and to potential biomedical interventions based on this genetic discovery.

Ethical Principles in Sport
Led by the international Olympic movement, organized sport has attempted to prevent the use of performance-enhancing drugs by banning them, establishing testing programs and punishing athletes caught using prohibited substances. The basic anti-doping principles of sport were laid down in 1967 by the International Olympic Committee:
  1. "protection of the athletes' health";
  2. "respect for medical and sports ethics"; and
  3. "ensuring an equal chance for everyone during competition."(4)
It might seem hard to disagree with the first principle, "protection of athletes' health." Clearly some performance-enhancing drugs are dangerous. Steroids, for example, are associated with a range of side effects, including heart attacks and liver cancer. But sports in general, and some sports in particular, are inherently dangerous. Athletes often injure themselves in training and in a ghoulish fashion. Indeed, for many people, it is the anticipation of beholding injury and even death that makes sports events fun to watch. Think of automobile or downhill ski racing, even football and hockey, not to mention boxing. If athletes are free to accept a certain degree of risk from dangerous sports, why shouldn't they be allowed to accept a comparable, or even greater, risk from enhancements?

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Readers Comments
(14) Comments have been made

Mike Maccallum
mine is not a comment but a question. Should doctors, coaches and teachers admit to anabolic steriods enhance performance or should they only stress the negative side effectsand discourage their use? I know I don't believe in their use and would discourage anyone from using them cause I have seen the side effects and dealt with people that have roid rage where I work. thanks yours Mike Maccallum
Posted Sun, Aug. 21, 2011 at 1:21 pm EDT
 
Jake Quade
I have no specific view, however there are some good points both for and against. It's still the athlete's body that is putting out the energy and results, which is an example of For. Another point is that what is equality in a sport? When all athletes have had to train in different locations under different situations for different periods of time. There is no equality in any of these areas, so why is choice of (ultimately) body system manipulators any different? No personal attacks, no opinion, just ideas to consider.
Posted Tue, Jun. 28, 2011 at 11:29 pm EDT
 
anonymous
But still it's not moral at all!
Posted Sat, Feb. 5, 2011 at 10:41 pm EST
 
gemma
i think they stink!!
Posted Tue, Nov. 30, 2010 at 6:53 am EST
 
9876543210
i hate them
Posted Tue, Sep. 28, 2010 at 2:27 pm EDT
 
Weezy F baby
I think drugs should stay banned, because it damages our sporting events, and also it is very unfair to your opponents.
Posted Tue, Apr. 27, 2010 at 11:32 pm EDT
 
retard
enhancing drugs are very selfish especially if you are wealthy
Posted Thu, Mar. 11, 2010 at 6:40 pm EST
 
LLLLOOOLLLL
Im against enhancing!!!!!!
Posted Thu, Mar. 11, 2010 at 6:12 pm EST
 
jiler
i think drugs are wrong and stupid
Posted Thu, Mar. 11, 2010 at 5:39 pm EST
 
Anonymous
i dont think there right
Posted Thu, Jan. 28, 2010 at 5:33 pm EST
 
bob
except if we are cheating
Posted Thu, Jan. 14, 2010 at 1:07 pm EST
 
Steve
Performance enhancing drugs are a great solution to all your problems
Posted Wed, Jan. 13, 2010 at 1:00 pm EST
 
RINGO
I agree
Posted Mon, Jan. 11, 2010 at 5:07 am EST
 
tomboy
weird
Posted Mon, Jan. 4, 2010 at 8:04 pm EST







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