Performance Enhancing Drugs

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Performance Enhancing Drugs Doping Control

• A Complicated Issue
• -ATC Beware-

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Origin of Word

• Before 1500s - South Africa
• Dop-stimulating liquor used by tribesman
• 1889 - English Dictionary
• Narcotic mixture of opium used for racehorses

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Goals

• Performance Enhancing Drugs
• Intent of Testing
• Legal Issues
• Moral Issues
• Process

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What is wrong with using Performance Enhancing
Drugs

• Ethics
• Rules Governing Sport
• Accepted Practice in Sport (others do it)

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Cheating

• Unfair Advantage
• Lying to avoid detection
• Voids public trust

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History of Doping
Event Year Athletes Tested Positives
Sapporo 1972 211 1
Montreal 1976 2061 11
Moscow 1980 2200 0
LA 1984 1520 11
Seoul 1988 1601 10
Barcelona 1992 2150 2
Atlanta 1996 2532 0
Sydney 2000 3521 14
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Doping Control
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Performance Enhancement

• Common Publicized
• AS Stimulants
• Common Not Publicized
• HGH Blood Transfusions
• Brake Drugs
• Beta Blockers

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Intent of Testing

• Eliminate competitive advantages - ergogenic aids
• Screening for recreational drugs
• Compliance w/sanctions TX programs

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Why Doping is a Problem

• They work!
• Athletes can use some drugs in ways that allow
  them to slip through the current doping system
• Athletes believe that if they dont use they
  wont be able to compete
• Many types of drugs are not illegal to use

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Why Doping is a Problem

• USAs quick fix mentality
• Legal protection
• Personal rights (invasion of privacy)
• AAS are not illegal

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Reality Check

• Highly political system
• Money
• Corruption
• Effects all!
• Team/Country
• Media Field Day
• No single unbiased judge

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Philosophical Issues

• Why do you want to test?
• Who are you testing?
• What are you going to do with a positive?
• Do you have controls?
• Do you have the for a comprehensive program?

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Whose Rules?

• IOC or IF
• USOC or NGB
• NCAA or Institution
• Table 15.1

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Rules Determine

• Testing Policy
• Banned Drugs
• Who Gets Tested
• When Tests are Done
• Penalty for Positives

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Written Policy

• Must be developed, distributed, and publicized to
  all those potentially affected by the program
• Policy should include purpose of testing, the
  criteria for testing, conditions of testing,
  drugs to be tested for, sanctions for positive,
  description for appeal

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Legal Issues

• Informed consent
• Confidentiality
• Chain of Custody
• internal and external
• Chain of Communication
• Due Process
• Appeal Process
• Testing of Minors

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Drug Testing Process
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Sample Collection

• Doping Control Officer (DCO)
• Everything done by the athlete
• Random usage of testing equipment (pick from 3)
• Test for pH and specific gravity
• Sign the forms

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(No Transcript)
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Consumption of Fluids

• All must be sealed bottles
• Athletes must choose bottle
• No handling by staff/DCO
• Do not supply drinks with cups
• No broken seals

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The Laboratory

• Must have National Accreditation for Urine
  Analysis Certification
• Over 100 labs have this certification in US

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Data Reliability

• Sensitivity - smallest quantity of a substance
  that can be detected
• Specificity - ability to prevent false positives
• False Positive - positive result when a substance
  is not present

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Why Urine?

• Non invasive
• Large volumes can be collected easily
• Drugs metabolites are generally present in high
  concentrations in urine than other fluids because
  of function of kidney

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Why Urine?

• Easier to analyze than blood
• Metabolites are stable when frozen for a period
  of time

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Disadvantages

• Humbling experience
• Tampering

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Test Results False positives

• Clerical error
• Technical factors (lab errors)
• Sample collection errors
• Natural occurring substances
• Masking agents

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Ways They Cheat

• Diuretics lower pH (illegal)
• Natural substances found in body
• Table 15.4
• Substitute urine

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Drug Analysis

• Gas Chromatography/Mass Spectrometry (GC/MS)

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GC/MS

• Most sensitive and accurate technique available
• Full scale test costs 200-350
• Must have good technicians performing tests due
  to precision involved (especially low level
  dosages)
• Required by IOC, USOC, NCAA, etc.

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GC/MS - How it Works

• GC - chemically separates the drugs
• MS - individually identifies compounds in sample

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CG/MS How it Works
GC
Separates Compounds
1 at a time
Sent to MS
Sample
Bombarded with electrons Breaks chemical
bonds Stronger ones stay
Molecular fingerprints Matched against known
Substances result
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GC/MS - Problems

• Expensive
• Some drugs have similar fingerprints but are very
  different
• Flexeril (mm relaxant) vs Elavil (antidepressant)
• Sensitivity Issue