Doping In Sports: History, Types & Techniques of Doping, Development of Anti-Doping Regulations

The phenomenon of doping in sports is increasing day by day and diversifying along as are the various drugs used for doping. There is always a permanent race among those who are going to invent new doping methods and various sports ethics committees that are searching for more performant and effective methods to detect them.

We all know that sports play an important role in physical and mental development and also in developing international understanding and cooperation.

But these days, the common use of doping products and methods has several consequences which impacts not only on an athlete’s health but also impacts the image of sport. Therefore, doping in sports is banned due to ethical and medical reasons.

Athletic performance enhancement can be increased using several; diets, training routines and hard work. However, it may and has been achieved since ancient competitions by using a variety of pharmacological, mechanical and physiological doping techniques.

There are hundred forms of known and potentially more strong unknown doping substances and techniques abused by various professional athletes across the world. This article will provide a summary of the various attempts of doping in sports, and will focus on the most commonly abused substances such as anabolic androgenic steroids, erythropoietin (EPO) and human growth hormone (hGH)^[2][1]

Whenever we hear the word ‘doping’, we perceive the use of several substances which are prohibited by different anti-doping agencies which help the athlete, in order to obtain a competitive advantage over others.

Doping is nowadays a global problem that follows various international sporting events across the world. Many International sports federations which are led by the International Olympic Committee, have attempted to stop the spread of doping problem, for the past half century.

In 1963, The first official definition of doping was given by the European Committee Council which said that “Doping represents the use of physiological mediators or substances which are not normally present in the human body but are introduced as an external, during a competition, aid to increase the athletes’ performance “.^[1]

The Anti-doping Convention of the European Council defined doping as “Doping in sports” explains the administration or use of doping substances or doping methods by athletes. The doping agents or methods referred to those doping agents which have been banned and which appear on a list of ineligible substances, given by by the Anti-Doping Agency^[1]

According to Galen and Philostratos, various performance enhancing substances were used in the beginning and the end of the third century BC. Ma Huang i.e an Ephedra extract was suggested by Chinese physicians to enhance performance over 5000 years ago.^[3]

Athletes used mixtures of strychnine, cocaine, heroin, and caffeine. Each coach or team had their own unique secret formulae. This was one of the most common practice until cocaine and heroin became available only by prescription in the 1920s.^[2]

Tom Hicks also died as a result of using a blend of cognac and strychnine during the Saint Louis marathon in 1904. In 1928, the International Athletics Federation (IAF), after multiple doping incidents in competitions, was the first international federation to forbid doping in athletic competitions ^[1]

Then in1930s, strychnine were replaced by amphetamines which served as the stimulant of choice for athletes.^[2]

The Soviet Olympic team first used male hormones, in the 1950s, so as to increase their strength and power. ^[2]

As time passed, the world became more aware of the extent and benefits of doping in sports. In the 1988 Seoul Olympics, Ben Johnson’s gold medal was stripped because he used the steroid stanozolol.^[2]

Mark McGuire who is an American baseball player, broke Roger Marris’ home run record in 1998 and it was found out that he was taking a supplement which contained a precursor to nandrolone that is a steroid.^[2]

In an investigation carried out in Paris in the year 2006, due to trafficking a cocktail of amphetamines and various other performance enhancing drugs which were known as “Belgium Pot” to professional cyclists, 23 individuals were sentenced to 4 years in jail.^[2]

In the field of cricket world also, it was revealed Shoaib Akhtar and Mohammad Asif, who were Pakistani Fast Bowlers, were tested positive for the steroid nandrolone.^[2]

There are hundreds of known doping substances and a same number of designer, veterinary, and yet to be identified drugs and techniques which are abused in sports today.

The 2006 WADA list of prohibited substances includes the following major categories:

• Glucocorticosteroids

Allowed externally but not internally

WADA has also listed prohibited methods such as :

Enhancement of oxygen transfer such as blood doping, efaproxiral, administration of products containing red blood cells in the circulatory system. Chemical and physical manipulation (tampering or substitution of sample)

Gene doping ie transfer of certain polymers of nucleic acids or their analogs ^[2][1]

One such substance studied for doping potential is paracetamol which is a substance commonly used as an analgesic and antipyretic drug .In the case of cyclists, the athletes’ performances have been improved through the intake of paracetamol. ^[1]

NSAIDs, diclofenac and ibuprofen, both being non-selective COX non-steroidal anti-inflammatory drugs have also been studied to identify if they could have an effect on the testosterone / glucuronidation epitestosterone ratio. ^[1]

L-carnitine is an endogenous amino acid which is synthesized in the liver and kidneys from lysine and methionine which are two essential amino acids.

Arginine is a semi-essential amino acid that could be used to increase performance since it has NO i.e nitrogen monoxide, release and the formation of citrulline, NO also has a vasodilatory effect. Athletes can make use of arginine to increase their physical performance, muscle mass and also their resistance in high effort.

Hydroxycitric acid is a substance which is often found in food supplements and it can be extracted from species such as Hibiscus sabdariffa or Garcinia cambogia.

Tyrosine is an essential amino acid which cannot be synthesized by our body and should be obtained through careful nutrition. It can also be utilized by athletes to gain various benefits such as reducing fat, controlling appetite.

Other amino acids or derivatives which are used to increase muscle strength and endurance are: glutamine, glycine, carnosine, citrulline, and taurine. Taurine and carnosine have particular effects, being used as energizing substances. ^[1]

There are certain pharmacological classes of substances which have a quantitative upper limit, so they can be used only in very small amounts such as central nervous system stimulants like caffeine and beta 2 selectives such as salbutamol or fenoterol.

Caffeine can be considered a dopant substance because of its effects like slight bronchodilation, which is beneficial for athletes participating in endurance races, and can also increase the diuresis which can be beneficial for an athlete who is doped and wants to rapidly eliminate the other drug in their body. Other effects of caffeine are: cerebral vasoconstrictor, increases gastric acidity and also the appetite. An athlete is said to be doped when the urine concentration of caffeine is above 12 μg/mL

Most beta 2 selective substances are forbidden from competitions, but there are exceptions such as salbutamol, which has a maximum dose of 1.6 mg/24h. In urine, if salbutamol is present in a concentration higher than 1000 ng/mL the athlete can be considered as doped. Formoterol is a substance used in asthma and it is in the same category as salbutamol. The dose of inhaled drug is 54 μg/ 4h, and its urine concentration should not exceed 40 ng/mL, otherwise the athlete is sanctioned according to the rules.

Specific central nervous system stimulants are substances that also have thresholds, ephedrine and methylephedrine are prohibited when the concentration reaches values higher than 10 μg/mL, pseudoephedrine is prohibited when concentrations are greater than 150 μg/mL. Adrenaline is not forbidden when used locally in nasal or ophthalmic administration.

Other such substances that have a superior limit and can lead to the elimination of the athlete are bupropion, nicotine, pipradrol, phenylephrine and phenylpropanolamine. ^[1]

Analysis of doping dates back to 1972, wherein during the Olympic Games of Munich, they were done using thin layer chromatography and gas chromatography.

Immunoassays were also used sometimes but the tests had to be confirmed with chromatography.

As advancements in analytical procedures took place, mass spectrometry combined with gas chromatography became the principle instrumentation for detection and quantification of doping agents. These have now been extended to tandem mass spectrometry, high resolution mass spectrometry and isotope ratio mass spectrometry. Nowadays, mass spectrometry with liquid chromatography is also used. ^[3]

Regarding the Olympics, the primary official controls happened at the 1972 Olympic Games in Munich for conventional substances. Anabolic steroids were the primary substances controlled at the 1976 Olympics in Montreal and as a consequence many athletes were disqualified and lost their medals. ^[1]

The first step for international harmonisation against doping was developed by the Anti Doping Convention of the Council of Europe in 1989.

In 1999, the IOC organized a World Conference on Doping in Sport in response to a shocking discovery of massive amounts of performance enhancing drugs and paraphernalia by French police at the 1998 Tour de France. It had been at this meeting that an independent global agency was founded, the planet Anti-Doping Agency (WADA). Its mission was to figure independently of the IOC, sports organizations and governments to steer the fight against doping in sport ^[3]

The World Anti-Doping Code (Code) is the one of the core documents that harmonize anti-doping policies, rules and regulations, across the world, within sport organizations and among various public authorities. ^[3]

Doping has become one of the key and complex issues in the sports which deserves a very serious consideration, as specialists are still striving to understand how and why it happens, and how to prevent it.

• The fight against doping continues till date. Several anti-doping agencies will always be one step behind manufacturers of latest undetectable substances with pharmacological properties almost like those already available on the market.
• It was expected that, with several educational programs, testing, and supportive medical treatment, this substance-abusing behavior would decrease. Unfortunately, this has not been the case. In fact, new, more powerful and undetectable doping techniques and substances are now abused by professional athletes, while sophisticated networks of distribution have developed.
• Physicians should concentrate when prescribing different substances, also as pharmacists who release the medication. By releasing a drug on the list of prohibited substances, the athlete could also be disqualified, therefore the regulations and therefore the list of prohibited substances should be carefully studied before prescribing a medicinal product.
• Current legislation isn’t very severe, perhaps if the repercussions of being positive with illegal substances were higher, violation of rules wouldn’t be so common.
• Athletes should be educated about doping, and about the side and adverse effects of the utilization of the varied prohibited substances, with the aim of teaching athletes to stop the doping phenomenon.
• To minimize the phenomenon of doping, information and prevention programs, starting with athletes at a young age, and involving other stakeholders (e.g. the athletes’ doctors, coaches or family), are necessary to determine and maintain correct attitudes and behaviors.

Still, keeping in mind every social and economic nature of professional sports, there is still a long way to go before completely eradicating doping in sports.

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