Drugs in Sport – to ban or not to ban?

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Allegations and revelations over the misuse of drugs in elite sport are never out of the news headlines for long.  2015 saw controversy surrounding Chris Froome’s second win of the Tour de France, there was the release of documents suggesting that athletes across multiple Olympia have shown abnormal test results, there was the battle between Usain Bolt and Justin Gatlin and towards the end of the year the Russian ‘state-sponsored’ doping program.  I recently re-read Matthew Syed’s book Bounce: The Myth of Talent and the Power of Practice and within this he presents an alternative viewpoint on the performance enhancing drugs in sport debate.

The essence of the book is to dispel the ‘myth’ of talent by presenting evidence for the power of practice.  Within the book Syed dedicates part of his time to drugs in sport and presents the curveball perspective of Julian Savulescu (a professor of ethics at Oxford University), who has suggested that some drugs should be legalised as ‘safe enhancers’, with an associated shift of testing focus from catching cheats towards protecting the health of athletes.  Endurance events are used to provide an illustrative example as success in these events is reliant on how efficiently oxygen can be transported to muscles via red blood cells.  It’s explained that the percentage of red blood cells in the blood are measured as the Haematocrit level (HCT) and that altitude training has long been used to legally increase this in endurance events.  Erythropoietin (EPO) is a naturally occurring hormone that controls red blood cell production but the World Anti-Doping Agency (WADA) have banned the use of EPO as, by injecting it, athletes can increase their HCT and thus increase the amount of oxygen that can be transported to their muscles during competition.  Increasing HCT to a level of 50% (whether by altitude training or use of EPO) has been shown to carry no significant health risks.  However, when HCT levels rise above 55%, the blood thickens to a point where it is the consistency of jam and as a result the risk of heart attack increases.  Tour de France cyclists like Marco Pantani have died with EPO consistent issues and mountain biking hasn’t escaped controversy with riders such as Bas van Dooren and Filip Meirhaeghe having tested positive during competitions.  As EPO is a naturally occurring hormone, there is no definitive way of testing for its misuse and it is possible to increase HCT over 55% by using EPO or by excessive altitude training.  This has led Professor Savulescu to suggest the authorities should therefore allow blood-altering techniques but test directly for HCT by setting a safe level (as an example HCT 50%) and screening for adverse physiological effects of drug misuse e.g. increased heart size.  The use of steroids is discussed in the same context as moderate steroid use has been shown to improve strength and aid recovery without significant damaging side effects.

Professor Savulescu argues that adopting certain drugs as safe enhancers would protect the health of athletes whether they take drugs knowingly or unknowingly (as has been reported in East German, Russian and Chinese athletes) but also that this move would ‘level the playing field’ as, under the current system, anyone not taking taking drugs are potentially at a disadvantage when competing against someone who is taking drugs but beating the drug detection program.  As Dwain Chambers put it: ‘it’s simple: science always moves faster than the testers’.

The views of Professor Savulescu do make sense but you can easily see how they would be shot down with aggressive counter arguments.  His views also draw attention to the fact that the current system isn’t working though and that maybe the current system does need review.  The foundation of the current anti-doping system is a belief that there is something inherently wrong with manipulating human abilities by artificial means.  It doesn’t take a massive leap from this standpoint however, to begin asking questions such as whether competitors who have undergone laser eye surgery should be allowed to compete as they have artificially enhanced their body’s ability?  This foundation would seem flawed.  With the debate in Syed’s book (and increasingly in sporting circles and the media) moving from drugs to gene manipulation, we are facing a time when it isn’t just the enhancement of the human structure under consideration but the fundamental alteration of it.  Now more than ever, it would therefore appear, there is a strong driver towards open discussion, that incorporates perspectives such as Savulescu’s, in order to future-proof the rules governing competitive sport.

Product available from Amazon 

Bounce: The Myth of Talent and the Power of Practice

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