02 February, 2016

A brief history of doping

Much as I hate writing about doping I will once again dabble in this subject. This time it was some friend of mine who asked questions about how all this doping business did start and since I could not answer all his questions I decided to learn more about the subject.

So, in for a penny, in for a pound. In this post I will present succintly the history of doping. Obviously there is nothing original about this post: I use material that could be easily found on the web and will start with the word itself. Most sources state that the word "dop" is dutch and refers to a stimulating beverage of Zulu warriors. Interesting!

Usually historical accounts on doping start with Ancient Greece. I find the reference to the ancient Olympics as starting point of the doping history totally unwarranted: a reference to special diets and fortifying potions of greek athletes is not an indication of doping. This does not mean that there were no cheating episodes in the ancient games: cheating in competitions is something deeply ingrained in the human nature.

The oldest documented occurence of doping in athletic events concerns professional walking races which were held in Britain in the 19th century. Since such races stretched over several days athletes were known to used laudanum (containing opiates) which helped to keep them awake. 

A more dramatic use of doping was at the occasion of the St. Louis, 1904, olympic Marathon. T. Hicks, who won the race, can be seen in the photo below being transported by two persons, but what is more shocking is the tale told by his trainer. In his own words:
"I therefore decided to inject him with a milligram of sulphate of strychnine ... He set off again as best he could but he needed another injection four miles from the end..."
After the race Hicks was "between life and death" but fortunately recovered. He was never stripped of his gold medal, while 8 years latter a suspicion of having played professional baseball costed J. Thorpe his medals.

The first doping substances to be used were stimulants. (In fact the greek word for doping substances is διεγερτικά which means precisely stimulants. It goes without saying that with the alienation from pure greek of greek journalists the word used now in greek media is simply doping or its transliteration). Caffeine and cocaine were the two traditional stimulants and amphetamine joined the cortège in the 20th century.

The IAAF was the first international sports federation to prohibit doping, in 1928. That decision was summarised in the following sentences:
“Doping is the use of any stimulant not normally employed to increase the poser of action in athletic competition above the average. Any person knowingly acting or assisting as explained above shall be excluded from any place where these rules are in force or, if he is a competitor, be suspended for a time or otherwise from further participation in amateur athletics under the jurisdiction of this Federation”. Pretty convoluted formulation.

A better definition of doping is that of the Council of Europe which defines doping as "the use of certain substances or the use of methods that could have the effect of unnaturally improving the physical and/or mental condition of a contestant before or during competition and thus enhance his performance".

An interesting story is told concerning the other large class of doping substances, that of anabolic steroids. They were created by a german scientist in the 30s and they were allegedly used by german soldiers and Hitler himself (!) in order to promote their physical strength and to become more aggressive. We do not know if this story is authentic but the paranoid behaviour of Hitler towards the end of the war was compatible with heavy steroid use. 

A better documented story is that of Dr. J. Ziegler. He was the physician of the US weightlifting team and in 1954 he befriended his russian homologue during an international competition. Over a few drinks they came to speak about enhancing substances and the russian doctor said that his athletes were taking testosterone. Returning to the US, Ziegler tried this on himself and two athletes with positive results. In order to eliminate side-effects he worked with a pharmaceutical company and created Dianabol. (It is interesting to point out here that in 1983, shortly before his demise, Dr. Ziegler stated that, after seeing the abuse of anabolic steroids by athletes he wished he had never created them).  

The IOC approved a ban of doping in 1968. The original list of prohibited substances consisted of just four categories:

Psychomotor stimulant drugs
Miscellaneous central nervous system stimulants
Narcotic Analgesics 
Anabolic Steroids (but, due to insufficient testing methods, steroids were not included officially in the list till 1975). 

(The list has now been expanded and supplemented by the categories of Prohibited Methods, Substances Prohibited Out-of-Competition, Specified Substances, and Substances Prohibited in Particular Sports). 

Doping tests at the Olympics first took place in the 1968, Mexico, Games. They were followed by more thorough tests during the 1972, Munich, Olympics. In the 1976, Montréal, Games tests for anabolic steroids were performed for the first time.

The real saga of steroids began with East Germany's state-sponsored and state-controlled sports. One of the best known cases is that of the shot-putter Ilona Slupianek (née Schoknecht). She was disqualified after she tested positive for anabolic steroids at the 1977, Helsinki, European Cup where she threw 21.20 m. She was banned for 12 months which allowed her to participate at the 1978, Prague, European Championships, were she won with 21.41 m. Slupianek's misfortune was the incentive for East Germany to institute systematic tests of their athletes before allowing them to participate at a competition abroad. (Slupianek went on to train unchecked, using steroids, establishing two world records 22.36 and 22.45 m, and winning the 1980, Moscow, Olympics with a throw of 22.41 m).

Gradually doping tests became more efficient and at the 1983, Caracas, Pan American Games they caught a lot of athletes by surprise. A dozen US athletes withdrew with various excuses as well as a comparable number of athletes of other nationalities. The best-known doping case is that of the canadian sprinter Ben Johnson who won the 100 m in the 1988, Seoul, Olympics with a world record time of 9.79 s. He tested positive for stanozolol, an anabolic steroid. Johnson claimed that his herbal drink was spiked, but was stripped of his medal and suspended for two years. Six of the eight finalists of the 100 m in Seoul would eventually be implicated in doping scandals, including the gold medalist, "king" Carl Lewis, who had tested positive for stimulants at the US Olympic trials and should not have participated at the Games. 

In 1999 the World Anti-Doping Agency (WADA) was established in order to promote and coordinate the fight against doping in sports internationally. It was set up as a foundation under the intiative of the International Olympic Committee.

Anabolic steroids were not the only drugs used by athletes who aimed at improving their performance. Endurance sports had also their share of time in the limelight. When Lasse Virén won two surprising doubles 5000-10000 m in the 1972 and 1976 Olympics we started hearing about bloog doping (or auto-transfusion). Nothing was proven in his case and the procedure was not banned until 1986. (Virén tried and failed in 1976, by finishing 5th in the Marathon, to emulate Zatopek who won all three races in 1952. Virén came back at the 1980, Moscow Olympics but only managed to finish 5th in the 10 km and dropped out at around 30 km in the Marathon). The first known case of blood doping is precisely one involving Virén's team-mate, K. Maaninka who won medals in the 5 and 10 km in the 1980 Games. 

Today the doping for endurance events revolves around erythropoietin (EPO). EPO  is an essential hormone for red blood cell production. Higher level of red blood cells, leads to more oxygenated blood, and a higher maximal aerobic capacity.  EPO is favoured by endurance athletes because of its efficiency and because it is not easily detectable. While EPO has been around for quite a few years there was no way to test directly for it until 2002. And even today there are rumours about athletes using micro-doses of EPO which are not detectable while having beneficial effects on the performance.

In 2003 the BALCO (Bay Area Laboratory Co-Operative) scandal broke out. The FBI raided the laboratory that was suspected of distributing steroids to professional athletes. Financial and medical records were seized. They led, among others, to the disqualification of Marion Jones, who had won no fewer than 5 medals at the 2000, Sydney, Olympics, after she had admitted to using the BALCO designer steroid known as "the Clear". She was obviously stripped of these medals and of those won in the World Championships of 2001 but, curiously, she got to keep her medals of the 1997 and 1999 World's. And a bizarre aside: in 2006 Jones was tested positive for EPO (!) during the US Championships, but, since the "B" sample did not confirm this, she was cleared from these doping allegations.

Caffeine had been in the dopping substances list from the outset. Curiously, for such a common substance, no serious tests had been carried out. When tests were finally performed they led WADA to revise their policy. Prior to 2004, athletes who had a caffeine concentration corresponding to the ingestion of roughly more than 8 cups of coffee were disqualified. However research showed that caffeine exceeding the amount allowed might actually decrease performance and thus WADA removed caffeine from the list of doping substances.

In two recent posts of mine I wrote about the leaks concering a possible cover-up of doping cases within the IAAF and, more recently, about a far more important crisis involving the Russian Federation as well former IAAF officials. If you are interested, you can follow the links above and read the related articles, although on the second subject the dust is far from having settled.

It wouldn't be fair, while talking about doping, to keep quiet about its long-term effects. The best way to deal with this is to use what we have learned from the case of East Germany. Doug Gilbert, an Edmonton Sun sports writer and former athlete, had the occasion to meet the east german head physician Dr. Wuschech, who was at the time the authority on steroids. Gilbert's impression was that the east germans felt that there was little danger from anabolic steroids provided the athletes were constantly medically monitored as to dosage (although they were aware of dangerous side-effects). However in 2007 there appeared a medical study based on german athletes who were given anabolic steroids in the 70's and 80's. The study revealed serious consequences for the ex-athletes. A quarter of them had some form of cancer and one third manifested suicidal tendencies. For women the risk of miscarriage and stillbirth had skyrocketed and among the children that survived 10 % had physical deformities and a few were mentally handicapped. 

So there is no doubt that doping, in particular for prolonged periods and substantial doses, is nefarious for health. At this point I cannot resist the temptation to mention Goldman's dilemma. The latter is a question that was posed to elite athletes by Bob Goldman, asking whether they would take a drug that would guarantee them success in sport, but cause them to die after five years. In a research carried through by Mirkin, circa 1970, approximately half the athletes responded that they would take the drug. It is interesting to note that more recent research (2009) yielded results contradicting totally those of Mirkin. The authors of this recent study attribute this change of attitude to increased understanding of the risks of doping and the development of a clearer moral stance on doping. While this argument may hold some thruth, I believe that the main reason behind this change of attitude is the professionalisation of athletics. Athletes now perceive athletics as a career to be pursued over the best part of 20 years and not as a "flash in the pan" performance.

Those who follow my blog know that I have a quite moderate attitude concerning doping. Thus, I will conclude this post with the words of Sally Jenkins, sports columnist for the Washington Post. She says:

"Personally, I have no problem with performance enhancers... Instead of solutions, we have showboat trials and vicious public condemnations of athletes... These are saddening, and they aren't getting us anywhere, except deeper into a vortex of bad law and science, black markets and failed social policy... One alternative is the 'libertarian' approach: legalize performance enhancers. Bite the bullet and say that what an adult athlete ingests should be a matter of personal conscience, not federal courts".

Roald Bradstock, thrower extraordinaire, in his web site goes one step further and suggests that we should create Super-Olympics where the athletes would actually be encouraged to take performance enhancing drugs. An extreme option but which, according to Bradstock, could be the solution to the doping problem.