Transcript Ergogenic_Abuse_in_Sport

Ergogenic Drug Abuse in
Sport: Issues & Current Trends
Cindy Thomas, MS, ATC, CPCT
Director of Educational Operations
Sports Culture Today
Many of today’s athletes are choosing
to dope, violating their own bodies as
well as their principles, values and
rules against doping, but WHY?
Victor Conte,
Director BALCO
Why Dope?
 To gain an edge on the competition
 Because the end justifies the means
 Only success and glory really matter
 Society rewards for winning; not performing
 Today’s athletes are utilizing technology,
nutrition, & science & are closing the gap
on physiological limits
 Unfortunately dopers miss the point of
athletic performance
They don’t understand nor value…
“The most important thing is not
to win but to take part, just as
the most important thing in life
is not the triumph but the
struggle. The essential thing is
not to have conquered but to have
fought well.”
Olympic Creed
Missing the Boat…
A typical conversation with a NCAA student-athlete regarding
an inquiry on the REC about an energy drink:
S.A.:
REC:
S.A.:
REC:
S.A.:
“If I drink Red Bull will it cause me to test
positive?”
“Red Bull contains large amounts of caffeine, a banned
substance.”
“Yeah, but will I test positive from drinking just one
can?”
“The NCAA cutoff for caffeine is > 15 micrograms/ml.
“So, how much can I drink before I’ll test
positive?”
What is a
Performance-Enhancing Substance?
“...any substance taken in
nonpharmacologic doses specifically
for the purposes of improving sports
performance … by increasing
strength, power, speed, or endurance
or by altering body weight or body
composition.”
“Use of Performance-Enhancing Substances” PEDIATRICS 9/9/05
What are the categories of
Performance-Enhancing Substances?
 Pharmacologic agents
 Agents for weight control
 Agents for weight gain
 Enhancement of O2 carrying capacity
 Any substance used for reasons other than
treating documented conditions
 Masking agents
 Many dietary supplement products
Performance-Enhancing
Drugs/Substances
Anabolic Agents
Stimulants
Peptide Hormones
Diuretics (weight loss,
dilution of urine)
Dietary Supplements
Anabolic Steroids
 Human-made
substances related to
testosterone
 Over 100 types of
anabolic steroids
 Schedule III Controlled
Substances
 Old is New - “designer
steroids”
 Pro-hormones
The Anabolic Steroid Control Act
2004 (effective Jan. 2005)
 Specifically lists
dozens of precursors
as Schedule III
substances
 Makes it easier for
DEA to outlaw similar
substances in future
 Illegal to possess any
of these substances
now
Who is Using?
 Body Image Disordered
 Eating Disordered
Stimulants, Laxatives,
Diuretics & Steroids
 Low Self-Esteem,
Depression, Suicide
Career Professionals
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Models
Firefighters
Police Officers
Military Personnel
Body Image & Steroid Use
Body perception
issues
Media promotes
“idealistic” body
5-7% of girls have
tried steroids to
tone bodies –
many have eating
disorders
Steroids & Suicidal Tendencies
Suicide rates rise in
adolescence
Already at risk:
3-11% adolescents
attempt suicide
Predisposing factors
Body image disorders
Family history
Low self-esteem
Risk taker
Steroid & other drug
use
Taylor Hooton
Efrain Marrero
Rob Garibaldi
When, Why, & Access?
Initial Use of Anabolic Steroids
 17% initially used in junior high school or before
 39% initially used in high school
Main Reason for Use
 51% to Improve athletic performance
 15.9% to improve appearance
Sources for obtaining Anabolic
Steroids
 25% from friend or relative
 22% from Website/mail order
 17% from coach or trainer
 15% from teammate or other athlete
2005-06 NCAA Substance Use & Abuse Survey
Other Statistics on Adolescent
Steroid Use
 12% boys & 8% girls use
products to improve
appearance &/or
performance (Pediatrics 2005)
 6% of high school
athletes have tried
steroids within past year
(doubled from 1991) (2003 CDC
Study)
 3.4% high school seniors
reported using steroids at
least once. (2004 Monitoring the
Future)
 Steroid use down 40 %
(lifetime), 37 % (past year),
and 21 % (past month) for 8th,
10th, & 12th graders combined.
(2006 Monitoring the Future)
 Over ½ million 8th and 10th
grade students use steroids
now; increasing number of
high school seniors don’t
believe steroids are risky. (NIDA)
 2002 Texas A&M study
indicated 42,000 students
using anabolic steroids
State High School Initiatives
 California
 Officials estimate that 20,000 have used PEDs
 Requires districts to ban steroids & contract with students &
parents
 Districts cannot use supplement manufactures as sponsors
 Coaches prohibited from promoting supplements
 Louisiana, Nevada, & Texas requires signed
contract saying they won’t use steroids
 Michigan & Florida are participating in
Atlas/Athena (Peer Education on Steroids)
 Virginia requires coaches, students, &
parents to view the NFHS education video
& is participating in the Atlas & Athena
programs
State H.S. Assoc. Initiatives
 New Mexico ran a pilot steroid testing program
Spring 2006 & will have mandatory steroid education
in every school next year
 Illinois bans use & distribution of PEDs, requires
steroid education in all secondary schools & is
considering a state-wide steroid testing program
 New Jersey added random steroid testing at state
championships & requires steroid education
programs beginning in junior high school
 Florida (FHSAA) provides multi-media steroid
education opportunities for coaches & athletes
 88% of Americans polled supported testing high
school athletes for steroids (The Sacred Heart University Polling Institute May
2006 interviews nationwide)
NCAA Drug Test Results
2003-04
2004-05
Total # Tests:
10, 541
11,610
Stimulants*
13
14
Ephedrine
2
1
Steroids
46
51
Beta blockers* 0
0
Diuretics or
Manipulators
3
3
Street Drugs*
10
17
Protocol
issues
0
20
TOTAL +:
74 (< 1%)
106 (< 1%)
*Championship Testing
Only
NCAA Steroid Results
2003-04
2004-05
(Most common steroid positives)
(Most common steroid positives)
 13 Nandrolones
 10 Testosterones
 6 Androstendiones
 4 Stanozolols
 2 Boldernones
 18 Nandrolones
 10 Androstendiones
 8 Testosterones
 5 Boldernones
 4 Stanozolols
Current NCAA Initiatives
 Division III Pilot Testing begins Fall 2007
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2 year program
100 schools will participate
12-16 athletes per school tested
Testing for all NCAA banned substances
No sanctions for positive tests
Aggregate results reported only
Participating schools will receive grants for education
 Anti-estrogens are being added as a Banned Drug
Class
 e.g., Tamoxifen, a breast cancer drug used to mask steroid use
by reducing negative side effects of steroids such as breast
enlargement
 A medical exception will be provided for legitimate reason
Current NCAA Initiatives
Proposed legislation to test for all banned
substances all the time
Administrators want marijuana tested for all
the time
Currently THC (+) is a 1-year sanction
Legislation seeks to reduce sanction to 50%
 To reinstate, school must document
treatment, s.a. must be tested by school
during sanction time, & need a negative exit
test
Stimulants
 Increase energy,
endurance, reduce mental
fatigue, increase fat usage
 Amphetamines
 Caffeine
 Synephrine
 Ephedrine
 Illegal to include in dietary
supplement products
 Smart Pills “Brain Steroids”
 Ritalin [methylphenidate], Provigil
[modafinil], Adderall
[amphetamine]
 High school & college students
using to gain an "edge" for
academic studies
Dietary Supplements
 Muscle builders
 Energy enhancers
 Endurance
increasers
 Weight loss
 Weight gain
 Workout recovery
 Pre-workout
 Joint health
Effective?
Safe?
Pure?
Accurate dosing?
Caffeine, Ephedrine,
Synephrine
• Stimulants found in
dietary supplements &
OTC drugs
• All banned in sport
• Several NCAA positives
• May not be listed
ingredient or…
• Listed several different
ways
• Sometimes large
quantities
Energy Drinks
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NOT A SPORTS DRINK
Contains stimulants
Increases HR & BP
Diuretic = Dehydration
Can cause + test
Alcohol further contributes
to problems
 Considered dietary
supplements & contain
NCAA banned substances!
Peptide Hormones
 Human Growth Hormone
(hGH)
 Real hGH is ineffective in tablet form
 Rx = $750/month
 Pilot testing with antibody
 Insulin-like Growth Hormone
(IGF-1)
 Increases rate of muscle repair after injury &
rate of growth with training
 No test yet
 Erythropoietin (EPO)
 Testing via blood & urine
 Hormone lasts only a few days in the
bloodstream
 If stop taking several days before testing
may not be caught
 Attempted adulteration in urine by adding
pepsin, a chemical found in spot removers –
destroyed all EPO including own natural
 Circumvent the test by taking very low
doses of EPO every day
Gene Manipulation
 “Non-therapeutic use of cells,
genes, genetic elements, or
modulation of gene expression,
having the capacity to improve
athletic performance” (WADA)
 Repoxygen™ is a type of gene
therapy that induces controlled
release of (EPO) – may be
impossible to detect
 May see in 2008 Games
 Current testing method trials
include tracking traces left by
viruses commonly used in gene
doping – detecting in blood, urine
& saliva
 When stimulating growth
hormones, also possible that
very early cancers, not yet
detected, could have their
growth dramatically
accelerated as well
Why Not Dope?
Why not risk health?
Why not risk ruin?
Why be concerned with principle of fair
play and naturalness of sport?
Why not do what everyone else is
doing?
‘It's only
cheating
if you
get
caught.'
Addressing Sport Ethics
 Sport culture has
direct effect on
athletes’ reasoning
or non-reasoning
about ethical issues
 Athletes are very
affected by role
models around them
(e.g., coaches,
teammates, athletic
trainers)
 Anti-doping must
focus on convincing
athletes, parents,
athletic trainers,
coaches,
administrators of the
necessity of a level
playing field & the
ideal performance
perspective
Future?
 Scientifically & ethically
complex
 Future determined more
by technology than
innate ability
 Addressing
supplements with
industry control,
education & testing
 Tomorrow? Gene
transfer therapy? Stem
cell transplants?
 Alternative specimens
in sports testing?