Should certain drugs be used in some sport?

The current use of performance-enhancing drugs in sport is widespread, despite the fact that they are banned. The literature based on this topic and related ones hold an array of viewpoints. This essay attempts to answer the above question through consideration of the differing views as well as critically analysing the methods used by current governing agencies to control doping in sport.

The use of performance-enhancing drugs dates back to the beginning of history books. There is evidence that the ancient Greeks attempted to enhance their performance through the use of alcoholic beverages, hallucinogenic mushrooms and sesame seed mixtures (Yesalis and Bahrke, 2001). Since those times, the will to improve performance through the use of various substances has never ceased. The only thing that has evolved is our understanding and development of them. Looking back a little more than 200 years, stimulants such as cocaine, strychnine and morphine drops led the way. Anabolic agents have been around since the 1800s. Nowadays some substances can manipulate or alter almost any pathway in the body, including brain chemistry (Yesalis and Bahrke 2001).

As with all aspects of life, there has to be rules and regulations. This is noticeable in the rules of the road, standards in schools, common laws, rules on and off the sports pitch, etc. It is essential, however, that these rules are appropriately designed and thought after, as to promote the peace, balance, and justice correctly. The World Ant-Doping agency- (WADA) is an organisation that leads the way in developing, regulating and coordinating the battle against doping in all sport internationally (World Anti-Doping Agency, 2016). 

They use three criteria to determine what drugs to ban:

1. “They must have the potential to increase sporting performance

2. And/or they must represent an actual risk to the athlete's health

3. And/or their use must be contrary to the spirit of sport” (WADA, 2003, pp. 15-16).

WADA's first critical point holds legitimacy when taking it at face value. A substance that increases physical performance unnaturally will give an unfair advantage to the user over the non-user. When analysing further, inconsistencies appear with their use of this argument. Nicotine and caffeine use are examples. These substances stimulate the central nervous system, are also psychoactive, addictive and are performance enhancing. Due to their widespread use in modern society, they are deemed legal according to WADA (Pesta et al., 2013). Amphetamines are also stimulants of the nervous system, are also psychoactive, and addictive too, but are deemed illegal by WADA (Jones and Pinchot, 2016). This fact alone corrupts the legitimacy of their first critical point.

The second critical point enforced by WADA is based on health risk. Most performance enhancing drugs work on up-regulation or down-regulating biochemical pathways, depending on the desired effect. In other words, they mimic natural processes. There can be two possible reasons for health risk associated with this. The drugs themselves could have side effects due to their chemical makeup and impurity, or, the manipulation of the bodily processes cause health issues. Medications like EPO increase red blood cell count and anabolic substances increase testosterone. Up-regulating an athletes red blood cell count to 50%, with the use of EPO, is considered safe. Beyond that percentile, however, may lead to having side effects such as stroke (Cross, 2005). Administering hormones like testosterone to patients in a 'hormone replacement therapy' protocol is an accessible and safe treatment. It is clear that small manipulations in the biological pathways themselves hold little health risks, but instead, it is the abuse of them that may cause grave danger. The purity of the drugs still carries a potential risk though. 

For a drug to be released and prescribed by doctors, it first needs to go through quality testing and trial periods. Based on the outcome of the tests and trials, they may or may not be approved by institutes like the FDA. What can prevent a drug from getting this approval is if it has a considerable health risk due to side effects while in the trial period. This system is meant to protect the consumer (Jato and Okhamafe, 2002). The problem with the current ban on performance drugs is that it opens the doors to the black market, being the only source of these substances to the masses. This illegal market is a Billion-Dollar international industry according to (Baron, Martin, and Magd, 2016). The main issue with obtaining drugs from this source is that they do not go through the rigorous quality testing and trials that legal medications have to go through. 

The current ban on doping may cause another potential health risk. It could pressure athletes into looking for alternative ways to enhance their performance, such as Gene Doping. 

This cutting-edge method takes someone's DNA code and alters it, to express a more desired trait. The problem with such a new procedure is, the potential side effects are currently unknown. The altered characteristics will also be passed on to future generations, and there are only invasive methods to test if someone has participated in a gene doping protocol. 

The difficulty in testing makes Gene Doping an uncontrollable way of enhancing performance.

It is clear that WADA's current approach to controlling the use of substances in sport has many holes that need plugging. Drawing on the literature and the extensive works of academics like Julian Savulesu, the head of the department of ethics at Oxford University, a new approach can be formulated. 

Firstly, the three critical points must be redefined:

1. Dominates or corrupts performance (Savulescu et al. 2013).

 2. "And/or they must represent an actual risk to the athlete’s health.

3. And/or their use must be contrary to the spirit of sport".

The redefined first critical point does not punish performance enhancers. If a substance improves recovery, it does not corrupt or removes essential human contribution. Where the line can be drawn is for example; a boxer takes a drug that causes him to lose the sense of fear in the ring or a pill that steadies a sharpshooter/archers hands. Overstepping this boundary would, in fact, corrupt the integral aspects of these sports. It should, therefore, be banned. This distinction needs to be understood and personalised for each individual sport.

The second critical point does not change by definition, but rather by the use of it. The focus must shift from the drugs themselves to the actual health of the athlete. In other words; certain health markers, like red blood cell count and testosterone levels, must be set to a range that is deemed safe. Based on this rule, the athlete may only compete if his/her health markers are within the set ranges. 

This new definition gives freedom to use any drug, but not to abuse any of them. 

It is much easier to test health markers than for 1000 of different compounds. The added benefit is, potentially, squashing the black market by giving the green light to large pharmaceutical companies who can produce quality cheap drugs for the masses. Practitioners would then moderate the pharmaceuticals by measured prescriptions. It also prevents the need of an athlete to explore alternative methods, such as gene doping. 

This altered approach would not only ensure that athletes are healthy to compete, but also levels the playing field by setting everyone to the same limit. This co-insides with one of WADA’s definitions of the spirit of sport which is that of ‘fair play’.

The final point brings us to the spirit of sport, currently defined as follows:

A. “Ethics, fair play and honesty

B. Health

C. Excellence in performance

D. Character and education

E. Fun and joy

F. Teamwork

G. Dedication and commitment

H. Respect for rules and laws

I. Respect for self and other participants

J. Courage

K. Community and solidarity” (Savulescu, 2004, p.666).

When looking at the above points, one may realise that these are merely random associations experienced through sport. 

It can also be argued that the use of performance drugs coincides with some of them, for instance; It takes a host of experts to administer, advise and moderate drugs to athletes and may be considered ‘teamwork.' 

Athletes may also be deemed ‘courages’ for being willing to exhaust all available option in pursuit of victory.

Julian Savulescu re-defined the ‘spirit of sport’ in another way; 

“Doing everything you can to enhance yourself in order to perform at the peak of your abilities in the pursuit of victory in competition” (Davidson, 2011, p.8).

This definition makes a lot of sense through the understanding that the point of competition is a victory. Performance is imperative to winning. Therefore, using means like doping to increase performance coincides with the spirit of sport.

Rules are a necessity in controlling any industry. The way in which these standards develop and are enforced is indicative to the success of any governing agency. In sport's case, WADA is struggling to control doping using their current approach. For them to find success, an alternative method must surface, where certain drugs are allowed in some sports. 

The proposal in this essay takes all of WADA's current points and redefines them in a way that will not only protect the health of the athlete, correspond with the spirit of sport and fair play, but also prevent unknowable ways of doping from developing in the future.

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Bibliography

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Savulescu, J., Creaney, L. and Vondy, A. (2013). Should athletes be allowed to use performance enhancing drugs?. BMJ, 347(oct22 1), pp.f6150-f6150.

Savulescu, J. (2004). Why we should allow performance enhancing drugs in sport. British Journal of Sports Medicine, 38(6), pp.666-670.

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