Performance-Enhancing Drugs

Transcription

1 Performance-Enhancing Drugs The use of performance enhancing drugs by athletes in competitive sports has been a controversial topic for many years. These controversies encompass the ethical dilemma on whether patients whom are also athletes may be able to take prohibited substances when medically necessary. With the rise of abuse and misuse of diet and supplements, there needs to be regulations in place to prevent medications from being restricted from all individuals. The drugs that are commonly abused and are considered performance enhancing drugs include stimulants such as amphetamines, diuretics, anabolic steroids, ephedrine and human growth hormone. These drugs are used to treat common medical conditions such as attention deficient disorder, congestive heart failure and high blood pressure. So is it fair to say everyone with one of these medical conditions is not eligible to participate in professional sports? Or are there certain regulations that should be utilized to provide a fair playing environment for all athletes? Pharmacists can play a critical in helping regulate the use of these drugs and making sure each patient receives the optimal care necessary. Professional sports have become more competitive than ever. Athletes are now seeking alternate methods to improving their performance. Many players may not believe that the conventional ways of advancing through workout, diet and training in their respective sports may not be enough for them to actually compete. Athletes many times will get bored with the hard work and turn to other means to give them the edge in sports world. The edge that athletes turn to is commonly performance enhancing drugs, which is commonly aided by the high pressure for perfection. The decision to do so impacts many and portrays a negative stigma to the individuals involved in the

2 professional sports world and the medical field itself. It is necessary to help regulate the use of these drugs to maintain a professional standard and consistency among all sports. In order to keep certain standards, there are many organizations that regulate the use of performance enhancing drugs. These organizations are put in place to prevent the abuse and misuse of performance enhancing drugs. One of the major organizations is the U.S. Anti-Doping Agency (USADA). The USADA is the national anti-doping organization for the Olympic movement in the United States. The U.S. Congress recognized USADA as "the official anti-doping agency for Olympic, Pan American and Paralympic sport in the United States." We are dedicated to eliminating the practice of doping in sport, and to preserving the well being of sport and ensuring the health of athletes through research initiatives and educational programs. The main purpose of the USADA is Doping Control, the terminology in sport that refers to drug testing for performance enhancing substances, is the process of collecting samples for analysis as described in the international standards of the World Anti-Doping Agency and specific International Federations. A key component of USADA's mission is to conduct doping controls, both in-competition and out-of competition without notice. Athletes under our jurisdiction include Olympic, Paralympic and Pan American athletes who live, compete and/or train in the United States. The USADA performs its functions through the utilization of many systems to optimize the anti-doping process. The major components of the USADA s processes include education, research, testing and results management. The research is probably the most important aspect of the USADA s mission. Spending approximately 2 million dollars a year on research, they are able to study performance enhancing drugs and come up with the most effective methods to maintain competitive standards. The results

3 management is also a very important aspect of the USADA. USADA is responsible for the results management and adjudication process of the Olympic movement in the United States. Our adjudication system includes numerous protections for athletes to ensure that only those athletes who are guilty of a doping or missed test violation are sanctioned. We work each day to achieve a transparent and fair results management and adjudication process. The education program is focused on informing both professional and amateur athlete of the dangers and the consequences of using performance enhancing drugs. There is also a serious effort to educate the athletes about the different policies and procedures surrounding the USADA. With each component, the USADA is able to maintain a very effective method to prevent and deter the use of performance enhancing drugs in many sports. There have many athletes that have tested positive for banned substances. One of the most infamous of these is Barry Bonds of the San Francisco Giants. His use of anabolic steroids has been highly publicized and has tarnished his image as a successful baseball player. A quote from the Associated Press describes this: The ball Barry Bonds hit for his record-breaking 756th home run will be branded with an asterisk and sent to the Baseball Hall of Fame. The asterisk suggests that Bonds' record is tainted by alleged steroid use. The slugger has denied knowingly using performance-enhancing drugs. Fans brought signs with asterisks on them to ballparks as he neared Aaron's hallowed mark. An achievement that any other athlete would be privileged to have, Bonds had to deal with the criticism and speculation of cheating. Bonds is one of many players that have been associated with performance enhancing drugs. Another recent athlete that has been implicated with performance enhancing drugs is Rodney Harrison of the New England

4 Patriots. He purchased human growth hormone (HGH), a banned substance in the National Football League (NFL), through an online pharmacy. Without any privacy, this information was made public and Harrison was suspended for a major part of the season. This hurt his team, his image and the image of all professional sports. These are examples of how performance enhancing drugs are abused but there are still athletes that medically need these medications therefore, there should be standards to make these drugs available to those who need them but prevent the illegal abuse of these drugs. No sport is more competitive than the National Football League (NFL). The competition is fierce and the need to stay ahead is always looming. Along with quick decision making and good vision, in order to succeed, one needs extreme training, hard work and discipline. This pressure and hard work proves to be too intense for some players as many will turn to alternative methods to stay ahead. These alternative means usually involve performance enhancing drugs. The use of such drugs is illegal but occurs very commonly. For this reason, the National Football League has implemented a drug policy program, which all players are required to follow. Many of the banned substances are listed below: List of Prohibited Substances

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6 Many of the drugs that are banned are apparently used for many common disease states such as hypertension, attention deficient disorder, and endocrine abnormalities. With such an overlap in use, it makes the regulation of these drugs very difficult. The NFL drug policy goes on to state: The illegal use of drugs and the abuse of prescription drugs, over-the-counter drugs, and alcohol (hereinafter referred to as substances of abuse ) is prohibited for players in the National Football League ( NFL ). Moreover, the use of alcohol may be prohibited for individual players in certain situations where clinically indicated in accordance with the terms of this Policy. Substance abuse can lead to on-the-field injuries, to alienation of the fans, to diminished job performance, and to personal hardship. The deaths of several NFL players have demonstrated the potentially tragic consequences of substance abuse. NFL players should not by their conduct suggest that substance abuse is either acceptable or safe. The NFL and the National Football League Players Association ( NFLPA ) have maintained policies and programs regarding substance abuse. In Article XLIV, Section 6(a) of the 1993 NFL Collective Bargaining Agreement, as extended and amended (the CBA ), the NFL Management Council and the NFLPA (hereinafter referred to individually as Party and collectively as the Parties ) reaffirmed that substance abuse is unacceptable within the NFL, and that it is the responsibility of the parties to deter and detect substance abuse... and to offer program intervention, rehabilitation, and support to players who have substance abuse problems. Accordingly, in fulfillment of this provision of the CBA, the Parties have agreed upon the following terms of a policy regarding substance abuse in the NFL (hereinafter referred to as the Policy ).

7 This policy applies to all active NFL players. Each team in the NFL must adhere to this drug policy in order to maintain professional standards for the sport. This policy was put into effect to test, evaluate and treat those individuals that may be abusing performance enhancing drugs. When the players do not comply to the policy, it is the role of the commissioner to discipline these individuals. The policy also seeks to put in guidelines to allow those with actual disease states that may potentially require performance enhancing drugs still receive treatment. In order for the patients that require treatment to actually receive it, the NFL makes it mandatory for each one of the thirty two football teams have a medical team that is responsible for maintaining the drug policy. This team consists of a Medical Director, Medical Advisor, Treating Clinician, Team Substance Abuse Physician, Chief Forensic Toxicologist, and Drug Program Agents. Each member of them has an important, specialized role making it a very successful operation. Possibly the most important of this team is the Medical Director, with a summary of his/her description below: The Parties will select a Medical Director who will have the responsibility, among other duties, of selecting and overseeing physicians, psychologists, social workers and other counselors ( Evaluating Clinician(s) ) who will be members of various Regional Teams headed by a Regional Psychiatrist. The Medical Director and the Evaluating Clinicians will work together in a collaborative manner to facilitate, coordinate, monitor, and assess players compliance with their Treatment Plans. (For purposes of this Intervention Program, a Treatment Plan is defined as a written plan of interventions and requirements developed by a player s Treating Clinician to assist in the treatment of the player.) The Medical Director will be assisted by an Administrator to be selected by the Parties. The services of the Medical Director and/or the Administrator may be terminated

8 by either Party at any time, or as otherwise delineated by the notice and termination provisions of their respective contracts, if any. The Parties agree that the Medical Director will have the sole discretion to make the various decisions assigned to him under the terms of this Policy, and such decisions shall be final and binding. The other duties of the Medical team are also of importance. The Medical Advisor is someone who directly advises the Medical Director on many aspects of their job description such as devising treatment plans for athletes and overseeing the drug testing operations. The Treating Clinician must be approved by the Medical Director and is trained on developing treatment plans for players abusing performance enhancing medications. The Team Substance Abuse Physician, Chief Forensic Toxicologist, and Drug Program Agent s roles are very closely related. The Team Substance Abuse Physician is able to assist with the treatment of substance abuse and is typically informed of the status of player s intervention stages. The Chief Forensic Toxicologist main responsibility is evaluating laboratory samples, interpreting data and providing technical counsel. Finally, the Drug Program Agents are independent contractors that have the sole responsibility to collect samples from the players. Through this very concise step-wise program, substance abuse is almost always identified and treated for. Although, there are still some incidences when substance abuse is mistaken for treatment of actual diseases and with confidentiality and privacy policies in place, it is difficult to determine if players that have tested positive are actually abusing medications to obtain a competitive advantage. Carolina Panther defensive end Julius Peppers, San Diego Chargers linebacker Shawn Merriman and Denver Bronco punter Todd Sauerbrun have all tested positive for banned substances, but it is difficult to determine if these players were being treated for an actual medical condition. There is a

9 need for systems to be in place in order to have players receive the necessary treatments they need and still compete fairly in the league. The best proposed solution for this ethical dilemma would be to have the team physician in place to diagnose disease states and have the player s medical history available to the Medical Team. I conducted a brief survey to obtain the general public s view on this topic. I distributed this survey to pharmacy students, pharmacists and nonspecified college students. I have normalized the results to an even one hundred participants and the results are as follows: Question 1: Should performance enhancing drugs be allowed in professional sports? 95 percent of the participants said no, while the remaining 10 percent said yes. Question 2: Should there be routine and random drug testing in professional sports? 85 percent answered yes and 15 percent answered no. Question 3: Who should be evaluating players to determine if they medically need drugs that are classified as performance enhancing drugs? 55 percent answered team physician while the remaining 45 percent said an individual physician. Question 4: If team physicians are evaluating players, should they be allowed to prescribe drugs known to be performance enhancing? An overwhelming 90 percent answered yes and 10 percent did not agree. With this brief survey it was apparent that many disagree with the use of performance enhancing drugs unless if they are being used to treat a disease that a player may have. This seems to be positive solution to the use of and abuse of performance enhancing drugs.

10 Regulating the use of performance enhancing drugs to prevent abuse is extremely important to maintain a safe and fair environment for all athletes. Without the regulations, there would be abuse by athletes trying to achieve a competitive advantage over their opponents. This is not only harmful to the players, but it is also unfair. Along with the risks associated with their use, performance enhancing drugs portray a negative image on all parties involved and give younger, aspiring athletes the wrong impression on how to advance in life. With the right policies and procedures in place, it is possible to limit the use of performance enhancing drugs and maintain integrity among sports. The USADA has developed anti-doping policies and similarly, the NFL has implemented policies to prevent substance abuse in the sport of football. This will allow for players at need to receive treatment, be able to participate in professional sports, and prevent the abuse of the performance enhancing drugs.

11 References 1. U.S. AntiDoping Agency. USADA. January USADA. Dec 1 st Available from: 2. NFL Players Association, "National Football League Policy and Program For Substances of Abuse."NFL Yahoo Sports. September Rick Freeman. Barry Bonds' No. 756 to be branded with an asterisk and sent to Baseball Hall of Fame. Available from: 4. Catlin, D. H., and Murray, T. H. "Performance-enhancing drugs, fair competition, and Olympic sport." JAMA 276(1996) 5. Orchard, John. "The Use and Misuse of Performance-enhancing Substances In Sport." The Medical Journal of Australia 3(2006):