Post on 15-Feb-2020
2018
Hendrik de Villiers
Critical things athletes & support
personnel need to know about
[anti]-Doping
Who is responsible for the fight against Doping?
Court of Arbitration
in Sport (for
appeals)
National Olympic / Paralympic
Comm.; National Federations;
Sporting bodies
International Olympic / Paralympic Comm.;
International Federations
WADA: international,
independent organisation
that:
• Coordinates & monitors
the fight against
doping in sport, in
cooperation with a
network of stakeholders.
• oversees implementation of
the WORLD ANTI-
DOPING CODE;
• publishes the LIST OF
PROHIBITED
SUBSTANCES &
METHODS.
PROTECT ‘CLEAN’ ATHLETES
What is Doping ?
mka
RUSSIAN Doping Scandal
Using a prohibited
substance or
method that gives
you an unfair
advantage over
your opponent
= cheating…!
Stimulant in
the USN
supplement
the team
used
Doping offences in SA Rugby divisions
13
18
14
8
15
3
Figure 1: # of ADRVs per division
Craven Week
U/19
U/21
Varsity Cup
Vodacom/Currie Cup
Super Rugby
462
73
# of ADRVs
Other sports
Rugby
❖ ‘Youth’ divisions (U/19 & Craven Wk) a major concern as they make up 42% of
the doping offences in sA Rugby!
• “# ADRVs” = # doping offences or “positives” (period 1998 – 2014)
Tested positive for the
following prohibited
substances:
• Anabolic steroids
• Stimulants
• Cannabis
Over past 2 years, Rugby is the sport with the highest number
of ‘positives’ in SA (33)
EDUCATE – protect & empower
Empower yourself = Prevent
Un-intentional doping
Understand / comply with the ‘rules’ (CODE)
RISKS of Prohibited MedicationsTell Drs & pharmacist to check
Athlete: Double check against the LIST
RISKS of Supplements
Risks vs limited benefits; Costs; vs alternatives
Source of advice: those w money/performance focus (not health); vs independent credible sources of advice.
RISKS of Illicit & Recreational drug use …
mka
Why do some use ‘unfair’ means to get to the top?
Pressure
Pressure to perform
“Win-at-all-costs”
“quick-fix” mentality
Scholarships; Sponsorships;
Income
Pressure to “look good” –body image
“culture”… “norm”, "everyone is doing
it… ?”
Feeling of inadequacy in
sport
Feels good, exciting, or out of
curiosity
Peer pressure or
it’s “fashionable”
Ignorance / inadvertent doping …
Gain confidence &
⬆ self-esteem
Obsession with “size” in sports
(e.g. rugby)
Threat: “you wont make the team”
unless you do it …
mka
What is often the difference between someone who
decides to play fair vs “cheat”?
What is a
Doping Offence
- it’s not only about
testing positive..
“anti-doping rule violation”(ADRV)
Complicity: any assisting, encouraging,
aiding, abetting, covering up etc...
Whether
successful
or not
Prohibited (Banned) Substances by class
Substances Methods
Non-Approved pharmacological
substances
Manipulation of blood or blood
components
Anabolic agents Chemical and physical manipulations
Peptide hormones and growth factors Gene Doping
Beta-2 Agonists
Hormone and metabolic modulators
Diuretics and other masking agents
Stimulants
Narcotics
Cannabinoids
Glucocorticosteroids
Alcohol
Beta-blockers
✷
✷✷
✷
✷✷
✷Also found in supplements…!
Check the medication you use!
Cannot search
for traditional
medication or
“supplements”
as they are not
regulated &
subjected to
rigorous controls
to verify
ingredients /
dosage /
efficacy /
safety…
✷ Simply don’t
know for sure
what’s in it.
– use the Online Medication Check ‘app’:
www.drugfreesport.org
Principle of Strict Liability
Even if treated by medical doctor or health professional,
the responsibility is on the athlete for banned substances
ingested / administered …
Even when using a traditional medicine or supplement
containing a banned substance that is not listed on the label…
YOU, and only YOU,
are responsible
for what goes into your body
✷✷
• For Chronic conditions the TUE typically expire 12-24 months
• Acute conditions / emergency situations: Apply for Retroactive TUE
• Acute TUE’s are only valid for that occurrence, not all future occurrences
“TUE” - Therapeutic Use Exemption
If you need a
prohibited
substance or
method for a
legitimate
medical
condition,
follow these
steps:
“Who needs a TUE?” www.drugfreesport.org.za/TUE/
Get the application form (download or contact SAIDS: 021 686 1634
Get medical doctor to fill out form & produce evidence (diagnostic test(s))
Submit application at least 30 days before competition
Wait for TUE to be granted before competing or starting treatment
1
2
3
4
5
If on this list and
do NOT have a
TUE in place
=Will be a doping
violation &
sanction
>> will not be
allowed to apply
for a retroactive
TUE!
Who needs a TUE in ROWING?
- Reg Testing Pool (RTP) Athletes
- If on long list or selected for SA
Olympic, Paralympic, Commonwealth
Games team
- competing in elite men’s and women’s
senior* national champs;
- selected to represent the senior*
national men’s and women’s team at a
continental or world championships
(*no matter your age)
Criteria for TUE approval – advance OR retroactive* TUEs
A TUE will
only be
approved
provided that
each of the
following
criteria are
met:
1
2
3
4
The Prohib. Substance / Method is needed to treat an acute
or chronic medical condition, such that the Athlete would
experience a significant impairment to health if it was to be
withheld.
The Therapeutic Use of it is highly unlikely to produce any
additional enhancement of performance beyond what might
be anticipated by a return to the Athlete’s normal state of
health following the treatment of the acute or chronic
medical condition.
There is no reasonable Therapeutic alternative
The necessity for the Use of the Substance / Method is not a
consequence, wholly or in part, of the prior Use (without a
TUE) of a substance or method which was prohibited at the
time of such use
*Those who may apply Retroactively for chronic meds need to have
a medical file in place with proof that the above conditions are met
Ritalin / Concerta – Prescription medication
• It is on the WDA Prohibited List – “Specified Stimulants” - Methylphenidate
• It’s indications for use, side-effects etc. need to be managed by a medical Dr.
• If you need to use it >> Check “Who needs a TUE” list – drugfreesport.org.za
a) If you compete in an event (jnr or senior) that appears on this list then you need to
apply for and have a TUE granted before competing (cannot do a retro-active
TUE)
b) if competing in an event / competition that is not on the list (&/or have the
potential to make a team that is on the list) then you need to have a ‘medical
file’ in place in the event that you get tested and then need to apply for a retro-
active TUE; (or make a team where you need to then get a TUE in place before
competing)
• There are specific criteria / medical information needed for a TUE
application related to ADHD and Ritalin / Concerta treatment
– SEE SAIDS WEBSITE under “TUE”
Doping Control Procedure
See info leaflet:
NOTE: Consumption of food or fluids prior to giving your sample is at your own
risk. Avoid excessive rehydration as you are required to produce a sample with
suitable specific gravity for analysis. Your urine sample should be collected from
the first urine passed by you after you have been notified of testing.
Doping Control Procedure
Full exposure requiredWHY? Athletes have gone to extremes to provide “false” urine samples by hiding devices in clothing, bodily cavities etc…
Males will have a Male Officer,Females will have a Female.
Youth (U/18) may have an accompanying adult.
CONSEQUENCES of a doping offence
• 4 year ban
• NO
involvement in
sport, incl no
coaching…
• Career…?
Income,
livelihood…
• Your own…
• Your Coach /
Manager… Family…
the sport…?
CRIMINAL OFFENCEPossession / dealing with illicit
& prescription drugs (Laws of
the country)
• Short- and
long-term?
…?
Risks to your health & wellbeing…
• Short- and
long-term
• We don’t always
know risks in
athletes …?
Anabolic Steroids – oral & injectable
Stunted growth & height in teens
Heart damage & failure
Kidney damage & failure
Increased blood pressure
Liver cysts and increased risk of cancer
Weakened immune system (get sick more easily)
Hair loss – male pattern baldness
Stretch marks
Acne and other skin irritations
https://www.usada.org/substances/effects-of-performance-enhancing-drugs/
Anabolic Steroids – oral & injectable
Reversal of Male characteristics in men e.g.
*Breast tissue development (“man-boobs”)
*Shrinking testicles, impotence, infertility
*EFFECTS MAY BE PERMANENT
*Females develop male characteristics - deepening voice, facial hair etc.
Intra-muscular abscess
Increased risk of muscle injury
Increased risk of tendon tears
“Roid-rage” – increased aggression, depression, suicidal tendencies
Dependency …?
Most steroids are obtained on the black market > questionable quality = high
risk of other medical events independent of steroid use …
mka
Stimulants (Drugs, Fat burners, “Energy boosters”,
recreational drugs etc.)
42
Stimulantse.g. dimethylamine / methylhex (in supplements), Amphetamines, Ephedrine
(cold & allergy meds, diet pills)
• Nervousness, irritability – making it hard to concentrate during a
fight
• Insomnia (sleeplessness) – poor rest & recovery;
• Dehydration;
• Heat stroke; vomiting; abdominal pain
• Addiction or tolerance, meaning athletes need greater amounts to
achieve the desired effect, so they'll take higher & higher doses …
• Heart palpitations / Heart rhythm abnormalities
• Weight loss (could also entail losing muscle mass)
• Tremors
• Raised blood pressure (hypertension)
• Hallucinations
• Brain bleeds / Stroke
• Heart attack and other circulatory problems
• Death (examples from several athletes from various sports globally)
43
Diuretics
➢ Used to “make weight” / mask presence of other banned
substances
• dehydration
• electrolyte imbalance (low potassium & Sodium)
• headache
• drop in blood pressure
• dizziness
• muscle cramps
• loss of coordination & balance
• skin rash
• gout
• diarrhea
Serious side effects• allergic reaction• severe dehydration• kidney failure• irregular heartbeat• heart failure• death
44
OTHER DRUGS OF MISUSE
• Cannabinoids (Dagga)
– Balance & muscle function impairment
– Distorted perception
– Decreased testosterone with long-term use
• Cocaine
– Irregular heart beat; palpitations; Heart Attack,
– stroke, seizures,
– dependence
• Traditional Medicines: No regulation
• Homeopathic meds: Limited regulation (& enforcement);
• Over-the-counter medication:
• Some regulation, limited implementation / enforcement.
• May have medical purpose, but banned in sport.
Non-regulated Substances
• Supplements: No regulation body in SA (and globally)
• May contain harmful and/or banned substances not
indicated on the product label
Know the RISKS you take with suppl-use:
Poor regulation & policing:
Retailers / pharmacies etc. get away with selling products with dubious
ingredients and false claims > don’t need to prove efficacy & safety
Increased reports of supplements containing drugs / unapproved
meds / harmful / banned ingredients – not listed on the label.
➔• Product Labels not accurate – cannot
trust ingredients, dosages, claimsRISK
• Majority have NO credible evidence of
efficacy OR safety >> NOT tested!? benefits
What do these
actually mean…?
How do you choose a ‘risk-free
supplement brand’…?
Be aware:
These still do NOT
provide a 100%
guarantee that you
will not test
positive!
Or that you wont
experience harmful
side-effects …
Supplements implicated in the positive tests in SA athletes!
Dr Amanda Claassen-Smithers
• Majority had not listed the banned substance on their label
• DMMA / Methylhex*: unapproved DRUG found in supplements – linked to
severe ill-health effects (incl. 4 deaths); many positives in SA athletes!
o Jack 3d (USP Labs)*
o StartFragment*
o Berseker (Titan Labs)*
o Neurocore (Muscletech)*
o Muscle Punch 3DT (Evox)*
o Endoburn NT (USN)*
o Hydro Heat (Evox)*
oUSN product Springboks were
sponsored with* (2 positive …)
o Noxipro – Extreme Energising Pre-
Workout with Beta-Alanine, Creatine (CTD
labs)
o Dynamite (NutriTech)*
o Ginseng Kianpi Pil – dexamethasone
Recently (2017):
o BIOGEN Testoforte – 4-Androstene-3,17-dione
o TEST Freak®tf - 4-Androstene-3,17-dione
some of these products might since have been withdrawn, “reformulated” or “re-named”
– ? Is the new product(s) any safer…?
Supplement manufacturers & retailers
*Vitamins
*Fish oil
*Minerals
Basic nutrients
Dangerous
High risk
Drugs, steroids, hormones, stimulants
Body building, ‘mass gainer’, ‘legal or natural steroid’ suppl.s
Pre-workout / ++Energy suppls(Ephedra, DMAA, DMBA, BMPEA)
Weight loss / fat burner suppls(Prescription drugs, HCG)
How do you know what is safe and not?
Unknown ?Mostly OK*Or are they?
Majority of products
mka
SAIDS Educational material
✓ Range of leaflets / info sheets
✓ Posters
✓ www.drugfreesport.org.za
✓ Facebook: I Play Fair ZA
✓ Twitter: @iplayfairZA
www.drugfreesport.org.za
Thank you!
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