Drugs and Sport
A review of Drug Sport Folio 3rd Edition
Dr Philip Randall
Drug Sport Folio is the 3rd edition of the CDROM produced by iNFOSOURCE, a drug
resource on what you can and cannot consume as a sportsperson in South Africa.
Dr Philip Randall provides perspectives into sport, doping and the Drug
SportFolio.
Firstly lets make it clear right from the start that Drug Sport Folio (DSF)
compiled and edited by Marlize Smuts and published by Infosource is not a recipe
book for those looking to substance abuse as a means of increasing performance.
To do that one should get a degree in biochemistry (a Ph.D. if you want to
design drugs yourself); a law degree to cut defense costs when you get caught,
and a full frontal lobotomy (major organ failure, sterility and substance
dependence are the more palatable conditions that can result) in case you do not
get caught quickly enough.
Secondly it is important to recognise that the anti-doping codes used in our
sports were written by lawyers, for the use of lawyers, and from the basic
premise that you are guilty until proven innocent. You can only prove
"innocence" by demonstrating that the laboratory made an error (very
difficult), the sample, or sample collection, could have been compromised
(difficult) or that the law contains a fundamental flaw (good luck with that
one) - it does not equate "ignorance" with "innocence".
I have been involved in the fight against drugs in sport for over 10 years
now. Much remains that indicates all is not well in sport. The on going war
against ignorance has, however, received a major boost with this top class
reference source. Regrettably this publication is only applicable in South
Africa. However with the ever increasing numbers of overseas sports men and
women flocking to South Africa, the message should rapidly travel worldwide -
you know the IOC have a policy of "ignorance is no excuse", with this
reference source there is "no longer an excuse to be ignorant".
In the Foreword Professor Tim Noakes eloquently establishes the true purpose
of this publication when he discusses the need to avoid the "criminalisation
of the innocent".
I took two high profile recent cases of "doping offenses" and
looked to see how DSF could, theoretically, have been used by the athletes
concerned if (and they did not) occur in South Africa.
The first relates to a recent visitor to South Africa in the form of Trinidad
and Tobago sprinter Ato Boldon who was reprimanded (not sanctioned) for the
presence of ephedrine in his urine sample. On his web site he apologises for the
incident and claims the substance originated from a cold and flu preparation.
Within the DSF search engine I typed in ephedrine and received 46 hits. Five
where within the anti-doping code and related literature, the remaining 41 where
in South African medications. Tonics, Slimming preparations, Ear/Eye/Nasal
drops, Bronchodilators/anti-asthmatics gave 11 hits the rest fall under the
category Coughs/Colds/Flu. Amongst the latter group where 'obvious' candidates
for performance enhancement such as Kiddiekof Syrup and Kernosan Horse-radish
Wine Cough Remedy !!! Type in pseudoephedrine and you get an additional 77 hits
of which 71 are medications.
The point of the above example is that many preparations - especially in the
over the counter cough/cold/flu group - contain prohibited substances. They are
there to alleviate the "side-effects" of the active ingredient. The
problem is the laboratory test is sensitive enough to detect trace levels of the
substance but not the original source or dosage level of that substance.
Type in Coughs/Colds/Flu and you get 271 hits of which 87 are permitted and a
further 8 have a warning because of caffeine or alcohol. There is plenty of
choice out there and DSF can help make that choice with the same professionalism
as you take with your sport.
This reference source repeatedly mentions that it is South African specific
and the second scenario I tried again proved the value of DSF.
Alain Baxter recently lost his bronze medal at the Winter Olympics for having
the presence of methamphetamine (or methylamphetamine) in his urine. According
to press articles this came from the use of a Vicks Inhaler purchased outside
the United Kingdom. Using DSF I typed in Vicks and obtained 8 hits relating to 6
Vicks products. One (Medinite Syrup) contained ephedrine (prohibited); two
contained alcohol (warning) and 5 are permitted - including the nasal spray
produced in South Africa.
Methamphetamine is commonly called "speed" or more correctly the
hydrochloride form of d - N- methylamphetamine (not the isomer p-methylamphetamine
claimed to be present in the nasal spray in question) is called
"speed". The problem for Alain Baxter, and all sports men and women,
is that the regulations clearly state "methamphetamine" and frequent
use is made of the term "and related substances". To tell which isomer
was in his sample is both schoolboy chemistry and totally irrelevant. This
publication "Drug Sport Folio" could have prevented the problem from
ever arising - if this is a case of "criminalisation the innocent".
What was also pleasing to note was that a start has been made on the
ever-increasing area of herbal, alternative medicines and nutritional
supplements.
Can you take something that contains Ephedra, Ephedra sinica, Ma-Huang or
Sida cordifolia ? They all sound suitably herbal and exotic and they are all the
herbal equivalent of ephedrine and will definitely get you into major conflict
with the authorities.
The medicinal use of herbs is the root of our modern day pharmacology. The
problem also often arises that it is not the "active" ingredient that
is the problem but a minor impurity - usually not declared - in many cases
because the manufacturer did not even think to test for it - but capable of
resulting in a failed dope test.
This reference source is the first I have found that attempts to catalogue
such products. DSF lists most of these products as permitted but does,
naturally, qualify that rating. As a first attempt it is highly commendable and,
hopefully, will receive increased technical support from the manufacturers who
often consider such information to be "sensitive".
To put the matter in context the IOC has been testing nutritional supplements
throughout 2001 and found 14.8% could lead to a positive dope test and 30 have
shown positive for ephedrine. None have any of the prohibited substances listed
on the ingredient list. Also the USA Food and Drugs Administration has reported
over 1000 cases of toxic reaction and a handful of deaths due to ephedrine in
the last few years. Clearly the problem exists and Drug Sport Folio makes a bold
attempt to draw the users attention to this hidden danger to the sport.
Like Professor Noakes and many overseas experts I believe more effort should
be placed into increased research focussed on identification of true performance
enhancing substances - eliminating the false positives if you like. To do this
we must inform the sports men and women of the potential dangers to their career
waiting in the bathroom cabinet. The IOC performs approximately 100,000 tests
per year and gets about 1,000 positives - it has been suggested that they should
halve that number and use the time and money (these tests are expensive) to, as
Professor Noakes puts it "…. unambiguously identify the recent and long
term use of those drugs ….. that really do improve athletic performance".
To be able to do this we must first eliminate the threat of accidental
ingestion.
This reference source should be considered essential to all involved with
sport and apart from the medical practitioners, pharmacists, sports
administrators, coaches etc mentioned this reference should find its way to
schools and into our tourist industry who cater for the overseas athletes.
Someone once said "ignorance is bliss" and it certainly was not the
IOC.
As a passing thought; do you know of a product that is available in South
Africa and is not listed in this reference source ? I am sure the publishers
would be delighted to hear from you.
For more information on DrugSportfolio enter here.
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