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DRUGS BANNED IN SPORT


Introduction

This document is written primarily for athletes and their coaches to use as a quick and easy guide to the status of drugs in sport and the South African Institute for Drug-Free Sport's (SAIDS) drug testing programme. The term "athlete" is used in the broad generic sense to describe any person who participates in sport.

This document contains general information about drugs used in sport, what they are and why they are banned.

Prohibited and Permitted Drugs.
A handy searchable List of all drugs available in South Africa is readily available on this Web site - you will be able to find out what drugs are permitted and what drugs are prohibited by accessing the "Drug Info" link on the Home Page.

If you are still not sure about a medication after referring to this document, you are encouraged to check it by contacting the S.A. Institute for Drug-Free Sport at the following E-mail address:

<drugfree@iafrica.com>


Remember : 'If in doubt, leave it out'.



1. What is doping?
Doping is the use by athletes of banned substances or methods that may enhance performance.

2. What is inadvertent doping?
Inadvertent doping occurs when an athlete uses a drug to treat an illness, or takes in food or drink, without realizing that it contains a banned substance. Even though you may not be taking a drug to enhance performance, if you are actively participating in competitive sport you are at risk of testing positive for a prohibited substance. To give a few examples, widely used medications used for coughs and colds such as Colcaps, Grippon and Sinutab contain banned substances. In most cases illnesses can be treated with an alternative medication that does not contain a prohibited drug. Many "energy" or "rave" drinks contain significant amounts of caffeine and should therefore be taken with care. If you are not 100 per cent certain that what you intend taking is safe, don't take it !

Remember: 'If in doubt, leave it out'..


3. The therapeutic use of banned medications
In some cases your doctor may not be able to find an alternative medication to one that is banned to treat an illness. If this is the case, you should contact your national sports federation for advice.

4. Banned substances and methods
The substances and methods that are banned by most national sports federations are based on those prohibited by the International Olympic Committee (IOC). These are summarized below, with a brief explanation of how they affect the body, together with some examples.
Note: Some sports codes also ban substances that are not prohibited by the IOC (e.g. archery bans the use of sedatives and other categories of substances). If you are unsure about the drugs banned by your sport, please check with your national sports federation.

Anabolic agents
There are two classes of anabolic agents:

  • anabolic androgenic steroids; and
  • beta-2 agonists.

    • Anabolic androgenic steroids
    Anabolic androgenic steroids are artificial versions of the hormone testosterone, which is found naturally in large amounts in males and smaller amounts in females. They are abused in sport to facilitate muscle building and improve muscle strength.
    Some examples of anabolic steroids are Deca-Durabolin (nandrolone) and Stanazol (stanozolol), a veterinary product. Possible short-term side effects of anabolic steroids include acne, hair loss, hair growth in unusual places, deepening of the voice, shrinking testicles, changes in mood (eg. more aggressive or violent) and changes in the menstrual cycle. Long term effects may include stunting of growth (in adolescents), liver and kidney damage, heart disease and infertility.

    Beta-2 agonists
    Beta-2 agonists are non-steroidal anabolic agents most commonly found among medications used to treat asthma. They are also classified as stimulants.
    Note: The policy concerning the therapeutic use of beta-2 agonists (eg. for asthma treatment) may vary from sport to sport. It is very important to check that you are complying with your national and international sports federation's doping rules.
    In general, beta-2 agonists are banned as they have anabolic effects when taken in oral or injectable form. They do not, however, have the same effects on the body as steroidal anabolic agents. Potential side effects of beta-2 agonists include palpitations, headaches, nausea, sweating and muscle cramps.
    Some beta-2 agonists are permitted but only under certain conditions. In most sports salbutamol, salmeterol and terbutaline are permitted but only if taken by inhaler and with written notification provided by a physician or team doctor to the relevant medical body. Some examples of inhalants that are permitted beta-2 agonists are Ventolin (salbutamol) and Serevent (salmeterol).

    Blood doping
    Blood doping involves taking blood from an athlete (or another person) several weeks before an event and transfusing it back into the athlete about one week before the event. This increases the number of red blood cells in the body, enabling the body to carry more oxygen.
    Some possible serious side-effects of blood doping include development of blood clots, strokes and infections (eg. hepatitis, HIV) from sharing needles.

    Diuretics
    Diuretics help your body to lose water and salt. This can cause weight loss and dilutes the urine so that banned drugs may not show up in a doping test.
    Some examples of diuretics are Lasix (frusemide) and Aldactone (spironolactone).
    Some possible side effects of diuretics are dehydration (not enough fluid in your body for it to work normally), fainting, dizziness, headaches, a sick feeling in the stomach, cramps, and loss of co-ordination and balance. If athletes lose too much fluid and/or electrolytes from their bodies, their heart rhythm can become abnormal, which may lead to the heart failure and death.

    Narcotics
    Narcotics decrease the amount of pain felt from injuries or illness. Often athletes use painkillers to hide the pain of injuries so they can continue to
    train or compete. This may make the injury or illness worse and may cause permanent damage.
    Some examples of narcotic medications include Physeptone (methadone) and Valoron (tilidine).
    Some possible side effects of narcotics are a loss of balance and co-ordination, loss of concentration, nausea and constipation, slowed breathing and loss of consciousness.

    Peptide hormones, mimetics and analogues
    Hormones act as messengers from one body organ to another to do things such as stimulate growth and influence sex drive, behaviour and sensitivity to pain. Hormones are responsible for a variety of functions, including body growth and the production of red blood cells. Athletes may, for example, take certain hormones to increase the size and strength of muscles or to increase the number of red cells and thereby increase the supply of oxygen to muscles. Analogues are substances that act in similar ways to hormones.
    Some examples of prohibited hormones are human growth hormone (hGH), human chorionic gonadotrophin (hCG), corticotrophin (ACTH), erythropoietin (EPO) and insulin.
    Some possible side effects of growth hormone use are diabetes and acromegaly (extra bone and cartilage growth in hands, forehead, jaw line, feet and ears). Some possible side effects of erythropoietin use are due to the excessive production of red blood cells, making the blood too thick to pump around the body. This can lead to high blood pressure, heart problems, strokes and possible death.

    Pharmaceutical, chemical and physical manipulations
    Athletes sometimes try to cover up the use of banned substances by using methods such as swapping urine, or using chemicals to hide performance enhancing drugs (masking agents).

    Stimulants
    Stimulants act on the central nervous system to speed up parts of the brain and body. They can make a person feel more awake and alert and hide feelings of tiredness.
    Some examples of drugs that contain stimulants are Sudafed (pseudoephedrine) and Demazin (phenylephrine). Amphetamines and caffeine are also stimulants.
    Some possible side effects of stimulants are a loss of co-ordination and balance, faster heart rate and rise in blood pressure, and an abnormally high body temperature which may be fatal. Stimulants can make some athletes aggressive and violent.

    Caffeine
    Caffeine is a stimulant which is banned when used in large amounts. Recent studies show the amount of caffeine an athlete would need to take to return a positive test result can be very different from person to person.
    Caffeine is banned when the concentration in an athlete's urine is more than 12 micrograms per millilitre.
    An average person would need to ingest approximately 500 milligrams of caffeine over a short period of time to return a positive test result for caffeine.In most normal cases, the social use of caffeine should not be a problem (eg. a can of Coke, a chocolate bar or a standard cup of coffee). The actual amount an athlete can ingest without going over the limit, though, will vary from person to person and depends on factors such as body size, metabolic rate and degree of dehydration. It may also be very different for the same athlete on different occasions. Caffeine use before events should therefore be minimal to avoid problems.

    Approximate caffeine concentrations of common products:

    Product Approximate caffeine content
    Coffee 50-350 milligrams per cup
    Tea 40-90 milligrams per cup
    Cola drinks 30-50 milligrams per cup
    Cocoa or chocolate drinks 40-80 milligrams per cup
    Chocolate bars 150 milligrams per family block
    Over the counter preparations 10-100 milligrams

    5. Why are these substances and methods banned ?
  • The substances and methods described are prohibited for ethical, health and legal reasons.
  • Ethical reasons - some drugs may help an athlete perform better than other athletes (eg. stimulants, beta-blockers). This is cheating.
  • Health reasons - many drugs, especially if they are not used properly, can seriously affect an athlete's health (eg. stimulants, anabolic steroids).
  • Legal reasons - some drugs are banned because they are illegal in general society (eg. heroin).
    • 6. Restricted substances
    There are a number of restricted substances which are:
  • banned in some forms only; or
  • only tested for in certain sports; or
  • only permitted under certain conditions. The following classes of substances are subject to certain restrictions:

    7. Health foods and herbal products
    Health foods and herbal products are increasingly popular for treating illness and other health conditions. There are now a vast number of these products available, with multiple ingredients and chemical properties. Unfortunately, these products are not subject to the same stringent registration and labelling requirements as approved pharmaceuticals, and the Institute for Drug-Free Sport (SAIDS) is not in a position to guarantee that they are free of prohibited substances.
    In some cases, the SAIDS may have little or no information on ingredients contained in these products.
    While most herbal and health food products probably do not contain banned ingredients, you should always be aware of the risk involved.

    8. Athletes with special needs
    Some athletes have special needs (eg. athletes with disabilities, or veterans).
    These needs include:

    If you have a different method of urine collection, you need to let the SAIDS know so that the sample collection procedure can be adapted to suit you.

    The list of banned substances for athletes with disabilities and masters or veterans is usually the same as the list for other athletes. Exceptions may be made for athletes with certain disabilities. You should clarify this with your national sports federation. The decision made may depend on the following factors:
     

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