Anti-doping Policy Research Articles

Doping control in sport: An investigation of how elite athletes perceive and trust the functioning of the doping testing system in their sport

Doping testing is a key component enforced by anti-doping authorities to detect and deter doping in sport. Policy is developed to protect athletes’ right to participate in doping-free sport; and testing is a key tool to secure this right. Accordingly, athletes’ responses to anti-doping efforts are important. This article explores how the International Standards for Testing, which face different interpretations and challenges when policy is implemented, are perceived by elite athletes. Particularly, this article aims to investigate how elite athletes perceive the functioning of the testing system (i.e., the efforts of stakeholders involved in testing) in their own sport both nationally and worldwide. Moreover, it seeks to identify whether specific factors such as previous experience of testing and perceived proximity of doping have an impact on athletes’ perceptions of the testing system. The study comprises a web-based questionnaire (N=645; response rate 43%) and uses qualitative findings to elaborate on and explain quantitative results. Results showed that two-thirds of the athletes reported the national testing programme in their sport to be appropriate. A majority of the athletes who had an opinion on the subject regarded testing programmes in some countries as not extensive enough or believed that in certain countries doping control was downgraded to win medals. Past experience of testing seemed to have a positive influence on trust in the concrete measures; however, if athletes experienced flaws during the control procedures, this could increase distrust and cause worry. The proximity of doping in an athlete's sport influenced the athlete's perception of the testing system. Particularly, athletes who need the testing system to be effective and to function well across the world show greater distrust of or dissatisfaction with the current testing system. The athletes’ diverging views indicate that contemporary anti-doping policy is simultaneously met with support, (dis)trust and frustration. By integrating the views and experiences of Danish elite athletes, this study confirms that the current testing system is confronted with obstacles, and it contributes knowledge about some of the challenges WADA faces when policy is implemented. Implications of results and recommendations for anti-doping authorities are outlined in the paper.

Anti-doping policies and the Gay Games; Morgan’s treatment–enhancement distinction in action

The anti-doping policy of the Gay Games offers an interesting exemplification of the treatment–enhancement distinction. Some Gay Games athletes require steroids to deal with the effects of HIV or for sexual reassignment, and the practice community had to negotiate coordinating conventions with regard to steroid use that remained committed to the deeper conventions of Gay Games sport. This paper will investigate the way that this policy emanated from the type of participatory social practice community that would be necessary for any sport to challenge the anti-doping fundamentalism within contemporary sports.

Beyond antidoping and harm minimisation: a stakeholder-corporate social responsibility approach to drug control for sport

Debate about the ethics of drug control in sport has largely focused on arguing the relative merits of the existing antidoping policy or the adoption of a health-based harm minimisation...

'Muscle Profiling': Anti-Doping Policy and Deviant Leisure

Doping in sport has become progressively viewed as a social problem and a number of actors have been successively identified as the carriers of this social harm (Ellis, 1987; in DeKeseredy & Dragiewicz, 2012). As a result the list of folk devils (Cohen, 1985) has grown and so too have the control mechanism employed to combat them. Performance and image enhancing drug (PIED) is deemed as morally reprehensible by the general population, and therefore a practice that should be banned and criminalized (Coomber, 2013; Coakley, 2014). However, there seems to be a tendency amongst policy makers to frame steroid or PIED use outside of elite sport as an issue within sport, and to call for the same types of policies that are being used in anti-doping (Kimergard, 2014). This paper will briefly explore the PIED policies of three countries, Sweden, Belgium and Denmark, highlighting the ways in which anti-doping in elite sport is informing national drug policy and encouraging a zero tolerance approach to PIEDs as a social health issue.

Strengthening global anti-doping policy through bilateral collaboration: the example of Norway and China

The aim of the article is to evaluate the contribution of bilateralism to global anti-doping policy. The article begins with an assessment of contemporary challenges facing the World Anti-Doping Agency in attempting to strengthen compliance with the World Anti-Doping Code and notes the weaknesses in compliance. The analytical framework for the article is derived from regime theory, neo-institutionalism and the concept of isomorphism. This is followed by a discussion of the nature of the anti-doping global policy regime and the part that bilateralism might play in the various stages of regime development. The development of bilateral collaboration is traced, and the leading role played by Norway in its development is examined. The central section of the article utilises neo-institutionalist theory and the concept of isomorphism to explore the case of Norway’s bilateral links with China and identifies the outputs of the collaboration and also the motives of both partners. The article concludes with an analysis of the factors that contributed to the longevity and success of the Norway–China collaboration and the extent to which this success could be replicated.

Legal and Institutional Consideration on Anti-Doping Policies

Legal and Institutional Consideration on Anti-Doping Policies

Condemning and condoning: Elite amateur cyclists’ perspectives on drug use and professional cycling

BackgroundSports doping is condemned by sports authorities and by society at large. Cycling has a particularly infamous relationship with sports doping, especially at professional level. Using interviews with elite amateur cyclists, this paper examines how cyclists close to, but not within, the ranks of professional cycling perceive the relationship between cycling and doping. MethodsEleven elite amateur cyclists from Melbourne were interviewed with regards to their experiences as cyclists, use of training technologies, supplements and other substances, and their attitudes to doping in sport, especially cycling. ResultsInterviewees described how their training schedule is extremely demanding and frequently necessitates the use of substances such as caffeine, anti-inflammatory medications, and energy boosters. Some distanced themselves and their use of supplements and substances from doping and condemned such practices as unethical and objectionable. Others appeared to empathise with professional cyclists’ use of doping substances given that they rely on cycling for their income and made comparisons between doping and their own licit (not WADA-prohibited) substance use. ConclusionsThe perception of professional cycling as a sport intimately tied to drug taking places those nearest to professional cycling into a practical and moral predicament. Our interviews suggest that while elite amateur cyclists do not appear supportive of drug deregulation in sport they are not necessarily fully supportive of current anti-doping policy.

‘Pool of responsibility’: A new approach to doping prevention

Doping has been an issue for the greater part of a century. Current anti-doping policies involve punishment and chemical testing aimed at a single individual. Doping scandals show that it is rarely the fault of only an individual athlete, particularly in a team scenario. Coaches, sports scientist and other athletes may all contribute to an athlete’s decision to dope. A novel solution has been formulated, a ‘pool of responsibility’; the idea that responsibility for doping is borne by all team-members not just the individual athlete. Case studies and examples from organisational and legal literature were used to justify the concept.

The symbiotic evolution of anti-doping and supply chains of doping substances: how criminal networks may benefit from anti-doping policy

Doping in sport has been explored predominantly from a user-perspective, widely neglecting an analysis of the supply-side of the market for doping products. In this article, we aim to fill a gap in the existing literature by demonstrating that the supply chains of doping substances have evolved over the course of the past two decades, not least due to the zero tolerance approach of anti-doping policy. Specifically, adopting the case studies of (elite) cycling and recreational weight-training (RWT) and bodybuilding (BB), we outline how the supply chains for performance and image enhancing drugs (PIEDs) have shifted away from “culturally embedded dealers” and into new organizational structures independent from these sub-cultures. We maintain that the evolution of doping supply mirrors the evolution of doping use; whereas doping was previously the result of a socialization process, and PIED suppliers were a cultural product, consumption is now often a secretive practice and “social suppliers” are no longer prepared to take risks in (openly) supplying doping products. Consequently, the increasingly clandestine nature of doping practices has led consumers to increasingly consider the “black market” as a potential source for PIEDs. Most importantly, this shift in doping supply chains has led to greater inequality among athletes, increased health risks and the rise of suppliers devoid of sociocultural characteristics. We suggest that as the current anti-doping regime, focused predominantly on punishment and control, continues unabated these unintended negative consequences are likely to increase. As several countries have begun to rethink their position on the criminalization of drugs and drug users, it is time to rethink our approach to curbing the problem of doping in sports.

Manufactured Dope: How the 1984 US Olympic Cycling Team Rewrote the Rules on Drugs in Sports

At the 1984 Los Angeles Olympic Games, the US cycling team not only won its first Olympic cycling medal since 1912 but also added eight more, marking a triumph for the team and its Polish-born coach, Eddie Borysewicz. Soon, however, news leaked that the seven members of the US cycling team, four of whom won medals, had employed controversial blood transfusions. Though not prohibited by the International Olympic Committee (IOC), the news caused a firestorm within the press and led to a significant revision of the IOC Medical Commission's anti-doping rules. Previous historical scholarship has ignored this event, focusing instead on early doping scandals such as Knud Jensen or more recent controversies such as Ben Johnson and Lance Armstrong. However, this event caused a significant shift within the IOC Medical Commission's attitude towards doping. Prior to 1984, the IOC Medical Commission had hesitated to prohibit any substance, including anabolic steroids, if it could not detect the substance through testing. The willingness of the US team to experiment with new medical procedures to improve performance galvanised the Medical Commission and set in motion new anti-doping policies that remain in place today.

An alternative approach to the prevention of doping in cycling

BackgroundFramed by an overly reductionist perspective on doping in professional cycling as an individual moral failing, anti-doping policies tend to envisage a combination of education and repression as the primary intervention strategies. We offer an alternative approach, which seeks to understand doping practices as embedded in social relations, especially in relation to team organisation and employment conditions. MethodsWe undertake an in-depth analysis of the functioning of nine of the 40 world professional cycling teams, and the careers of the 2,351 riders who were or have been professionals since 2005. ResultsWe find that anti-doping approaches rest upon questionable assumptions of doping as an individual moral fault, and have not produced the anti-doping effects expected or intended. Based on an analysis of team practices, and the ways in which riders produce their achievements, we offer an alternative perspective which emphasises doping as a product of social-economic condition. Our findings emphasise employment and business models, as well as day-to-day working conditions, as structural drivers of doping practices in which individuals and teams engage. ConclusionAnti-doping requires structural as well as cultural change within the sport of professional cycling, especially in the ways teams function economically.

French speaking athletes’ experience and perception regarding the whereabouts reporting system and therapeutic use exemptions

The introduction of two anti-doping measures by the World Anti-Doping Agency (WADA) directly affects athletes lives: obligatory whereabouts reporting with the Anti-Doping Administration and Management System (ADAMS), and recorded applications for Therapeutic Use Exemption (TUE). French-speaking elite athletes (N=69) from France, Belgium and Switzerland responded to a web-based questionnaire about their perceptions and experiences under these two measures. The results showed a strong ambivalence towards the whereabouts system. Though 94% considered it necessary, and accepted it as part of an athlete's duties, 34% considered that it infringed too much on their private life, 54% felt that it reduced the pleasure of being an athlete, 74% felt to be under surveillance, 54% found it too time-consuming, 57% encountered technical hurdles, and 58% perceived its application between different countries and sports as unequal and unfair. Many athletes did not like the testing procedures and more than half felt that it causes anxiety. Trust in the system's capacity to detect doping in athletes was partial (83% of athletes under the whereabouts system trusted it, and 60% of athletes not under the system trusted it). Concerning the management of TUEs, 49% of athletes had low trust in their management by authorities, 47% suspected abuse by fellow athletes and 46% had refrained from medically justified treatment. Our findings suggest considerable dissatisfaction with the whereabouts system and TUE among French-speaking athletes. We conclude that there is a need to improve on the above aspects in order to increase athletes’ satisfaction and adherence to WADA's anti-doping policies.

Anti-doping policy development process in the sports world (1968~1999): focusing on IOC activities and passive response from Korea

This study investigated the anti-doping policy promoted by the IOC historical sociologically focusing on the period from 1968 to 1999. Public opinion surrounding doping control has emerged as a large amount of drug possession by athletes who had participated in the 1952 Olympics was caught, as well as following the accident where an athlete had died during the competition as a result of doping. From 1960, as many doping cases in sports games were exposed, several international organizations proclaimed fight against doping in order to seek a preventive measure. In 1961, the IOC newly established a medical commission within the organization. It was decided to implement doping control and female sex testing at the same time for all athletes who participated in the 1967 Olympics, and they were implemented from 1968 winter and summer Olympic Games. In 1971, the provisions for the tests were prescribed as mandatory on the IOC charter. From 1989, the OCT system was introduced as a measure to overcome limitations of the detection during competition period. As political problems and limitations emerged, WADA (World Anti-Doping Agency) was established in 1999 to professionally manage and push for doping control. Female sex testing policy contributed to preventing males from participating in female competition by deceiving their gender to some extent. However, it was abolished due to strong public condemnation such as women's rights issues, social stigma and pain, and gender discrimination debate. In 1984, a doping control center was established in Korea, which enabled drug use or doping in the sports world to emerge to the surface in our society. Korea Sports Council and KOC articles of association that supervise doping related matters of Korean athletes were revised in 1990. The action of inserting doping related issue in the articles of association was taken 20 years after the start of IOC doping policy. Beginning with two international competitions in the 1980s, Korean athletes experienced doping test directly, yet education about doping was limited. However, some national team level athletes tested positive on the doping test and underwent disciplinary action. In addition, athletic federation or leaders acquiesced athletes doping made secretly; this indicated that South Korea was also not free from doping. It was found that Korea world of sports showed very passive countermeasures and development process.

Prevalence of doping use in elite sports: a review of numbers and methods.

The prevalence of doping in elite sports is relevant for all those involved in sports, particularly for evaluating anti-doping policy measures. Remarkably, few scientific articles have addressed this subject so far, and the last review dates back to 1997. As a consequence, the true prevalence of doping in elite sports is unknown. Even though it is virtually impossible to uncover the exact prevalence of a prohibited activity such as doping, various methods are available to uncover parts of this particular problem, which enables the circumvention (to a certain degree) of the issues of truthfulness, definition problems and the limits of pharmacological evidence. This review outlines the various methods that exist and presents the scarce data available in this area. It is concluded that a combination of questionnaires using the Randomised Response Technique and models of biological parameters is able to provide the statistical possibilities to reveal accurate estimates of this often undisclosed practice. Data gathered in this way yield an estimation of 14-39% of current adult elite athletes who intentionally used doping. These period prevalences have been found in specific sub-groups of elite athletes, and the available data suggest that the prevalence of doping is considerably different between sub-groups with varying types of sport, levels and nationalities. The above-mentioned figure of 14-39% is likely to be a more accurate reflection of the prevalence of intentional doping in elite sports than that provided by doping control test results (estimate of doping: 1-2% annually) or questionnaire-based research (estimations between 1 and 70% depending on sport, level and exact definitions of intent and doping). In the future, analytical science may play a more important role in this topic if it may become feasible to detect very low concentrations of prohibited substances in sewage systems downstream of major sporting events. However, it is clear that current doping control test results show a distinct underestimation of true doping prevalence. It does not seem feasible to distil better estimates of the prevalence of doping based on performance indicators or ego documents because of the various existing effects that influence athletic performance. Such information can only be used as extra information to augment the accuracy of prevalence rates that have been found by using other techniques. True doping prevalence studies have been scarce in elite sports so far. With the correct application of the available scientific methods, preferably using harmonised definitions of the terms 'doping' and 'elite sports', more information on this topic may be gathered in a relatively short time. This would assist anti-doping professionals in the future in order to evaluate the effects of possible anti-doping measures, and better anti-doping policies would serve athletes who compete without doping. The existing anti-doping measures seriously impact the lives of elite athletes and their immediate entourage, which imposes a moral burden to evaluate these measures in the best possible way.

Personal and Psychosocial Predictors of Doping Use in Physical Activity Settings: A Meta-Analysis

There is a growing body of empirical evidence on demographic and psychosocial predictors of doping intentions and behaviors utilizing a variety of variables and conceptual models. However, to date there has been no attempt to quantitatively synthesize the available evidence and identify the strongest predictors of doping. Using meta-analysis, we aimed to (i) determine effect sizes of psychological (e.g. attitudes) and social-contextual factors (e.g. social norms), and demographic (e.g. sex and age) variables on doping intentions and use; (ii) examine variables that moderate such effect sizes; and (iii) test a path analysis model, using the meta-analyzed effect sizes, based on variables from the theory of planned behavior (TPB). Articles were identified from online databases, by contacting experts in the field, and searching the World Anti-Doping Agency website. Studies that measured doping behaviors and/or doping intentions, and at least one other demographic, psychological, or social-contextual variable were included. We identified 63 independent datasets. Study information was extracted by using predefined data fields and taking into account study quality indicators. A random effects meta-analysis was carried out, correcting for sampling and measurement error, and identifying moderator variables. Path analysis was conducted on a subset of studies that utilized the TPB. Use of legal supplements, perceived social norms, and positive attitudes towards doping were the strongest positive correlates of doping intentions and behaviors. In contrast, morality and self-efficacy to refrain from doping had the strongest negative association with doping intentions and behaviors. Furthermore, path analysis suggested that attitudes, perceived norms, and self-efficacy to refrain from doping predicted intentions to dope and, indirectly, doping behaviors. Various meta-analyzed effect sizes were based on a small number of studies, which were correlational in nature. This is a limitation of the extant literature. This review identifies a number of important correlates of doping intention and behavior, many of which were measured via self-reports and were drawn from an extended TPB framework. Future research might benefit from embracing other conceptual models of doping behavior and adopting experimental methodologies that will test some of the identified correlates in an effort to develop targeted anti-doping policies and programs.

The final frontier of anti-doping: A study of athletes who have committed doping violations

Although the use of banned drugs in sport is not a new phenomenon, little is known about the experiences and perceptions of athletes who have committed anti-doping rule violations. This study qualitatively explored the experiences of 18 athletes (from the sports of bodybuilding, powerlifting, cricket, sprint kayak, rugby league, and swimming) who had committed anti-doping violations. Themes explored included motivations for initiating and maintaining doping, the psychology of doping, deterrents to doping, and views on current anti-doping policy. In most cases doping had started early in their careers. The perceived culture of the sport was considered central to the ‘normalization’ of doping, particularly in bodybuilding. When explaining their decision to dope, athletes engaged in processes or moral disengagement (including advantageous comparison, minimizing consequences and diffusion of responsibility). Ironically, moral arguments were perceived as the most effective deterrents to doping. Findings are discussed in relation to the difficulties in establishing credible deterrents and suggestions for the future development of anti-doping policy.

Athletes’ and coaches’ perceptions of deterrents to performance-enhancing drug use

Policies to prevent performance-enhancing drug use in sport are implicitly based on a form of deterrence theory, whereby the threat of sanctions deters prohibited behaviour. While deterrents generally fail to deter serious criminal actions, criminological research suggests that deterrents can be effective with certain types of offences or offenders. This study explored the perceptions of elite athletes (n = 488) and coaches (n = 92) of two forms of deterrents to performance-enhancing drug use (legal and material loss sanctions) and a range of other anti-doping policy issues. There were marked differences in the perceived deterrent effect for athletes and coaches, with coaches consistently seeing deterrents as less credible than athletes. Both groups endorsed sanctions for the coaches and clubs of doping athletes and expressed support for the withdrawal of commercial and government sponsorship for such athletes. Findings are discussed in relation to the increasing focus of anti-doping campaigns towards elite coaches rather than athletes.

Australian athlete support personnel lived experience of anti-doping

Athlete support personnel (ASP) implement drug control policies for sport, such as anti-doping. Interviews with 39 ASP reveal how differences between policy and practice play out in their “lived experience” of anti-doping. While most ASP support the ideology underlying anti-doping at a “common sense” level (using popular drug and sporting discourses such as “drugs are bad” and sporting virtue), they are critical of anti-doping practice. Combined with no direct experience with doping, ASP saw doping as a rare event unlikely to emerge in practice. Most ASP took a laissez-faire approach to anti-doping, relying on managers to know what to do in the unlikely event of a doping incident. Despite broadly supporting the ideas of anti-doping, ASP raised concerns around implementation with regards to Athlete Whereabouts and recreational drug use. In response to hypothetical doping events, a number of ASP would seek to persuade the athlete to discontinue doping rather than meet mandatory reporting obligations. Part of this extended from conflicts between professional and anti-doping obligations (e.g. mandatory reporting and patient confidentiality). ASP demonstrate anti-doping policies are in tension with a practice that systematically normalises substance based performance enhancement early in sporting careers. Anti-doping agencies need to do more to engage with ASP as the “front line” of drug management in sport, including resolving contradictions across policies and in practice.

Elite athletes’ perspectives on key elements of current anti-doping policy

The implementation of global anti-doping regulations was intended to provide a level playing field for all athletes entering sports competitions. However, studies have shown that the worldwide harmonization of rules has not been entirely efficacious. For instance, great variation has been found in how anti-doping organizations implement anti-doping regulations, and it has also been shown that athletes distrust the equivalence of the worldwide rules as regards their effects. The purpose of the present article is to examine how elite athletes from different contexts experience anti-doping procedures and to analyse the legitimacy of anti-doping practice. In order to capture a variety of voices and perspectives, 13 elite athletes from five different continents and three international sports federations were interviewed. The analysis shows that when global anti-doping policy is implemented in different contexts and under different conditions, inequities and structural injustices emerge concerning infrastructure, knowledge and support at the individual athlete level. These consequences may have implications for the legitimacy of anti-doping work, because the existence of procedural justice may be called into question. We therefore suggest that anti-doping policy-making should be based on taking into account these different conditions and being aware of the perspectives that underpin regulations intended to be applied global.

Does anti-doping policy contribute to the development of a real doping market?

We qualitatively explored the Sport Drug Control Model (SDCM; Donovan, Eggar, Kapernick, & Mendoza, 2002), in order to examine coaches’ perceptions of adolescent athletes’ attitudes and susceptibility towards doping.Eleven coaches (M = 10) from four countries, who worked in seven different sports (athletics, basketball, kayaking, racquetball, rowing, rugby league, and rugby union) were recruited to take part in semi-structured interviews. Transcribed interviews were analysed via a three-stage inductive and deductive coding process, which allowed us to identify common themes among the participants.The coaches believed that adolescents’ attitudes towards doping were influenced by perceptions of threat and benefit appraisals, morality, self-esteem, legitimacy, and reference group opinion. We also identified additional factors, which included age/maturation, sport level, pressure, country of residence, and ethnicity.Our findings provide qualitative support for the SDCM, but also offer fresh insight into some of the nuances specific to adolescent athletes from different countries and cultures. Further research is required to test our proposed model with larger samples of adolescent athletes.