Summary Two (2) of the Professor Arne Ljungqvist Anti-Doping Foundation Symposium in Stockholm

Session 3: Drug free sport and society

Beyond any competitive advantage – the public health and social consequences of performance enhancing substances
Timothy Armstrong (WHO, Geneva) discussed “Beyond any competitive advantages – the public health and social consequences of performing enhancing substances.” He described the structure of WHO and presented the areas which WHO is primarily responsible for:

-       providing leadership on global health matters
-       shaping the health research agenda
-       setting norms and standards
-       articulating evidence-based policy options
-       providing technical support to countries
-       monitoring and assessing health trends

 Timothy Armstrong concluded by stating that WHO can move the agenda of doping and public health, but global data on substance use for sport in population requires strengthening. There is a lack of global data on the public health implications of doping in sports, but appropriate partnerships, agreements across relevant agencies to promote health and sport.

Strategies against the abuse of alcohol, narcotics, drugs, doping and tobacco.
Maria Renström (Director ANDT and Social services Ministry of Health and Social Affairs in Sweden) reported on the Swedish cohesive strategy for alcohol, narcotic drugs, doping and tobacco (ANDT-policy). The Swedish overall objectives in this issue are:

 A society free from illegal drugs and doping, with reduced alcohol-related medical and social harm, and reduced tobacco use – where all may grow up, live and work without risking harm through their own or others use/misuse of ANDT

 Since 2011, the ANDT-policy also includes doping outside sport. It focuses on coordinated prevention, early interventions, treatment and rehabilitation to individuals and families. The policy is based on the knowledge of common poly-drug use, but also linked to mental health, violence, and social problems.

 Other activities include an anti-doping network (PRODIS) that has been established to prevent the use of doping substances and improved testing of drugged drivers.

Anti-doping from the Athletes’ perspective
Sara Fischer (Falun, Sweden) is part of the WADA Athlete Committee. It has 19 members that should be spokespersons for the athletes of the world in anti-doping matters and aims to make the daily life of the athletes easier. The members are elected for two years and should represent the two genders, all continents, active and former athletes, winter and summer sports, and team and individual sports. Today the committee consists of

• Vyacheslav Fetisov, Ishockey, Russia (chairman)
• Frank Fredericks, Track and field, Namibia
• Claudia Bokel, Fencing, Germany
• David Millar, Cycling, Great Britain
• Andréanne Morin, Rowing, Canada
• Daichi Suzuki, Swimming, Japan
• Cydonie Mothersill, Track and field, Cayman
• Felipe Contepomi, Rugby, Argentina
• Alberto López Moreno, Soccer, Spain
• Nina Kemppel, Nordic skiing, USA
• Tania Elias, Sailing, Mexico
• Matt Dunn, Swimming, Australia
• Ken Egan, Boxing, Ireland
• Katarzyna Rogowiec, Parolympic skiing, Poland
• Annelies Vanderberghe, Korfball, Belgium
• Yang Yang, Speed skating, China
• Rania Elwani, Swimming, Egypt
• Barbara Kendall, Windsurfing, New Zealand
• Sara Fischer, Snowboard, Sweden

Sara Fischer talked about the whereabouts registration for the international top level athletes, which from an outside perspective may look very intruding on the athletes’ personal integrity. However, many top level athletes welcome this system as it is a necessary mean in order to undertake tests out-of-competition and to know that one is competing against other clean athletes.

Session 4: Why do people engage in doping?

Mechanisms underlying the misuse of doping substances.
David Hoff (Lund, Sweden) talked about “Mechanisms underlying the misuse of doping substances.” He divided the mechanisms as

 -       individual factors
-       social mechanisms
-       societal influences

There are individual factors and motives underlying the use of doping. In sports the most important motive is the improvements of sporting performance, while cosmetic reasons (bigger muscles) a risk-taking personality and strategic criminal reasons may be just as important outside sport. David Hoff stated that some beauty and health ideals in society could generate a breeding ground for obsessive training, eating disorders and use of doping.

According to Hoff, doping use could not be understood (entirely) as a substance abuse like any other, as doping is a mean to reach a goal such as better endurance, better results, a stronger and more muscular and beautiful body – and not merely a “rush”.

 The ethics of anti-doping in sports
“The ethics of anti-doping in sport” were discussed by Sigmund Loland (Oslo, Norway). He started with the word fairness, which means that doping must be banned as it is forbidden by the rules. Performance-enhancing drugs must then be banned as it is a rule violation to cheat.

From a health perspective this is not necessarily equally clear as there are other potential harms built into sports that are generally accepted (such as injury risks in downhill skiing and Formula 1). He asked if dangerous sports could be banned.

Loland then discussed doping from en ethic perspective and focused on one of the requisites for doping on WADAs prohibiting list: the use of substances or methods that violates the spirit of sport. He stated that there is not one but many possible definitions of the spirit of sport.

-       ethics, fair play and honesty
-       health
-       excellence in performance
-       character and education
-       fun and joy
-       teamwork
-       dedication and commitment
-       respect for rules and laws
-       respect for self and other participants
-       courage
-       community and solidarity  

Drugs and sport : A public health ethical perspective
The first day ended by Tom Murray (president emeritus of the Hastings Center, New York) discussing “Drugs and sport: ethics, morality and law in today’s society.” He stated why doping should be resisted in sports, i.e. for the same reason sport decides on equipment and rules

-       promote fairness
-       prevent harm
-       preserve meaning

Murray discussed the risks involved with the notation that some drugs are safe and that dopers tend to use performance-enhancing drugs at non-therapeutic dosages, and in novel and poorly understood combinations.

He concluded by quoting a study, according to which honesty, fair play and respect for others were considered much more important than winning, and that this by itself may counteract doping.

Professor Arne Ljungqvist Anti-Doping Foundation
Author: Åke Andrén-Sandberg