tag:theconversation.com,2011:/us/topics/performance-enhancement-1761/articlesPerformance enhancement – The Conversation2024-02-06T19:08:18Ztag:theconversation.com,2011:article/2228692024-02-06T19:08:18Z2024-02-06T19:08:18ZVenture capitalists are backing a ‘steroid Olympics’ to find out what happens when athletes are doped to the gills<figure><img src="https://images.theconversation.com/files/573654/original/file-20240206-15-zgrilp.jpg?ixlib=rb-1.1.0&rect=10%2C0%2C6979%2C4663&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">
</span> <span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/very-muscular-strong-man-hero-athletic-207704356">Shutterstock</a></span></figcaption></figure><p>For many, elite sport is the quintessential human endeavour. It drives ferocious competition, captures unconditional tribal loyalty, and rewards the victors with fame and fortune. </p>
<p>As the Olympic motto declares, the limits of human performance are there to be tested – faster, higher, stronger. But what would happen if the boundaries were not just pushed, but abandoned altogether?</p>
<p>That’s what PayPal cofounder <a href="https://news.uk.cityam.com/story/2109160/content.html">Peter Thiel</a> wants to do, putting some cash into lawyer <a href="https://www.theguardian.com/sport/2023/jun/24/australian-entrepreneur-plots-enhanced-games-for-drug-taking-athletes">Aron D’Souza’s</a> concept of an “<a href="https://enhanced.org">Enhanced Games</a>”, where drug testing is out the window and anything goes. </p>
<p>Will <a href="https://enhanced.org/2024/01/29/seedfundingannouncement/">venture capital</a> make the Enhanced Games a reality? Despite rhetoric about making sport safer and “the medical and scientific process of elevating humanity to its full potential”, the games are out to make money. </p>
<h2>The case for enhancement</h2>
<p>The argument in favour of “enhanced” sport declares the current system dishonest and ineffective, as <a href="https://enhanced.org/2023/11/27/honest-sports/">drug use is supposedly already widespread</a>. It calls for athletes to make their own body-boosting decisions, and for their excellence to be rewarded with a <a href="https://enhanced.org/pay-athletes/">more equitable share</a> of the sport-entertainment loot. </p>
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<p>As drug use in sport is here to stay, the argument goes, athletes should be permitted to use every advantage they can to secure success. In the world of hyper-commercialised, spectacle-driven sport theatre, athletes and fans alike are desperate to find out what can be done when anything is possible.</p>
<h2>Costs to participants</h2>
<p>As experts in sport management and integrity, we have a few concerns with this proposed venture. </p>
<p>It’s not that we’re averse to “thinking outside the box” to shake up existing systems, which are sometimes inequitable and unfair. And we agree there’s always more that can be done to reduce the harm elite athletes’ bodies endure.</p>
<p>However, any enhanced entertainment value would come at a cost to the participants. There’s no shortage of evidence demonstrating the <a href="https://www.sportintegrity.gov.au/what-we-do/education/health-effects-of-doping">dangers of pharmaceutical abuse for performance enhancement</a>, let alone what might happen when used in experimental combinations and dosages. </p>
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Read more:
<a href="https://theconversation.com/why-its-time-to-legalise-doping-in-athletics-46514">Why it's time to legalise doping in athletics</a>
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<p>Let’s not pretend this will be a kind of harm-reduction strategy to combat banned substance use in sport either, a bit like decriminalising cannabis. </p>
<p>In the Enhanced Games, athletes would be rewarded for “excellence”. That means the race to dope, where inevitably more is better, will not be limited to medicines that have been approved for human use.</p>
<h2>What’s sport for?</h2>
<p>In addition to damage to athletes, there’s also the damage to sport. </p>
<p>We’d like to think that most committed sport fans would prefer to watch athletes, not injectable avatars. But this event is designed as instantly accessible consumer fodder, not a treat for sporting aficionados. </p>
<p>The Enhanced Games suggests the path to victory is via what many sport fans would regard as cheating. Instead of promoting success via persistence, resilience and hard work, it suggests there is a “magic pill” or “silver bullet” for every challenge. </p>
<p>Even if we leave aside the significant health risks of a “go for it” open category of sport (which presents deal-breaking legal and medical ethics concerns anyway), it challenges the very essence of what sport should be about. </p>
<p>Perhaps we’re being idealistic, but what’s the point of sport if it isn’t at least aiming to be authentic? The main thing these games will “enhance” is the existing problems with elite sport. </p>
<h2>More inequality and prospects for exploitation</h2>
<p>The idea of the Enhanced Games seems to proceed from the premise that all participants are adults who can make fully informed decisions about their own short-term goals and long-term health in ways that will affect only themselves. This is unlikely to reflect the reality. </p>
<p>Elite sport is not conducted on a level playing field. Access to money, knowledge, power and technology already gives some athletes an edge over others, and the Enhanced Games would exacerbate these inequalities.</p>
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<p>The Enhanced Games proposal does not set out how the increased risk to athletes exploited for commercial gain will be managed. The games also proposes to include events in which the burgeoning elite competitors are young and vulnerable, such as gymnastics and swimming, which may have serious implications for these children and their carers.</p>
<h2>Winning – but at what cost?</h2>
<p>Sport has never been a “win at all costs” proposition. Sport should be part of a society that cares about respect, fun, friendship, health, learning new skills and vitality. </p>
<p>If only the entrepreneurs and venture capitalists could concentrate their money and efforts on bringing the joy of sport to disadvantaged people and help support building thriving communities. </p>
<p>In years to come, we hope to look back on the Enhanced Games with as much interest as sprinter Ben Johnson’s 1998 novelty race against two horses. (Johnson, notoriously banned from normal competition for life after failing multiple drug tests, <a href="https://www.nytimes.com/1998/10/17/sports/plus-running-johnson-is-third-in-charity-race.html?pagewanted=print">came third</a>.)</p>
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<p class="fine-print"><em><span>Catherine Ordway has been appointed as a member of the World Anti-Doping Agency (WADA) Social
Science Research Expert Advisory Group (SSREAG) and previously worked for the Australian
Sports Anti-Doping Authority (precursor to Sport Integrity Australia). The University of Canberra has a Memorandum of Understanding with Sport Integrity Australia and is researching several co-funded projects, including on anti-doping.</span></em></p><p class="fine-print"><em><span>The University of Canberra has a Memorandum of Understanding with Sport Integrity Australia and is researching several co-funded projects, including on anti-doping.</span></em></p>A plans for ‘Enhanced Games’ with no restrictions on performance-enhancing drugs would be bad for athletes and for sport itself.Catherine Ordway, Associate Professor Sport Management and Sport Integrity Lead, University of CanberraAaron CT Smith, Director, UC Research Institute for Sport and Exercise, University of CanberraLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/1932212023-02-08T23:16:03Z2023-02-08T23:16:03ZCan beetroot really improve athletic performance?<figure><img src="https://images.theconversation.com/files/502267/original/file-20221220-12-uv9t4t.jpg?ixlib=rb-1.1.0&rect=34%2C317%2C4566%2C2855&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">
</span> <span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/two-glasses-beetroot-juice-on-white-1518235694">Shutterstock</a></span></figcaption></figure><p>Beetroot is gaining <a href="https://www.tiktok.com/discover/beet-root-performance-improver">popularity</a> as a <a href="https://www.washingtonpost.com/national/health-science/beet-juice-gains-traction-as-an-evidence-based-aid-for-athletes/2019/03/22/8e93b1cc-45a2-11e9-90f0-0ccfeec87a61_story.html">performance-enhancer</a> for athletes and those wanting to gain a competitive advantage in running and cycling. </p>
<p>Some people juice beetroot, some eat it, others mix up a drink from the powdered form. But will it make a noticeable difference on how quickly we run a race or cycle up a hill?</p>
<h2>Small benefits for some</h2>
<p>A large <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7494956/">systematic review in 2020</a> included 80 clinical trials, in which the included studies had participants randomly assigned to consume beetroot juice or not. It found consuming beetroot juice provided performance benefits for athletes. </p>
<p>In sports where every second or centimetre counts, this can be a significant improvement. In a <a href="https://pubmed.ncbi.nlm.nih.gov/21471821/">16.1 kilometre cycling time trial</a> the gains linked to beetroot consumption were equivalent to 48 seconds. </p>
<p>But when the authors analysed subgroups within these studies they found beetroot juice wasn’t effective for women or elite athletes – though this could be because there were too few study participants in these groups to draw conclusions.</p>
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<img alt="Man runs" src="https://images.theconversation.com/files/502265/original/file-20221220-22-tq0w6h.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/502265/original/file-20221220-22-tq0w6h.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/502265/original/file-20221220-22-tq0w6h.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/502265/original/file-20221220-22-tq0w6h.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/502265/original/file-20221220-22-tq0w6h.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/502265/original/file-20221220-22-tq0w6h.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/502265/original/file-20221220-22-tq0w6h.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
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<span class="caption">Beetroot juice may provide a small performance benefit.</span>
<span class="attribution"><a class="source" href="https://www.pexels.com/photo/man-in-green-t-shirt-and-black-shorts-running-on-the-park-5037354/">Ketut Subiyanto/Pexels</a></span>
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<p>Another large systematic review in 2021 of 73 studies that looked at <a href="https://www.tandfonline.com/doi/full/10.1186/s12970-021-00450-4">endurance athletes</a> (who run, swim or cycle long distances) found similar results. Supplementation with beetroot (and other vegetables rich in nitrate) improved their time to exhaustion by an average of 25.3 seconds and the distance travelled by 163 metres. </p>
<p>This improvement was seen in recreational athletes, but not in elite athletes or sedentary people. This analysis didn’t look specifically at women.</p>
<h2>What is it about beetroot?</h2>
<p>Beetroots are rich in nitrate and <a href="https://theconversation.com/were-told-to-eat-a-rainbow-of-fruit-and-vegetables-heres-what-each-colour-does-in-our-body-191337?utm_source=twitter&utm_medium=bylinetwitterbutton">anthocyanins</a>. Both provide health benefits but it’s primarily the nitrates that give the performance benefits.</p>
<p>Once ingested, the nitrate is converted in the mouth by the local bacteria into nitrite. In the acidic conditions of the stomach, the nitrite is then <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4863140/">converted</a> to nitric oxide, which is absorbed into the bloodstream. </p>
<p><a href="https://www.sciencedirect.com/science/article/pii/S1089860316300015?via%3Dihub">Nitric oxide</a> dilates blood vessels, which delivers oxygen more quickly to the muscles, so energy can be burned to fuel the exercising muscles. </p>
<p>The result is that less energy is used for performance, which means it takes longer to tire. </p>
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Read more:
<a href="https://theconversation.com/why-nitrates-and-nitrites-in-processed-meats-are-harmful-but-those-in-vegetables-arent-170974">Why nitrates and nitrites in processed meats are harmful – but those in vegetables aren’t</a>
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<h2>How can I use beetroot juice?</h2>
<p>The <a href="https://www.ais.gov.au/nutrition/supplements/group_a">Australian Institute of Sport</a> (AIS) has assessed beetroot and classified it as a Group A supplement. This means there is strong scientific evidence for use in specific situations in sport.</p>
<p>The AIS <a href="https://www.ais.gov.au/__data/assets/pdf_file/0005/1001102/Beetroot-juice-Infographic-2pg.pdf">advises</a> beetroot supplementation can be beneficial for exercise, training and competitive events that lasts 4–30 minutes and in team sports with intermittent exercise.</p>
<p>For performance benefits, the AIS advises the beetroot product (be it juice, powder or food) should have between 350–600mg of inorganic nitrate in it. Check the label. There are several concentrated juices available on the market. </p>
<p><a href="https://www.sciencedirect.com/science/article/pii/S2212267211019484?via%3Dihub">Beetroot contains about 250mg per 100g</a> of nitrate, so you need to consume at least 200g of baked beetroot to get the same effect. </p>
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<img alt="Roasted beetroot and garlic in a pan" src="https://images.theconversation.com/files/507278/original/file-20230131-26-40xau8.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/507278/original/file-20230131-26-40xau8.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/507278/original/file-20230131-26-40xau8.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/507278/original/file-20230131-26-40xau8.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/507278/original/file-20230131-26-40xau8.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/507278/original/file-20230131-26-40xau8.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/507278/original/file-20230131-26-40xau8.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
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<span class="caption">You need to consume a large portion of beetroot to have the same effect.</span>
<span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/roasted-beetroots-cast-iron-skillet-on-668286019">Shutterstock</a></span>
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<p>To give the nitrates time to be converted to nitric oxide and absorbed into your bloodstream, you need to <a href="https://www.ais.gov.au/__data/assets/pdf_file/0005/1001102/Beetroot-juice-Infographic-2pg.pdf">consume</a> the product 2–3 hours before training or competition. You may get added benefits drinking beetroot juice for several days leading up to training or competition.</p>
<p>However, don’t use antibacterial products like mouthwashes, chewing gums or lollies. These will kill the bacteria in your mouth needed to convert the nitrate to nitrite.</p>
<h2>Are there any downsides?</h2>
<p>Your urine will turn red, and this will make it difficult to determine if you are <a href="https://theconversation.com/why-do-i-wake-up-thirsty-183731">dehydrated</a>. Your poo may also turn red.</p>
<p>Some people may experience an upset stomach when consuming beetroot juice. So try drinking it while training to determine if you have any problems. You don’t want to find this out on competition day.</p>
<h2>What about nitrate from the rest of your diet?</h2>
<p>While it’s difficult to consume enough nitrate to boost your athletic performance directly from vegetables before an event, consuming five serves of vegetables a day will help keep the nitric oxide levels elevated in your blood.</p>
<p>Vegetables higher in nitrate include celery, rocket, spinach, endive, leek, parsley, kohlrabi, Chinese cabbage and celeriac. There isn’t clear evidence about the effect of cooking and storage on nitrate levels, so it’s probably best to eat them in the way you enjoy the most.</p>
<p>However, it’s best to avoid <a href="https://www.theguardian.com/society/2022/dec/27/too-much-nitrite-cured-meat-brings-clear-risk-of-cancer-say-scientists">cured meats with added nitrate</a>. The additive is used to stop the growth of bacteria and adds flavour and colour, but the resulting sodium nitrite can increase the risk of cancer.</p>
<p>While beetroot may give you a small performance boost, don’t forget to tailor the rest of your training as well. Ensure you have enough carbohydrates and protein, and that you drink enough water. You may need to consult an exercise scientist and an accredited practising sports dietitian to get the best outcome.</p>
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<em>
<strong>
Read more:
<a href="https://theconversation.com/do-athletes-really-need-protein-supplements-92773">Do athletes really need protein supplements?</a>
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<p class="fine-print"><em><span>Evangeline Mantzioris is affiliated with Alliance for Research in Nutrition, Exercise and Activity (ARENA) at the University of South Australia. Evangeline Mantzioris has received funding from the National Health and Medical Research Council, and has been appointed to the National Health and Medical Research Council Dietary Guideline Expert Committee.</span></em></p>Some people juice beetroot, some eat it, others mix up a drink from the powdered form. Here’s how it might affect your athletic performance.Evangeline Mantzioris, Program Director of Nutrition and Food Sciences, Accredited Practising Dietitian, University of South AustraliaLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/1868012022-09-28T12:32:30Z2022-09-28T12:32:30ZYour mighty tendons help you sprint, jump and move – a genetic mutation in one key protein may increase athletic performance<figure><img src="https://images.theconversation.com/files/486922/original/file-20220927-26-skh2t7.jpg?ixlib=rb-1.1.0&rect=0%2C3%2C2139%2C1396&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">A variant of Piezo1 may boost tendon strength and, subsequently, athletic ability.</span> <span class="attribution"><a class="source" href="https://www.gettyimages.com/detail/photo/sprinters-in-motion-royalty-free-image/a0091-000172">Yellow Dog Productions/The Image Bank via Getty Images</a></span></figcaption></figure><p>The ability to move is an essential part of daily life. The <a href="https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/locomotor-system">locomotor, or musculoskeletal, system</a> of the body consists of muscles, bones, tendons, ligaments, joints, cartilage and other connective tissue. <a href="https://www.physio-pedia.com/Ageing_and_the_Locomotor_System">Loss of motor function</a> due to disease or injury can result in a lifetime of disability. In a rapidly aging society, maintaining and improving motor function can be a significant challenge for many people.</p>
<p>But there are ways to get around motor failure. As <a href="https://scholar.google.com/citations?user=6NvNu40AAAAJ&hl=en">molecular biologists</a> and <a href="https://www.researchgate.net/profile/Ryo-Nakamichi">orthopedic surgeons</a> who study the locomotor system, we believe one key part of it has been underestimated – the tendons.</p>
<p><a href="https://my.clevelandclinic.org/health/body/21738-tendon">Tendons</a> are tough tissues that connect muscle to bone. Tendons are what allow <a href="https://a-z-animals.com/blog/how-high-and-far-can-a-kangaroo-jump/">kangaroos</a> to jump over 25 feet (7.62 meters) high and run up to 40 mph (64 kph). While their leg muscles are small, the kangaroos’ highly developed and long tendons act like powerful springs. People can also jump higher if they squat down first because their tendons <a href="https://spaniardperformance.com/muscle-tendon-unit-characteristic-to-potenciate-training/">store elastic energy</a> that helps propel them upward.</p>
<p>In our research, we found that the presence of <a href="https://doi.org/10.1126/scitranslmed.abj5557">one particular protein in tendons</a> plays a key role in how tendons heal – and a genetic mutation in that protein may also enhance athletic performance.</p>
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<figcaption><span class="caption">Tendons connect muscle to bone and are essential to movement.</span></figcaption>
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<h2>Identifying tendon proteins</h2>
<p>Tendon damage can be <a href="https://doi.org/10.1002/jor.22869">difficult to heal</a>. Approximately <a href="https://doi.org/10.1177/0363546520939897">60% of tendon injuries</a> lead to <a href="https://www.cdc.gov/arthritis/basics/osteoarthritis.htm">osteoarthritis</a>, a disease resulting from the breakdown of the cartilage in joints that can make movement even more difficult.</p>
<p>Developing treatments for tendon injuries has likewise been challenging. One of the reasons is that the proteins controlling the genes instructing the body to create tendons, called <a href="https://www.nature.com/scitable/definition/transcription-factor-167">transcription factors</a>, had been unknown.</p>
<p>To identify these proteins, we <a href="https://www.embrys.jp/embrys/html/MainMenu.html">created a catalog</a> of the 1,600 transcription factors in the human body. Based on this catalog, we examined what genes were active in the Achilles tendon of genetically engineered mice and found that a protein called Mkx was a central transcription factor for the health of tendons.</p>
<p>Researchers have long considered tendons to be inert tissue unable to contract like muscles can. But we discovered with our colleague, <a href="https://scholar.google.com/citations?user=2aSu29oAAAAJ&hl=en">Ardem Patapoutian</a>, the <a href="https://www.nobelprize.org/prizes/medicine/2021/advanced-information/">Nobel Prize-holder</a>, that one particular protein on the surface of tendon cells, Piezo1, can sense when the tendon is engaging in moderate exercise and stimulate the Mkx transcription factor.</p>
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<figcaption><span class="caption">The discovery of Piezo1’s role in the perception of touch won the 2021 Nobel Prize in physiology or medicine.</span></figcaption>
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<h2>Piezo1 and athletic performance</h2>
<p>We then wondered about the role that Piezo1 plays in athletic performance. We were particularly interested in a variant of Piezo1 called E756del, which is found in around <a href="https://doi.org/10.1016/j.cell.2018.02.047">a third of people of African descent</a> and thought to play a potential role in <a href="https://doi.org/10.1038/s41551-021-00716-x">how high people can jump</a>. </p>
<p>So we genetically engineered mice to produce an equivalent mouse version of Piezo1 E756del proteins throughout their body and then <a href="https://doi.org/10.1126/scitranslmed.abj5557">tested their performance</a> on different physical activities, including long jump and running on a treadmill. Surprisingly, we found that mice with E756del proteins were able to jump about 1.6 times farther without training than mice without the E756del proteins. Mice with Piezo1 in their tendons were also able to run about 1.2 times faster than those without Piezo1.</p>
<p>To identify which body part was producing this jumping ability, we then created mice that produced Piezo1 proteins either in their muscles or their tendons. The results were even more surprising: Mice with Piezo1 in their tendons improved in their jumping ability just as well as mice with Piezo1 throughout their entire body. Mice with Piezo1 only in their muscles, however, did not have any improvement in jumping ability.</p>
<p>We then decided to test the role of Piezo1 in human athletic performance. In collaboration with the <a href="http://www.athlomeconsortium.org/">Athlome Consortium</a>, an international athletic genomics organization, we compared the prevalence of the gene that codes for E756del in 91 Olympic-level Jamaican sprinters and 108 people in the general population in Jamaica. We found that 54% of Jamaican sprinters had an active gene for E756del, compared to just approximately 30% of the general population.</p>
<p>Our findings show that changing a single protein, in this case E756del, can play a role in athletic performance. Further research on tendons and other parts of the human motor systems could help improve treatments for musculoskeletal conditions.</p><img src="https://counter.theconversation.com/content/186801/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Hiroshi Asahara receives funding from National Institute of Health, Japan Society for the Promotion of Science, Japan Agency for Medical Research and Development.</span></em></p><p class="fine-print"><em><span>Ryo Nakamichi does not work for, consult, own shares in or receive funding from any company or organization that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.</span></em></p>The discovery of the role that the protein Piezo1 plays in touch and body awareness won the 2021 Nobel Prize in physiology or medicine. Piezo1 may also be a significant player in motor function.Hiroshi Asahara, Professor of Molecular Medicine, The Scripps Research InstituteRyo Nakamichi, Postdoctoral Researcher in Molecular Medicine, The Scripps Research InstituteLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/1562652021-03-02T12:47:15Z2021-03-02T12:47:15ZSuper shoes: Explaining athletics’ new technological arms race<figure><img src="https://images.theconversation.com/files/387060/original/file-20210301-15-1vxa1so.jpg?ixlib=rb-1.1.0&rect=0%2C11%2C1827%2C1167&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">
</span> <span class="attribution"><a class="source" href="https://www.alamy.com/photo-taken-during-a-qualifier-of-the-tokyo-olympics-marathon-in-tokyo-on-sept-15-2019-shows-runners-wearing-controversial-nike-shows-world-athletics-the-sports-international-federation-said-on-jan-31-2020-that-nikes-vaporfly-available-on-the-open-market-will-be-allowed-at-the-2020-olympics-but-customized-version-worn-by-kenyan-star-eliud-kipchoge-during-his-sub-2-hour-marathon-in-the-fall-of-2019-will-be-banned-kyodo==kyodo-photo-via-newscom-image341979750.html?pv=1&stamp=2&imageid=2D2DF364-6184-4C8B-99D5-DDC70B422585&p=433731&n=0&orientation=0&pn=1&searchtype=0&IsFromSearch=1&srch=foo%3dbar%26st%3d0%26pn%3d1%26ps%3d100%26sortby%3d2%26resultview%3dsortbyPopular%26npgs%3d0%26qt%3dvaporfly%26qt_raw%3dvaporfly%26lic%3d3%26mr%3d0%26pr%3d0%26ot%3d0%26creative%3d%26ag%3d0%26hc%3d0%26pc%3d%26blackwhite%3d%26cutout%3d%26tbar%3d1%26et%3d0x000000000000000000000%26vp%3d0%26loc%3d0%26imgt%3d0%26dtfr%3d%26dtto%3d%26size%3d0xFF%26archive%3d1%26groupid%3d%26pseudoid%3d%26a%3d%26cdid%3d%26cdsrt%3d%26name%3d%26qn%3d%26apalib%3d%26apalic%3d%26lightbox%3d%26gname%3d%26gtype%3d%26xstx%3d0%26simid%3d%26saveQry%3d%26editorial%3d%26nu%3d%26t%3d%26edoptin%3d%26customgeoip%3dGB%26cap%3d1%26cbstore%3d1%26vd%3d0%26lb%3d%26fi%3d2%26edrf%3d0%26ispremium%3d1%26flip%3d0%26pl%3d">Newscom/Alamy Stock Photo</a></span></figcaption></figure><p>In the 1960s, when traditional cinder athletics tracks were replaced by spongy, synthetic surfaces, endurance running experienced a revolution. Long distance runners began clocking far faster times on the synthetic tracks, smashing multiple world records in the process.</p>
<p>Today, another revolution is afoot: the development of the so-called “super shoe”, which is driving another spike of <a href="https://www.bbc.co.uk/sport/athletics/53513971">record toppling</a> in endurance running. The new shoe technology was introduced to road running in 2016 and track running in 2019, and since those key dates virtually all endurance running world records, from the <a href="https://www.worldathletics.org/records/by-category/world-records">5,000m to the marathon</a>, have been broken.</p>
<p>This has <a href="https://www.podiumrunner.com/gear/a-new-rule-limiting-vaporfly-like-shoes-is-coming-soon-maybe/">divided opinion</a> in the athletics world, with some arguing the shoes are unfair while others argue they’re just like synthetic running tracks: an inevitable technological leap for endurance runners to capitalise upon.</p>
<p>Research in sports biomechanics helps explain exactly what’s happening inside these shoes. While super shoes are clearly disruptive to old records – some of which have stood for decades – this technology should simply be seen as another entry in sports’ long list of performance-enhancing innovations.</p>
<h2>Nike’s new shoes</h2>
<p>In the <a href="https://www.olympic.org/rio-2016/athletics/marathon-men">2016 Olympic marathon</a>, all three male medallists climbed onto the podium in the same shoes. They were a Nike prototype, later released as the “Nike Vaporfly 4%”, which are now almost ubiquitous on the feet of elite road runners. </p>
<p>Then, in 2019, similar super-shoe technology hit the athletics track. A slew of Nike-sponsored <a href="https://www.runnersworld.com/uk/news/a26440923/muirs-record-breaking-spikes-cause-controversy/">athletes</a>, wearing Nike’s prototype track spikes, began running some astonishingly fast times.</p>
<p>The performance enhancement afforded by both types of super-shoe – the trainer and the track spike – is generated by enhancing athletes’ <a href="https://sportsmedicine-open.springeropen.com/articles/10.1186/s40798-015-0007-y">running economy</a>, which means reducing the energetic cost of running at a given speed. </p>
<p>The original Vaporfly improved the running economy of highly trained runners by <a href="https://link.springer.com/article/10.1007/s40279-017-0811-2?MvBriefArticleId=32183&error=cookies_not_supported&error=cookies_not_supported&code=04597c20-4432-445f-8c00-268c69420fab&code=e09ac8ca-a1fc-40b6-b8cc-3ee6f5ce252a">around 4%</a> when compared to a control marathon shoe – hence the 4% moniker. In practice, this equates to a rough improvement in running performance of between 2% and 3%. </p>
<figure class="align-center ">
<img alt="Many runners' legs and shoes running on tarmac" src="https://images.theconversation.com/files/387202/original/file-20210302-23-8egplr.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/387202/original/file-20210302-23-8egplr.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=267&fit=crop&dpr=1 600w, https://images.theconversation.com/files/387202/original/file-20210302-23-8egplr.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=267&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/387202/original/file-20210302-23-8egplr.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=267&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/387202/original/file-20210302-23-8egplr.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=335&fit=crop&dpr=1 754w, https://images.theconversation.com/files/387202/original/file-20210302-23-8egplr.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=335&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/387202/original/file-20210302-23-8egplr.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=335&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">The new super shoes are a dramatic improvement on all previous running trainers.</span>
<span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/many-runners-race-finish-line-marathon-227283232">ChiccoDodiFC/Shutterstock</a></span>
</figcaption>
</figure>
<p>The shoes have delivered on this claim. In the years since <a href="https://www.medrxiv.org/content/medrxiv/early/2021/01/02/2020.12.26.20248861.full.pdf">the 2016 advent of the Vaporfly</a>, the times of the top 50 male marathon runners have improved by about 2% on average. For the top 50 female marathon runners, that figure was closer to 2.6%. Nike’s track spikes are considered to be delivering significant running economy boosts to athletes, too.</p>
<h2>Fancy footwork</h2>
<p>Several footwear features are behind this performance boost. They include the shoe’s weight, its material composition, the thickness of its heel, and what’s called its “longitudinal bending stiffness”, which in simple terms is how flexible the shoe is from heel to toe.</p>
<p>The inclusion of a carbon fibre plate, running from heel to toe within the Vaporfly’s foam sole, has been the headline-grabbing innovation. These plates aren’t actually a <a href="https://www.biomechanist.net/carbon-fibre-plates-the-science-behind-the-latest-hype-in-running-shoe-technology/">new concept</a> but their specific scoop shape is being credited for the latest performance enhancement. It causes a “<a href="https://bjsm.bmj.com/content/early/2020/08/06/bjsports-2020-102550">teeter-totter</a>” effect, which effectively helps return energy to the runner each time their foot strikes the ground. </p>
<figure>
<iframe width="440" height="260" src="https://www.youtube.com/embed/wVXrIaPuP7c?wmode=transparent&start=0" frameborder="0" allowfullscreen=""></iframe>
<figcaption><span class="caption">To understand Nike’s new super shoe, it helps to look within its sole.</span></figcaption>
</figure>
<p>The Vaporfly also uses <a href="https://blogs.bmj.com/bjsm/2019/10/14/shoes-and-sub-2-hr-marathon/">PEBA foam</a>, which stores far more energy from foot strikes, and returns more energy to the runner, than the TPU and EVA materials that are traditionally used in trainers. PEBA foam is also lighter: the Vaporfly weighs around 50g less than previous competitors. </p>
<p>Finally, the shoe’s heel thickness of up to 40mm is around 10mm thicker than that of other racing shoes. That’s partially to accommodate the other technology in the shoe, and partially to increase the wearer’s leg length, which contributes to their energy saving. The above features have likely formed the basis for Nike’s new track spikes, too.</p>
<h2>Blistering pace</h2>
<p>Nike’s new shoes aren’t the only technological, science-driven interventions delivering “<a href="https://www.weforum.org/agenda/2016/08/this-coach-improved-everything-by-1-this-is-the-remarkable-difference-it-s-made/">marginal gains</a>” to the world of endurance running. </p>
<p>When Eliud Kipchoge <a href="https://www.bbc.co.uk/sport/athletics/50025543">broke the two-hour marathon barrier</a> in an unofficial race in 2019, beating his own world record time of <a href="https://www.worldathletics.org/records/by-progression/17427?type=1">2:01:39</a>, he was wearing super shoes. But everything else – his race kit, the course design, his pacing and training strategies – all of it was exhaustively researched and scientifically optimised.</p>
<figure>
<iframe width="440" height="260" src="https://www.youtube.com/embed/14xZ8iiFPYc?wmode=transparent&start=0" frameborder="0" allowfullscreen=""></iframe>
<figcaption><span class="caption">Eliud Kipchoge broke the two hour marathon threshold in 2019 wearing Nike’s super-shoes.</span></figcaption>
</figure>
<p>Similarly, advanced footwear is certainly helping track athletes run faster. But other innovative tools – such as the <a href="https://www.worldathletics.org/news/feature/wavelight-technology-athletics">wave-light pacing technology</a>, used during the 5,000m and 10,000m world records in 2020 – may also contribute to their increased speed.</p>
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<em>
<strong>
Read more:
<a href="https://theconversation.com/science-of-champion-runners-inside-the-body-of-elite-endurance-athletes-146639">Science of champion runners: inside the body of elite endurance athletes</a>
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</em>
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<p>World Athletics, the governing body responsible for endurance running, issued updated <a href="https://www.worldathletics.org/news/press-releases/shoe-technology-rules-tokyo-qualification-roa">guidance</a> on footwear in August 2020, permitting a heel thickness of up to 40mm in road running shoes and 25mm in distance running spikes. Many have called for further restrictions. </p>
<p>There are parallels to other sports. The introduction of full-body, Nasa-designed <a href="http://news.bbc.co.uk/sport1/hi/other_sports/swimming/8161867.stm">swimsuits to competitive swimming</a> in 2008 was held responsible for the world records that toppled that year. The full-body swimsuit was quickly banned, though <a href="https://www.si.com/olympics/2016/07/13/tech-behind-those-olympic-swimsuits-rio-michael-phelps">the technology lives on</a> in a reduced form in today’s swimsuits.</p>
<p>The super-shoe arms race will inevitably spread to sprint distances in the <a href="https://www.runnersworld.com/uk/news/a35585698/nike-viperfly-shelved/">near future</a>. New technology will usher in a new cohort of world record holders. During this process of leaderboard recalibration, greater emphasis should be placed on results as opposed to times. After all, regardless of the technology, it’s titles that transcend generations, and medals that last longer than times.</p><img src="https://counter.theconversation.com/content/156265/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Jonathan Taylor does not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.</span></em></p>Endurance running is experiencing its ‘marginal gains’ moment.Jonathan Taylor, Lecturer in Sport and Exercise, Teesside UniversityLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/1426012020-08-10T12:07:27Z2020-08-10T12:07:27Z‘Morality pills’ may be the US’s best shot at ending the coronavirus pandemic, according to one ethicist<figure><img src="https://images.theconversation.com/files/351641/original/file-20200806-18-1o03yut.jpg?ixlib=rb-1.1.0&rect=373%2C137%2C3780%2C2821&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">A psychoactive substance to make you act in everyone's best interest?</span> <span class="attribution"><a class="source" href="https://www.gettyimages.com/detail/photo/close-up-of-capsule-on-spoon-over-white-background-royalty-free-image/956911912">Sayanh Kaew Mni/EyeEm via Getty Images</a></span></figcaption></figure><p>COVID-19 is a collective risk. It threatens everyone, and we all must cooperate to lower the chance that the coronavirus harms any one individual. Among other things, that means <a href="https://www.cdc.gov/coronavirus/2019-ncov/index.html">keeping safe social distances and wearing masks</a>. But <a href="https://www.pewresearch.org/fact-tank/2020/06/23/most-americans-say-they-regularly-wore-a-mask-in-stores-in-the-past-month-fewer-see-others-doing-it/">many people choose not to do these things</a>, making spread of infection more likely.</p>
<p>When someone chooses not to follow public health guidelines around the coronavirus, they’re defecting from the public good. It’s the moral equivalent of the <a href="https://en.wikipedia.org/wiki/Tragedy_of_the_commons#:%7E:text=The%20tragedy%20of%20the%20commons,resource%20through%20their%20collective%20action.">tragedy of the commons</a>: If everyone shares the same pasture for their individual flocks, some people are going to graze their animals longer, or let them eat more than their fair share, ruining the commons in the process. Selfish and self-defeating behavior undermines the pursuit of something from which everyone can benefit.</p>
<p>Democratically enacted enforceable rules – mandating things like mask wearing and social distancing – might work, if defectors could be coerced into adhering to them. But <a href="https://www.aarp.org/health/healthy-living/info-2020/states-mask-mandates-coronavirus.html">not all states have opted to pass them</a> or <a href="https://www.clickondetroit.com/news/local/2020/05/15/several-michigan-sheriffs-say-they-wont-enforce-parts-of-executive-orders/">to enforce the rules</a> that are in place.</p>
<p><a href="https://scholar.google.com/citations?user=oEHIR14AAAAJ&hl=en&oi=ao">My research in bioethics</a> focuses on questions like how to induce those who are noncooperative to get on board with doing what’s best for the public good. To me, it seems the problem of coronavirus defectors could be solved by moral enhancement: like receiving a vaccine to beef up your immune system, people could take a substance to boost their cooperative, pro-social behavior. Could a psychoactive pill be the solution to the pandemic?</p>
<p>It’s a far-out proposal that’s <a href="https://slate.com/technology/2017/03/why-we-are-so-alarmed-by-the-idea-of-a-moral-enhancement-pill.html">bound to be controversial</a>, but one I believe is worth at least considering, given the importance of social cooperation in the struggle to get COVID-19 under control.</p>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/351642/original/file-20200806-18-1gju1on.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="Protesters outside California state capital building" src="https://images.theconversation.com/files/351642/original/file-20200806-18-1gju1on.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/351642/original/file-20200806-18-1gju1on.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=392&fit=crop&dpr=1 600w, https://images.theconversation.com/files/351642/original/file-20200806-18-1gju1on.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=392&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/351642/original/file-20200806-18-1gju1on.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=392&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/351642/original/file-20200806-18-1gju1on.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=492&fit=crop&dpr=1 754w, https://images.theconversation.com/files/351642/original/file-20200806-18-1gju1on.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=492&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/351642/original/file-20200806-18-1gju1on.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=492&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">People in California protested stay-at-home orders in May – prioritizing the personal over the collective.</span>
<span class="attribution"><a class="source" href="https://www.gettyimages.com/detail/news-photo/hundreds-of-people-gather-to-protest-the-stay-at-home-news-photo/1211479844">Josh Edelson/AFP via Getty Images</a></span>
</figcaption>
</figure>
<h2>Public goods games show scale of the problem</h2>
<p>Evidence from experimental economics shows that defections are common to situations in which people face collective risks. Economists use <a href="https://en.wikipedia.org/wiki/Public_goods_game#:%7E:text=The%20public%20goods%20game%20is,put%20into%20a%20public%20pot.">public goods games</a> to measure how people behave in various scenarios to lower collective risks such as from climate change or a pandemic and to prevent the loss of public and private goods.</p>
<p>The evidence from these experiments is no cause for optimism. <a href="https://doi.org/10.1073/pnas.0504902103">Usually everyone loses</a> because people won’t cooperate. This research suggests it’s not surprising people aren’t wearing masks or social distancing – lots of people defect from groups when facing a collective risk. By the same token, I’d expect that, as a group, we will fail at addressing the collective risk of COVID-19, because groups usually fail. <a href="https://www.cdc.gov/coronavirus/2019-ncov/cases-updates/cases-in-us.html">For more than 150,000 Americans so far</a>, this has meant losing everything there is to lose.</p>
<p>But don’t abandon all hope. In some of these experiments, the groups win and successfully prevent the losses associated with the collective risk. What makes winning more likely? Things like keeping a running tally of what others are contributing, <a href="https://doi.org/10.1038/s41598-019-50964-w">observing others’ behaviors</a>, <a href="https://doi.org/10.1073/pnas.1102493108">communication and coordination</a> before and during play, and <a href="https://doi.org/10.1038/nature13530">democratic implementation of an enforceable rule requiring contributions</a>. </p>
<p>For those of us in the United States, these conditions are out of reach when it comes to COVID-19. You can’t know what others are contributing to the fight against the coronavirus, especially if you socially distance yourself. It’s impossible to keep a running tally of what the other 328 million people in the U.S. are doing. And communication and coordination are not feasible outside of your own small group.</p>
<p>Even if these factors were achievable, they still require the very cooperative behavior that’s in short supply. The scale of the pandemic is simply too great for any of this to be possible.</p>
<h2>Promoting cooperation with moral enhancement</h2>
<p>It seems that the U.S. is not currently equipped to cooperatively lower the risk confronting us. Many are instead pinning their hopes on the rapid development and distribution of an enhancement to the immune system – a vaccine.</p>
<p>But I believe society may be better off, both in the short term as well as the long, by boosting not the body’s ability to fight off disease but the brain’s ability to cooperate with others. What if researchers developed and delivered a moral enhancer rather than an immunity enhancer?</p>
<p>Moral enhancement is the use of substances to make you more moral. The psychoactive substances act on your ability to reason about what the right thing to do is, or your ability to be empathetic or altruistic or cooperative.</p>
<p>[<em>You need to understand the coronavirus pandemic, and we can help.</em> <a href="https://theconversation.com/us/newsletters/the-daily-3?utm_source=TCUS&utm_medium=inline-link&utm_campaign=newsletter-text&utm_content=coronavirus-help">Read The Conversation’s newsletter</a>.]</p>
<p>For example, oxytocin, the chemical that, among other things, can induce labor or increase the bond between mother and child, may cause a person to be more empathetic and <a href="https://doi.org/10.1126/science.1189047">altruistic</a>, <a href="https://doi.org/10.1371/journal.pone.0001128">more giving and generous</a>. <a href="https://doi.org/10.1093/ijnp/pyx047">The same goes for psilocybin</a>, the active component of “magic mushrooms.” These substances have been shown to <a href="https://doi.org/10.1007/s40732-015-0139-y">lower aggressive behavior in those with antisocial personality disorder</a> and to improve the <a href="https://doi.org/10.1016/j.psyneuen.2017.07.483">ability of sociopaths to recognize emotion in others</a>. </p>
<p>These substances interact directly with the psychological underpinnings of moral behavior; others that make you more rational could also help. Then, perhaps, the people who choose to go maskless or flout social distancing guidelines would better understand that everyone, including them, is better off when they contribute, and rationalize that the best thing to do is cooperate. </p>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/351643/original/file-20200806-14-1wz4hlx.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="Hand injecting a shot into a bare upper arm" src="https://images.theconversation.com/files/351643/original/file-20200806-14-1wz4hlx.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/351643/original/file-20200806-14-1wz4hlx.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=445&fit=crop&dpr=1 600w, https://images.theconversation.com/files/351643/original/file-20200806-14-1wz4hlx.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=445&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/351643/original/file-20200806-14-1wz4hlx.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=445&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/351643/original/file-20200806-14-1wz4hlx.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=560&fit=crop&dpr=1 754w, https://images.theconversation.com/files/351643/original/file-20200806-14-1wz4hlx.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=560&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/351643/original/file-20200806-14-1wz4hlx.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=560&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">A moral booster rather than an immunological one?</span>
<span class="attribution"><a class="source" href="https://www.gettyimages.com/detail/photo/person-receiving-a-vaccine-royalty-free-image/83290870">Jeffrey Hamilton/DigitalVision via Getty Images</a></span>
</figcaption>
</figure>
<h2>Moral enhancement as an alternative to vaccines</h2>
<p>There are of course pitfalls to moral enhancement.</p>
<p>One is that the science isn’t developed enough. For example, while oxytocin may cause some people to be more pro-social, it also <a href="https://doi.org/10.1073/pnas.1015316108">appears to encourage ethnocentrism</a>, and so is probably a bad candidate for a widely distributed moral enhancement. But this doesn’t mean that a morality pill is impossible. The solution to the underdeveloped science isn’t to quit on it, but to direct resources to related research in neuroscience, psychology or one of the behavioral sciences.</p>
<p>Another challenge is that the defectors who need moral enhancement are also the least likely to sign up for it. As some have argued, a solution would be to <a href="https://global.oup.com/academic/product/unfit-for-the-future-9780198707929">make moral enhancement compulsory</a> or <a href="https://doi.org/10.1111/bioe.12496">administer it secretly, perhaps via the water supply</a>. These actions require weighing other values. Does the good of covertly dosing the public with a drug that would change people’s behavior outweigh individuals’ autonomy to choose whether to participate? Does the good associated with wearing a mask outweigh an individual’s autonomy to not wear one?</p>
<p>The scenario in which the government forces an immunity booster upon everyone is plausible. And the military has been <a href="https://www.theatlantic.com/technology/archive/2012/02/more-than-human-the-ethics-of-biologically-enhancing-soldiers/253217/">forcing enhancements like vaccines or “uppers” upon soldiers</a> for a long time. The scenario in which the government forces a morality booster upon everyone is far-fetched. But a strategy like this one could be a way out of this pandemic, a future outbreak or the suffering associated with climate change. That’s why we should be thinking of it now.</p><img src="https://counter.theconversation.com/content/142601/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Parker Crutchfield does not work for, consult, own shares in or receive funding from any company or organization that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.</span></em></p>Rather than a vaccine to beef up your immune system, a psychoactive substance could boost your cooperative, pro-social behavior – curtailing the selfish actions that spur on coronavirus’s spread.Parker Crutchfield, Associate Professor of Medical Ethics, Humanities and Law, Western Michigan UniversityLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/1172362019-05-24T13:02:13Z2019-05-24T13:02:13ZDoping soldiers so they fight better – is it ethical?<figure><img src="https://images.theconversation.com/files/276123/original/file-20190523-187176-1bdn0zf.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">A waxwork of Captain America on display at Madame Tussauds in Bangkok, Thailand. </span> <span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/bangkok-july-22-waxwork-captain-america-302674247?src=uDJsZqGalBddn6FkQUoHTw-1-13">Nuamfolio/Shutterstock.com</a></span></figcaption></figure><p>The military is constantly using technology to build better ships, warplanes, guns and armor. Shouldn’t it also use drugs to build better soldiers?</p>
<p>Soldiers have long taken drugs to help them fight. <a href="https://www.ncbi.nlm.nih.gov/pubmed/16018329">Amphetamines like Dexedrine were distributed widely</a> to American, German, British and other forces during World War II and to U.S. service members in Korea, Vietnam, Kuwait, Iraq and Afghanistan. In 1991, the <a href="https://www.nytimes.com/2003/01/19/us/threats-and-responses-military-bombing-error-puts-a-spotlight-on-pilots-pills.html">Air Force chief-of-staff stopped the practice</a> because, in his words, “Jedi knights don’t need them.” But the ban lasted only five years. DARPA, an agency that does cutting-edge research for the U.S. Department of Defense, is trying to make soldiers “kill-proof” by developing super-nutrition pills and substances to <a href="http://www.dana.org/Publications/pressbooks/Details.aspx?id=50128">make them smarter and stronger</a>. New drugs that reduce the need for sleep, such as modafinil, are being tested. Researchers are even looking into <a href="https://apps.dtic.mil/dtic/tr/fulltext/u2/a535866.pdf">modifying soldiers’ genes</a>.</p>
<p>As a <a href="https://law.case.edu/Our-School/Faculty-Staff/Meet-Our-Faculty/Faculty-Detail/id/135">professor of health law and bioethics</a>, I began studying the use of drugs to enhance performance in sports, and I soon became interested in the use of performance-enhancing drugs in the military. Most people think <a href="http://globalsportsdevelopment.org/2014/01/28/doping-survey-reveals-public-opinion/">doping in sports is harmful cheating</a>; shouldn’t that be how doping in combat is viewed? The answer, I decided, was no: Doping in sports doesn’t produce any meaningful social benefit, but using drugs to improve performance in the military could save lives and make it easier to complete missions.</p>
<p>But the military still needs rules for how performance enhancements should be used. </p>
<h2>Mandatory use</h2>
<p>Can soldiers be ordered to take enhancement drugs? What if the drugs have dangerous side effects? What if there hasn’t been a lot of research on their long-term effects? It’s also important to realize that the risks from performance-enhancing drugs are not only to the soldiers who use them; in 2004, pilots in Afghanistan who accidentally dropped a bomb that killed four Canadian soldiers <a href="https://www.globalsecurity.org/org/news/2003/030104-speed01.htm">blamed their mistake on being hopped up on amphetamines</a>.</p>
<p>Soldiers generally have to follow orders, so it’s important for their commanders to carefully think through whether use of these drugs should be mandatory or voluntary. Applying a set of principles that I developed to guide <a href="https://doi.org/10.1080/15027570.2014.992214">bioethical decision-making in the military</a>, superiors should force troops to use enhancement drugs only when the advantages that the drugs provide and the importance of the mission outweigh the risks to the user. <a href="http://jpsl.org/archives/defending-against-biochemical-warfare-ethical-issues-involving-coercive-use-investigational-drugs-and-biologics-military/">Soldiers in the Gulf War were required to take drugs</a> that hadn’t been approved for the purpose for which they were given, which was to try to provide some protection in case Saddam Hussein’s forces resorted to chemical or biological warfare. Congress stepped in and said that troops could be ordered to take drugs for such “off-label” purposes only if the president authorized it directly or declared a national emergency.</p>
<p>Opponents of doping in sports maintain that athletes who win races by doping should not be rewarded. Should we adopt the same policy in the military? Should soldiers who act bravely or shoot straighter with the help of drugs get promotions or medals? If the soldiers are ordered to use the drugs by their commanders, I suggest the answer should be yes, since it doesn’t seem fair to punish them for doing something about which they had no choice, especially if the drugs they were ordered to use could have serious side effects.</p>
<figure class="align-center ">
<img alt="" src="https://images.theconversation.com/files/276148/original/file-20190523-187143-4sbdn4.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/276148/original/file-20190523-187143-4sbdn4.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=352&fit=crop&dpr=1 600w, https://images.theconversation.com/files/276148/original/file-20190523-187143-4sbdn4.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=352&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/276148/original/file-20190523-187143-4sbdn4.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=352&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/276148/original/file-20190523-187143-4sbdn4.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=442&fit=crop&dpr=1 754w, https://images.theconversation.com/files/276148/original/file-20190523-187143-4sbdn4.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=442&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/276148/original/file-20190523-187143-4sbdn4.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=442&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Should soldiers take steroids to bulk up?</span>
<span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/muscular-male-body-testosterone-hormone-formula-1169361682?src=gNNI4xg4SDagO1a5jn0ZRQ-1-79">BLACKDAY/Shutterstock.com</a></span>
</figcaption>
</figure>
<h2>Voluntary use</h2>
<p>What if soldiers take performance-enhancing drugs on their own, or if using them is illegal? A study in 2014 reported that <a href="https://doi.org/10.17226/12095">67% of active-duty service members</a> in all branches of the military took dietary supplements. In special forces like Navy SEALS, the percentage increases to over 75%.</p>
<p>What if these substances actually gave users a performance boost? The most popular doping drugs in sports are <a href="https://www.drugabuse.gov/drugs-abuse/steroids-anabolic">anabolic steroids</a>, which are Schedule III controlled substances that can be purchased legally only by prescription. In most states these can’t legally be prescribed for enhancement purposes. </p>
<p>You might think that the military should test soldiers to see if they were illegally using steroids just like athletes are tested in the Olympics, but currently the <a href="http://www.esd.whs.mil/Portals/54/Documents/DD/issuances/dodi/101016p.pdf">military is not allowed to do random drug testing</a> or “unit sweeps” for steroids. In short, the jury is still out on whether the military should reward or punish military success achieved with the aid of self-help drugs.</p>
<p>A final concern is when performance-enhancing drugs give troops advantages over civilians. Soldiers in the reserves, and those who serve on bases but reside with their families, have both military and civilian lives. What if they compete in sports or intellectual contests with civilians? One solution is to require them to disclose that they are taking enhancement drugs, but this could violate military secrecy and help enemies figure out ways of combating the drugs’ effects. </p>
<p>Some commentators argue that the effects of the drugs must be reversible, but soldiers may regard the advantages they get from the drugs as one of the benefits of being in the service; it could even be a recruiting incentive, like the prospect of being trained in a skill that can land them a good civilian job later.</p>
<p>Proper use of performance-enhancing drugs in the military could shorten wars and save lives. But with the development of more powerful drugs that increase strength and endurance and reduce the need for sleep and food, commanders need to carefully consider the risks to soldiers as well as the benefits for them and their mission.</p><img src="https://counter.theconversation.com/content/117236/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Maxwell Mehlman receives funding from the National Institutes of Health to study the ethical, legal, and social implications of using genomic technologies to enhance warfighter performance. He also was part of a team funded by the Greenwall Foundation that studied ethical, legal, and social implications of performance enhancement in the military.</span></em></p>Doping is condemned in sports. But what about in the military? Should soldiers be allowed or even encouraged to take drugs that make them superior fighters and more likely to complete a mission?Maxwell Mehlman, Professor of Biomedical Ethics, Case Western Reserve UniversityLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/923662018-02-26T11:57:04Z2018-02-26T11:57:04ZCan coffee improve your workout? The science of caffeine and exercise<figure><img src="https://images.theconversation.com/files/207827/original/file-20180226-120971-1b6j9ij.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">
</span> <span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/resting-runner-260897984?src=XTj1Xdt-nA15eRNsMggkmg-1-1">Shutterstock</a></span></figcaption></figure><p>Caffeine is one of the most researched substances reported to help athletes perform better and train longer and harder. As a result, professional and amateur sportspeople often take it as a performance-enhancing “ergogenic” aids for a wide range of activities. These include intermittent exercise such as football and racket sports, endurance exercise such as running and cycling, and resistance exercise such as weightlifting.</p>
<p>But while most research looks at the effects of pure caffeine consumed as tablets with water, in the real world most people get their caffeine from coffee, energy drinks or other products like special gels or <a href="https://link.springer.com/article/10.1007/s40279-017-0848-2">chewing gum</a>. So will drinking a cup of joe before your workout actually make a difference? The answer could depend as much on your genes as what kind of coffee you’re drinking.</p>
<p><a href="https://jissn.biomedcentral.com/articles/10.1186/1550-2783-7-5">Scientists think</a> caffeine affects the body chemical adenosine, which normally promotes sleep and suppresses arousal. Caffeine ties up the receptors in the brain that detect adenosine and so makes it more alert.</p>
<p>But it may also increase stimulation of the central nervous system, making exercise seem like it involves less effort and pain. In high-intensity activities such as resistance training or sprinting, it may increase the number of fibres used in muscle contractions, meaning movements can be more frequent and forceful. </p>
<h2>Faster, higher, stronger</h2>
<p>Research has shown that pure caffeine can help endurance athletes <a href="https://link.springer.com/article/10.1007/s40279-014-0257-8">run faster</a> and <a href="http://www.mdpi.com/2072-6643/7/7/5219/htm">cycle for longer</a>. It can help footballers to <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3279366/">sprint more often and over greater distances</a>, and basketball players to <a href="http://www.mdpi.com/2072-6643/9/9/1033/htm">jump higher</a>. It can help <a href="http://online.liebertpub.com/doi/abs/10.1089/jcr.2012.0019?journalCode=jcr">tennis players</a> and <a href="https://journals.lww.com/acsm-msse/fulltext/2016/01000/Effect_of_Caffeine_on_Golf_Performance_and_Fatigue.18.aspx">golfers</a> to hit the ball with greater accuracy. And it can help <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2876999/pdf/1550-2783-7-18.pdf">weightlifters lift more weight</a>.</p>
<p>The evidence for caffeine’s effects on sprinting is more mixed. Limited improvements <a href="http://www.mdpi.com/2075-4663/4/3/45">have been found</a> for events lasting under three minutes. But for races of around ten seconds,
caffeine can improve peak <a href="https://jissn.biomedcentral.com/articles/10.1186/1550-2783-12-S1-P57">power output, speed, and strength</a>.</p>
<p>An increasing number of studies have also shown that coffee can be used as an alternative to caffeine to <a href="http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0059561">improve cycling</a> and <a href="https://journals.humankinetics.com/doi/abs/10.1123/ijspp.2017-0456?url_ver=Z39.88-2003&rfr_id=ori%3Arid%3Acrossref.org&rfr_dat=cr_pub%3Dpubmed&">competitive running</a> performance, and produce similar results similar to pure caffeine. In fact, coffee may even be more effective at <a href="https://journals.lww.com/nsca-jscr/Abstract/2016/10000/Effect_of_Coffee_and_Caffeine_Ingestion_on.27.aspx">improving resistance exercise than caffeine alone</a>. Similarly, drinking <a href="https://jissn.biomedcentral.com/articles/10.1186/1550-2783-10-1">energy drinks</a> containing caffeine before exercise can improve mental focus, alertness, anaerobic performance and endurance performance.</p>
<figure class="align-center ">
<img alt="" src="https://images.theconversation.com/files/207825/original/file-20180226-120971-lly7xa.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/207825/original/file-20180226-120971-lly7xa.png?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=330&fit=crop&dpr=1 600w, https://images.theconversation.com/files/207825/original/file-20180226-120971-lly7xa.png?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=330&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/207825/original/file-20180226-120971-lly7xa.png?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=330&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/207825/original/file-20180226-120971-lly7xa.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=414&fit=crop&dpr=1 754w, https://images.theconversation.com/files/207825/original/file-20180226-120971-lly7xa.png?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=414&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/207825/original/file-20180226-120971-lly7xa.png?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=414&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Total weight lifted when performing back squats to failure.</span>
<span class="attribution"><a class="source" href="https://journals.lww.com/nsca-jscr/Abstract/2016/10000/Effect_of_Coffee_and_Caffeine_Ingestion_on.27.aspx">Journal of Strength and Conditioning Research</a>, <span class="license">Author provided</span></span>
</figcaption>
</figure>
<p>But drinking coffee isn’t like taking a measured dose of caffeine. The amount of stimulant in a cup, and so how it affects you, will depend on the blend of coffee and how it is brewed. Studies have shown consuming either <a href="http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0059561">0.15g</a> or <a href="https://journals.humankinetics.com/doi/abs/10.1123/ijspp.2017-0456?url_ver=Z39.88-2003&rfr_id=ori%3Arid%3Acrossref.org&rfr_dat=cr_pub%3Dpubmed">0.09g</a> of caffeinated coffee per kilogram of body weight can improve performance. So a dessert spoon of coffee granules rather than a traditional teaspoon is probably best. </p>
<p>It’s also worth bearing in mind that each piece of research shows caffeine improves athletic performance of a group of people as a whole. But we also know that <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5752738/pdf/40279_2017_Article_776.pdf">genetic factors</a> have a big influence on our responses to caffeine and not everyone reacts in the same way. This means consuming caffeine won’t necessarily improve your performance.</p>
<h2>Potential downsides</h2>
<p>In fact, you could end up feeling nauseated and jittery at a time when, if you are competing, you are already feeling anxious. And, as caffeine’s effects can linger for up to <a href="https://www.ncbi.nlm.nih.gov/books/NBK223808/">five hours</a>, taking it too late in the day could disrupt your sleep, which is a big factor in health and fitness in general. This means it’s important to practice with caffeine during training sessions or friendly fixtures before using it for an important event. </p>
<p>Some <a href="http://www.mysportscience.com/single-post/2017/06/18/Do-you-need-to-refrain-from-coffee-to-get-the-maximal-effect-of-caffeine">have also suggested</a> that you should abstain from caffeine in order to enjoy a better effect on your performance when you consume it for exercise. But maintaining your normal intake will prevent any <a href="https://theconversation.com/caffeine-withdrawal-drives-need-for-more-but-are-we-addicts-17380">possible withdrawal symptoms</a> and still provide benefits if caffeine is taken before exercise. Its effects peak between <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4898153/pdf/ictx-54-308.pdf">30 and 75 minutes after ingestion</a>.</p>
<p>Finally, it’s a a commonly held belief that caffeine is a diuretic that will lead to dehydration because it makes you produce more urine. But a <a href="http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0084154">number of studies</a> have shown that this isn’t the case with moderate amounts of coffee, cola or any other caffeinated beverage, which help keep you hydrated like any other drink.</p><img src="https://counter.theconversation.com/content/92366/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Neil Clarke receives funding from The Institute for Scientific Information on Coffee. </span></em></p>Drinking coffee before exercising could make you run faster and lift heavier - if you’ve the right genes.Neil Clarke, Principal Lecturer in Sport and Exercise Science at Coventry University, Coventry UniversityLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/773432017-05-15T20:07:49Z2017-05-15T20:07:49ZAustralia should stop beefing up its steroid laws – that won’t help users<figure><img src="https://images.theconversation.com/files/168686/original/file-20170510-7904-9futrr.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">There has been a dramatic increase in the amount of steroids seized at the Australian border over time.</span> <span class="attribution"><span class="source">AAP</span></span></figcaption></figure><p>The use of image and performance enhancing drugs – in particular steroids – is a growing area of concern <a href="https://www.ncbi.nlm.nih.gov/pubmed/24582699">globally</a>. </p>
<p>The use of these drugs has traditionally been limited to elite athletes and professional bodybuilders. But now their use is becoming normalised as part of a <a href="http://onlinelibrary.wiley.com/doi/10.1111/hsc.12326/pdf">fitness and beauty regime</a> for people who want to gain muscle, become leaner, and improve their appearance.</p>
<p>Several <a href="http://www.tandfonline.com/doi/abs/10.3109/09687637.2015.1061975">population studies</a> have shown the use of image and performance enhancing drugs in Australia is relatively low. However, the dramatic increase of <a href="https://www.acic.gov.au/sites/g/files/net1491/f/2016/08/acic-iddr-2014-15.pdf?v=1470178813">steroids detected</a> at the country’s borders, and the number of users <a href="https://www.ncbi.nlm.nih.gov/pubmed/26644363">accessing needle and syringe programs</a>, seem to indicate otherwise. </p>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/168825/original/file-20170510-21593-cled6x.png?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="" src="https://images.theconversation.com/files/168825/original/file-20170510-21593-cled6x.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/168825/original/file-20170510-21593-cled6x.png?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=273&fit=crop&dpr=1 600w, https://images.theconversation.com/files/168825/original/file-20170510-21593-cled6x.png?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=273&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/168825/original/file-20170510-21593-cled6x.png?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=273&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/168825/original/file-20170510-21593-cled6x.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=344&fit=crop&dpr=1 754w, https://images.theconversation.com/files/168825/original/file-20170510-21593-cled6x.png?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=344&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/168825/original/file-20170510-21593-cled6x.png?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=344&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">Number of performance- and image-enhancing drug detections at the Australian border, 2005–06 to 2014–15.</span>
<span class="attribution"><span class="source">DIBP</span></span>
</figcaption>
</figure>
<p>If Australia is to respond to image and performance enhancing drug use effectively, we need to improve our prevention and harm-reduction strategies – and not merely further criminalise users.</p>
<h2>Potential health harms</h2>
<p>The most-researched (and targeted) image and performance enhancing drugs are steroids. But other examples include <a href="https://theconversation.com/health-warning-about-body-sculpting-drug-clenbuterol-23815">clenbuterol</a> (to lose weight) and <a href="http://www.news.com.au/lifestyle/health/health-problems/melanotan-ii-sold-illegally-online-to-people-desperate-for-a-tan/news-story/878a895097e72cfe6b723e5d9f4234ed">melanotan II</a> (a tanning agent).</p>
<p>The inappropriate and excessive use of these drugs has been associated with a range of negative <a href="http://www.sciencedirect.com/science/article/pii/S0376871608001919">physical</a> and <a href="https://www.ncbi.nlm.nih.gov/pubmed/19769977">psychological</a> health consequences. Steroid use, for example, has been linked to high blood pressure, heart attack, stroke, acne and skin infections, liver damage, tendon rupture, premature baldness and stunted bone growth in adolescents. There are also psychological implications such as addiction, mood syndromes, and body image disorders. </p>
<p>Another issue is that the widespread use of <a href="https://www.ncbi.nlm.nih.gov/pubmed/20355210">illicitly manufactured products</a> sourced through the black market puts drug users at risk of adverse reactions to tainted products.</p>
<p>In addition, as many of these substances are injected, there are potential harms from unsafe injecting practices. For example, <a href="http://www.tandfonline.com/doi/abs/10.1080/09595230802392568">research</a> has found that 41% of Australian men who injected steroids reported an injection-related health problem such as such as fevers, scarring and abscesses. </p>
<h2>Beefing up steroid laws</h2>
<p>In Australia, increases in the detection of these drugs at the border, coupled with <a href="https://theconversation.com/why-organised-crime-should-not-be-used-to-shape-anti-doping-policy-42385">contested concerns</a> about <a href="http://www.tandfonline.com/doi/abs/10.1080/09595230802392568">links to organised crime</a>, has led to greater levels of law enforcement. </p>
<p><a href="https://www.legislation.qld.gov.au/Bills/54PDF/2014/SafeNightOutLAB14E.pdf">Queensland</a>, Australia’s steroid capital, reclassified steroids a <a href="https://www.tga.gov.au/scheduling-basics">schedule-one drug</a> in 2014. This means they are now classed alongside heroin, cocaine and ice in the highest category of dangerous illicit drugs. </p>
<p>Under this legislation, the maximum penalty for possession or supply of steroids is 25 years’ imprisonment. Similar tough penalties apply in <a href="http://www.criminallawyers.net.au/reclassification-of-steroids-as-narcotics/">New South Wales</a> and <a href="https://www.sentencingcouncil.vic.gov.au/sites/default/files/publication-documents/Major%20Drug%20Offences%20Current%20Sentencing%20Practices.pdf">Victoria</a>. </p>
<p>However, there is little evidence that tougher penalties have resulted in reductions in steroid availability. The total number of seizures at the border fell in 2013-14. But <a href="https://www.acic.gov.au/sites/g/files/net1491/f/2016/08/acic-iddr-2014-15.pdf?v=1470178813.">there is evidence</a> of increases in recent years. </p>
<p>The <a href="https://www.acic.gov.au/sites/g/files/net1491/f/2016/06/oca2015.pdf">Australian Crime Commission</a> suggested in 2015 that any decrease in border interceptions could be the result of an increase in domestic production, coupled with increasingly easy access to drugs over the internet. </p>
<p>Despite having the toughest legislation, Queensland accounts for the greatest proportion of <a href="https://www.acic.gov.au/sites/g/files/net1491/f/2016/08/acic-iddr-2014-15.pdf?v=1470178813">national steroid arrests</a> (58% in 2014-15). But the greatest proportion of those arrested are steroid consumers – not suppliers. This suggests the current criminal justice approach may have limited capacity to limit distribution. </p>
<p>That growth in steroid use is most apparent in jurisdictions where recent legal changes have increased penalties suggests enhancing law enforcement measures may be an ineffective response to steroid use. <a href="https://theconversation.com/australias-recreational-drug-policies-arent-working-so-what-are-the-options-for-reform-55493">Other research</a> on the impact of drug policies on other illicit substances have reached similar conclusions. </p>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/168826/original/file-20170510-21620-1c28tgl.png?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="" src="https://images.theconversation.com/files/168826/original/file-20170510-21620-1c28tgl.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/168826/original/file-20170510-21620-1c28tgl.png?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=324&fit=crop&dpr=1 600w, https://images.theconversation.com/files/168826/original/file-20170510-21620-1c28tgl.png?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=324&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/168826/original/file-20170510-21620-1c28tgl.png?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=324&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/168826/original/file-20170510-21620-1c28tgl.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=407&fit=crop&dpr=1 754w, https://images.theconversation.com/files/168826/original/file-20170510-21620-1c28tgl.png?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=407&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/168826/original/file-20170510-21620-1c28tgl.png?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=407&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">Number of national steroid arrests, 2005-06 to 2014-15.</span>
<span class="attribution"><span class="source">ACIC</span></span>
</figcaption>
</figure>
<h2>Consequences of a tough law enforcement approach</h2>
<p>As is the case with drug use broadly, users of enhancement drugs can be considered rational consumers who make a deliberate choice to use steroids to achieve a desired outcome.</p>
<p>But social and cultural factors are also very influential in the decision to use drugs. <a href="http://www.aihw.gov.au/WorkArea/DownloadAsset.aspx?id=10737421139&libID=10737421138">Research</a> suggests people considering drug use rarely take the illegality of a particular substance into consideration. </p>
<p>Increasing penalties associated with the use and possession of image and performance enhancing drugs are unlikely to prevent uptake or encourage users to stop. Instead, this may result in several unintended negative consequences. For one, it can hinder <a href="https://link.springer.com/article/10.1007%2Fs12117-014-9235-7">access to medical services</a> and information by discouraging both users and healthcare practitioners from talking about drug use.</p>
<p>Tougher penalties can also distract from key harm-minimisation measures, such as safe injecting practices. </p>
<p>Other unintended negative consequences of criminal justice responses to such drug use include:</p>
<ul>
<li><p><a href="http://www.springer.com/gb/book/9781461482406">a growing black market</a>;</p></li>
<li><p><a href="http://www.sciencedirect.com/science/article/pii/S2211266915300086">geographical displacement</a> of users and suppliers; and </p></li>
<li><p><a href="https://www.ncbi.nlm.nih.gov/pubmed/20355187">increased risk of bad-quality drugs</a>. </p></li>
</ul>
<h2>What about harm-reduction strategies?</h2>
<p>Victoria’s existing harm-reduction initiative, the <a href="http://www.publish.csiro.au/py/pdf/PY02022">Steroid Education Project</a>, lags far behind services for alcohol and other illicit drugs in its funding and resources. It provides face-to-face and over-the-phone counselling to steroid users, and delivers training to needle and syringe program staff. </p>
<p>Greater resourcing is required to extend this program to allow for training in needle and syringe programs across Australia, and to deliver training to GPs. Given the reluctance of users to engage <a href="https://harmreductionjournal.biomedcentral.com/articles/10.1186/1477-7517-11-19">with traditional drug services</a>, GPs may be an <a href="https://www.youtube.com/watch?v=IQiZ4gGflKo">important avenue</a> for providing harm-minimisation messages to this group.</p>
<figure>
<iframe width="440" height="260" src="https://www.youtube.com/embed/IQiZ4gGflKo?wmode=transparent&start=0" frameborder="0" allowfullscreen=""></iframe>
</figure>
<p>There is an urgent need to reconsider steroid use as a public health issue, as opposed to a criminal justice concern. Harsher penalties will do nothing to tackle misinformation about steroids or underlying issues of body image dissatisfaction, depression and mental health concerns among users.</p><img src="https://counter.theconversation.com/content/77343/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>The authors do not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and have disclosed no relevant affiliations beyond their academic appointment.</span></em></p>There is an urgent need to reconsider steroid use as a public health issue as opposed to a criminal justice concern.Katinka van de Ven, Research Fellow, National Drug and Alcohol Research Centre, UNSW SydneyRenee Zahnow, Postdoctoral Research Fellow, Faculty of Humanities and Social Sciences, The University of QueenslandLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/586602016-04-29T14:24:56Z2016-04-29T14:24:56ZTerbutaline: the drug at the heart of British Cycling’s week from hell<figure><img src="https://images.theconversation.com/files/120670/original/image-20160429-10493-17azsdw.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Simon Yates at start of the British Mens Road Race Cycling Championships, Abergavenny, 2014</span> <span class="attribution"><a class="source" href="https://www.flickr.com/photos/sumofmarc/14537451775/in/photolist-wpXNVp-o9CeWg-9ea8f6-9ea8ve-ogeFvX-fUNnP6-9ea8oK-fFufiL-9s2JU8-dc3vFj-o9K4Va-eWjyn3-rTzqV7-obwfYe-AdMWVg-nSfGRH-o9DMYh-nSgtrT-5ktcSS-rWLyXQ-rWJorL-rhyfSi-rWJi9b-se9S4h-nSg9Ee-6LtX9-nWk9fA-nSgayP-o9BasC-55rnX9-nXbeFt-dXVsCF-55rnPQ-73C77R-5GXwLe-73FEfb-74kQXV-argzLq-756ofQ-nSfdbh-o9JH1e-nSfcTy-o9rzmg-2pkXoV-uVTmnU-nV4tyU-G7ssY2-reaBVA-sb2fjo-uq4ouz">Marc/Flickr</a>, <a class="license" href="http://creativecommons.org/licenses/by-nc-nd/4.0/">CC BY-NC-ND</a></span></figcaption></figure><p>It was a week British Cycling would rather forget. Accusations of discrimination <a href="http://www.bbc.co.uk/sport/cycling/36153485">forced the resignation</a> of technical director Shane Sutton and then, it was reported that one of its brightest young stars <a href="http://www.theguardian.com/sport/2016/apr/29/orica-green-simon-yates-positive-test-administrative-error">had submitted</a> a positive drug test. Just 100 days before the Olympic Games kick off in Brazil, it is a gruelling time for a sport that has delivered national success for Britain like few others.</p>
<p><a href="http://www.greenedgecycling.com/team/simon-yates">Simon Yates</a>, who rides for Australian professional team Orica-Greenedge, was found to have a drug called terbutaline in his system during the March stage of the Paris-Nice. The team confirmed <a href="http://www.greenedgecycling.com/news/statement-regarding-simon-yates-adverse-analytical-finding.phps">the news in a statement</a> but said the positive result was for the drug’s use as an asthma treatment noted by the team doctor on a doping control form signed at the time of the test. </p>
<p>The UCI, cycling’s governing body, does allow the use of terbutaline under its programme of <a href="http://www.uci.ch/clean-sport/therapeutic-use-exemptions/">therapeutic-use exemptions</a> (TUEs), and Orica blamed one of the team’s doctors for failing to submit the relevant paperwork. It said it was “solely based on a human error that the doctor in question has taken full responsibility for”. The UCI said it <a href="http://www.bbc.co.uk/sport/cycling/36169275">would not be suspending the 23-year-old rider</a> because use of this drug did not call for its imposition. </p>
<p>So what is terbutaline? How does it work? And why have anti-doping authorities required athletes to seek permission before using it?</p>
<h2>At the limit</h2>
<p>Many athletes have a form of asthma known as <a href="http://acaai.org/asthma/exercise-induced-asthma-eib">exercise induced bronchoconstriction</a>(EIB). In fact, the prevalence of asthma/EIB in elite athletes (21%) is reported to be <a href="http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1747493/">more than double</a> that of the UK general population (9%). Athletes are more susceptible to this form of asthma because they regularly expose themselves to a significant volume of asthma triggers (dry air, dust, pollution) as a result of long and intense hours of training on the road. In simple terms, increased exposure to those triggers equals greater chance of asthma/EIB. </p>
<p><a href="http://www.aafa.org/page/exercise-induced-asthma.aspx">Asthma/EIB</a> is an obstructive airway disease characterised by inflammation and muscle constriction around the airway. Any asthma sufferer will be able to relate to familiar symptoms such as tight chest, difficulty in breathing and wheezing. An athlete’s aerobic performance will obviously be compromised if they are unable to ventilate their lungs effectively so a group of drugs known as β2-Agonists can be used to reverse the muscle constriction, open up airways and reduce symptoms. These drugs allow athletes with asthma/EIB to train and compete without compromising their health and performance. </p>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/120679/original/image-20160429-10512-10u1xcs.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="" src="https://images.theconversation.com/files/120679/original/image-20160429-10512-10u1xcs.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/120679/original/image-20160429-10512-10u1xcs.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=398&fit=crop&dpr=1 600w, https://images.theconversation.com/files/120679/original/image-20160429-10512-10u1xcs.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=398&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/120679/original/image-20160429-10512-10u1xcs.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=398&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/120679/original/image-20160429-10512-10u1xcs.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=501&fit=crop&dpr=1 754w, https://images.theconversation.com/files/120679/original/image-20160429-10512-10u1xcs.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=501&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/120679/original/image-20160429-10512-10u1xcs.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=501&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">Performance enhancing?</span>
<span class="attribution"><a class="source" href="https://www.flickr.com/photos/niaid/5950870440/in/photolist-a4RLsu-9ah9vn-6DtYim-cCnjkG-6DpPXX-5vMrJi-m5KpY4-6SM5dy-na51eJ-oH4rdU-osBKo-8pAw9q-5tz14g-3QDtwr-gMQcjo-29eQm-4URrnm-aMoZfn-eZjr3q-5Adove-7cNP1a-2XVWgL-9qMECF-99xZRa-su6i2z-9x67Q3-8DcgGt-8PeqeY-pZLdgL-8F3aBC-9x383K-2gtk5s-8x6gbV-9x387t-baD1Hx-ekYLQy-8CnCVQ-aBA6JJ-q34hzt-79dsDq-dSUcid-qtiDb1-ossFKs-9FoACn-9FrwSQ-9FrwXJ-9FrxSW-PWitQ-8j1Kom-dFZiox">NIAID/Flickr</a>, <a class="license" href="http://creativecommons.org/licenses/by/4.0/">CC BY</a></span>
</figcaption>
</figure>
<p>All but four forms of β2-Agonists are banned for athletes to use in and out of competition by the World Anti-Doping Agency (WADA). <a href="https://wada-main-prod.s3.amazonaws.com/resources/files/wada-2016-prohibited-list-en.pdf">Clenbuterol, for example, is banned</a> for enhancing strength and power performance as well as reducing body fat. Athletes can use salbutamol, salmeterol, formoterol and terbutaline – although terbutaline is the only one that requires an athlete to apply for a TUE certificate before they can use it. </p>
<p>Salbutamol and formoterol have limits on the amount you can use but do not require special permission. This is because it is possible to distinguish between whether a dose is inhaled (to treat asthma) or taken orally. But this is not possible for terbutaline (and there is no oral form of salmeterol). In other words, once you have an exemption for terbutaline you could in theory use an oral dose without specifically targeting asthma. </p>
<h2>Performance gains?</h2>
<p>But can terbutaline and the others make a difference in a cycling race? Well, there is evidence that oral doses of terbutaline improve <a href="http://jap.physiology.org/content/119/5/475.long">strength and power performance</a> and that high doses of inhaled terbutaline <a href="http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4270505/">may improve sprint and power</a> but not endurance. Strangely enough, the action behind the potential performance improvement is not linked to improved lung function. </p>
<p>Terbutaline and other treatments may improve performance by altering muscle function so that power production per muscle contraction is enhanced. Long-term use may also improve the energy producing pathways that do not require the presence of oxygen, hence a boost to anaerobic bursts of power. But to achieve these performance gains inhaled doses of terbutaline must be <a href="http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4270505/">well above the therapeutic dose</a>.</p>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/120699/original/image-20160429-10518-306iz1.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="" src="https://images.theconversation.com/files/120699/original/image-20160429-10518-306iz1.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/120699/original/image-20160429-10518-306iz1.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=421&fit=crop&dpr=1 600w, https://images.theconversation.com/files/120699/original/image-20160429-10518-306iz1.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=421&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/120699/original/image-20160429-10518-306iz1.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=421&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/120699/original/image-20160429-10518-306iz1.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=529&fit=crop&dpr=1 754w, https://images.theconversation.com/files/120699/original/image-20160429-10518-306iz1.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=529&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/120699/original/image-20160429-10518-306iz1.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=529&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">All a blur. Inhaler drugs may boost your sprint power.</span>
<span class="attribution"><a class="source" href="https://www.flickr.com/photos/puliarfanita/8744956413/in/photolist-ejLbSz-cUJFKQ-eAxT5s-iENCPw-byZvwV-om4FKn-oPWnRN-puTcM3-y9954-4Qsfkc-y9wPt-9vj3T6-eie7wK-6tyif7-y994m-6NfiFv-iELjfQ-amqjaf-4Cbczy-nYwDYo-hdwBoS-otidut-iGRSu9-CMeLCH-iGRNwu-iGRQH3-iGRPmA-fdjrhc-fni3YD-6sxuPQ-iEKFwt-ajz8rL-afRCEV-8j1HMr-fmYi34-nGE59Y-fpCxcB-oVbA3B-fndtAw-y994Y-i5wYRZ-y8BUT-eAuFKr-5K11JA-iELiYN-fnbW1w-oPWnCw-admxQ9-619P9a-3xVkMq">Anita Ritenour/Flickr</a>, <a class="license" href="http://creativecommons.org/licenses/by/4.0/">CC BY</a></span>
</figcaption>
</figure>
<p>So an athlete using terbutaline as prescribed therapeutically is not likely to benefit from a performance enhancement in their sprinting. However, once an athlete has a TUE for terbutaline they have licence to use as much as they like. So an unscrupulous athlete could seek to gain an advantage once they had the exemption. </p>
<p>There is no hint that climbing specialist Yates was using the asthma drug for anything other than his condition, or that the dose in his case was unusually high. </p>
<p>Fellow British rider Owain Doull also leapt to Yates’ defence on Twitter:</p>
<p><div data-react-class="Tweet" data-react-props="{"tweetId":"725973890221137920"}"></div></p>
<h2>Anti-doping retreat</h2>
<p>Because athletes need to apply for permission to use terbutaline, most athletes with asthma/EIB choose to use salbutamol – which is found in the commonly-seen blue inhaler. </p>
<p>Back in 2009 however, the World Anti Doping Authority (WADA) <a href="https://wada-main-prod.s3.amazonaws.com/resources/files/WADA_Prohibited_List_2009_EN.pdf">had placed all four</a> β2-Agonists on the list of banned substances. The upside was that athletes had to prove they had asthma/EIB by producing a specific objective test as evidence of their condition, and there is <a href="http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1747493/">plenty of evidence</a> that this process improved diagnostic practices and the management of athletes with the condition. The downside was that it massively increased the administration burden on sports medics and governing bodies. </p>
<p>And so, by 2010 the decision was reversed for all but terbutaline. There was at the time limited evidence that inhaled β2-Agonists improved performance, and crucially, the costs and practicality of testing every athlete around the world with suspected asthma/EIB were deemed impractical. Given the <a href="https://www.ncbi.nlm.nih.gov/pubmed/23834392">emerging evidence</a> that these treatments may improve strength and power performance, WADA may decide to revisit that position.</p><img src="https://counter.theconversation.com/content/58660/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>John Dickinson has previous received funding from World Anti-Doping Agency. </span></em></p>Asthma medication can cause trouble for athletes but why are some inhalers alright while others need permission to use?John Dickinson, Head of the Respiratory Clinic and Senior Lecturer, University of KentLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/456022015-08-20T20:25:38Z2015-08-20T20:25:38ZThe science of doping and how cheating athletes pass drug tests<figure><img src="https://images.theconversation.com/files/90983/original/image-20150806-2924-1qvmena.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Two news outlets have alleged there was widespread cheating in endurance sports between 2001 and 2012.</span> <span class="attribution"><a class="source" href="https://www.flickr.com/photos/peterm7/7773673900/">Peter Mooney/Flickr</a>, <a class="license" href="http://creativecommons.org/licenses/by-sa/4.0/">CC BY-SA</a></span></figcaption></figure><p>The <a href="http://www.iaaf.org/competitions/iaaf-world-championships">15th Athletics World Championships</a>, which open on August 22 in Beijing, China, present a significant challenge for the organisers. Allegations in early August of <a href="http://www.dailymail.co.uk/sport/othersports/article-3182579/Athletics-hit-fresh-doping-crisis-shock-report-claims-one-distance-running-medal-winners-using-drugs.html">mass doping among athletes</a> mean any untoward behaviour will pose a threat to the integrity of the competition. </p>
<p>According to the media revelations, <a href="http://www.express.co.uk/sport/othersport/595488/Top-UK-athlete-among-seven-Britons-suspicious-blood-scores-WADA-revelations">a third of endurance runners</a> who won Olympic and world championship medals from 2001 to 2012 may have cheated by taking performance enhancers or by “blood doping”. More than 800 track and field athletes are thought to have <a href="http://www.foxsports.com.au/more-sports/wada-investigate-accusations-of-widespread-doping-in-athletics/story-e6frf56c-1227467698368">returned abnormal blood tests</a>, suggesting they were cheating with impunity. </p>
<p>The <a href="https://www.wada-ama.org/en/media/news/2015-08/wada-alarmed-by-widespread-doping-allegations-against-international-athletics">World Anti-Doping Agency (WADA)</a> uses a battery of blood and urine tests to determine if athletes are cheating. A key tool is the biological passport program, which tests all athletes for doping and performance-enhancing drugs.</p>
<h2>Blood doping</h2>
<p>Blood doping increases the blood’s ability to carry oxygen. This can have a direct impact on VO2max, the measure of a person’s aerobic capacity. Ultimately, blood doping is one of the more effective illegal ways of improving endurance performance. </p>
<p>Athletes blood dope by either using <a href="http://bjsm.bmj.com/content/38/1/99.full">blood transfusions</a> or specific drugs to increase their red blood cell count (haemoglobin). When they <a href="http://bjsm.bmj.com/content/38/1/99.full">transfuse blood</a> into their bodies, they can re-infuse their own blood (autologous) or use blood from another person who serves as a donor (homologous). </p>
<p>And when blood is taken out of the body and used for transfusions, up to four components, including red blood cells, platelets, plasma and cryoprecipitated antihemphilic factor (AHF), are removed from the sample and then frozen. Typically the red blood cells are returned to the athlete’s body when the sample is re-infused, in order to increase their ability to carry oxygen. </p>
<p>When athletes re-infuse their own blood, there’s no direct way of detecting what they’ve done. But indirect detecting methods are available, such as measuring their total haemoglobin mass (red blood cell size) or metabolites of <a href="http://www.ncbi.nlm.nih.gov/pubmed/24764552">blood bag plasticisers</a> (by-products of the container the blood is stored in).</p>
<p>If the athlete transfuses someone else’s blood, drug testers can look directly at the antigen pattern of the red blood cells to detect doping. Since everyone has a different genetic code, doping is easily spotted when red blood cells present different genetic markers. </p>
<p>Testers can also indirectly look for the presence of plasticisers in urine tests. Because stored blood is exposed to plasticisers and their metabolites, they can be detected when expelled through urine. </p>
<figure class="align-center ">
<img alt="" src="https://images.theconversation.com/files/91684/original/image-20150813-18071-igsgyr.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/91684/original/image-20150813-18071-igsgyr.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=450&fit=crop&dpr=1 600w, https://images.theconversation.com/files/91684/original/image-20150813-18071-igsgyr.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=450&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/91684/original/image-20150813-18071-igsgyr.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=450&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/91684/original/image-20150813-18071-igsgyr.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=566&fit=crop&dpr=1 754w, https://images.theconversation.com/files/91684/original/image-20150813-18071-igsgyr.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=566&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/91684/original/image-20150813-18071-igsgyr.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=566&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Blood doping is one of the more effective illegal ways of improving endurance performance.</span>
<span class="attribution"><a class="source" href="https://www.flickr.com/photos/40964293@N07/4353440641/">Shannan Muskopf/Flickr</a>, <a class="license" href="http://creativecommons.org/licenses/by-nc/4.0/">CC BY-NC</a></span>
</figcaption>
</figure>
<p>As you can see, the combination of both blood and urine analytic techniques is very useful in detecting potential doping infractions involving blood transfusions. </p>
<h2>Erythropoietin (EPO)</h2>
<p>Another common method of doping is the use of <a href="https://www.researchgate.net/profile/Gopinath_Subash/publication/264201220_Monitoring_recombinant_human_erythropoietin_abuse_among_athletes/links/54c4b6950cf256ed5a9562dd.pdf">recombinant human erythropoietin (rHuEPO)</a>, which stimulates the production of red blood cells. Erythropoietin (EPO) is a naturally occurring hormone found in the blood; recombinant EPO is the artificial version. </p>
<p>EPO’s ability to increase the number of red blood cells results in a dramatic increase of oxygen in the blood, which boosts athletic performance. Originally produced to treat several forms of chronic anaemia, EPO has been the source of numerous doping scandals in sport, especially in endurance sports such as cycling, distance running and cross-country skiing. </p>
<p>In addition to rHuEPO, athletes are likely to use erythropoiesis-stimulating agents (ERAs) such as FG-4592 (also known as Rodadustat). These are used to stimulate the body’s natural production of EPO in a fashion similar to training at altitude. </p>
<p>WADA added this compound to its testing regime only this year and athletes have already <a href="http://www.cyclingnews.com/news/taborre-positive-for-novel-epo-stimulating-drug-fg-4592/">been caught</a> using them. It’s likely many athletes have used these types of compounds before they were tested for, receiving a performance benefit without the risk of positive doping test.</p>
<h2>Getting caught or evading detection</h2>
<p>When the athlete’s blood samples are placed into the biological passport program, they are evaluated for changes in blood components (<a href="https://en.wikipedia.org/wiki/Mean_corpuscular_hemoglobin_concentration">haemoglobin concentration</a>; <a href="https://en.wikipedia.org/wiki/Reticulocyte">reticulocyte percentage</a>; <a href="http://www.ncbi.nlm.nih.gov/pubmed/18981937">haemoglobin mass</a>; <a href="http://www.webmd.com/a-to-z-guides/reticulocyte-count">reticulocyte count</a>; <a href="http://www.healthline.com/health/rbc-count#Overview1">red blood cell count</a>; <a href="https://en.wikipedia.org/wiki/Mean_corpuscular_volume">mean corpuscular volume</a>; <a href="https://en.wikipedia.org/wiki/Mean_corpuscular_hemoglobin">mean corpuscular haemoglobin</a>; and <a href="https://en.wikipedia.org/wiki/Mean_corpuscular_hemoglobin_concentration">mean corpuscular haemoglobin concentration</a>) that are collectively used to assess if he or she may have blood doped. </p>
<p>After the athlete’s blood is thoroughly analysed, the data is used to calculate what has been termed the OFF Score (OFF-hr). This variable is calculated from the haemoglobin (a protein responsible for transporting oxygen in the blood) concentration, the reticulocyte (immature blood cells) percentage and an abnormal profile score. </p>
<p>If a suspicious or abnormal profile is determined with this calculation, the data is forwarded to a panel of doping experts who review it to determine if a doping infraction has actually occurred. If the panel deems that it has, WADA initiates a suspension process. </p>
<p>One way athletes appear to be circumventing the biological passports model is by small, frequent use of EPO. In 2011, <a href="http://www.ncbi.nlm.nih.gov/pubmed/21336951">Australian researchers</a> found frequent micro-dosing allows athletes to use rhEPO without abnormal changes in the blood variables that are currently monitored by the athlete blood passport. </p>
<p>As the fight against doping continues, athletes appear to be continually searching for ways to elevate their performance and evade detection. The biological passport offers a great tool for limiting the practice of doping, but it seems that many athletes have already found ways to circumvent it.</p><img src="https://counter.theconversation.com/content/45602/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Greg Haff is affiliated with the National Strength and Conditioning Association and currently serves as the organisations president.</span></em></p>Organisers of the World Championship in Athletics will be on their toes after recent revelations of mass doping by endurance athletes. Here’s what you need to know about doping and how to evade it.G. Gregory Haff, Senior Lecturer in Exercise and Health Sciences, Edith Cowan UniversityLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/443272015-07-07T18:45:10Z2015-07-07T18:45:10ZTaking gym steroids can affect your learning and memory<figure><img src="https://images.theconversation.com/files/87497/original/image-20150706-1012-1q0js8z.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">What was I lifting again?</span> <span class="attribution"><a class="source" href="http://www.shutterstock.com/pic-194099144/stock-photo-powerlifter-with-strong-arms-lifting-weights.html?src=5qYYnVLCixaT0KNLL6hFAA-1-0">Weights by Shutterstock</a></span></figcaption></figure><p>Although much is known about the physical and psychiatric effects of anabolic steroid abuse, very little is known about their putative impact upon learning and memory. In a new study <a href="http://benthamopen.com/contents/pdf/TOPJ/TOPJ-9-1.pdf">published in The Open Psychiatry Journal</a>, we wanted to find out if users reported any difference from using Anabolic-androgenic steroids, or AAS. Our findings suggest that the drug can affect recollection in long-term users. </p>
<p>Anabolic-androgenic steroids are synthetic compounds which resemble testosterone and promote lean body mass and muscle growth. Since the mid-twentieth century, they have been used by elite athletes and bodybuilders to trim body fat and increase muscle size in order to gain the edge over their rivals. But they are have now become <a href="https://theconversation.com/anabolic-steroid-use-is-not-just-about-bodybuilding-29180">much more widespread</a> within non-competitive recreational sports circles and are also often prescribed for medical conditions such as delayed puberty and for muscle-wasting diseases such as AIDS and cancer.</p>
<p>AAS are typically taken orally or injected directly into the muscles. Doses can be as high as 100 times greater than those normally prescribed medically. In some specialist gym user groups – such as bodybuilders and weightlifters – as many as 38% may take AAS. The abuse of AAS brings with it a range of potential <a href="http://www.ncbi.nlm.nih.gov/pubmed/18599224">physical side effects</a>, including skin lesions, oedema (where an excess of watery fluid collects in the body cavities or tissues), kidney and liver damage, heart problems, high blood pressure and cardiovascular disease. A number of <a href="http://www.ncbi.nlm.nih.gov/pubmed/16356691">psychiatric effects</a> have also been reported, from mild irritation and agitation, depression, and increased aggression and violence – so-called “roid rage” – towards others. The types and degree of problems experienced may differ depending upon what types of steroids are being abused, their pattern of abuse, the amount taken and the length of abuse. </p>
<h2>Mind as well as body</h2>
<p>In the first study of its kind in 2013, psychiatrist Harrison Pope and colleagues <a href="http://www.sciencedirect.com/science/article/pii/S0376871612004498">discovered that</a> long-term AAS users performed significantly worse on visuospatial memory task where they had to remember a collection a visual patterns that they were previously shown, compared with non-users. Pope explained the real-world implications by stating that problems in visuospatial memory might correspond to problems with finding a specific location, such as someone’s address or the location of a specific room in a building. </p>
<figure class="align-left ">
<img alt="" src="https://images.theconversation.com/files/87503/original/image-20150706-1008-8yybs3.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=237&fit=clip" srcset="https://images.theconversation.com/files/87503/original/image-20150706-1008-8yybs3.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/87503/original/image-20150706-1008-8yybs3.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/87503/original/image-20150706-1008-8yybs3.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/87503/original/image-20150706-1008-8yybs3.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/87503/original/image-20150706-1008-8yybs3.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/87503/original/image-20150706-1008-8yybs3.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Prospective memory.</span>
<span class="attribution"><span class="source">Note by Shutterstock</span></span>
</figcaption>
</figure>
<p>For our study we examined whether the long-term use of AAS within a sporting context might affect everyday memory. We assessed almost 100 male regular gym users aged 18-30 in an online survey; half of whom used AAS and half of whom did not. As a relatively young group in our study, the participants reported using AAS regularly for an average of about four years (up to eight years) with doses. Each participant completed three memory-related questionnaires. The first measured retrospective memory – the recall of past memories or previous facts, for example the name of your favourite soap star. A second measured prospective memory – the process of carry out a planned activity at future point in time, for example remembering to post a birthday card or to take an important medication on time. Finally, a third questionnaire measured executive function – processes that help an individual pay attention, coordinate information and plan and execute tasks. </p>
<p>Significant failures in any or all of these domains could compromise everyday functioning. Our findings revealed that AAS users reported 28% more forgetting in terms of retrospective memory, 39% more forgetting in terms of prospective memory and reported 32% more problems in their executive function. The findings suggest that use of AAS has a significant detrimental impact on an individual’s everyday memory and ability to remember. </p>
<p>Such deficits could affect many spheres of life, including interpersonal, occupational, educational and health-related aspects, given the ubiquitous nature of everyday remembering. Of course, these findings need further verification before any firm conclusions can be reached given that self-reports can be subject to a range of biases, for example some people may think their memory is poor and respond accordingly, while some think it is better than perhaps it is. The next step would be to look at more objective measures and to show why the use of AAS affects memory and learning and what impact steroid abuse has on the brain and its cognitive functions.</p><img src="https://counter.theconversation.com/content/44327/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Tom Heffernan does not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.</span></em></p>The physical impact of anabolic steroids are well known but there are also mental effects.Tom Heffernan, Programme Leader in Psychology with Criminology, Northumbria University, NewcastleLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/342712014-11-19T09:21:13Z2014-11-19T09:21:13ZA-Rod may get his millions but his future remains murky<p>Alex Rodriguez, the New York Yankees’ erstwhile third baseman, has had an interesting career in more ways than one. His use of steroids has resulted in a sullied reputation and a one-year suspension without pay, but now he is potentially back on the active player roster for the 2015 season and poised to receive US$61 million from the Yankees over the next three years. </p>
<p>How can a player who twice admitted to using performance enhancing drugs (PEDs) for several years and who repeatedly lied about his use, be allowed to return to the game? After all, the league has the option to punish him with as much as a lifetime ban if it deems his actions damaged baseball’s image. And the Yankees have their own means at their disposal to try to penalize him if they so choose. </p>
<p>The answer, however, is complicated by ironclad contracts and the nature of PEDs, and benefits from a look back at how we got here, along with his tale’s many twists and turns.</p>
<h2>A-Rod confesses, kind of</h2>
<p>It all began in December 2007, when George Mitchell’s <a href="http://files.mlb.com/mitchrpt.pdf">report on steroid use</a> in Major League Baseball came out. The next day, Rodriguez told CBS’ “60 Minutes” that he had never used steroids. Fourteen months later Sports Illustrated reported that Rodriguez had tested positive for steroid use under MLB’s anonymous testing program in 2003. Ten days after SI’s report, Rodriguez confessed to using steroids in 2001, 2002 and 2003, but asserted that he hadn’t used them since.</p>
<p>Following various reports connecting Rodriguez to PEDs after 2003, in January of last year Rodriguez was <a href="http://www.miaminewtimes.com/specialReports/tony-bosch-and-biogenesis-mlb-steroid-scandal-3698782/">linked</a> to Tony Bosch and his Biogenesis Clinic in Miami – an infamous source of PEDs for various professional athletes. In August, MLB suspended Rodriguez through the end of the 2014 season for violating the league’s PED policy, a total of 211 regular-season games plus any postseason games. He was one of 13 players suspended for their roles in the scandal. </p>
<figure class="align-right zoomable">
<a href="https://images.theconversation.com/files/64905/original/xxqsrx5h-1416343617.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="" src="https://images.theconversation.com/files/64905/original/xxqsrx5h-1416343617.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=237&fit=clip" srcset="https://images.theconversation.com/files/64905/original/xxqsrx5h-1416343617.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=626&fit=crop&dpr=1 600w, https://images.theconversation.com/files/64905/original/xxqsrx5h-1416343617.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=626&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/64905/original/xxqsrx5h-1416343617.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=626&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/64905/original/xxqsrx5h-1416343617.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=787&fit=crop&dpr=1 754w, https://images.theconversation.com/files/64905/original/xxqsrx5h-1416343617.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=787&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/64905/original/xxqsrx5h-1416343617.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=787&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">Alex Rodriguez was considered one of the Yankees’ top stars until he was suspended for using banned substances.</span>
<span class="attribution"><a class="source" href="https://www.flickr.com/photos/keithallison/3514039239/in/photolist-6mwnrr-6UDaJ3-4RRTcU-4RMHm2-5fGfU1-5fXjP3-9B8xc1-6mwibi-4wj5N5-6mwo5i-6UtuDr-5fBUf6-6UAouS-4RaVNT-4GGDY9-4Rf8KJ-6UwzKH-5fYi1E-4GH9Pq-4weTKx-6mAsYU-6mAti7-6mwkf4-6mAt1W-4wcHK5-6mAt7b-4wcNRS-4w8yNZ-4weUPi-4GCfyT-66VDmv-fNzML9-4wcNj7-4w8FZ6-4w8Bnz-4wcNFy-4wcJ81-6mAr9C-6mAqQs-6mwhQt-6mAr6y-6n1q2k-6mAv7m-fQtGBw-fPwCy4-6mwkkH-6Utxkp-6n1pWr-6UwQHP-6mAuY1">Keith Allison/Flickr via CC BY-SA</a>, <a class="license" href="http://creativecommons.org/licenses/by-sa/4.0/">CC BY-SA</a></span>
</figcaption>
</figure>
<p>Although the standard punishment for a first offense under MLB’s drug policy is 50 games, the league had the option of suspending Rodriguez for longer than that under the collective bargaining agreement if it determined his actions constituted conduct detrimental to baseball or it determined that A-Rod’s various PED involvements entailed more than one offense.</p>
<h2>A litany of lies</h2>
<p>Almost immediately after the suspension was announced, Rodriguez declared he would appeal. He was the only one of the 13 Biogenesis players to do so; the others accepted season-ending 50-game suspensions without appeal. </p>
<p>In January, following a lengthy arbitration process, A-Rod’s <a href="http://sports.yahoo.com/news/arbitrator-rules-alex-rodriguez-should-be-suspended-for-2014-season-for-ped-use-164637215.html">suspension was upheld</a>. Defeated by overwhelming <a href="http://sports.yahoo.com/blogs/big-league-stew/rod-ruling-explained-arbitrator-fredric-horowitz-decided-162-013800428--mlb.html">evidence</a> and unwilling to take the stand, Rodriguez stormed out of his arbitration hearing. A-Rod then went on Mike Francesa’s radio show and explained that the system of appeals was unjust and that Selig had a personal vendetta against him. He also stated unequivocally that he had not used steroids since 2003.</p>
<p>Rodriguez then issued a <a href="http://abcnews.go.com/Sports/alex-rodriguez-file-suit-challenging-suspension-lawyer/story?id=21507061">statement</a> saying he would be challenging the arbitrator’s decision but later changed his mind and accepted his suspension for the 2014 season. </p>
<h2>A-Rod finally comes clean</h2>
<p>This month it was revealed that Rodriguez had <a href="http://www.miamiherald.com/sports/mlb/article3578762.html">admitted</a> to the Drug Enforcement Administration back in January that he had used performance-enhancing drugs. This was contrary to his strident claims 18 days earlier in the arbitration hearing and the Mike Francesa show.</p>
<p>Because MLB did not have an automatic punishment policy in place from 2001 to 2003, A-Rod was not suspended or fined for his earlier transgressions. But since the 2005-06 seasons, negotiations with the union led to a policy with stiff sanctions – probably the stiffest in US sports leagues – allowing for a lifetime ban after a third offense.</p>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/64906/original/nvdvqzmb-1416343954.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="" src="https://images.theconversation.com/files/64906/original/nvdvqzmb-1416343954.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/64906/original/nvdvqzmb-1416343954.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=450&fit=crop&dpr=1 600w, https://images.theconversation.com/files/64906/original/nvdvqzmb-1416343954.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=450&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/64906/original/nvdvqzmb-1416343954.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=450&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/64906/original/nvdvqzmb-1416343954.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=566&fit=crop&dpr=1 754w, https://images.theconversation.com/files/64906/original/nvdvqzmb-1416343954.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=566&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/64906/original/nvdvqzmb-1416343954.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=566&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">A Yankees fan shares his thoughts on Rodriguez during a game in late 2013.</span>
<span class="attribution"><a class="source" href="https://www.flickr.com/photos/keithallison/9734013247/in/photolist-fQan1B-4wj5AC-6mwsgc-6UAxFJ-dhLgok-4GCmzi-4wiYWE-6mwiYa-4FoHXV-4weRvV-6mwoy6-5fBXCH-5fTxxg-5fGYX1-6UrMKP-8pvNqr-4GGt8L-9BpTvG-5fTPGX-4GcEBx-6n5Dfs-6n1uCD-6mMxCH-5fsuQL-4Rf1JG-6n1ujV-6mRGS9-4wj2PS-4GGXTs-6UwvhV-6n1ysg-6n1vEx-5fTt8i-9B7454-fNAxXy-6n1wsa-6n5Es7-6n1ueT-6n5EYs-6n5Gu3-6mMwkF-6n1sHZ-6n5F41-6n5DaS-6n1uVi-4GuNz5-6n1tov-4Gcuy4-9B8U7C-9BnxPc">Keith Allison/Flickr via CC BY-SA</a>, <a class="license" href="http://creativecommons.org/licenses/by-sa/4.0/">CC BY-SA</a></span>
</figcaption>
</figure>
<p>From the standpoint of the Commissioner’s Office, MLB has to be very careful with any lifetime ban. For instance, whether getting steroid injections from Tony Bosch five times in one month and then getting caught in a laboratory test the following month constitutes one or five offenses is subject to interpretation. MLB would only have “analytic” evidence of one offense (the failed test), but it may have anecdotal or written evidence for all five offenses. If MLB argues for a lifetime ban in such a case, it would undoubtedly be challenged by the union. Thus, the difficulty in identifying the number of offenses and the politics of dealing with the union, make enforcement problematic. A-Rod’s possible return to the Yankees in 2015 reflects this dynamic. </p>
<p>So how was he allowed to rejoin the team and keep his salary? The answer is that MLB has to play by the rules negotiated with the baseball’s strong player union. The union has resisted more frequent testing and stiffer penalties on the grounds that players sometimes use PEDs unknowingly, that they should be given second or third chances and that tests can produce false positives. So MLB has been circumscribed, but still has a strong and effective program. </p>
<h2>A murky future</h2>
<p>As for A-Rod, his future is not so clear. After two major hip surgeries and numerous injuries, his soon-to-be 40-year-old body may simply be unable to perform. A-Rod needs to attempt to come back in order to assure his qualification for the US$61 million remaining on his contract. Should A-Rod be found unable to perform at spring training and he is forced to retire from baseball, the Yankees would still be liable for the US$61 million because the contract is guaranteed. The good news in this case for the Yankees is that approximately 80% of A-Rod’s salary would be covered by insurance.</p>
<p>Still another outcome might be that the Yankees sue A-Rod for breach of contract. When A-Rod was signed to his record ten-year US$271 million (plus bonuses of up to US$30 million) before the 2008 season, A-Rod denied using steroids. Since steroids usually help players in the short run, but make their bodies break down in the long run (due to imbalances in their muscles and bones), the Yankees could claim that A-Rod’s likely future productivity was misrepresented to them. The Yankees could then propose a settlement, buying out A-Rod for his remaining three years at a discounted price and potentially reducing the team’s bill to MLB under the luxury tax. </p>
<p>There is, of course, another possibility. A-Rod could return to the Yankees’ active roster, bat .300 and hit 30 home runs. And Mitch McConnell might come out against coal.</p><img src="https://counter.theconversation.com/content/34271/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Andrew Zimbalist does not work for, consult, own shares in or receive funding from any company or organization that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.</span></em></p>Alex Rodriguez, the New York Yankees’ erstwhile third baseman, has had an interesting career in more ways than one. His use of steroids has resulted in a sullied reputation and a one-year suspension without…Andrew Zimbalist, Professor of Economics, Smith CollegeLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/328222014-10-16T19:30:36Z2014-10-16T19:30:36ZWant to win? Let music give you the edge<p>Let’s hope the Wallabies are inspired by a rousing rendition of the national anthem as they prepare to face their old enemy the All Black’s at tomorrow’s Bledisloe Cup match. The Kiwis invariably come out fighting after the chest-thumping, thigh-slapping ritual of their traditional haka.</p>
<p>The last time the Australian team prepared to do battle on the field, an incomprehensible version of the anthem left them <a href="http://www.foxsports.com.au/what-the-fox/argentine-singer-butchers-advance-australia-fair-before-wallabies-v-pumas-rugby-match/story-fnn4peyo-1227080428816">chuckling with mirth</a> at kick-off rather than fired up with nationalistic fervour.</p>
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<iframe width="440" height="260" src="https://www.youtube.com/embed/gHZ17anodtY?wmode=transparent&start=0" frameborder="0" allowfullscreen=""></iframe>
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<p>Did Argentinian tenor Marcelo Zelada deliberately botch his rendition of Advance Australia Fair? The Pumas went on to <a href="http://www.abc.net.au/news/2014-10-05/wallabies-suffer-shock-loss-to-argentina/5791252">defeat the Wallabies</a> 21-17 so perhaps Zelada was onto something.</p>
<h2>More than just easy listening</h2>
<p>Millions of joggers habitually cope with the physical discomfort of running using the distractive effects of music, in particular by synchronising their stride rate to the tempo of the music.</p>
<p>Swimmers now embrace the tedium of endless laps by tuning in to their favourite tracks, thanks to tiny MP3 players that clip onto goggles and deliver music through the cheekbone direct into the inner ear. </p>
<p>For athletes to be headphone-clad has been de rigeur for many years but it now appears to be almost compulsory.</p>
<p>After music devotee Michael Phelps swam to an all-time record of eight Olympic gold medals in 2008, one of his first tasks when arriving home was to personally thank rap artist Lil’ Wayne for the inspiration he had provided in Beijing.</p>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/61821/original/ywk4gx25-1413358954.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="" src="https://images.theconversation.com/files/61821/original/ywk4gx25-1413358954.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/61821/original/ywk4gx25-1413358954.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=465&fit=crop&dpr=1 600w, https://images.theconversation.com/files/61821/original/ywk4gx25-1413358954.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=465&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/61821/original/ywk4gx25-1413358954.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=465&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/61821/original/ywk4gx25-1413358954.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=584&fit=crop&dpr=1 754w, https://images.theconversation.com/files/61821/original/ywk4gx25-1413358954.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=584&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/61821/original/ywk4gx25-1413358954.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=584&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">What does Michael Phelps (left) listen to before a race? It’s usually rap artists like Eminem and Lil’ Wayne.</span>
<span class="attribution"><a class="source" href="https://www.flickr.com/photos/jdlasica/3652749376">Flickr/JD Lasica</a>, <a class="license" href="http://creativecommons.org/licenses/by-nc/4.0/">CC BY-NC</a></span>
</figcaption>
</figure>
<p>But is the ubiquitous use of music by athletes and exercisers justified or simply hype? Well, decades of research on the use of music in sport and exercise has confirmed some powerful effects and surprising benefits. </p>
<h2>Music and performance</h2>
<p>The first published <a href="http://www.tandfonline.com/doi/abs/10.1080/23267224.1911.10651270#.VDuQUfmSyyc">study</a> on the subject, in 1911, showed that cyclists in a six-day race in New York produced faster lap times when a brass band was playing.</p>
<p>Although it was impossible to separate the effects of the music from the increased crowd noise that it generated, this humble observation paved the way for the many scientific studies that have followed. </p>
<p>A recent meta-analysis of more than 100 empirical investigations of music in sport and exercise conducted over the past century has confirmed that music produces significant beneficial effects on psychological responses, perceived exertion, physical performance, and even physiological functioning. </p>
<figure class="align-center ">
<img alt="" src="https://images.theconversation.com/files/61955/original/nmv34kyj-1413437534.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/61955/original/nmv34kyj-1413437534.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/61955/original/nmv34kyj-1413437534.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/61955/original/nmv34kyj-1413437534.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/61955/original/nmv34kyj-1413437534.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=502&fit=crop&dpr=1 754w, https://images.theconversation.com/files/61955/original/nmv34kyj-1413437534.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=502&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/61955/original/nmv34kyj-1413437534.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=502&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Listening to the right music can improve your performance.</span>
<span class="attribution"><a class="source" href="https://www.flickr.com/photos/sangudo/6145833799">Flickr/Sangudo</a>, <a class="license" href="http://creativecommons.org/licenses/by-nd/4.0/">CC BY-ND</a></span>
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</figure>
<p>Although it should be no surprise that music influences psychological responses, – especially our moods, emotions and feelings – the ways that athletes use music to manipulate their pre-competition mindset are occasionally surprising.</p>
<p>Olympic rowing champion, James Cracknell, listening to the Red Hot Chili Peppers’ Get On Top to inspire him to the ultimate effort is logical enough. </p>
<p>But what music would you recommend to an Olympic super-heavyweight boxer before his gold medal bout? Tina Turner’s Simply The Best or Survivor’s Eye Of The Tiger would be popular choices. But how about Japanese classical music?</p>
<p>When you’re a technical boxer trying to generate the qualities of speed, lightness, precision and relaxation to outbox a brawling opponent then his choice of music starts to make sense. It certainly worked for Great Britain’s Audley Harrison, a former student of mine, at the Sydney 2000 Olympics. </p>
<h2>The rhythm of exercise</h2>
<p>Music has the capacity to reduce perceived exertion by about 10% when used during physical activity, which explains the enduring popularity of exercise-to-music classes.</p>
<p>The stimulative and motivational properties of up-tempo music, with lyrics that encourage effort (Bruce Springsteen’s Born To Run, Britney Spears’ Stronger) and associations of glory or success (M People’s Search For The Hero, Gloria Gaynor’s I Will Survive) typically help exercisers to work harder for longer by masking the objective level of effort. In turn, this produces a performance benefit that some elite performers have been able to exploit.</p>
<p>Ethiopian superstar runner, Haile Gebrselassie, the double Olympic 10,000m gold medallist and multiple world champion, has broken several world records while running in time to the high-tempo song Scatman, the rhythm and tempo of which he describes as “<a href="http://www.theguardian.com/lifeandstyle/the-running-blog/2013/may/10/haile-gebrselassie-interview">perfect for running</a>”.</p>
<p>A 2012 <a href="http://www.ncbi.nlm.nih.gov/pubmed/21803652">study</a> conducted with elite triathletes at the Queensland Academy of Sport showed that treadmill running to exhaustion was increased by a staggering 18% when participants ran in time to music that included everything from Oasis and UB40 to Beyoncé and Taylor Swift, compared to completing the same task without music.</p>
<p>Such clear performance benefits have caused music to be labelled a “<a href="http://www.bbc.co.uk/wales/raiseyourgame/sites/motivation/psychedup/pages/costas_karageorghis.shtml">legal drug</a>” by some commentators. </p>
<p>Perhaps for this reason, many sports prohibit listening to music while performing. The New York Marathon famously tried to “<a href="http://www.nytimes.com/2007/11/01/sports/01iht-run.1.8142612.html">strongly discourage</a>” competitors from using personal listening devices in 2007, ostensibly for safety reasons.</p>
<p>The outcry and outright defiance from a large proportion of recreational runners who used their iPods regardless, caused race organisers to subsequently restrict the ban to elite runners, many of whom prefer to focus attention on sensory feedback from their own bodies rather than, as they see it, the distracting effects of music.</p>
<h2>Sing when you’re winning</h2>
<p>Of course nothing can prevent athletes from creating their own musical rhythm during a race, like six-time marathon kayak world champion, Anna Hemmings, who gained an edge by singing R. Kelly’s The World’s Greatest to herself, but only during the world championships so as not to dilute its impact. </p>
<p>Other <a href="http://www.ncbi.nlm.nih.gov/pubmed/21803652;%20http://www.ncbi.nlm.nih.gov/pubmed/22828457">recent studies</a> have demonstrated greater physiological efficiency when exercising to music, notably the completion of identical workloads using significantly less oxygen consumption than without music. This indicates that music effects are far more than just a psychological phenomenon.</p>
<p>Whether the physiological benefits are explained by greater biomechanical efficiency derived from a metronome effect, improved blood flow derived from a generalised relaxation response, or some other mechanism that is not yet well understood, there is little doubt about the wide-ranging potential benefits of listening to music.</p>
<p>There’s no shortage of ways to use music to your advantage and many different musical genres have been shown to boost athletic performance, although preferably not something that leaves the Wallabies giggling before taking on the All Blacks in Brisbane tomorrow evening.</p><img src="https://counter.theconversation.com/content/32822/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Peter Terry receives funding from the Queensland Academy of Sport.</span></em></p>Let’s hope the Wallabies are inspired by a rousing rendition of the national anthem as they prepare to face their old enemy the All Black’s at tomorrow’s Bledisloe Cup match. The Kiwis invariably come…Peter Terry, Professor of Psychology, University of Southern QueenslandLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/216362014-01-10T02:02:44Z2014-01-10T02:02:44ZMuscling up: are steroids an emerging criminal threat?<figure><img src="https://images.theconversation.com/files/38608/original/xw7rvzv2-1389137167.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Many more Australians want to build the 'body beautiful' and we want to do it in a hurry, increasingly through the use of performance and image enhancing drugs (PIEDs).</span> <span class="attribution"><span class="source">shutterstock</span></span></figcaption></figure><p>High-profile claims of links between <a href="http://www.smh.com.au/national/this-is-the-blackest-day-in-australian-sport-20130207-2e1i3.html">elite sports and organised crime</a> in Australia – such as those outlined in last year’s Australian Crime Commission (ACC) <a href="http://www.crimecommission.gov.au/sites/default/files/files/organised-crime-and-drugs-in-sports-feb2013.pdf">report</a> – have put performance and image enhancing drugs (PIEDs) squarely in the consciousness of mainstream society. But what are they, and how widespread is their use?</p>
<p>PIEDs is a term used to describe a range of substances that include steroids, hormones, insulin and peptides. There are several categories: anabolic and androgenic steroids (AAS) as well as ergogenic. They refer to any substances that will physically enhance the capacity for mental and or physical activity. </p>
<p>The (ongoing) saga of both the <a href="https://theconversation.com/frankenfooty-essendons-mixed-bag-of-supplements-17323">Essendon</a> and <a href="https://theconversation.com/cronulla-sharks-and-thymosin-beta-4-is-it-doping-12694">Cronulla</a> football clubs regarding allegedly illegal supplement programs continue to <a href="http://www.theage.com.au/victoria/essendon-drug-use-sparks-copycat-rush-20140105-30c3i.html">dog the headlines</a>. But there are broader, more concerning trends regarding the use of PIEDs than merely at the elite level. Recent statistics have shown that the community hunger for PIEDs is increasing rapidly. </p>
<p>It seems many of us want to build the body beautiful and we want to do it in a hurry.</p>
<h2>A growing market</h2>
<p>Data from the ACC’s 2011-12 <a href="http://www.crimecommission.gov.au/publications/illicit-drug-data-reports/2011-12/index/other-drugs#anabolic">Illicit Drug Data report</a> indicated that the market for PIEDs has expanded, with record numbers of seizures, detections and arrests.</p>
<p>Between 2007 and 2012, Australian arrests for steroids increased by 213%. In comparison, amphetamine arrests for the same period only increased by 5%, despite amphetamines being traditionally regarded as “hardcore” drugs. While the number of arrests for steroids is comparatively small, there is no doubt it is an emerging crime trend which is rapidly becoming a serious threat.</p>
<p>Steroid use is overwhelmingly a male issue: only 9% of arrests for steroids in 2011-12 involved females. New South Wales leads the way Australia-wide, accounting for 70% of the national seizures of steroids, while Queensland comes a distant second. Interestingly, however, Queensland accounted for 58% of steroid arrests for the same period. </p>
<p>Nationally, the detection of PIEDs <a href="http://www.heraldsun.com.au/news/law-order/australian-crime-commissions-illicit-drug-data-report-warns-on-doping-threat-to-australian-sport/story-fni0fee2-1226646285414">increased</a> by 56% in 2011-12, with actual figures rising from 5,561 to 8,726.</p>
<h2>Injecting rates</h2>
<p>Anecdotal <a href="http://www.druginfo.adf.org.au/alerts/performance-and-image-enhancing-drugs">reports</a> from Needle and Syringe Program services in NSW and QLD suggest an increase in the number of people who are injecting steroids. At the jurisdictional level, <a href="http://onlinelibrary.wiley.com.ezproxy.bond.edu.au/doi/10.1111/j.1465-3362.2012.00499.x/abstract">PIED injection rates</a> rose from 4.3% to 9.2% in NSW between 2010 and 2011. Injection rates in Queensland increased from 1.1% to 7.4% between 2009 and 2011. </p>
<p>Over the past year, some needle exchange programs have experienced a substantial increase in the number of clients asking for injecting equipment for PIEDs, with <a href="http://www.abc.net.au/news/2013-05-30/steroid-use-on-the-rise/4724140">data</a> showing that the biggest client base was steroid users. The burgeoning steroid use is not limited to Australia. International rates are also increasing, according to reports from the <a href="http://www.mirror.co.uk/news/uk-news/abuse-of-steroids-is-rivalling-heroin-use-908198">UK</a> and <a href="http://globalnews.ca/news/191618/graphic-drug-seizures-across-canada/">Canada</a>. </p>
<p>There has been some anecdotal <a href="http://bmjopen.bmj.com/content/3/9/e003207.full">evidence</a> to suggest that PIED users do not see themselves as drug users in the same context as an opiate or amphetamine injector. While they will use the networks in place to service their requirements, they do not avail themselves of the harm reduction education available around vein care, hepatitis C or HIV.</p>
<p>The greatest barrier faced is the perception that PIED users do not identify themselves as a person who injects drugs nor as someone committing a criminal act. Much of the steroid literature outlines that steroids are natural body hormones and are not the same as other illicit drugs. The alleged use by elite athletes and sports clubs <a href="http://www.theage.com.au/victoria/essendon-drug-use-sparks-copycat-rush-20140105-30c3i.html">may also</a> portray the use of PIEDs as an acceptable method to gain results. </p>
<h2>Criminal links</h2>
<p>Many law enforcement agencies are concerned that PIED consumers are increasingly coming to the attention of organised crime. Bikie gangs in particular <a href="http://www.goldcoastbulletin.com.au/bikies-on-parole-and-probation-facing-going-back-to-jail-after-failing-drug-tests/story-fnj90t7b-1226798488854">have been linked</a> with the PIED market. </p>
<p>The Queensland Crime and Misconduct Commission <a href="http://www.cmc.qld.gov.au/topics/crime-and-law-enforcement/major-crime/organised-crime/drugs/drug-market-profiles/performance-and-image-enhancing-drugs-pieds">noted</a> that while the prevalence of PIED use seems to be low at this point, it is an emerging market area that has been on the rise since 2009, particularly on the Gold Coast and in Northern Queensland.</p>
<figure class="align-center ">
<img alt="" src="https://images.theconversation.com/files/38620/original/h2jn9wxf-1389143334.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/38620/original/h2jn9wxf-1389143334.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=450&fit=crop&dpr=1 600w, https://images.theconversation.com/files/38620/original/h2jn9wxf-1389143334.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=450&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/38620/original/h2jn9wxf-1389143334.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=450&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/38620/original/h2jn9wxf-1389143334.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=565&fit=crop&dpr=1 754w, https://images.theconversation.com/files/38620/original/h2jn9wxf-1389143334.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=565&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/38620/original/h2jn9wxf-1389143334.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=565&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
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<span class="caption">Seizures of and arresting relating to steroids are on the rise, but should it be cause for concern?</span>
<span class="attribution"><span class="source">AAP/Supplied</span></span>
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</figure>
<p>For users, the ends justifies the means – to some degree. This tends to legitimise the use of steroids and reinforces user perceptions that they are different from other drug injectors committing criminal acts. While this may be valid in terms of medically prescribed steroids, it is fair to say that the majority of consumers obtain steroids from sources other than medical professionals. </p>
<p>The issue of PIEDs is not limited to mainstream society either. Problems with the abuse of such drugs have arisen even within law enforcement agencies themselves. Investigations have uncovered inappropriate use among police <a href="http://www.theage.com.au/victoria/police-stood-down-over-steroids-20131008-2v5ze.html">in Australia</a> and <a href="http://www.bbc.co.uk/news/uk-21154316">overseas</a>.</p>
<p>When considering the criminal impact of PIEDs, there is not only the issue of criminality in use, possession and distribution, there is also the derived criminal behaviour from the side-effects of use. There is some debate over the link between the use of steroids and acts of violent crime. However, some <a href="http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2636528">studies</a> have indicated that those who engage in the use of anabolic steroids are twice as likely to engage in violence compared to non-users. </p>
<p>A <a href="http://www.bocsar.nsw.gov.au/agdbasev7wr/bocsar/documents/pdf/cjb35.pdf">general survey</a> of research literature would seem to confirm this link. Given the <a href="http://www.abc.net.au/news/2014-01-03/push-to-refer-to-king-hit-attacks-as-coward-punches/5183260">recent community concern</a> regarding violent public assaults this is just one more reason for attention to be paid to the increasing use of PIEDs.</p>
<p>As we move toward the start of another season in the major football codes, we should consider that steroids and other PIEDs are not only a threat to a level playing field for our elite athletes, but are also a broader emerging criminal threat to the wider community.</p><img src="https://counter.theconversation.com/content/21636/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Terry Goldsworthy does not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.</span></em></p>High-profile claims of links between elite sports and organised crime in Australia – such as those outlined in last year’s Australian Crime Commission (ACC) report – have put performance and image enhancing…Terry Goldsworthy, Assistant Professor, Bond UniversityLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/187552013-10-14T03:48:20Z2013-10-14T03:48:20ZHealth Check: does caffeine enhance performance?<figure><img src="https://images.theconversation.com/files/32961/original/r3ygtkqs-1381719737.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">About 80% of the world’s caffeine is consumed in the form of coffee.</span> <span class="attribution"><span class="source">jennybach</span></span></figcaption></figure><p>Unlike many drugs, caffeine may be taken legally by people of all ages, which helps make it the world’s most widely used stimulant. </p>
<p>Approximately <a href="http://tiny.cc/ix6j4w">80% of the world’s caffeine</a> is consumed in the form of coffee; it’s been estimated that <a href="http://tiny.cc/hi7j4w">500 billion cups of coffee</a> are consumed throughout the world every year. </p>
<p>Tea, chocolate, cola drinks, and energy drinks and shots are the other main sources of caffeine.</p>
<h2>Impact on physical performance</h2>
<p>Caffeine has been used to good effect by athletes as an <a href="http://www.ncbi.nlm.nih.gov/pubmed/19088794">aid to physical performance</a> for many years. Initially, it was believed to be of greatest benefit in endurance events (marathon running, for instance, or long-distance swimming). </p>
<p>More recently, we’ve realised that caffeine also boosts performance for short-term, high-intensity activities, such as middle-distance running, and stop-start sports, such as tennis.</p>
<p>Until a decade or so ago, it was thought that very high doses of caffeine (higher than could be obtained by simply drinking coffee, for example) were needed to enhance athletic performance. </p>
<figure class="align-center ">
<img alt="" src="https://images.theconversation.com/files/32968/original/f2yb3t3z-1381720954.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/32968/original/f2yb3t3z-1381720954.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=399&fit=crop&dpr=1 600w, https://images.theconversation.com/files/32968/original/f2yb3t3z-1381720954.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=399&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/32968/original/f2yb3t3z-1381720954.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=399&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/32968/original/f2yb3t3z-1381720954.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=501&fit=crop&dpr=1 754w, https://images.theconversation.com/files/32968/original/f2yb3t3z-1381720954.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=501&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/32968/original/f2yb3t3z-1381720954.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=501&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Initially, caffeine was believed to be of greatest benefit in endurance events, such as long-distance swimming.</span>
<span class="attribution"><span class="source">Airman Magazine/Flickr</span></span>
</figcaption>
</figure>
<p>Such high doses could usually only be obtained from caffeine-containing capsules, and often led to adverse side effects. </p>
<p>Consequently, the International Olympic Committee (<a href="http://www.olympic.org/ioc">IOC</a>) banned caffeine use by athletes above a certain level of intake.</p>
<p>But by early this century, it became clear that moderate doses of caffeine — achievable by drinking coffee, tea or energy drinks — were just as effective as very high doses for enhancing physical performance. And they had minimal risk of side effects. </p>
<p>It was also discovered that caffeine intake is “self-limiting” to some extent, that is, extremely high doses are likely to have a detrimental effect on athletic performance. </p>
<p>So, in 2004, the IOC ban on caffeine was <a href="http://tiny.cc/585j4w">completely lifted</a>; Olympic athletes may now take as much caffeine as they like.</p>
<h2>How much is enough?</h2>
<p>What, then, is the most appropriate source of caffeine if you’re an athlete who wants to safely obtain a performance benefit?</p>
<figure class="align-center ">
<img alt="" src="https://images.theconversation.com/files/32963/original/pjv8mww9-1381720298.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/32963/original/pjv8mww9-1381720298.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=300&fit=crop&dpr=1 600w, https://images.theconversation.com/files/32963/original/pjv8mww9-1381720298.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=300&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/32963/original/pjv8mww9-1381720298.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=300&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/32963/original/pjv8mww9-1381720298.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=377&fit=crop&dpr=1 754w, https://images.theconversation.com/files/32963/original/pjv8mww9-1381720298.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=377&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/32963/original/pjv8mww9-1381720298.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=377&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">The amount of caffeine in tea and coffee varies greatly.</span>
<span class="attribution"><span class="source">Ryan Hyde</span></span>
</figcaption>
</figure>
<p>Well, you could try coffee or tea, but the amount of caffeine in these beverages <a href="http://australianbeverages.org/for-consumers/caffeine-facts/">varies greatly</a>. Energy drinks, on the other hand, are formulated to contain a known quantity of caffeine, so they allow for a more controlled intake. </p>
<p>A dose of about three milligrams of caffeine per kilogram of body weight will give you the <a href="http://www.ncbi.nlm.nih.gov/pubmed/19088794">desired boost to performance</a>, with little likelihood of inducing the “caffeine shakes” that can result from overdosing.</p>
<p>So, for example, if an energy drink contains 80 milligrams of caffeine, and you weigh 55 kilograms, a couple of cans of energy drink will provide the recommended dose.</p>
<p>Some people believe that caffeine is a diuretic, that it promotes excessive urine production and therefore leads to dehydration. This is not correct, at least when caffeine is <a href="http://www.ncbi.nlm.nih.gov/pubmed/12187618">consumed in moderate amounts</a> by habitual users.</p>
<p>People who regularly drink tea, coffee, cola drinks, energy drinks or energy shots can expect to receive the desired performance enhancement from caffeine without experiencing greater dehydration.</p>
<h2>Making you sharper</h2>
<p>There’s also evidence that caffeine improves <a href="http://www.ncbi.nlm.nih.gov/pubmed/?term=Nutrition.+2010+Oct%3B+26(10)%3A+932-8">some aspects of mental performance</a>. Doses up to about 200 milligrams (similar to the dose that enhances physical performance) lead to increasingly quicker reactions, increased alertness, elevated mood and improvements in activities such as typing (greater typing speed with fewer mistakes).</p>
<p>The quantity of caffeine needed to enhance mental performance can be obtained by drinking one or two cups of coffee, one or two cans of energy drink, or several cups of tea. (But note the earlier advice that caffeine concentration is very variable in coffee and tea.)</p>
<figure class="align-center ">
<img alt="" src="https://images.theconversation.com/files/32965/original/ycw3dyb3-1381720764.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/32965/original/ycw3dyb3-1381720764.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=398&fit=crop&dpr=1 600w, https://images.theconversation.com/files/32965/original/ycw3dyb3-1381720764.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=398&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/32965/original/ycw3dyb3-1381720764.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=398&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/32965/original/ycw3dyb3-1381720764.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=501&fit=crop&dpr=1 754w, https://images.theconversation.com/files/32965/original/ycw3dyb3-1381720764.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=501&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/32965/original/ycw3dyb3-1381720764.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=501&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Energy drinks are formulated to contain a known quantity of caffeine, so they allow for a more controlled intake.</span>
<span class="attribution"><span class="source">Nattu/Flickr</span></span>
</figcaption>
</figure>
<p>People who need to maintain vigilance during a period when they would normally be asleep, such as long-distance truck drivers, nightwatchmen, shift workers, students “cramming” for exams and soldiers on sentry duty, often use caffeine from coffee, tea, energy drinks and shots or capsules to keep them awake and alert.</p>
<p>The US Army now uses a commercially available caffeinated chewing gum called “Stay Alert” in one of its combat rations (the First Strike Ration). This ration is issued to soldiers who are expected to take part in operations of up to 72 hours with minimal sleep. Stay Alert gum contains 100 milligrams of caffeine per stick and there are five sticks in the First Strike Ration.</p>
<h2>A little doubt</h2>
<p>In the interests of objectivity, I should point out that a small minority of researchers believe that caffeine <a href="http://www.ncbi.nlm.nih.gov/pubmed/16001109">does not truly enhance</a> mental performance. Rather, they claim that taking caffeine will simply overcome the drop in performance that results from caffeine withdrawal in people who are used to having caffeine in their body.</p>
<p>But looking at data from military studies I’m familiar with, I believe there’s little room for doubt that caffeine can greatly enhance at least some aspects of cognitive performance, particularly when people are sleep-deprived.</p>
<p>It’s important to keep in mind though that <a href="http://jama.jamanetwork.com/article.aspx?articleid=645466&resultClick=3">overdosing on caffeine</a> is potentially dangerous, particularly for those (mostly young) people who consume too many energy drinks or shots – especially if they combine these with alcohol.</p>
<p>Caffeine undoubtedly enhances many aspects of physical performance, and very likely several aspects of mental performance too. And unlike most performance-enhancing drugs, it’s legal, readily available, and comes in forms that are highly acceptable to most people.</p><img src="https://counter.theconversation.com/content/18755/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Chris Forbes-Ewan received funding from the National Health and Medical Research Council in 2006 for his contribution to the development of Nutrient Reference Values for Australia and New Zealand. His contribution was in the area of estimated energy requirements.</span></em></p>Unlike many drugs, caffeine may be taken legally by people of all ages, which helps make it the world’s most widely used stimulant. Approximately 80% of the world’s caffeine is consumed in the form of…Chris Forbes-Ewan, Senior Nutritionist, Defence Science and Technology OrganisationLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/122352013-02-19T19:26:12Z2013-02-19T19:26:12ZWe’re getting tougher on doping cheats – but why?<figure><img src="https://images.theconversation.com/files/20402/original/sjc2npgf-1361250884.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Is our current form of hyper-competitive sport transgressive of fair play?</span> <span class="attribution"><span class="source">Art-Of-2</span></span></figcaption></figure><p>What’s the point of anti-doping? And what’s the point of sport in the early 21st century? Is the current system of anti-doping good for our kids, our athletes and is it good for sport? Is it even good for society? These are not easy questions to answer – but surely they’re not beyond us.</p>
<h2>Penal pursuits</h2>
<p>In the midst of the current doping scandal, the Australian Olympic Committee (AOC) has announced the introduction of the landmark rule to make it mandatory for all future Australian <a href="http://corporate.olympics.com.au/news/soch-olympians-first-to-sign-stat-decs-to-counter-doping">Olympians to sign a statutory declaration</a> about doping. </p>
<p>The refusal to do so, or an admission of having taken performance enhancing drugs, would make athletes <a href="http://www.abc.net.au/pm/content/2012/s3624618.htm">ineligible</a> for team inclusion. Those found to have made inaccurate representation in the statutory declaration face up to five years in jail. </p>
<p>This measure is yet another designed to segregate all perceived impure elements from the ranks of Australian sport. </p>
<p>The AOC move follows the <a href="http://www.regional.gov.au/sport/resources/reports/review-of-cycling-australia.aspx">recommendations</a> of Justice Wood and his inquiry into the governance of Australian cycling and the banishment from that sport of former cyclists turned officials, <a href="http://www.heraldsun.com.au/sport/more-sport/cycling-australia-vice-president-stephen-hodge-resigns-after-confessing-to-doping/story-e6frfglf-1226499246901">Stephen Hodge</a> and <a href="http://www.deakin.edu.au/research/stories/2012/10/11/drug-pedalling">Matthew White</a> after their admissions that they had doped in the past.</p>
<p>On February 6, the Commonwealth introduced the <a href="c">Australian Sports Anti-Doping Authority Amendment Bill 2013</a>. The introduction of the Bill will potentially see <a href="http://www.asada.gov.au/">ASADA</a> being given new and unprecedented powers including the imposition of civil penalties and being able to compel the handing over of documents and the giving of evidence, not only from athletes and those directly involved in sport, but presumably from other stakeholders such as academic researchers who explore athletes’ lived experiences in elite sport. </p>
<p>It’s easy to speculate – based on one of the author of this paper’s unpublished research – that the Bill is at least in part a response to the refusal of some cyclists to cooperate with ASADA given the repercussions of them speaking about their sporting careers. </p>
<p>Without some protection for such potential witnesses many athletes continue to equate confessing or cooperating with ASADA as their own career and personal suicide.</p>
<h2>Lipstick on a pig</h2>
<p>Simply getting “tough” on the “cheats” through such measures has been criticised by WADA President John Fahey as having the result of only reinforcing the <a href="http://www.theroar.com.au/2013/02/13/fahey-worried-by-aoc-drug-declaration/">cone of silence</a> that pervades sport and its administration. </p>
<p>Both Fahey and his director-general David Howman have made numerous recent statements that signal WADA’s uneasiness with the blind pursuit of zero tolerance embarked on by governments and sporting administrators. </p>
<p>The signal is that WADA feels that such measures will be in the longer term <a href="http://www.telegraph.co.uk/sport/othersports/cycling/9656497/World-Anti-Doping-Agency-chief-David-Howman-attacks-Team-Sky-for-zero-tolerance-policy-towards-drug-cheats.html">counterproductive</a>.</p>
<p>In the course of their separate research experiences, both authors of this article are convinced that heavy-handed zero tolerance policies at the elite level simply pushes experimental use of performance-enhancing substances into the sub elite level, where younger athletes prepare themselves prior to encountering elite anti-doping testing regimes. </p>
<p>A question that needs to be asked is whether we really want our sub-elite and junior sports to become laboratories for professional athlete preparation.</p>
<p>The problem with anti-doping is that it is another “anti”; another war on something that appears to be more about protecting commercial and national investments and reputation than it does protecting the <a href="http://www.newcyclingpathway.com/news/blog/cyclists-anti-doping-and-medical-monitoring-%E2%80%93-a-better-approach">athletes’ health</a>. </p>
<p>The focus thus far has mainly been on individual fault-finding. But from our perspective it is not about individual “cheats”; what is in issue is the entire sporting system and its links to business and government (and even organised crime). </p>
<p>If there is one lesson we can learn from recent events – whether it be the <a href="http://cyclinginvestigation.usada.org/">Armstrong investigation</a>, the <a href="http://deportes.elpais.com/tag/operacion_puerto/a/">Spanish Operacion Puerto trial</a> or the Australian Crime Commission public report – it’s that there are systemic and institutional drivers of doping practice. </p>
<p>Former cyclist and team manger <a href="http://www.cyclingnews.com/blogs/jonathan-vaughters/opinion-its-not-all-about-lance-armstrong-and-heres-how-we-can-fight-doping">Jonathan Vaughters has said</a> in respect of his sport that everyone involved is to blame for the problem, not just individuals such as Armstrong.</p>
<h2>Make-up or make-over</h2>
<p>Sport and games have not always been what we know today. The etymology of the word sport points us towards ideas of “pleasure” and “diversion”. </p>
<p>Pre-modern European folk games were based around an ethic that is very different from today’s hyper competitive sport – rather than win at all costs many of these games operated on the principle of not leaving anybody behind. </p>
<p>Sport as an ideal of human pursuit, and an economic activity, is very much a modern-day phenomenon such that sport has become a primary mechanism for governance of society in a global neo-liberal world. </p>
<p>Anti-doping has replaced the previous emphasis on the ethics of amateur sport. Research conducted by one of the authors of this paper <a href="http://www.amazon.com/Wish-was-Twenty-One-Now/dp/1478351993">revealed widespread cynicism</a> from cyclists who had not bought the line that anti-doping was either about fair play or about their health. </p>
<p>In circumstances in which professional sport is an industry and athletes are commodities, the health and welfare of the athlete should be the focus of anti-doping. There are too many cases of athletes having adverse health effects or even having died as a result of doping practices gone wrong. </p>
<p>It is because of sport’s economic and symbolic role that our current form of hyper-competitive sport, supported by business and government, is by its very nature transgressive of fair play. </p>
<p>We should forget the intangible and rhetorical claims about preserving the integrity of sport and protecting a romanticised image of sport that attract sponsors. </p>
<p>The AOC statutory declarations and the ASADA Bill are simply more measures to get tough on the cheats. But they are merely symptomatic solutions that will do nothing to ensure athlete health and welfare or assist in curbing the systemic drivers of doping in sport; nor are they measures that might address the underlying pathology inherent in modern sport.</p>
<p>Whether sport mirrors society or today’s society mirrors sport, we believe that some of the questions we should be asking include:</p>
<ul>
<li>What is the point of sport in the early 21st century? <br></li>
<li>What do we want the point of sport to be in the future? <br></li>
</ul>
<p>It is only when we start to ask ourselves whether our past ideals should define our future goals that we can begin to more clearly articulate the point of anti-doping. In reflecting on issues beyond the superficial, we remind ourselves that in the end the question is about what type of society we want.</p><img src="https://counter.theconversation.com/content/12235/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span> Martin Hardie teaches law at Deakin University. He has worked as a cycling journalist in Spain and contributes on an occasional basis to El Pais newspaper and co authored the Report “I Wish I Was Twenty One Now – Beyond Doping in the Australian Peloton” which is available in print and on Amazon kindle. That report was funded by the Commonwealth Government's Anti-Doping Research program. He also organised the New Pathways for Pro Cycling Conference in Geelong in September 2010. He is included in the WADA Social Science Research Directory.
</span></em></p><p class="fine-print"><em><span>Benjamin Koh does not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.</span></em></p>What’s the point of anti-doping? And what’s the point of sport in the early 21st century? Is the current system of anti-doping good for our kids, our athletes and is it good for sport? Is it even good…Martin Hardie, Lecturer in Law, Deakin UniversityBenjamin Koh, Doctoral Researcher, Complementary and Alternate Medicine, University of Technology SydneyLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/121192013-02-11T02:59:05Z2013-02-11T02:59:05ZWe need an advocate against ASADA’s power in doping control<figure><img src="https://images.theconversation.com/files/20110/original/ftn9xtnz-1360540722.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">In light of relevations into doping in Australian sport, should more be done to protect and inform professional athletes?</span> <span class="attribution"><span class="source">Phil Roeder</span></span></figcaption></figure><p>Should an athlete advocacy organisation be established to help athletes navigate the minefield of banned and permitted substances in sport? We believe it should be.</p>
<p>Last week’s <a href="http://www.crimecommission.gov.au/publications/other/organised-crime-drugs-sport">report by the Australian Crime Commission</a> (ACC) on the impact of doping in professional sport coincided with the introduction of the <a href="http://www.aph.gov.au/Parliamentary_Business/Bills_Legislation/Bills_Search_Results/Result?bId=s902">Australian Sports Anti-Doping Authority Amendment Bill 2013</a>, that would potentially give the Australian Sports Anti-Doping Authority (<a href="http://www.asada.gov.au/">ASADA</a>) unprecedented power and control over investigations into anti-doping rule violations.</p>
<p>Even without the proposed prosecution powers, ASADA may already not be perceived by athletes as a preferred source for information into supplement use. In research conducted by one of this article’s authors as part of his (yet-to-be-published) thesis, elite and pre-elite athletes were given a list of individuals and organisations and asked who they had previously contacted with regards to clarifying the rules of doping for their sport prior to taking a new medication/supplement. </p>
<p>The three top answers were: athletes’ club coaches (87.85%), general practitioner doctors (86.52%), and the internet (83.23%). ASADA was one of the least common sources for that information, at just 23.34%. </p>
<figure class="align-center ">
<img alt="" src="https://images.theconversation.com/files/20121/original/dcgzzp67-1360546849.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/20121/original/dcgzzp67-1360546849.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/20121/original/dcgzzp67-1360546849.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/20121/original/dcgzzp67-1360546849.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/20121/original/dcgzzp67-1360546849.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/20121/original/dcgzzp67-1360546849.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/20121/original/dcgzzp67-1360546849.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Politicians join the heads of Australia’s sporting organisations to announce the findings of a report into corruption in Australian sport.</span>
<span class="attribution"><span class="source">AAP/Lukas Coch</span></span>
</figcaption>
</figure>
<p>As the lead national authority on what is legal or illegal in sport, ASADA is the ultimate source in Australia to confirm whether a substance is banned. But if ASADA is also the prosecutor of athletes for anti-doping violations – as per the proposals in the new bill – that will make it difficult (and even <em>less</em> appealing) for athletes to approach the organisation to clarify the status of supplements. An analogy would be a person asking the police how much cannabis he or she is allowed to legally grow/possess.</p>
<h2>Supplements</h2>
<p>Many modern-day elite athletes <a href="http://www.ncbi.nlm.nih.gov/pubmed/16377972">use dietary supplements</a> to help cope with the pressures of being an elite athlete – a practice that also <a href="http://www.ncbi.nlm.nih.gov/pubmed/?term=morrison+gizis">extends to non-elite level athletes</a>. </p>
<p>Supplements <a href="http://www.ncbi.nlm.nih.gov/pubmed/?term=Maughan+Depiesse">include</a> vitamins, minerals, herbal remedies, traditional Asian remedies, amino acids and various other “ergogenic” (performance enhancing) <a href="http://www.ncbi.nlm.nih.gov/pubmed/22905051">substances</a>.</p>
<p>Such substances may often also be used independently of expert (physicians and dieticians) advice, and many athletes <a href="http://www.ncbi.nlm.nih.gov/pubmed/17997853">may not know</a> if the supplements used are banned in sports.</p>
<p>Even if athletes have the relevant scientific knowledge and are aware of the legalities of the active ingredients, not all supplements are regulated, and traces of substances that may be banned in sport <a href="http://www.ncbi.nlm.nih.gov/pubmed/15467106">may be present but not listed</a> on the supplement bottle.</p>
<p>One of the first <a href="http://www.ncbi.nlm.nih.gov/pubmed/14986195">comprehensive studies</a> to evaluate the doping risk posed by dietary supplements showed about 15% of a total of 634 supplements purchased in various countries in 2000 and 2001 contained varying levels of cross-contamination with prohibited anabolic androgenic steroids (AAS). <a href="http://www.ncbi.nlm.nih.gov/pubmed/18563865">Studies since 2002</a> have found further supplement products contaminated with high amounts of undeclared AAS. </p>
<p>Because the manufacturers of these contaminated products also manufacture other nutritional supplements on the same production line, the <a href="http://www.ncbi.nlm.nih.gov/pubmed/18049988">risk of cross-contamination</a> with such AAS is very high.</p>
<h2>Athletes’ ombudsman</h2>
<p>An independent athlete advocacy organisation that looks out for the athletes with regards to performance-enhancing substances and methods (PESM) is important, and we believe it should have the following characteristics:</p>
<ul>
<li><p>It should comprise professionals who are knowledgeable in the area of PESM and can tell athletes what are legal or illegal PESM, acting as an “ethics” body to make sure athletes have an informed choice and a neutral second opinion. </p></li>
<li><p>It should not be tasked with also policing the athletes/clubs. After all, it’s not hard to imagine there could be a perceived conflict of interest where an organisation has a duality of policing and advising functions. </p></li>
<li><p>It must be independent from the clubs’/sports’ codes. Each club’s sports science staff will continue to do what is necessary to improve athletic performance, but ultimately they work for the interest of the clubs that pay them. </p></li>
</ul>
<figure class="align-right zoomable">
<a href="https://images.theconversation.com/files/20111/original/chkscdmx-1360541606.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="" src="https://images.theconversation.com/files/20111/original/chkscdmx-1360541606.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=237&fit=clip" srcset="https://images.theconversation.com/files/20111/original/chkscdmx-1360541606.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=800&fit=crop&dpr=1 600w, https://images.theconversation.com/files/20111/original/chkscdmx-1360541606.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=800&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/20111/original/chkscdmx-1360541606.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=800&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/20111/original/chkscdmx-1360541606.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=1005&fit=crop&dpr=1 754w, https://images.theconversation.com/files/20111/original/chkscdmx-1360541606.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=1005&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/20111/original/chkscdmx-1360541606.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=1005&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption"></span>
<span class="attribution"><span class="source">Treasure Tia</span></span>
</figcaption>
</figure>
<ul>
<li>It should be funded through players’ lobby groups that currently help negotiate on behalf of athletes’ matters pertaining to welfare, salaries, insurance, and so forth.</li>
</ul>
<p>An advocate agency is important especially in the context of inadvertent doping. <a href="http://sma.org.au/wp-content/uploads/2012/04/1389-SMA_ConferenceBOA_WEB_FA_150ppi.pdf">Research</a> by one of this article’s authors has shown that amateur elite athletes may not know all anti-doping rules and this puts the athletes at risk of inadvertent doping under the <a href="http://www.wada-ama.org/rtecontent/document/qa_strict_liability.pdf">strict liability standard</a>. </p>
<p>An informed consent requires that athletes understand both the risks and benefits of any potential treatment or substance they are receiving. The <a href="http://www.heraldsun.com.au/afl/more-news/mark-mcveigh-insists-essendon-players-only-took-sanctioned-vitamins/story-e6frf9jf-1226572139293">use of waiver/consent forms</a> does not relinquish the responsibility for individuals/organisations providing the potential PESM. </p>
<p>As a protection for athletes, the information for all new treatments would be screened by the athlete’s organisation, acting as a <a href="http://www.gal.nsw.gov.au/gal/gal_what_is_gal.html,c=y">guardian <em>ad litem</em></a>. </p>
<h2>Illegal secretagogues</h2>
<p>Let us take the recent ACC report as an example. In that report, one of the alleged violations that are deemed to have been committed is the use of <a href="https://theconversation.com/essendon-faces-a-doping-investigation-but-what-are-peptides-12042">peptides</a>. The report states:</p>
<blockquote>
<p>Peptides are classified as a Schedule 2 (S2) prohibited substance on the WADA Prohibited List and are therefore prohibited for use by professional athletes both in and out of competition. Peptides have been a WADA prohibited substance since at least 2008 …</p>
</blockquote>
<p>The report then cites the misuse of the following peptides:</p>
<p>• CJC-1295</p>
<p>• GhRP-6</p>
<p>• hexarelin</p>
<p>It is unknown what information was provided to athletes under investigation for doping practices before they were allegedly injected with the peptides. An unscrupulous therapist could have informed the athletes that they were being injected with small proteins. This would be technically correct. So what’s wrong with being treated with proteins? </p>
<figure class="align-left zoomable">
<a href="https://images.theconversation.com/files/20112/original/tkh9njqh-1360543099.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="" src="https://images.theconversation.com/files/20112/original/tkh9njqh-1360543099.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=237&fit=clip" srcset="https://images.theconversation.com/files/20112/original/tkh9njqh-1360543099.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=901&fit=crop&dpr=1 600w, https://images.theconversation.com/files/20112/original/tkh9njqh-1360543099.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=901&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/20112/original/tkh9njqh-1360543099.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=901&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/20112/original/tkh9njqh-1360543099.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=1132&fit=crop&dpr=1 754w, https://images.theconversation.com/files/20112/original/tkh9njqh-1360543099.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=1132&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/20112/original/tkh9njqh-1360543099.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=1132&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption"></span>
<span class="attribution"><span class="source">I woz ere</span></span>
</figcaption>
</figure>
<p>There are certainly enough protein powders available in health food stores. There are also numerous top athletes promoting the virtues of protein supplements in advertisements.</p>
<p>The issue at hand is that the alleged peptides may act as secretagogues: a substance that, when introduced into the human body, causes another substance to be secreted. </p>
<p>In this case, the substance being <a href="http://www.vivo.colostate.edu/hbooks/pathphys/endocrine/hypopit/gh.html">secreted by the body</a> is the human growth hormone (HGH). </p>
<p>The peptides do not in themselves cause the effects of HGH. It needs to act through the body’s own gland (pituitary gland) to produce this hormone. The peptides simply maximises the body’s own HGH production.</p>
<p>The WADA Prohibited List states for specific substances under section S2:</p>
<blockquote>
<p>S2. PEPTIDE HORMONES, GROWTH FACTORS AND RELATED SUBSTANCES</p>
<p>The following specific substances and their releasing factors are prohibited:</p>
<p>Growth Hormone (GH), Insulin-like Growth Factor-1 (IGF-1), Fibroblast Growth Factors (FGFs), Hepatocyte Growth Factor (HGF), Mechano Growth Factors (MGFs), Platelet-Derived Growth Factor (PDGF), Vascular-Endothelial Growth Factor (VEGF) …</p>
</blockquote>
<p>But it also has a “catchall” clause in the section that states:</p>
<blockquote>
<p>… as well as any other growth factor affecting muscle ,tendon or ligament protein synthesis/degradation ,vascularisation, energy utilisation, regenerative capacity or fibre type switching and other substances with similar chemical structure or similar biological effect(s) …</p>
</blockquote>
<p>An athlete who is diligent and wants to check if, for example, CJC-1295 is listed in the banned list, will not be able to find it, unless he or she knows how the substance acts – its “similar biological effect(s)”.</p>
<p>But – because of the inconsistency of applying the section S2 rule – the issue is also not straightforward for those familiar with the pharmacodynamics of substances and body physiology. </p>
<p>If, as per the rule, “growth factor affecting muscle, tendon or ligament protein synthesis/degradation, vascularisation, energy utilisation, regenerative capacity or fibre type switching and other substances with similar chemical structure or similar biological effect(s)” are to be prohibited, then it would be inconsistent to accept the substance of <a href="http://journals.lww.com/cjsportsmed/Abstract/2009/01000/Medication_Use_by_Athletes_at_the_Athens_2004.7.aspx">Actovegin</a> and <a href="http://bjsm.bmj.com/content/44/15/1072.short">Platelet-Rich plasma</a>. Neither substance is currently banned in sport. </p>
<p>There are also some amino acids that are legal in sport that may act as secretagogues. Amino acids such as arginine, ornithine, glycine and glutamine are readily available over-the-counter. </p>
<p>These amino acids <a href="http://www.vrp.com/amino-acids/growth-hormone-amino-acids-as-gh-secretagogues-a-review-of-the-literature">have the potential</a> to act as growth hormone secretagogues but are not banned under the WADA prohibited list.</p>
<p>As can be seen, even when confined to the matter of specific substances and section S2 of the prohibited list, the issue is not straightforward. Navigating through the problem of supplementation would require some knowledge of the science and the law.</p>
<p>We do not advocate the use of any substance that has not been approved for human use. Nor are we condoning the abuse of illicit substances that put athletes’ health at risk. </p>
<p>We do, however, believe that athletes’ have a right to an <em>informed</em> choice. Something a zero-tolerance policing approach does not provide.</p><img src="https://counter.theconversation.com/content/12119/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>
Martin Hardie teaches law at Deakin University. He has worked as a cycling journalist in Spain and contributes on an occasional basis to El Pais newspaper and co authored the Report “I Wish I Was Twenty One Now – Beyond Doping in the Australian Peloton” which is available in print and on Amazon kindle. That report was funded by the Commonwealth Government's Anti-Doping Research program. He also organised the New Pathways for Pro Cycling Conference in Geelong in September 2010. He is included in the WADA Social Science Research Directory.</span></em></p><p class="fine-print"><em><span>Benjamin Koh does not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.</span></em></p>Should an athlete advocacy organisation be established to help athletes navigate the minefield of banned and permitted substances in sport? We believe it should be. Last week’s report by the Australian…Benjamin Koh, Doctoral Researcher, Complementary and Alternate Medicine, University of Technology SydneyMartin Hardie, Lecturer in Law, Deakin UniversityLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/120422013-02-06T05:54:15Z2013-02-06T05:54:15ZEssendon faces a doping investigation … but what are peptides?<figure><img src="https://images.theconversation.com/files/20003/original/n9mr2mwp-1360124869.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">An ASADA investigation has been launched into the alleged use of supplements by Essendon players last year.</span> <span class="attribution"><span class="source">AAP/Ben Macmahon</span></span></figcaption></figure><p>By now you’ll have heard the Australian Sports Anti-Doping Authority (<a href="http://www.asada.gov.au/">ASADA</a>) is investigating Essendon Football Club. At this stage, there has been <a href="http://www.smh.com.au/afl/essendon-bombers/dons-may-have-been-forced-into-drugs-reveal-20130206-2dxbo.html?skin=text-only">speculation</a> about the injection of “peptides” by players in training, without any confirmation that this was the case. </p>
<p>So assuming the speculation has some foundation, what are peptides?</p>
<p>In the literal sense, a peptide is just a very small protein. As might be expected, there are hundreds upon hundreds of known peptides, as many as there can be <a href="http://www.biology.arizona.edu/biochemistry/problem_sets/aa/aa.html">amino acids</a> combined in short chains. Peptides have a wide range of potential activities, including:</p>
<ul>
<li>hormones (<a href="http://www.vivo.colostate.edu/hbooks/pathphys/endocrine/pancreas/insulin_struct.html">insulin</a> and <a href="http://maptest.rutgers.edu/drupal/?q=node/253">glucagon</a> are both peptide hormones)</li>
<li>neurotransmitters (such as the <a href="http://flipper.diff.org/app/pathways/info/4654">endogenous opioid</a>)</li>
</ul>
<p>There may be no cause for alarm in the case of Essendon, as there are several sports-legitimate and unregulated uses for peptides, per se. <a href="http://proteinfactory.com/shop/Leucine-Peptides">Leucine peptides</a> or the hydrolysed protein mixture <a href="http://www.dsm.com/le/en_US/peptopro/html/home_peptopro.htm">PeptoPro</a>, for instance, are simply the high-performance cousins of <a href="http://www.mrsupplement.com.au/whey-protein-powder">whey protein supplements</a> - essentially, they are “pre-digested” protein fragments designed to aid recovery from vigorous activity.</p>
<p>These substances are no more controversial than ordinary protein supplements. Such peptides can be bought over the counter and require no secrecy.</p>
<p>Certainly, such peptides are never injected.</p>
<h2>Worst-case scenario</h2>
<p>The ugly and entirely more likely option is that the peptide being speculated about is one from the family of <a href="http://www.betterhealth.vic.gov.au/bhcv2/bhcarticles.nsf/pages/Growth_hormone">growth-hormone</a>-releasing peptides, of which there are several available: <a href="http://www.drugs.com/international/pralmorelin.html">pralmorelin</a>, <a href="http://thinksteroids.com/steroid-profiles/hexarelin/">hexarelin</a>, <a href="http://www.drugs.com/cdi/tesamorelin.html">tesamorelin</a>, or <a href="http://www.defymedical.com/resources/health-articles/3-sermorelin">sermorelin</a>, and more.</p>
<p>These various growth hormone-releasing peptides, or <a href="http://dtc.ucsf.edu/types-of-diabetes/type2/treatment-of-type-2-diabetes/medications-and-therapies/type-2-non-insulin-therapies/insulin-releasing-pills-secretagogues/">secretagogues</a>, stimulate the production of growth hormone by the pituitary gland. This is reminiscent of Lance Armstrong’s drug of choice, <a href="https://theconversation.com/lance-armstrong-charged-with-blood-doping-and-epo-use-so-how-do-they-work-7666">erythopoetin (EPO)</a>, which stimulates the body to produce red blood cells.</p>
<p>A spike in endogenous growth hormone (which may also be injected directly) is used to aid recovery and muscular growth - and, while not as effective as anabolic steroids for the growth and maintenance of muscle mass, growth hormone has significantly fewer side effects. Significantly, it’s also more difficult to detect.</p>
<p>Suffice to say, these growth hormone-releasing peptides sit squarely in the <a href="http://list.wada-ama.org/list/s2-peptide-hormones-growth-factors-and-related-substances/#growth%20hormone%20%28GH%29">WADA banned substances list</a>. Much <a href="http://www.ncbi.nlm.nih.gov/m/pubmed/21298258/">recent research</a> has gone into identifying their patterns of usage, and how the individual drugs might be identified in blood tests.</p>
<h2>Where to now?</h2>
<p>The current investigation may have broad repercussions. Representatives of the <a href="http://www.couriermail.com.au/sport/afl/gold-coast-suns-link-in-essendon-anti-doping-investigation/story-e6frepf6-1226571189503">Geelong and Gold Coast</a> football clubs, and rugby league club <a href="http://www.theage.com.au/afl/afl-news/manly-had-no-concerns-about-dank-20130206-2dxed.html">Manly</a>, have said they employed some of the people who worked for Essendon’s fitness program.</p>
<p>Given ASADA is involved in this case, there is unlikely to be much clemency if any club is found guilty.</p>
<figure class="align-right ">
<img alt="" src="https://images.theconversation.com/files/20006/original/xz9f8wxy-1360128743.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=237&fit=clip" srcset="https://images.theconversation.com/files/20006/original/xz9f8wxy-1360128743.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=415&fit=crop&dpr=1 600w, https://images.theconversation.com/files/20006/original/xz9f8wxy-1360128743.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=415&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/20006/original/xz9f8wxy-1360128743.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=415&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/20006/original/xz9f8wxy-1360128743.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=522&fit=crop&dpr=1 754w, https://images.theconversation.com/files/20006/original/xz9f8wxy-1360128743.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=522&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/20006/original/xz9f8wxy-1360128743.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=522&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Essendon coach James Hird and assistant Mark Thompson face a doping investigation on the eve of the 2013 AFL season.</span>
<span class="attribution"><span class="source">AAP/Joe Castro</span></span>
</figcaption>
</figure>
<p>Athletes operate under what is known as the “<a href="http://www.wada-ama.org/en/Resources/Q-and-A/Strict-Liability-in-Anti-Doping/">strict liability</a>” clause, which means an athlete is directly responsible at all times for substances that are found in them, regardless of how they got there - and guilty until proven innocent. </p>
<p>The fact Essendon players supposedly signed a consent form or waiver will be of little relevance either way. But it’s unclear what the position is, as so far we are dealing with a report that a program of drug use existed, and not hard evidence of use. </p>
<p>We can assume more information will come to light and, given the high profile accorded to doping cases recently, we certainly haven’t heard the last of this story. </p>
<p>People <a href="http://www.foxsports.com.au/rugby/sunshine-coast-rugby-player-francis-burke-cops-four-year-ban-for-possession-of-growth-hormone/story-e6frf4pu-1226375861924#.URHmpRlhR9Y">have been busted</a> for possession and use of growth-hormone releasing peptides before … and that list may be about to get a whole lot longer.</p><img src="https://counter.theconversation.com/content/12042/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>James Heathers does not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.</span></em></p>By now you’ll have heard the Australian Sports Anti-Doping Authority (ASADA) is investigating Essendon Football Club. At this stage, there has been speculation about the injection of “peptides” by players…James Heathers, PhD Candidate in Applied Physiology, University of SydneyLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/80712012-08-07T20:16:49Z2012-08-07T20:16:49ZCarbo loading for sport is simple … when you know how<figure><img src="https://images.theconversation.com/files/13292/original/2yw2wy8p-1343022144.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Pasta and other carbohydrate-rich foods can boost muscle glycogen stores.</span> <span class="attribution"><span class="source">chrismar</span></span></figcaption></figure><p>During the London Olympics, and beyond, many endurance athletes will attempt to increase their muscle <a href="http://orthomolecular.org/nutrients/glycogen.html">glycogen</a> stores by carbohydrate loading. This is because, despite its importance, glycogen is a fuel present only in small amounts in skeletal muscles and can be rapidly depleted during prolonged intense aerobic exercise, thus causing fatigue. </p>
<p>Unfortunately, many athletes aiming to increase their glycogen stores find this aspect of their preparation challenging. It is thus important to remind them that nearly a decade ago my colleagues and I developed <a href="http://www.ncbi.nlm.nih.gov/pubmed/12048325">some carbohydrate loading regimens</a> to make this task easier.</p>
<h2>Six-day regimen</h2>
<p>Close to the end of the 1960s, a team of scientists from Northern Europe introduced a <a href="http://onlinelibrary.wiley.com/doi/10.1111/j.1748-1716.1967.tb03720.x/abstract">carbohydrate loading regimen</a> that resulted in a near two-fold increase in muscle glycogen stores. </p>
<figure class="align-right zoomable">
<a href="https://images.theconversation.com/files/13296/original/psjbjdbx-1343024925.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="" src="https://images.theconversation.com/files/13296/original/psjbjdbx-1343024925.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=237&fit=clip" srcset="https://images.theconversation.com/files/13296/original/psjbjdbx-1343024925.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=600&fit=crop&dpr=1 600w, https://images.theconversation.com/files/13296/original/psjbjdbx-1343024925.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=600&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/13296/original/psjbjdbx-1343024925.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=600&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/13296/original/psjbjdbx-1343024925.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=754&fit=crop&dpr=1 754w, https://images.theconversation.com/files/13296/original/psjbjdbx-1343024925.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=754&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/13296/original/psjbjdbx-1343024925.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=754&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption"></span>
<span class="attribution"><span class="source">treehouse1977</span></span>
</figcaption>
</figure>
<p>This regimen involved a glycogen-depleting bout of exercise followed by three days of a carbohydrate-poor diet. Another bout of exercise was then performed to deplete once more the stores of muscle glycogen. </p>
<p>For the next three days the athletes were asked to eat a <a href="http://www.livestrong.com/article/233659-list-of-foods-rich-in-carbohydrates/">carbohydrate-rich diet</a> and to avoid any strenuous physical activity. </p>
<p>As one would expect, despite its benefits, this regimen was difficult to tolerate and highly impractical, particularly for athletes wishing to train during the carbohydrate-deprivation phase of this regimen.</p>
<h2>Three-day regimen</h2>
<p>It is in part for this reason that nearly 30 years ago, Sherman and colleagues introduced <a href="http://www.ajcn.org/content/34/9/1831.short">an improved carbohydrate-loading regimen</a> that resulted in comparable increases in muscle glycogen levels, but without the disadvantages associated with the classical regimen. </p>
<p>These investigators found that the accumulation of high levels of muscle glycogen is possible without any glycogen-depletion phase. </p>
<figure class="align-left zoomable">
<a href="https://images.theconversation.com/files/13295/original/5mqt9xzf-1343024881.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="" src="https://images.theconversation.com/files/13295/original/5mqt9xzf-1343024881.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=237&fit=clip" srcset="https://images.theconversation.com/files/13295/original/5mqt9xzf-1343024881.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=800&fit=crop&dpr=1 600w, https://images.theconversation.com/files/13295/original/5mqt9xzf-1343024881.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=800&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/13295/original/5mqt9xzf-1343024881.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=800&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/13295/original/5mqt9xzf-1343024881.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=1005&fit=crop&dpr=1 754w, https://images.theconversation.com/files/13295/original/5mqt9xzf-1343024881.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=1005&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/13295/original/5mqt9xzf-1343024881.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=1005&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption"></span>
<span class="attribution"><span class="source">Emily Barney</span></span>
</figcaption>
</figure>
<p>All that is required is for athletes to taper their training over several days and rest on the day before competition while ingesting a carbohydrate-rich diet for three days prior to competing. </p>
<p>Unfortunately, even this three-day carbohydrate loading regimen was difficult to adhere to given the large amounts of carbohydrate that needed to be ingested over several consecutive days. </p>
<p>For this reason, nearly a decade ago my colleagues and I at UWA undertook to develop an improved carbohydrate-loading regimen that allows the attainment of maximal muscle glycogen levels within a shorter time period.</p>
<h2>One-day regimen</h2>
<p>As a result, we introduced two novel one-day long carbohydrate loading regimens (published <a href="http://www.ncbi.nlm.nih.gov/pubmed/12048325">here</a> and <a href="http://www.ncbi.nlm.nih.gov/pubmed/12111292?dopt=Abstract">here</a>).</p>
<p>Since the rates of muscle glycogen synthesis are generally higher during recovery from a short bout of high intensity exercise than during recovery from prolonged exercise of moderate intensity, we examined whether combining a short bout of high intensity exercise with a one day high-carbohydrate intake could provide a faster way to carbohydrate load. </p>
<p>To this end, we asked a group of participants to cycle for 150 seconds at 130% of their maximal aerobic capacity followed by a 30-second all-out sprint. For the next 24 hours, we fed them the equivalent of 10 grams of carbohydrate-rich food per kilo of body mass. </p>
<p>To our surprise, after only 24 hours their muscle glycogen stores increased to levels comparable to or higher than those reported in previous studies on carbohydrate loading. </p>
<figure class="align-right zoomable">
<a href="https://images.theconversation.com/files/13299/original/cd6dj998-1343024989.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="" src="https://images.theconversation.com/files/13299/original/cd6dj998-1343024989.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=237&fit=clip" srcset="https://images.theconversation.com/files/13299/original/cd6dj998-1343024989.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=900&fit=crop&dpr=1 600w, https://images.theconversation.com/files/13299/original/cd6dj998-1343024989.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=900&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/13299/original/cd6dj998-1343024989.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=900&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/13299/original/cd6dj998-1343024989.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=1130&fit=crop&dpr=1 754w, https://images.theconversation.com/files/13299/original/cd6dj998-1343024989.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=1130&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/13299/original/cd6dj998-1343024989.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=1130&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption"></span>
<span class="attribution"><span class="source">foodiesathome.com</span></span>
</figcaption>
</figure>
<p>One limitation with this regimen is that many endurance athletes may not wish to perform three minutes of intense exercise on the day before competing. Ideally, it would be better if they could accumulate as much glycogen within one day but without a glycogen-depleting exercise bout. </p>
<p>Sherman and colleagues had shown it was possible without a glycogen-depleting period of exercise to store maximal amounts of muscle glycogen if a carbohydrate-rich diet was adopted for three days while tapering exercise-training. </p>
<p>We examined whether this approach could work in endurance-trained athletes fed the equivalent of 10 g of carbohydrate-rich food per kilo of body mass while remaining physically inactive for a whole day. </p>
<p>We found that muscle glycogen stores reach maximal levels within only one day of starting this regimen, with no added benefits by extending the high-carbohydrate intake period for up to three days. </p>
<p>In other words, all that is required of our endurance athletes who trained regularly and want to carbohydrate load before competing is simply to interrupt their training for one day and eat the equivalent of 10 grams of carbohydrate-rich food (e.g. pasta, bread, rice, potatoes) per kilo of body mass during that day.</p>
<h2>Simply, the best</h2>
<p>To the best of our knowledge, no better carbohydrate loading regimen has been published since then, but many athletes still rely on earlier regimens. </p>
<p>Our carbohydrate loading protocol sounds simple, and it is simple – but it works. </p><img src="https://counter.theconversation.com/content/8071/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Our work is not compromised in any way, with no potential conflicts.</span></em></p>During the London Olympics, and beyond, many endurance athletes will attempt to increase their muscle glycogen stores by carbohydrate loading. This is because, despite its importance, glycogen is a fuel…Paul Fournier, Professor Exercise Physiology and Biochemistry, The University of Western AustraliaLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/76662012-06-14T06:26:27Z2012-06-14T06:26:27ZLance Armstrong charged with ‘blood doping’ and EPO-use … so how do they work?<figure><img src="https://images.theconversation.com/files/11720/original/jwdcw89z-1339650962.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Lance Armstrong could potentially lose all seven of his Tour de France victories.</span> <span class="attribution"><span class="source">Jean-Christophe Bott/AAP</span></span></figcaption></figure><p>The cauldron of long-standing doping allegations against former professional cyclist Lance Armstrong has finally boiled over.</p>
<p>The seven-time Tour de France winner is now <a href="http://online.wsj.com/public/resources/documents/armstrongcharging0613.pdf">facing charges from the US Anti-Doping Agency</a> that he:</p>
<blockquote>
<p>“… used EPO, blood transfusions, testosterone and cortisone during the period from before 1998 through 2005 and that he had previously used EPO, testosterone and <a href="http://www.wada-ama.org/en/Resources/Q-and-A/Human-Growth-Hormone-hGH/">hGH (human growth hormone)</a> through 1996.”</p>
</blockquote>
<p>The charges are the latest in a decade-long saga, including a <a href="http://www.nytimes.com/2012/06/14/sports/lance-armstrong-faces-new-doping-charges.html">two-year-long federal investigation</a> which was eventually terminated earlier this year <a href="http://www.nytimes.com/2012/02/04/sports/cycling/federal-prosecutors-drop-lance-armstrong-investigation.html?ref=lancearmstrong">with little explanation</a>.</p>
<p>Armstrong has been suspended from participating in triathlon events and if the new charges are upheld, the USADA <a href="http://www.washingtonpost.com/sports/lance-armstrong-faces-fresh-doping-charges-from-usada/2012/06/13/gJQAefnPaV_story.html">could strip Armstrong of his Tour de France victories</a>.</p>
<p>Armstrong has <a href="http://lancearmstrong.com/news-events/lance-armstrong-responds-to-usada-allegation">vehemently denied</a> any wrongdoing, describing the USADA’s actions as a “witch hunt” and arguing that in 25 years as a professional athlete he has “passed more than 500 drug tests and never failed one”.</p>
<p>But the recent accusations suggest Armstrong was nothing less than a willing participant and active leader in a culture of doping (including himself and other cyclists) for more than a decade.</p>
<p>Ouch.</p>
<p>In light of this, and in prediction of the oncoming thunderclouds of accusations, counter-accusations and moral hysteria, it’s worth precisely examining a few of the key processes at work.</p>
<p>What is “blood doping”? What is EPO? How are they detected? And how are they “masked”?</p>
<figure class="align-center ">
<img alt="" src="https://images.theconversation.com/files/11721/original/4ynvm8pd-1339651147.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/11721/original/4ynvm8pd-1339651147.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=463&fit=crop&dpr=1 600w, https://images.theconversation.com/files/11721/original/4ynvm8pd-1339651147.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=463&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/11721/original/4ynvm8pd-1339651147.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=463&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/11721/original/4ynvm8pd-1339651147.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=582&fit=crop&dpr=1 754w, https://images.theconversation.com/files/11721/original/4ynvm8pd-1339651147.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=582&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/11721/original/4ynvm8pd-1339651147.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=582&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Lance Armstrong (L) celebrates with teammate George Hincapie (R) on the final stage of the 2005 Tour de France.</span>
<span class="attribution"><span class="source">Gero Breloer/EPA</span></span>
</figcaption>
</figure>
<p>Let’s start with the methods themselves. <a href="http://www.wada-ama.org/en/Resources/Q-and-A/EPO-Detection/">EPO (Erythropoietin)</a> and blood doping are both designed to increase the ability of the blood to carry oxygen by increasing the number of oxygen-carrying red blood cells.</p>
<p>The performance increase in real terms is not enormous, perhaps a few percent, but long cycling road races – heavy aerobic exercise over hundreds or thousands of kilometers and several days – are often decided by minutes or seconds. A 2-3% increase in this context can make an enormous difference.</p>
<p>In light of this, the incentives to use performance enhancers are substantial.</p>
<h2>Erythropoetin (EPO)</h2>
<p>Like most performance enhancing drugs, EPO has an entirely legitimate medical use. It’s a hormone, usually made in the kidneys, which signals to the bone marrow to produce more blood cells.</p>
<p>It’s very successfully used to treat various forms of serious anaemia – disorders where the oxygen-carrying capacity of the blood is below normal. The first paper which described the human EPO gene was <a href="http://www.pnas.org/content/82/22/7580">published in 1985</a>, which allowed the successful production of EPO as a drug. Widespread use in cycling is believed to have started in <a href="http://www.springerlink.com/content/t1007224n2355115/">the early 90s</a>, but this is anything but clear.</p>
<p>Historically, EPO has been difficult to detect as the EPO that is injected is precisely the same as the form that is already present in the body. Not only that, but the effects of injectable EPO last a lot longer than the substance itself.</p>
<p>The first great wave of investigation into EPO use in cycling started only after the 1998 Tour de France imploded following the physical drug itself <a href="http://en.wikipedia.org/wiki/Festina_affair">was discovered</a> in team cars and hotel rooms.</p>
<h2>“Blood doping”</h2>
<p>Blood doping is a similar process, but a slightly more involved one. Blood is drawn from the athlete earlier in the season, stored, and then re-injected when performance enhancement is required, instantly increasing the haematocrit.</p>
<p>This has historically been difficult to detect as there is no external drug or process at work – the performance enhancing substance is the athlete’s own red blood cells.</p>
<figure>
<iframe width="440" height="260" src="https://www.youtube.com/embed/l0x9uT-sWK0?wmode=transparent&start=0" frameborder="0" allowfullscreen=""></iframe>
</figure>
<p>Of course, some endurance athletes have a naturally high <a href="http://www.nlm.nih.gov/medlineplus/ency/article/003646.htm">haematocrit</a> – the percentage of oxygen-carrying red blood cells. Perhaps that’s one of the things which makes such athletes successful in the first place! As a result, the haematocrit test must evolve to let these “naturally enhanced” athletes compete legitimately.</p>
<p>So how can blood doping be detected? Recent work has focused on a surprising angle.</p>
<p>Blood must be drawn through, stored in, and re-injected through plastic objects. While everything is sterile, a minute amount of various plastics may make their way into the blood. Of course, there are perfectly benign ways that athletes could come into contact with plastics – legitimate medical procedures or through the diet, for example. The way to administer this test is still under development.</p>
<h2>Masking agents</h2>
<p>Masking agents are another issue again. Both EPO and blood doping raise the haematocrit to levels which are easily detectable. Thus, athletes have often attempted to:</p>
<ul>
<li>dilute their haematocrit with the injection of substances which increase their total blood volume</li>
<li>increase drug clearance times by using <a href="http://en.wikipedia.org/wiki/Diuretic">diuretics</a></li>
<li>use other drugs which interfere with the various drug tests that their samples are subjected to.</li>
</ul>
<h2>Whack-A-Mole</h2>
<p>If this feels a little like the old arcade game <a href="http://www.youtube.com/watch?v=D0n8N98mpes">Whack-A-Mole</a>, where cheeky moles continually pop up and are beaten down again and again, it is. There is a continual cycle between new clandestine methods of performance enhancement, their eventual discovery by the regulatory bodies that police sport’s legal and ethical boundaries, and the development and institution of tests for those methods.</p>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/11739/original/qjrz864f-1339654961.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="" src="https://images.theconversation.com/files/11739/original/qjrz864f-1339654961.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/11739/original/qjrz864f-1339654961.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=427&fit=crop&dpr=1 600w, https://images.theconversation.com/files/11739/original/qjrz864f-1339654961.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=427&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/11739/original/qjrz864f-1339654961.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=427&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/11739/original/qjrz864f-1339654961.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=537&fit=crop&dpr=1 754w, https://images.theconversation.com/files/11739/original/qjrz864f-1339654961.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=537&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/11739/original/qjrz864f-1339654961.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=537&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">At the 2009 Tour de France.</span>
<span class="attribution"><span class="source">Ian Langsdon/EPA</span></span>
</figcaption>
</figure>
<p>Some final points should be made here: firstly, there is an enormous disconnect between clandestine performance enhancement at the highest levels and our understanding and detection of it.</p>
<p>Obviously, these topics cannot be discussed freely. Commentators often refer to an <a href="http://en.wikipedia.org/wiki/Omert%C3%A0">“Omertà”</a> within professional sport, a Mafia-like code of silence which prevents anyone speaking out. </p>
<p>Drug users who “come clean” are routinely portrayed as corrupt, bitter or litigious people, regardless of the truth or falsity of their stories.</p>
<p>This is also an extremely difficult area to research. Working with existing sportspeople would be a tacit admission of their guilt, and thus we, as scientists, are unlikely to be allowed. We are often forced to review old records or performances and <a href="http://www.ingentaconnect.com/content/aahperd/rqes/2011/00000082/00000004/art00017">look for patterns</a> in them which might imply changes due to drug use.</p>
<p>Of course, it’s possible to do research on participants where we <a href="http://www.cyclingtips.com.au/2009/12/epo-trial-report/">administer performance enhancing drugs</a> and measure their performance. But this may provide a different situation to clandestine and elite use. </p>
<p>It can also be ethically challenging to give healthy people powerful pharmaceuticals and exercise them to exhaustion!</p>
<p>Finally, anyone with a simple solution for these issues (e.g. more doping control, legalising or allowing drug use as a “level playing field”) is, well, wrong. Drug use in sport is an exceedingly complicated issue, where the limits of human physiology, the issue of sporting ethics and fair play, and the often harsh glare of public and media morality meet.</p>
<p>Rarely is that meeting comfortable. Regardless of the outcome of the pending case against him, Lance Armstrong is about to find out just how uncomfortable.</p>
<p><strong>Further reading:</strong></p>
<ul>
<li><a href="http://online.wsj.com/public/resources/documents/armstrongcharging0613.pdf">Letter from the USADA to Lance Armstrong (and others) about the new doping charges</a> - USADA</li>
</ul><img src="https://counter.theconversation.com/content/7666/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>James Heathers does not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.</span></em></p>The cauldron of long-standing doping allegations against former professional cyclist Lance Armstrong has finally boiled over. The seven-time Tour de France winner is now facing charges from the US Anti-Doping…James Heathers, PhD Candidate in Applied Physiology, University of SydneyLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/73242012-05-29T20:01:27Z2012-05-29T20:01:27ZSports referees should take performance-enhancing drugs<figure><img src="https://images.theconversation.com/files/11164/original/2yjqyktt-1338272286.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">It's obvious: better referee performance is better for players and better for spectators. Right?</span> <span class="attribution"><span class="source">AAP Image/Joe Castro</span></span></figcaption></figure><p>Late last week football (soccer) website <a href="http://www.football365.com/news/21554/7774898/Blimey-Refs-Will-Have-To-Undergo-Drugs-Tests">football365.com reported</a> that <a href="http://www.fifa.com/">FIFA</a>, the international governing body for the world game, is considering forcing referees to pass fitness tests prior to games.</p>
<p>This quite sensible, if innocuous, suggestion was accompanied by the far more provocative idea that officials should also be tested to make sure they are not taking performance-enhancing substances.</p>
<p>We disagree wholeheartedly with this suggestion, for reasons we’ll explain shortly.</p>
<p>Speaking about the proposed fitness and drug testing at a conference in Budapest, FIFA’s chief medical officer, Jiri Dvorak said: “[we] have to consider referees as part of the game”. Michel D'Hooghe, chairman of FIFA’s medical committee, agreed with Dr Dvorak, noting that “the referee is an athlete on the field, so I think he should be subjected to the same rules”.</p>
<p>These comments are instructive in a number of ways:</p>
<ul>
<li><p>they acknowledge that some substances can actually improve athletic performance, meaning anyone involved a vigorous physical activity, including referees, can get a similar boost in performance</p></li>
<li><p>they suggest that some referees might actually be using banned substances to improve their adjudication capability already</p></li>
<li><p>they suggest that, given referees are required to focus completely on the job at hand, and not let fatigue blur their judgements, they may want to use substances to not only deliver an improvement in bodily or athletic performance, but to also deliver an improvement in mental or cognitive performance.</p></li>
</ul>
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<p>We have known for some time that many groups of people have used substances, especially prescription pharmaceutical products, to enhance their mental and cognitive capacities.</p>
<p><a href="http://en.wikipedia.org/wiki/Methylphenidate">Ritalin</a> and <a href="http://en.wikipedia.org/wiki/Adderall">Adderall</a> are used by doctors to treat <a href="http://www.nimh.nih.gov/health/publications/attention-deficit-hyperactivity-disorder/complete-index.shtml">attention deficit hyperactivity disorder (ADHD)</a>. But such substances have also been used by so-called “normal” people to improve memory and ability to focus more diligently on particular tasks, such as preparing a long report, sitting a stressful exam, or writing advertising copy.</p>
<p><a href="http://www.modafinil.com/">Modafinal</a>, a drug used to treat sleep disorders, especially those involving the inability to stay awake during daytime, has also become a popular cognitive performance substance. It is supposed to make normal people more alert, target their energies, strengthen their powers of concentration and enable them to meet deadlines with a minimum of fuss.</p>
<p>The interest in substances that might increase one’s cognitive power increased exponentially with the release of Limitless (see trailer below), a movie in which Eddie Mora, played by Bradley Cooper, found his creative nirvana after having been introduced to NZT, the ultimate cognitive enhancer.</p>
<p>Eddie’s writer’s block disappeared with the first tablet, his manuscript was completed within days and took on best-seller status. He subsequently went on to get all the girls, win all the fights, and secure all the prizes.</p>
<p>But his successes were conditional on using NZT. Fantasy and reality were soon blurred as NZT took on a life of its own outside the cinema.</p>
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</figure>
<p>But there is no doubting the reality of people’s desire to build their mental and cognitive capacities, and nor should there be any doubt about the widespread use of mental and cognitive enhancers:</p>
<ul>
<li><p>long-distance truck-drivers have been <a href="http://abcnews.go.com/GMA/DrJohnson/story?id=128275&page=1#.T8TE2cXlZeg">taking stimulants of various sorts</a> for more than 60 years to keep themselves and alert and focused</p></li>
<li><p>it is an open secret that most military operations around the world involve the <a href="http://www.modafinil.com/article/soldiers.html">dispensing of pep-pills to keep soldiers awake</a></p></li>
<li><p>theatre actors take <a href="http://www.ethanwiner.com/BetaBlox.html">beta-blockers</a> – used to treat heart arrhythmias – as a matter of course to calm the nerves before a performance</p></li>
<li><p>students take caffeine and the occasional pharmacy-stimulant to give themselves an energy boost when putting together assignments</p></li>
<li><p>white-knuckle air travellers <a href="http://en.wikipedia.org/wiki/Pteromerhanophobia#Pharmacologic">take anti-anxiety pills</a> to get themselves on to the plane, and to think more coherently while on it.</p></li>
</ul>
<p>But we need to remember that benefits from the use of cognition-enhancing substances are spread very unevenly through the population.</p>
<p><a href="http://www.ncbi.nlm.nih.gov/pubmed/10704519">Studies have shown</a> that the people who want them most – that is, the highly paid high-achievers – are precisely the people who derive the least benefit. The people who have most to gain from their use – the low-paid, the less-ambitious, and the disadvantaged – are the ones less likely to score, so to speak.</p>
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<p>So, where does all this leave football referees?</p>
<p>It is in our interests, as sports fans, to encourage referees to do whatever it takes to improve their level of performance, especially where their cognitive limitations are frequently there for everyone to see.</p>
<p>With the disciplined use of appropriate drugs approved by reputable physicians, the referees can concentrate for longer, make the clearest of judgements, and communicate their decisions more coherently.</p>
<p>As a result the players will gain confidence in the referees, and play with less uncertainty and more creativity. At the same time the fans will get to watch a game that flows with less disruption and fewer disputes.</p>
<p>There is a massive social benefit here.</p>
<p>To call for drug testing for referees – be it for physical/athletic enhancement, or mental/ cognitive enhancement – is therefore totally nonsensical. It goes against the common-sense view that if the quality of a public performance is enhanced by clearer thinking, sharper focus, less anxiety, and decisive action, then the greater the benefit to everyone.</p>
<p>There is no cheating to speak of, no-one gets harmed, and the game’s reputation remains intact.</p>
<p>What’s not to love?</p>
<p><strong>Further reading:</strong></p>
<ul>
<li><a href="https://theconversation.com/drugs-to-enhance-us-will-enchant-us-especially-if-there-are-no-side-effects-3790">Drugs to enhance us will enchant us … especially if there are no side effects</a> – Olivia Carter, The Conversation</li>
</ul><img src="https://counter.theconversation.com/content/7324/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>The authors do not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and have disclosed no relevant affiliations beyond their academic appointment.</span></em></p>Late last week football (soccer) website football365.com reported that FIFA, the international governing body for the world game, is considering forcing referees to pass fitness tests prior to games. This…Bob Stewart, Associate Professor in the School of Sport and Exercise Science, Victoria UniversitySimon Outram, Postdoctoral Research - Institute of Sport, Exercise and Active Living (ISEAL), Victoria UniversityLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/68992012-05-08T20:00:34Z2012-05-08T20:00:34ZCannabis use, WADA and the Australian sports system<figure><img src="https://images.theconversation.com/files/10429/original/tdwskqn5-1336436114.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Should cannabis to be considered a "performance-enhancing" drug by the World Anti-Doping Agency?</span> <span class="attribution"><span class="source">pietroizzo</span></span></figcaption></figure><p>It has been <a href="http://www.abc.net.au/news/2012-05-01/sporting-codes-to-meet-with-global-watchdog-over-marijuana-stan/3983708">widely reported</a> that representatives from a group of Australian sporting codes – including athletics, cricket, rugby league and Australian Rules Football – met with the director-general of the World Anti-Doping Agency (WADA), David Howman, to suggest cannabis be removed from WADA’s list of banned substances.</p>
<p>Since WADA was established in 1999 the agency has produced an <a href="http://list.wada-ama.org/">annual list of prohibited substances</a> for “stakeholders” (their terminology). That list has included <a href="http://www.news-medical.net/health/Cannabinoids-What-are-Cannabinoids.aspx">cannabinoids</a> since its inception. </p>
<p>In response to the calls from Australian sporting organisations, WADA’s head John Fahey <a href="http://www.theage.com.au/sport/wada-to-consider-change-of-status-for-cannabis-20120502-1xzg9.html">said the agency would consider any submission</a> made by these sporting bodies, and that it may be possible that cannabis could be listed as a banned substance only in sports where it has a demonstrable performance-enhancing effect. </p>
<p>Fahey, acting in line with his previous manifestation as a politician (he is a <a href="http://www.parliament.nsw.gov.au/prod/parlment/members.nsf/0/1d9dd8e732a5fa06ca256a940020ad9e?OpenDocument">former premier of New South Wales</a>), made clear he would not pre-empt WADA’s examination of any submission by these Australian sporting bodies.</p>
<h2>So what’s going on?</h2>
<p>To be listed by WADA, a substance must meet two of the <a href="http://www.rfu.com/TheGame/AntiDoping/ProhibitedList">following three criteria</a>: </p>
<p>1) it must be proven to be performance-enhancing</p>
<p>2) it must be harmful to the health of athletes</p>
<p>3) its use must go against the spirit of sport</p>
<p>The suggestion by the Australian sporting bodies is that cannabis provides no proven performance-enhancing effect in their sports. </p>
<p>According to one of the authors of <a href="http://www.ncbi.nlm.nih.gov/pubmed/12744713">a 2003 review on the performance-enhancing effects of cannabis</a> for the academic journal Sports Medicine: “the intent to use [cannabis] to enhance performance will fail.” </p>
<p>Cannabis use is <a href="http://www.drugabuse.gov/publications/drugfacts/marijuana">known to increase heart rate</a> and reduce <a href="http://www.medterms.com/script/main/art.asp?articlekey=7526">stroke volume</a>, which will result in diminished performance in most, if not all, sports. Cannabis use also slows reaction times, can interfere with motor and hand-eye co-ordination, and impairs concentration. </p>
<p>A small number of athletes report that cannabis use has a positive effect increasing relaxation and reducing anxiety. But this “positive effect” argument was derived from subjects’ <a href="http://www.ncbi.nlm.nih.gov/pubmed/20445359">responses to surveys</a> and has not been objectively demonstrated. </p>
<p>Over the past week we’ve seen a flood of Chicken Littles <a href="http://www.theage.com.au/afl/afl-news/take-cannabis-off-matchday-banned-list-afl-20120430-1xv5p.html">writing comments</a> on news sites suggesting sporting codes were condoning the use of cannabis and that athletes would all immediately become pot-smoking deviants. </p>
<p>But it’s important to note that Australian sporting organisations accept cannabis is potentially harmful to the health of athletes. Indeed, most of these sports control for cannabis use through their <a href="http://www.afl.com.au/laws%20of%20the%20game/tabid/13956/default.aspx">illicit drug testing procedures</a>. </p>
<p>Prolonged smoking of cannabis may contribute to respiratory tract infections, bronchitis and lung cancers and use of <a href="http://www.healthyplace.com/anxiety-panic/articles/link-between-marijuana-use-and-panic-and-anxiety/">cannabis has been linked to increased anxiety</a>, panic, restlessness and sleeping disruptions.</p>
<p>If it is not, therefore, proven to be performance-enhancing, then the only remaining consideration – from WADA’s perspective, given banned drugs need to meet two of the three criteria mentioned above – must be whether cannabis goes against the “spirit of sport”. </p>
<p>It is here that WADA has created a rod for its own back. Sports ethicists have debated the justifications for the ban on performance-enhancing drugs for <a href="http://www.getcited.org/pub/103366027">more than 30 years</a> now. </p>
<p>The one thing supporters and opponents both agree on is that the “spirit of sport” is such a nebulous concept as to be almost useless in resolving any argument about whether a substance should be listed or not. </p>
<p>To be clear, there are at least four problems with this concept: </p>
<p>1) the variety of sports covered by WADA is too great to allow for any generalisations. Behaviour that would fit in with the spirit of rugby union wouldn’t fit with the spirit of netball</p>
<p>2) any sport is played at a variety of levels of seriousness, all of which would impose different orientations towards the spirit of sport. What would be acceptable behaviours or practices in elite-level professional sport may not be acceptable in amateur or recreational sport</p>
<p>3) members of different countries, races, ethnic groups and other communities have differing views on the characteristics of the “spirit of sport”. Whose judgement should take precedence when using this criterion to assess a given substance? </p>
<p>4) there are many practices currently permitted in sport that are either performance-enhancing or harmful to athletes – such as the use of altitude chambers, disc wheels, dietary supplements, painkillers, winged keels – and which appear no less likely to contravene the spirit of sport than most banned substances.</p>
<p>Given all of the above, the “spirit of sport” criterion holds little water.</p>
<h2>The best way forward?</h2>
<p>I’d suggest the following:</p>
<ul>
<li><p>any substance or practice proven to be performance-enhancing should be listed on a performance-enhancing banned substances <em>and</em> practices list</p></li>
<li><p>any substance or practice that’s dangerous to the health of athletes should be listed on a dangerous substances and practices list, which would be an extension of the illicit substances list of most codes</p></li>
<li><p>any sports organisation in any country that wants to ban a given substance or practice should be able to do so, provided it recognises it could alienate its members</p></li>
<li><p>any sports organisation should also be able to determine penalties for athletes who use substances or practices that are on either the performance-enhancing list or the dangerous substances and practices list </p></li>
<li><p>and the “spirit of sport” category? We should just forget about that completely.</p></li>
</ul>
<p>I suspect we have been sold a pup in WADA – one that has now grown into a voracious, adult Great Dane. </p>
<p>The organisation’s <a href="http://www.wada-ama.org/en/News-Center/Articles/WADA-publishes-2010-Annual-Report/">2010 annual report</a> stated its budget, half of which comes from governments around the world, as US$25m. Those same governments also need to contribute to their own national anti-doping agencies, many of which are growing, from a finite budget.</p>
<p>Few would disagree that WADA served a purpose – at best to clean up sport and at worst to produce the misguided belief that elite level sport is free from performance-enhancing drug-use, and therefore occurs on an even playing field.</p>
<p>It’s also widely held that WADA has produced a set of policies, legal frameworks, governance structures, resources and research documents that could remain useful.</p>
<p>But what seemed to start as a regulatory body made necessary by a variety of anxieties – including illicit drug use and residual suspicions from the Cold War – has become a bureaucratic/political body that imposes its authority over all. </p>
<p>When local sporting leagues such as the AFL and the NRL feel obliged to request a change to the banned substances list to be considered by the WADA committee, I think the bureaucracy has extended its reach way too far.</p>
<p>What I’d actually prefer is that WADA be disbanded, that individual sports organisations – and even global ones such as the International Olympic Committee – set their own rules. Money saved by dismantling the control agencies could then be churned back into increasing sports participation.</p><img src="https://counter.theconversation.com/content/6899/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Michael Burke does not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.</span></em></p>It has been widely reported that representatives from a group of Australian sporting codes – including athletics, cricket, rugby league and Australian Rules Football – met with the director-general of…Michael Burke, Senior Lecturer, School of Sport and Exercise Science, Victoria UniversityLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/37902011-10-27T04:25:13Z2011-10-27T04:25:13ZDrugs to enhance us will enchant us … especially if there are no side effects<figure><img src="https://images.theconversation.com/files/4891/original/3196180881_58e0bbde60_o.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Are we entering an era of better memory, less fear, greater popularity?</span> <span class="attribution"><span class="source">Divine Harvester</span></span></figcaption></figure><p>When people think about taking a new drug that can enhance who they are, or consider giving it to their child, their most immediate and appropriate concern centres on the potential health dangers. </p>
<p>While health concerns are obviously important, we need to look beyond these to the ways these drugs may affect the very essence of who we are as people and the nature of the society we live in. </p>
<p>Our current understanding of how the brain generates complex thoughts, emotions and perceptions is still relatively limited. Advances in this area have traditionally come from studies measuring the activity of different brain regions or individual neurons while people experience different thoughts, emotions or perception. </p>
<p>More recently, there has been an explosion of discoveries coming from psychopharmacology – the study of the effect of drugs on the mind – that is leading us to question who we are and who we want to be.</p>
<p>This field of drug development is currently being pushed, by the drug companies eager to make their next billion dollars, and by individual researchers interested in better understanding the role the brain’s natural chemicals play in both healthy and abnormal mental functioning. </p>
<p>The bulk of this research and drug development will be aimed at improving treatment outcomes for patients. But, through intention or accident, a handful of drugs will end up providing some benefit to healthy people, too.</p>
<p>As with many fascinating discoveries in science, the increased development and understanding of drug action brings with it ethical and philosophical dilemmas for individuals and society.</p>
<figure class="align-right ">
<img alt="" src="https://images.theconversation.com/files/4892/original/205492402_106e304705_z.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=237&fit=clip" srcset="https://images.theconversation.com/files/4892/original/205492402_106e304705_z.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=595&fit=crop&dpr=1 600w, https://images.theconversation.com/files/4892/original/205492402_106e304705_z.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=595&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/4892/original/205492402_106e304705_z.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=595&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/4892/original/205492402_106e304705_z.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=748&fit=crop&dpr=1 754w, https://images.theconversation.com/files/4892/original/205492402_106e304705_z.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=748&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/4892/original/205492402_106e304705_z.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=748&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption"></span>
<span class="attribution"><span class="source">imaphotog</span></span>
</figcaption>
</figure>
<h2>Feel no fear</h2>
<p>Lets take as an example recent experiments using <a href="http://www.drugs.com/propranolol.html">propranolol</a>. This drug has been known for some time to block the body’s natural fear response. </p>
<p>One interesting and debilitating aspect of fearful memories is that imagining or remembering a terrifying event can cause the same extreme responses of the mind and body that were triggered during the original event. This acts to reinforce the original fear association with the object or event – if you have a panic attack every time you fly or think of flying, the idea that flying is a terrifying, horrible experience will be reinforced even if the plane doesn’t fall out of the sky. </p>
<p>Researchers <a href="http://www.nature.com/neuro/journal/v12/n3/full/nn.2271.html">have shown</a> it now might be possible to break this cycle. They basically showed people images of spiders that induced fear responses (because they had previously electrocuted people every time they saw a spider). </p>
<p>Half the participants were then given propranolol and shown the spider images again. In contrast to those given no drug, these participants were able to “erase” the fear memory by learning a new association between the spider images and the calm feeling created by the drug. </p>
<p>This work has now led to <a href="http://muse.jhu.edu/journals/perspectives_in_biology_and_medicine/v053/53.1.donovan.html">new studies</a> aimed at treating <a href="http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0001923/">post-traumatic stress disorder</a>. The potential positive applications for a drug that can reduce traumatic memories are obvious. </p>
<p>But important questions are now being asked about potential downsides. Might we be fundamentally changing our identities or sense of self if we tamper with the emotional content of our memories? </p>
<p>Concerns are also being raised about whether the ability to reduce the fear and long-term suffering experienced by victims of crime will reduce their rights for compensation, and reduce the eventual punishments in the criminal and civil courts for the perpetrators of those crimes.</p>
<figure class="align-left ">
<img alt="" src="https://images.theconversation.com/files/4894/original/2521458613_539b9b09ca_o.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=237&fit=clip" srcset="https://images.theconversation.com/files/4894/original/2521458613_539b9b09ca_o.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=800&fit=crop&dpr=1 600w, https://images.theconversation.com/files/4894/original/2521458613_539b9b09ca_o.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=800&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/4894/original/2521458613_539b9b09ca_o.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=800&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/4894/original/2521458613_539b9b09ca_o.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=1005&fit=crop&dpr=1 754w, https://images.theconversation.com/files/4894/original/2521458613_539b9b09ca_o.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=1005&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/4894/original/2521458613_539b9b09ca_o.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=1005&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption"></span>
<span class="attribution"><span class="source">onesevenone</span></span>
</figcaption>
</figure>
<h2>Taking it on trust</h2>
<p>Researchers in a series of other studies have tried to artificially induce trust. They found people would report greater feelings of trust towards complete strangers, <a href="http://www.frontiersin.org/developmental_psychology/10.3389/fpsyg.2011.00258/full#B8">made larger donations to charities</a> and were willing to <a href="http://www.nature.com/nature/journal/v435/n7042/full/nature03701.html">risk more money</a> in strategic financial games after having <a href="http://www.vivo.colostate.edu/hbooks/pathphys/endocrine/hypopit/oxytocin.html">oxytocin</a> squirted up their nose. </p>
<p>Oxytocin – a hormone that occurs naturally in the brain and released during breast-feeding and maternal bonding – is now being <a href="http://www.nature.com/nrn/journal/v12/n9/full/nrn3044.html">tested clinically</a> for conditions such as autism and social anxiety. </p>
<p>But might it also provide greater confidence for people that feel inhibited by general shyness but are otherwise normal? Would that be a good thing? Or would it just increase the pressure on people to conform within an increasingly extroverted society?</p>
<h2>Cognitive enhancement</h2>
<p>Let’s consider the advent of drugs for “cognitive enhancement”. The inescapable “problem” with the development of drugs to improve memory and attention for the clinical treatment of conditions such as <a href="http://www.abc.net.au/health/library/stories/2003/04/24/1828304.htm">ADHD</a> or <a href="http://203.89.197.244/understanding-dementia/alzheimers-disease.aspx">Alzheimer’s</a>, is that the drug development is informed (and informs) our understanding of the underlying brain processes involved in memory and attention across human and animal species. </p>
<p>To the same extent any new drug successfully alters or enhances these processes in a clinical population, they are also likely to lead to similar changes or improvements in the average person walking down the street. </p>
<p>That might strike you as a good thing if the person taking these drugs is a doctor about to perform open-heart surgery on you, but what if it is a colleague in your office that you are competing with for a promotion? </p>
<figure class="align-right ">
<img alt="" src="https://images.theconversation.com/files/4890/original/1405216080_94c35075ff_o.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=237&fit=clip" srcset="https://images.theconversation.com/files/4890/original/1405216080_94c35075ff_o.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/4890/original/1405216080_94c35075ff_o.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/4890/original/1405216080_94c35075ff_o.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/4890/original/1405216080_94c35075ff_o.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=502&fit=crop&dpr=1 754w, https://images.theconversation.com/files/4890/original/1405216080_94c35075ff_o.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=502&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/4890/original/1405216080_94c35075ff_o.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=502&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
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<span class="attribution"><span class="source">silverlinedwinnebago</span></span>
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</figure>
<p>If you just want the best for your child and decide to hire a maths tutor, would it be abusive to give your child a drug that would help them learn and remember their lessons, or negligent not to?</p>
<p>Finally, consider sleep. Everyone needs it and most people don’t get enough of it. Drugs, such as <a href="http://www.aboutmodafinil.com/">modafinil</a>, were originally developed for the treatment of <a href="http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0001805/">narcolepsy</a> – the severe and chronic sleep disorder that causes people to nod off repeatedly throughout the day. </p>
<p>But this drug seems to reduce the need for sleep for everyone and is now being used widely in the US by shift workers and others feeling the pressure of deadlines. </p>
<p>This might be great if you’re the only person taking the drug, but if everyone starts taking it, the expectations and demands placed on individuals will just increase accordingly: we could end up with what some people have referred to as a pharmacological arms war.</p>
<p>As should be clear from the examples above, we need to look beyond the tablet when we think about drugs. I have no doubt the future will bring new discoveries and developments leading to an increase in the range and availability of drugs that can enhance human mental capacities. </p>
<h2>Better tomorrows?</h2>
<p>As I sit here today, my overall sense is that a considerable portion of the downstream consequence of drugs used for cognitive enhancement will be negative. But, as a scientist, it’s also important to have an open mind. </p>
<p>There is no rule of nature that mandates all drugs must be bad, and that every positive effect is balanced by a negative side effect. </p>
<p>I certainly don’t believe the world’s population has reached maximum levels (if there even is such a concept) of general happiness, productivity and mental ability. So I see no reason why a drug might not be developed that appears to cause greater good then harm. </p>
<p>But this brings its own dilemmas, such as fair and equal access to the drug across all racial and socio-economic boundaries. </p>
<p>Could we end up in a society where certain drugs are mandated for the good of all people in society, in the same way immunisations are given to most children and fluoride is added to our water? </p>
<p>With this future approachin,g we need to be prepared for the wider impact of drug use – good and bad – as the distinction between these two opposites is becoming increasingly blurred.</p><img src="https://counter.theconversation.com/content/3790/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Olivia Carter receives funding from the National Health Medical Research Council (NHMRC).</span></em></p>When people think about taking a new drug that can enhance who they are, or consider giving it to their child, their most immediate and appropriate concern centres on the potential health dangers. While…Olivia Carter, Senior Research Fellow and Lecturer, The University of MelbourneLicensed as Creative Commons – attribution, no derivatives.