As in the daytime there is no star in the sky warmer and brighter than the sun, likewise there is no competition greater than the Olympic Games.
Pindar (5th century BC)
Greek lyric poet
The use of performance-enhancing drugs dates from antiquity.1 The ancient Greeks used herbs and funguses, many hallucinogenic, to improve their performance. In 400 BC, Greek athletes were given honey as a carbohydrate boost and Roman gladiators readily gulped stimulants, including caffeine and strychnine. The aristocrats were using the royal jelly, a gelatinous substance secreted from the worker bees that stimulates the growth and development of the queen bee to improve their strength, knowledge, and sexual performance.2
In his work “Gymnasticos,” Filostratos (3rd-2nd century BC) mentions that the doctors had been significantly helping the preparation of the Olympic Games athletes, and that the cooks had been preparing bread with spices from juice of the plant poppy opium. Plinios, the younger (1st century BC), mentions that the athletes in running sports had been drinking a decoctum of a plant called hippouris for muscle mass and increased strength. However, more data are not easy to retrieve, because ancient doping had been well hidden by the Hellanodikai (judges) and the priests of the Games.1
The term doping first appeared in an English dictionary in 1879, its definition being “the use of drugs in an attempt to enhance sporting performance.” The word “dope” originated in South Africa. Dope referred to a primitive alcoholic drink that was used as a stimulant in ceremonial dances.3 In the modern games, doping is the fuel for the jet of high competitive sports.
The results of a positive doping testing can be devastating for the athlete’s career and the reputation of his country. In 1886, an English cyclist became the first recorded fatality from a performance-enhancing drug after an overdose of trimethyl during a race in France.4 The first recorded death in the modern Olympic Games was in Rome in 1960 when Danish cyclist Kurt Jensen collapsed and died from an amphetamine overdose.3
In the modern era, athletes use various drugs to enhance performance and improve strength, speed, and fine motor control. In addition, many properly prescribed medications are illegal for competitive athletes. Narcotics are used to mask pain. Lists of medications, as well as testing protocols have been published.5,6 Anabolics have been banned since 1990 in the United States. However, 3 million people continue to use them in the United States and 3% of the Americans are reporting at least one previous use of anabolics in gyms.
World Anti-Doping Agency
Testing of athletes for performance-enhancing drugs did not begin until 1965, over half a century after testing was introduced in racehorses. The first International Olympic Committee (IOC) banned substances list was produced in 1968. Subsequently the World Anti-Doping Agency (WADA) was created in November 1999 through a collective initiative of sporting organizations and governments led by the IOC.7,8 In 2003, all major sporting federations and 73 governments approved a resolution accepting the WADA Code as the basis for the fight against doping.3
Athletes can be selected for testing anytime, any place, and without notice, and they may be asked to provide a blood or urine specimen. Specimens are analyzed at an approved WADA/IOC laboratory, usually by gas chromatography or isotope mass spectrometry.3,9 Failure to comply with the specified times of testing carries the same sanctions as a positive test. Chemical substances such as beta-blockers, diuretics, or amphetamines are prohibited, as are hormonal substances such as steroids or erythropoietin. A medical exemption (Therapeutic Use Exemption) is given for athletes who are medically required to take drugs from the prohibited list, such as athletes requiring inhaled salbutamol or nonsystemic administration of corticosteroids during competition.10
The Athens 2004 Olympic and Paralympic Games were the first Games to take place after the WADA Code had been accepted and implemented by sports organizations.7,8 The opening ceremony of the Olympic Games in Athens marked the deadline for international sports organizations to accept and implement the WADA Code. The Olympic oath sworn by the athletes during the Opening Ceremony of the Athens 2004 Olympic Games was changed after the Lausanne Conference in 1999. The following passage was added: “committing ourselves to a sport without doping and without drugs.”
Athens 2004 Olympic Games had been referred to as “the cleanest games.” The WADA accredited laboratory at Onassis Hospital analyzed >2815 pre- and post competition blood and urine tests.7,8 Overall, WADA conducted >3000 tests immediately before and during the Athens Games. Those tests resulted in 24 athletes being removed from competition, including two Greek track stars, who were removed right before the Games for skipping a mandatory test. When asked if that incident tainted the Athens Games, WADA chairman Dick Pound replied, “On the contrary, I feel it purified them.” In all, seven medals were taken from athletes who tested positive or refused tests: three gold, one silver, and three bronze.11
The doubling of doped athletes compared to the Sydney 2000 Olympic Games and the dozens of high-competitive athletes who did not participate in Athens 2004 Olympic Games was proof that the IOC started a war against doping. However, it appears that the number of the athletes being tested and found doped is small compared to those who are using performance-enhancing drugs. By 2006, WADA hopes to have all governments involved in the fight against doping, which might open avenues for bringing collectively bargained plans in line with the global code.8
As Jyri Tamm, Olympic medalist and former world record holder stated, “Doping destroys the integrity of sports and it is against every principle sport stands for. Today athletes need to mentor up and coming competitors and teach them that doping is wrong and has no place in fair play.”7,8
- Andronikos M, Despotopoulos A, Theodorakopoulos J, et al. Athletics in the Ancient Greece. The Game Spirit. In: History of the Greek Nation. Archaic Hellenism. Vol 2. Athens, Greece: Ekdotiki Athinon; 1971:472-480.
- Fujiwara S, Imai J, Fujiwara M, Yaeshima T, Kawashima T, Kobayashi K. A potent antibacterial protein in royal jelly. Purification and determination of the primary structure of royalisin. J Biol Chem. 1990; 265:11333-11337.
- Smith R, Barnsley L, Kannangara S, Mace A. Rheumatological prescribing in athletes: a review of the new World Anti-Doping Agency guidelines. Rheumatology (Oxford). 2004 Aug 3 [Epub ahead of print].
- Wadler GI, Hainline B. Drugs and the Athlete. Philadelphia, Pa: F.A. Davis Co; 1989.
- Australian Sports Drug Agency (ASDA). Available at: www.asda.org.au. Accessed September 3, 2004.
- Knopp WD, Wang TW, Bach BR Jr. Ergogenic drugs in sports. Clin Sports Med. 1997; 16:375-392.
- International Olympic Games Committee (IOC). Available at: www.olympic.org. Accessed September 3, 2004.
- World Anti-Doping Agency (WADA). Available at www.wada-ama.org. Accessed September 3, 2004.
- Athletes Guide to WADA’s Out of Competition Doping Control Programme, 2003. Available at www.wada-ama.org. Accessed September 3, 2004.
- International Standard for Therapeutic Use Exemption, Section 8. Available at www.wada-ama.org. Accessed September 3, 2004.
- Ruibal S. Tackling long time issue on drugs No. 2 on sports changes wish list. Available at www.usatoday.com/sports. Accessed September 9, 2004.