2018

Hendrik de Villiers

Critical things athletes & support

personnel need to know about

[anti]-Doping

Who is responsible for the fight against Doping?

Court of Arbitration

in Sport (for

appeals)

National Olympic / Paralympic

Comm.; National Federations;

Sporting bodies

International Olympic / Paralympic Comm.;

International Federations

WADA: international,

independent organisation

that:

• Coordinates & monitors

the fight against

doping in sport, in

cooperation with a

network of stakeholders.

• oversees implementation of

the WORLD ANTI-

DOPING CODE;

• publishes the LIST OF

PROHIBITED

SUBSTANCES &

METHODS.

PROTECT ‘CLEAN’ ATHLETES

What is Doping ?

mka

RUSSIAN Doping Scandal

Using a prohibited

substance or

method that gives

you an unfair

advantage over

your opponent

= cheating…!

Stimulant in

the USN

supplement

the team

used

Doping offences in SA Rugby divisions

13

18

14

8

15

3

Figure 1: # of ADRVs per division

Craven Week

U/19

U/21

Varsity Cup

Vodacom/Currie Cup

Super Rugby

462

73

# of ADRVs

Other sports

Rugby

❖ ‘Youth’ divisions (U/19 & Craven Wk) a major concern as they make up 42% of

the doping offences in sA Rugby!

• “# ADRVs” = # doping offences or “positives” (period 1998 – 2014)

Tested positive for the

following prohibited

substances:

• Anabolic steroids

• Stimulants

• Cannabis

Over past 2 years, Rugby is the sport with the highest number

of ‘positives’ in SA (33)

EDUCATE – protect & empower

Empower yourself = Prevent

Un-intentional doping

Understand / comply with the ‘rules’ (CODE)

RISKS of Prohibited MedicationsTell Drs & pharmacist to check

Athlete: Double check against the LIST

RISKS of Supplements

Risks vs limited benefits; Costs; vs alternatives

Source of advice: those w money/performance focus (not health); vs independent credible sources of advice.

RISKS of Illicit & Recreational drug use …

mka

Why do some use ‘unfair’ means to get to the top?

Pressure

Pressure to perform

“Win-at-all-costs”

“quick-fix” mentality

Scholarships; Sponsorships;

Income

Pressure to “look good” –body image

“culture”… “norm”, "everyone is doing

it… ?”

Feeling of inadequacy in

sport

Feels good, exciting, or out of

curiosity

Peer pressure or

it’s “fashionable”

Ignorance / inadvertent doping …

Gain confidence &

⬆ self-esteem

Obsession with “size” in sports

(e.g. rugby)

Threat: “you wont make the team”

unless you do it …

mka

What is often the difference between someone who

decides to play fair vs “cheat”?

What is a

Doping Offence

- it’s not only about

testing positive..

“anti-doping rule violation”(ADRV)

Complicity: any assisting, encouraging,

aiding, abetting, covering up etc...

Whether

successful

or not

Prohibited (Banned) Substances by class

Substances Methods

Non-Approved pharmacological

substances

Manipulation of blood or blood

components

Anabolic agents Chemical and physical manipulations

Peptide hormones and growth factors Gene Doping

Beta-2 Agonists

Hormone and metabolic modulators

Diuretics and other masking agents

Stimulants

Narcotics

Cannabinoids

Glucocorticosteroids

Alcohol

Beta-blockers

✷

✷✷

✷

✷✷

✷Also found in supplements…!

Check the medication you use!

Cannot search

for traditional

medication or

“supplements”

as they are not

regulated &

subjected to

rigorous controls

to verify

ingredients /

dosage /

efficacy /

safety…

✷ Simply don’t

know for sure

what’s in it.

– use the Online Medication Check ‘app’:

www.drugfreesport.org

Principle of Strict Liability

Even if treated by medical doctor or health professional,

the responsibility is on the athlete for banned substances

ingested / administered …

Even when using a traditional medicine or supplement

containing a banned substance that is not listed on the label…

YOU, and only YOU,

are responsible

for what goes into your body

✷✷

• For Chronic conditions the TUE typically expire 12-24 months

• Acute conditions / emergency situations: Apply for Retroactive TUE

• Acute TUE’s are only valid for that occurrence, not all future occurrences

“TUE” - Therapeutic Use Exemption

If you need a

prohibited

substance or

method for a

legitimate

medical

condition,

follow these

steps:

“Who needs a TUE?” www.drugfreesport.org.za/TUE/

Get the application form (download or contact SAIDS: 021 686 1634

Get medical doctor to fill out form & produce evidence (diagnostic test(s))

Submit application at least 30 days before competition

Wait for TUE to be granted before competing or starting treatment

1

2

3

4

5

If on this list and

do NOT have a

TUE in place

=Will be a doping

violation &

sanction

>> will not be

allowed to apply

for a retroactive

TUE!

Who needs a TUE in ROWING?

- Reg Testing Pool (RTP) Athletes

- If on long list or selected for SA

Olympic, Paralympic, Commonwealth

Games team

- competing in elite men’s and women’s

senior* national champs;

- selected to represent the senior*

national men’s and women’s team at a

continental or world championships

(*no matter your age)

Criteria for TUE approval – advance OR retroactive* TUEs

A TUE will

only be

approved

provided that

each of the

following

criteria are

met:

1

2

3

4

The Prohib. Substance / Method is needed to treat an acute

or chronic medical condition, such that the Athlete would

experience a significant impairment to health if it was to be

withheld.

The Therapeutic Use of it is highly unlikely to produce any

additional enhancement of performance beyond what might

be anticipated by a return to the Athlete’s normal state of

health following the treatment of the acute or chronic

medical condition.

There is no reasonable Therapeutic alternative

The necessity for the Use of the Substance / Method is not a

consequence, wholly or in part, of the prior Use (without a

TUE) of a substance or method which was prohibited at the

time of such use

*Those who may apply Retroactively for chronic meds need to have

a medical file in place with proof that the above conditions are met

Ritalin / Concerta – Prescription medication

• It is on the WDA Prohibited List – “Specified Stimulants” - Methylphenidate

• It’s indications for use, side-effects etc. need to be managed by a medical Dr.

• If you need to use it >> Check “Who needs a TUE” list – drugfreesport.org.za

a) If you compete in an event (jnr or senior) that appears on this list then you need to

apply for and have a TUE granted before competing (cannot do a retro-active

TUE)

b) if competing in an event / competition that is not on the list (&/or have the

potential to make a team that is on the list) then you need to have a ‘medical

file’ in place in the event that you get tested and then need to apply for a retro-

active TUE; (or make a team where you need to then get a TUE in place before

competing)

• There are specific criteria / medical information needed for a TUE

application related to ADHD and Ritalin / Concerta treatment

– SEE SAIDS WEBSITE under “TUE”

Doping Control Procedure

See info leaflet:

NOTE: Consumption of food or fluids prior to giving your sample is at your own

risk. Avoid excessive rehydration as you are required to produce a sample with

suitable specific gravity for analysis. Your urine sample should be collected from

the first urine passed by you after you have been notified of testing.

Doping Control Procedure

Full exposure requiredWHY? Athletes have gone to extremes to provide “false” urine samples by hiding devices in clothing, bodily cavities etc…

Males will have a Male Officer,Females will have a Female.

Youth (U/18) may have an accompanying adult.

CONSEQUENCES of a doping offence

• 4 year ban

• NO

involvement in

sport, incl no

coaching…

• Career…?

Income,

livelihood…

• Your own…

• Your Coach /

Manager… Family…

the sport…?

CRIMINAL OFFENCEPossession / dealing with illicit

& prescription drugs (Laws of

the country)

• Short- and

long-term?

…?

Risks to your health & wellbeing…

• Short- and

long-term

• We don’t always

know risks in

athletes …?

Anabolic Steroids – oral & injectable

Stunted growth & height in teens

Heart damage & failure

Kidney damage & failure

Increased blood pressure

Liver cysts and increased risk of cancer

Weakened immune system (get sick more easily)

Hair loss – male pattern baldness

Stretch marks

Acne and other skin irritations

https://www.usada.org/substances/effects-of-performance-enhancing-drugs/

Anabolic Steroids – oral & injectable

Reversal of Male characteristics in men e.g.

*Breast tissue development (“man-boobs”)

*Shrinking testicles, impotence, infertility

*EFFECTS MAY BE PERMANENT

*Females develop male characteristics - deepening voice, facial hair etc.

Intra-muscular abscess

Increased risk of muscle injury

Increased risk of tendon tears

“Roid-rage” – increased aggression, depression, suicidal tendencies

Dependency …?

Most steroids are obtained on the black market > questionable quality = high

risk of other medical events independent of steroid use …

mka

Stimulants (Drugs, Fat burners, “Energy boosters”,

recreational drugs etc.)

42

Stimulantse.g. dimethylamine / methylhex (in supplements), Amphetamines, Ephedrine

(cold & allergy meds, diet pills)

• Nervousness, irritability – making it hard to concentrate during a

fight

• Insomnia (sleeplessness) – poor rest & recovery;

• Dehydration;

• Heat stroke; vomiting; abdominal pain

• Addiction or tolerance, meaning athletes need greater amounts to

achieve the desired effect, so they'll take higher & higher doses …

• Heart palpitations / Heart rhythm abnormalities

• Weight loss (could also entail losing muscle mass)

• Tremors

• Raised blood pressure (hypertension)

• Hallucinations

• Brain bleeds / Stroke

• Heart attack and other circulatory problems

• Death (examples from several athletes from various sports globally)

43

Diuretics

➢ Used to “make weight” / mask presence of other banned

substances

• dehydration

• electrolyte imbalance (low potassium & Sodium)

• headache

• drop in blood pressure

• dizziness

• muscle cramps

• loss of coordination & balance

• skin rash

• gout

• diarrhea

Serious side effects• allergic reaction• severe dehydration• kidney failure• irregular heartbeat• heart failure• death

44

OTHER DRUGS OF MISUSE

• Cannabinoids (Dagga)

– Balance & muscle function impairment

– Distorted perception

– Decreased testosterone with long-term use

• Cocaine

– Irregular heart beat; palpitations; Heart Attack,

– stroke, seizures,

– dependence

• Traditional Medicines: No regulation

• Homeopathic meds: Limited regulation (& enforcement);

• Over-the-counter medication:

• Some regulation, limited implementation / enforcement.

• May have medical purpose, but banned in sport.

Non-regulated Substances

• Supplements: No regulation body in SA (and globally)

• May contain harmful and/or banned substances not

indicated on the product label

Know the RISKS you take with suppl-use:

Poor regulation & policing:

Retailers / pharmacies etc. get away with selling products with dubious

ingredients and false claims > don’t need to prove efficacy & safety

Increased reports of supplements containing drugs / unapproved

meds / harmful / banned ingredients – not listed on the label.

➔• Product Labels not accurate – cannot

trust ingredients, dosages, claimsRISK

• Majority have NO credible evidence of

efficacy OR safety >> NOT tested!? benefits

What do these

actually mean…?

How do you choose a ‘risk-free

supplement brand’…?

Be aware:

These still do NOT

provide a 100%

guarantee that you

will not test

positive!

Or that you wont

experience harmful

side-effects …

Supplements implicated in the positive tests in SA athletes!

Dr Amanda Claassen-Smithers

• Majority had not listed the banned substance on their label

• DMMA / Methylhex*: unapproved DRUG found in supplements – linked to

severe ill-health effects (incl. 4 deaths); many positives in SA athletes!

o Jack 3d (USP Labs)*

o StartFragment*

o Berseker (Titan Labs)*

o Neurocore (Muscletech)*

o Muscle Punch 3DT (Evox)*

o Endoburn NT (USN)*

o Hydro Heat (Evox)*

oUSN product Springboks were

sponsored with* (2 positive …)

o Noxipro – Extreme Energising Pre-

Workout with Beta-Alanine, Creatine (CTD

labs)

o Dynamite (NutriTech)*

o Ginseng Kianpi Pil – dexamethasone

Recently (2017):

o BIOGEN Testoforte – 4-Androstene-3,17-dione

o TEST Freak®tf - 4-Androstene-3,17-dione

some of these products might since have been withdrawn, “reformulated” or “re-named”

– ? Is the new product(s) any safer…?

Supplement manufacturers & retailers

*Vitamins

*Fish oil

*Minerals

Basic nutrients

Dangerous

High risk

Drugs, steroids, hormones, stimulants

Body building, ‘mass gainer’, ‘legal or natural steroid’ suppl.s

Pre-workout / ++Energy suppls(Ephedra, DMAA, DMBA, BMPEA)

Weight loss / fat burner suppls(Prescription drugs, HCG)

How do you know what is safe and not?

Unknown ?Mostly OK*Or are they?

Majority of products

mka

SAIDS Educational material

✓ Range of leaflets / info sheets

✓ Posters

✓ www.drugfreesport.org.za

✓ Facebook: I Play Fair ZA

✓ Twitter: @iplayfairZA

www.drugfreesport.org.za

Thank you!

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in contact with the

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