A case for doping in sports: Is it time to embrace the needle?

Lance Armstrong

From hero to villain in the blink of an eye

On an ordinary night in the summer of 2012, when Lance Armstrong read out from a carefully crafted statement that he would no longer contend the drug abuse charges made by the United States Anti-Doping Agency, a number of tiny delicate dials of the sporting universe changed gears.

Armstrong’s body, once celebrated for winning that arduous battle against cancer alongside an unprecedented seven Tour de France titles, was now reduced to the remnants of a chemical stockpile. His charities that helped millions fight cancer around the world were declared shiny distractions from the dark underworld of a heartless criminal. Sporting institutions across the whole spectrum of athletic activity used his example to impose harsher regulations and invasive test routines.

In the span of a night, Armstrong turned from an inspiring, lovable poster boy to an unforgivable monster beyond shame. There are fictional characters in fast-paced novels that have taken longer to make the transition.

Elsewhere, in the well-lit offices of World Anti-Doping Agency (WADA), middle-aged men in designer suits perhaps clicked their gleaming glassware with sparkling wine, celebrating what they must have considered a significant triumph in their crusade against drugs. The warmth of victory in their hearts was no doubt accompanied by a glow of self-righteousness, for these men truly believed that they had just rendered the human race a significant service.

They had rescued sport, humanity’s favourite toy, from the clutches of a drug-enthused monster.

The battle has only just begun

Sparkling wine aside, they must also have known that their victory was a minor one. There surely was the quiet awareness of the magnitude of the problem that they were up against. Of the 21 podium finishers of Tour de France in the period of 1999-2005, 20 were either suspected or proven to have used illegal substances.

Ben Johnson, Tim Montgomery, Justin Gatlin, Yohan Blake, Tyson Gay – it seemed that every man who ever flirted with the 9.7 second mark in a 100m dash had also flirted with a performance-enhancing drug. Fresh cases of doping emerged everyday as athletes sought to find those 0.03 seconds that their bodies did not possess.

Extraordinary minds in lab coats and protective goggles toiled away in facilities across the world, looking to synthesize new drugs, easier to administer, harder to detect.

This was no easy battle, but these nice men in designer suits were driven by a powerful ideal. They were convinced that they were protecting the sanctity of sport, that they were the guardians of a sacred tradition, of the immortal Athenian principle of ‘faster, higher, stronger’, without the dope. Too bad then, that it is a battle they are bound to lose.

Detecting the undetectable

In tiny cages located in the labs of John Hopkins University School of Medicine in Baltimore live some distinctly large mice. These particularly well-built rodents have uncharacteristically large muscles and are appropriately nicknamed the ‘Schwarzenegger mice’.

The only difference in these mice from the regular vermin that you might find in your basement is that they have been genetically modified to block the production of a substance called myostatin, a protein that controls muscle growth. This is a genetic mutation that was also observed in a family in Eastern Germany, resulting in the newborn baby to develop extraordinarily strong muscles.

It isn’t hard to imagine the athletes of the near future genetically modified to limit their myostatin production, resulting in an ‘unnaturally’ strong physiology, a modification impossible to detect using existing methods. The drugs of the future aren’t going to be chemicals streaming through your blood and urine, but genetic modifications impossible to detect without dangerous and intrusive muscle biopsies, a proposition unthinkable in organized sport.

We are at a point of time, when we have to re-examine our views and attitude about drugs, both performance-enhancing and otherwise. For now, let’s stick to the former.

Rules can be changed at the drop of a hat

The complete rationale behind the existing regulation boils down to two key points: that drugs might adversely affect the health of an athlete, and that their usage violates the spirit of the sport. The former is a valid concern and uncontroversial, but the latter is a far more ‘fuzzy’ area.

Consider this: an athlete who was found with a high level of caffeine before a race in 2003 was considered a cheat and a criminal who brought dishonour to the game that we all so loved. Bakhaavaa Buidaa of Mongolia was stripped of his Olympic silver medal and Alex Watson of Australia given a ban because of elevated levels of caffeine. Sometime in 2004, a tiny clause in the catacomb of legal paragraphs was changed and suddenly you could walk to the racetrack while sipping a venti latte from the Starbucks nearby (caffeine is known to enhance endurance by up to 20%).

The spirit of sport is largely, if not entirely, defined by rules that govern them. And rules, as it so happens, can be changed. One day tennis racquets with larger heads were the devil’s handiwork; a tiny change in clause later, you were an idiot not to use them.

The inefficency of WADA’s policies

The WADA spends over 26 million dollars a year testing 10-15% of the athletes in an attempt to enforce the zero tolerance policy that it believes embodies the spirit of sport. But it has very little to show for it. In fact, one could argue that it does more harm than good.

The zero tolerance policy creates an environment of risk and insecurity for the athletes, by banning a tiringly long list of substances but failing to enforce the ban. Vicky Rabinowicz, after interviewing groups of Olympic athletes found that in general, they believed the most successful athletes were using banned substances.

This forces the unwilling athletes to push boundaries and risk taking drugs obtained illegally from the black market and administered in an uncontrolled manner with no concern for the athlete’s safety. The policy is also killing the spectacle of sport itself.

The inescapable inefficiency that results naturally from trying to enforce an unenforceable policy means that every time an athlete is caught doping, which is quite often, it gets us to question the authenticity of competition and raises doubts about the other athletes. The very sanctity of the sport that the policy tries to preserve is ironically being destroyed by it.

A problem with many impossible solutions

If you peek behind the curtain to look at why an elite athlete risks using a performance-enhancing drug, the answer is simple. There is so much at stake. Milliseconds is the difference between fame and anonymity, millimetres separate the champions from the also-rans. Every one of us knows that Michael Phelps won the 100m butterfly gold in Beijing by 0.01 seconds. Who is the guy that missed by that hundredth of a second? I rest my case.

There are two straightforward solutions to the doping problem. The first is to implement round-the-clock surveillance of every athlete of every sport and impose severe restrictions on their diet and medication. This would cost us billions of dollars, not to mention we will be getting dangerously close to the line that lies between fair sport and human rights. Impractical.

The other solution is to down the ante, reduce prize money, disassociate fame with sporting success and deliberately undermine sporting achievement. If there isn’t much to lose, there isn’t much to risk. I can imagine some hard-line communist regime toying with this idea, but in our fair free lands of democracy, free markets and Lady Gaga, this is an ethical blasphemy.

Julian Savulescue and his radical idea

So what is our alternative to the existing scenario in which, as Peter Singer puts it, gold medals go not to those who are drug-free, but to those who most successfully refine their drug use for maximum enhancement without detection? Enter Julian Savulescue.

Julian Savulescue is a bio-ethicist at the Oxford University and holds degrees in both medicine and bio-ethics, which gives him an almost perfect vantage point to tackle the problem if he also happened to throw a ball or two in childhood.

Savulescue offers a solution that is at once both radical and brilliant. He argues for an open market for doping and says that the focus should shift away from monitoring drugs to monitoring the health of the athlete. An athlete, then, is free to take whatever he wants as long as it doesn’t harm him.

If an athlete doesn’t fulfil a certain health criterion, he is excluded from the competition. Savulescue offers, ‘‘In cycling, if your haematocrit is too high (over 50%), you cannot compete because your blood viscosity puts you at risk, whatever the cause.”

“Similarly, if athletes have left ventricle hypertrophy from steroid use or other cause or if their testosterone levels are above a certain limit, they should be informed of the risk. It would be possible to exclude them, even if the drug itself was legal, or even if they just had a naturally high level of testosterone. Exclusion would give athletes an incentive to look after their bodies,’’ he adds.

Making PEDs legal – a safe alternative?

The millions of dollars that WADA spends on blood and urine samples (to little effect), can instead be used fund medical spot checks to see if an athlete is fit to participate in an event, creating a much safer and risk-free environment for the athletes to compete in. By legalizing performance-enhancing drugs, the spotlight will shift towards the safe administration of them and away from trying to find the most elusive way to ingest them.

The major concern against this solution seems to be that the drugs might override human effort and grit, virtues that we deeply value in sports.

In the existing scenario, who excels at sport is as much a result of genetic lottery as it is of training and hard work. If you are born with a better ability to metabolize carbohydrates than I am, then you are going to have a distinct advantage irrespective of how hard I train. The cyclist whose genes produce more erythropoietin (EPO) has a biological head-start over his competitors whose genes produce lesser. But by setting an upper limit on what is a safe level of EPO, we can level the playing field, and effort and training then become much more important than having the right genes.

The issue becomes a little trickier when a drug interferes with the very things that the sport is supposed to be testing. For instance, shooter Abhinav Bindra negotiated a rock face blindfolded, climbed a 40 foot ‘pizza’ pole, and skydived from an airplane to conquer his nerves, a quality central to his trade. The effect of all the above could be achieved on your couch by using beta-blockers, and this is something we clearly need to regulate.

Sport, after all, is about pushing the boundaries

Sport is as much a test of human strength as it is of human weakness. Central to Savulescue’s idea is not the aim to dehumanize athletes, but to recognize the fact that drugs in small, safe dosages can help athletes train harder, recover faster, achieve better results and enhance the spectacle that is elite sport. There will still be the athletes who will want to take that extra risk, push those limits and flirt with the dangerous, but as long as our focus remains fixed on the core issue of an athlete’s health, I don’t see a problem. After all, what is sport but an attempt to operate at the very edge?

Every sprinter who trains for endless hours before a race risks a fractured leg and a torn ligament. Every tennis player who ever steps on the court knows what he is subjecting his shoulder to. Cyclists train at insane altitudes and archers sky dive to conquer their nerves. The risk that the athletes are willing to take is defined by just how badly they want to win, and as long as the risk is small, manageable and taken by consenting adults, I don’t think we should play headmaster in the backyard.

Most of the facts and numbers presented in this article were obtained from the wonderfully detailed chapter named ‘Ethics of Performance Enhancements in Sports’ by Bennett Foddy and Julian Savulescu in ‘Principles of Healthcare Ethics’.