Dop­ing is sim­ply the use of a sub­stance or tech­nique to il­le­gal­ly im­prove per­for­mance in a sport. A sub­stance may be drugs such as am­phet­a­mines or a tech­nique such as au­tol­o­gous blood dop­ing. Re­searchers claim that the rea­sons ath­letes dope is to im­prove and main­tain phys­i­cal func­tion­ing, cope with the so­cial and psy­cho­log­i­cal pres­sures and for fi­nan­cial gains.

Dop­ing is cer­tain­ly not a new is­sue. The ear­li­est records of dop­ing in sport date back to the an­cient Olympic Games. Charmis, the Spar­tan win­ner of the stade race, which was a 183-me­tres race and the on­ly event at the Olympic Games be­tween 776 and 724 BC, used a di­et of dried figs to im­prove per­for­mance. It is not sur­pris­ing that to­day we make sim­i­lar claims. It is hy­poth­e­sized that Ja­maican yams con­tribute to the dom­i­nance of Ja­maica’s sprint­ers. An­cient Greeks were al­so the first to use al­co­hol as a stim­u­lant dur­ing their train­ing rou­tine. The prop­er­ties of the hor­mone testos­terone were iden­ti­fied as an­i­mals were ob­served fol­low­ing cas­tra­tion. This led to the re­ports of con­sump­tion of an­i­mal and hu­man tests to re­ceive a per­for­mance boost. Ro­man Glad­i­a­tors al­so used drugs to com­bat fa­tigue and in­jury. It is, how­ev­er, not pos­si­ble to say ear­ly ath­letes were dop­ing, as, based on the de­f­i­n­i­tion, the ac­tion must be il­le­gal. In an­cient times, no laws pre­vent­ed these at­tempts to im­prove per­for­mance.

With the de­vel­op­ment of mod­ern phar­ma­col­o­gy in the late 1800s, the types of drugs used to im­prove per­for­mance in­creased. Al­co­hol con­tain­ing cor­dials, mix­tures con­tain­ing caf­feine, sug­ar cubes dripped in ether and ni­tro­glyc­er­ine were among mix­tures used with the aim of im­prov­ing per­for­mances. The lit­er­a­ture sug­gests that the first dop­ing-re­lat­ed death oc­curred around this time as Eng­lish ath­lete Arthur Lin­ton was al­leged to have over­dosed on ‘tri-methyl’ and died while com­pet­ing in the 600km bi­cy­cle race in 1886. A few years lat­er, Dr Charles Brown-Se­quard pub­lished an ar­ti­cle in The Lancet, where he de­scribed mak­ing sub­cu­ta­neous in­jec­tions of “the first blood of the tes­tic­u­lar vein, se­men and juice ex­tract­ed from a crushed tes­ti­cle of a dog or guinea pig.” There were sig­nif­i­cant im­prove­ments in phys­i­cal abil­i­ty fol­low­ing these in­jec­tions. Per­for­mance-en­hanc­ing drugs in the ear­ly 1900s in­clud­ed pri­mar­i­ly stim­u­lants and al­co­hol. The In­ter­na­tion­al Am­a­teur Ath­let­ic Fed­er­a­tion (IAAF) banned the use of stim­u­lants in track and field in 1928. Dur­ing the same pe­ri­od, testos­terone was iso­lat­ed and its chem­i­cal prop­er­ties were es­tab­lished. Kearns et al., 1942 record­ed and pub­lished the first case of testos­terone use in com­pe­ti­tion. An 18-year-old horse was giv­en 525 mg of testos­terone which sig­nif­i­cant­ly im­proved the horse’s per­for­mance, lead­ing to many vic­to­ries.

The use of stim­u­lants such as am­phet­a­mines to im­prove ath­let­ic per­for­mance be­gan as ear­ly as the 1930s. Its use be­came even more preva­lent in sports such as cy­cling in the 1960s and 1970s, which led to the death of Eng­lish cy­clist Tom Simp­son in 1967. He died dur­ing the tele­vised Tour de France race due to an over­dose of metham­phet­a­mine. That same year, the Coun­cil of Eu­rope adopt­ed a res­o­lu­tion against dop­ing in sport and the In­ter­na­tion­al Olympic Com­mit­tee (IOC) cre­at­ed a Med­ical Com­mis­sion to fight dop­ing in sport. The im­ple­men­ta­tion, how­ev­er, start­ed in 1960 fol­low­ing the death of Dan­ish cy­clist Knut Jensen in the Olympic Games. Knut’s train­er had ap­par­ent­ly giv­en him a va­sodila­tor for a per­for­mance in­crease. In 1967, FI­FA (foot­ball), UCI (cy­cling) and UIPM (pen­tathlon) start­ed the com­pi­la­tion of a list of sub­stances banned in their spe­cif­ic sport. The IOC then is­sued their first list of banned sub­stances for the 1968 Olympic Games in Greno­ble and Mex­i­co. The first world con­fer­ence on Dop­ing in Sport was con­vened in 1999 by the IOC and this led to the es­tab­lish­ment of the World An­ti-Dop­ing Agency (WA­DA). WA­DA now pub­lish­es an up­dat­ed pro­hib­it­ed list an­nu­al­ly that be­comes ef­fec­tive on Jan­u­ary 1 each year.

An­ti-dop­ing in sport is es­tab­lished not on­ly to cre­ate a more lev­el play­ing field but to pre­vent ath­letes from tak­ing ex­treme mea­sures to win, which may lead to harm to them­selves or oth­ers. Dop­ing is a ma­jor pub­lic health con­cern. Dop­ing is not on­ly an in­di­vid­ual crime; coun­tries pur­sued state-spon­sored dop­ing in the 1970s and 1980s.

There is even a very cur­rent case of state-spon­sored dop­ing for which an en­tire coun­ty was sanc­tioned. In his book Death in the Lock­er Room: Drugs & Sports, 1992, Robert Gold­man re­veals that when he asked elite ath­letes if they would take drugs that would guar­an­tee wins, even if it would kill them in five years, ap­prox­i­mate­ly half of the ath­letes in­di­cat­ed they would take the drugs. There were 24 re­port­ed dop­ing vi­o­la­tions at the Athens Olympic Games, af­ter the es­tab­lish­ment of WA­DA. This demon­strates the sac­ri­fices and risks ath­letes would take to win and as such val­i­dates the need for dop­ing con­trol.

• Dr Aldeam Facey is at­tached to the Mona Acad­e­my of Sport and can be reached at aldeam.facey@uwi­mona.edu.jm.