Should
performance enhancing drugs (such as steroids)
be accepted in sports
Proponents of accepting performance enhancing drugs (PEDs) in
sports argue that their harmful health effects have been overstated, that
health risks are an athlete’s decision to make, that using drugs is part of the
evolution of sports much like improved training techniques and new
technologies, and that efforts to keep athletes from using PEDs are
overzealous, unproductive, unfairly administered, and bound to fail.
Opponents argue that PEDs
are harmful and potentially fatal, and that athletes who use them are cheaters
who gain an unfair advantage, violate the spirit of competition, and send the
wrong message to children. They say PED users unfairly diminish the historic
achievements of clean athletes, and that efforts to stop PED use in sports
should remain strong.
perception that it is impossible to
fully enforce anti doping laws, some commentators argue that these laws be
relaxed to create an “open” but arguably more “even” playing field. However,
sport without anti doping laws would disadvantage further those athletes who
wanted to compete at an elite level without risking their health. The recently
formed World Anti-Doping Agency (WADA) is responsible for developing and
implementing uniform anti doping standards worldwide (both with respect to
lists of banned drugs and penalties for misusing them). The World Anti-Doping
Code (“WADA Code”) was adopted after consultation with governments, sporting
bodies, national anti doping agencies and other relevant parties in 2003 by all
Olympic Committees, many nations and many elite sports associations. A
substance can be included on the World Anti-Doping Code Prohibited List if it
meets two of the three major criteria defined by WADA, or if it is a potential
masking agent. The three criteria are that the substance is
performance-enhancing, that there are health risks to the athlete with use of
the substance and that use of the substance violates the spirit of sport. The
need for two out of the three criteria means that the WADA Code can ban “social
drugs” such as marijuana (even though they are not performance-enhancing) but
can permit the use of a drug such as caffeine (even though low levels of this
drugs are performance enhancing). Anti doping laws do not just relate to
positive tests for prohibited substances. Refusing to submit to testing procedures,
tampering with samples (before or after they are submitted), possession and/or
trafficking illegal substances, and refusal to supply accurate regular
whereabouts information to authorities (to allow for regular unannounced out of
competition testing) can lead to doping infringements. Therefore, doctors who
may potentially prescribe or otherwise assist athletes in taking banned drugs
may also be subject to doping sanctions and suspended from involvement in elite
sport. Exploring the role of performance enhancing drugs (PED) in sport gives performance
psychology an opportunity to look into its „dark side'. The psychology of the use of PED
in sport moves away from traditional performance psychology aimed at helping people
fulfill their potential, top reventing a performance enhancing behavior. What
motivates an athlete to use the high stakes of being caught? The obvious answer is „to win',
which more likely reflects factors like economic incentives (prize and
sponsorship money) and social pressures (national gold medal expectations). However, winning is unlikely to be a
complete explanation.
Anshel (1991) reviewed a range of
factors identified through personal interactions with coaches and athletes to
provide advice on intervening in PED behavior based on cognitive (e.g., show
concern or discuss ethics) and behavioral (e.g., assist with boredom or goal
setting) perspectives. While a useful foundation to build testable grounded
theory, the anecdotal nature of the research gives little insight into the
underlying psychology. To this author's knowledge, a grounded theory based on
Anshel's or other work founded on interactions with coaches and athletes is yet
to be formulated.
Donovan, Egger, Kapernick and Mendoza
(2002) used principles from social cognition to conceptualize a model for an
athlete's decision to use PED. The model explores the effect appraisals of
threat, benefit, morality and legitimacy have on attitudes and intentions and
subsequent compliance with the World Anti-Doping Code. Importantly, other
influences such as reference groups (e.g., coaches), athlete personality, and
the affordability and availability of PED are explicitly included in the model.
Research on the validity of this elegant model is part of an Australian
Research Council Grant that is yet to be reported.
Strelan and Boeckman's (2003) model is
based on an application of deterrence theory, explaining athletes' PED use in
terms of criminal behavior. The model posits an athlete's decision to use PED
as the consequence of an analysis of deterrents (e.g., sanctions) relative to
benefits (e.g., sponsorship) moderated by situational factors (e.g., type of
drug or perceived prevalence). The only empirical test of this theory uses AFL
players (Strelan & Boeckman, 2006) and shows the model has merit as an
explanation of the psychology underlying an athlete's decision making on PED
use.
Developing a psychology of PED use is an opportunity for basic
and applied research to work together towards rigorous grounded theory that
explains something of human behavior. Australian research into the psychology
of PED use is an excellent starting point. The experience of practicing
performance and sports psychologists could greatly inform the development of a
psychology of PED use among athletes. The key is to tap into that experience
and report it so we can learn more about what people are willing to do excel.
However, there are two key issues those working towards a psychology of PED use
need to keep in mind.
One of the biggest barriers to PED research is the absence of an
epidemiology that defines a reliable dependent variable. Put simply, there is
no reliable evidence about the prevalence of PED use among athletes of any
level (Kayser, Mauron, & Miah, 2007). Of significant concern for psychology
is the absence of a psychometrically valid self-report mechanism (Yesalis,
Kopstein, & Bahrke, 2001). Perhaps psychology can help address this issue
with some rigorous practitioner-based research, finding out prevalence
estimates from those helping athletes reach peak performance.
The second issue is that elite athletes are only one group of
people to whom PED use models apply. The psychological work outlined above
focuses on elite (Olympic or professional) athletes' PED use in high stakes
competitions. The psychology of PED use at the elite level may be very
different to the psychology at the nonprofessional level. A psychology of
nonelite PED use could provide insight into the aetiology of elite athlete PED
use. The Victorian Government (2006) has made some progress on this issue with
the release of a discussion paper on non-elite athlete PED use.
While models for performance enhancement in elite athletes might
be limited to sporting contexts, a model explaining performance enhancement
behaviors‟ among „weekend warriors' might have more relevance for more common
contexts (Mazanov, in press). For example, such a model may explain why some
people pursue cosmetic surgery enhancements, why some company directors engage
in illegal behavior to boost share performance, or why some students use
cognition enhancers. Conversely, research in these fields may help shed light
on why some athletes use PED.
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PRO
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CONTRA
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Maeve Juday,
columnist for the Swarthmore College newspaper The Phoenix,
stated the following in her Feb. 15, 2018 article titled, "To Dope, or
Not to Dope?," available at swarthmorephoenix.com:
"If we really
want to address the issue of illegal steroid use in professional sports, I
propose that it's time to head in the opposite direction: legalizing
performance enhancing drugs (PEDs)...
If steroid use for professional athletes is permitted, they will be able to
legally obtain physical enhancement drugs which have been regulated, and are
therefore possibly safe to use...
Now, let's not forget that the purpose of professional sports is
entertainment, witnessing the seemingly magical feats of human athleticism
and physical ability. An increase in steroid use would only serve to increase
the talent and intensity of the game and bring it to a higher level...The
essence of sports is that winning touchdown, that sprinting finish, and that
fence-clearing homerun. Steroid legalization for professional athletes won't
jeopardize that; it will only enhance it."
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Thomas H. Murray, PhD, President Emeritus of the Hastings
Center, wrote the following in his Jan. 29, 2018 article titled "Why
Don't We Just... Allow Athletes to Dope?," available at
bigissuenorth.com:
"Some people suggest that since athletes are going to
dope anyway why not just let them? The collateral damage, though, to both
public health and the meaning of sport, would likely be severe...
Not everyone will resort to doping but, if we remove both legal controls and
the stigma attached to it, many will. The likely result is a public health
crisis, with particularly dire consequences for young people...
When a drug exists that can significantly enhance performance and you believe
that your competitors are using it, you have three unhappy options. You can
hold fast to your principles knowing you may lose to an inferior competitor
without your scruples; you can stop competing at this level; or you can dope
like the others. The point of anti-doping is to create a fourth option: to
compete clean with reasonable confidence that your fellow athletes are doing
the same."
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Conclusion
Exploring the use of PED by athletes is a fertile field for performance
psychology to plough. There is scope to think about performance psychology in a
non-traditional way by looking at whether the
factors that promote performance enhancing behavior are also those which help
prevent certain performance enhancing behaviors.
Further, in the absence of well defined models
there is an opportunity to bring to light an area where very little of the
psychology is understood. Bringing light to
the „dark side' of performance psychology may help the sub discipline to explain a little bit more about what drives
humans to aspire and excel. Doping authorities are further ahead than they have ever
been, but awareness that doping is prevalent
in sport is also greater than it has ever been. With current anti doping
policies, authorities greatly decrease the
widespread use of dangerous substances in sport. However the difficulties with enforcing prohibitions lead to many
areas of controversy. It is planned that
subtle ongoing changes will be made to the WADA Code, making it necessary for
all medical practitioners who treat athletes
to know how to check up-to-date lists of legal drugs and substances.
Physicians involved in professional sport need to fully understand
the complexity of performance-enhancing drugs and where we draw the line. To do
so, not only must the physiologic and psychotropic properties of each drug be
considered, but also the individual characteristics of each sport and, more
important, the individual biology of each athlete. A medical system for
athletes that ensures a fair and accepted standard for all individuals in a given
sport needs to be established. In a world of advancing neuroscience and
concomitant psychotropic drug development, the psychiatrist must become an
advocate for the appropriate uses of psychoactive medicines. The issues
involved are complex and potentially have far reaching cultural effects in how
psychotropic medicines are perceived by the public. Unfortunately, the majority
of prescriptions given for psychotropic drugs are not given by psychiatrists
and probably the world of sport is no exception. If the integrity of the
practice of medicine and professional sport are to be maintained, all involved
must be more informed and directly involved in the decision making about
medication efficacy and appropriateness. To address the issue of where the line
is drawn and who draws it, the world of sports is unknowingly calling for
physicians who possess expertise in psychopharmacology, psychiatry, and
athletics.
References
Ø Anshel,
M. H. (1991) Causes for drug use in sport: A survey of intercollegiate
