Emerging Drugs in Sport

Foreword by Witold Banka
Foreword by Claude Guillou
Preface
Acknowledgements
Contents
About the Editors
About the Contributors
Part I: The Evolving Doping Scenario
The Evolution of Performance-Enhancing Drug Use in Sport
Introduction
The 1950s and 1960s: The Spread of PEDs Use in Sport
Evolution of PEDs Use
Stimulants
Anabolic Agents
Peptide Hormones: Human Growth Hormone
Diuretics
Beta-Blockers
Genetic Manipulation
Novel Psychoactive Substances
Conclusion
References
Contamination of Sports Supplements with Novel Psychoactive Substances: An Old History with New Players
Historic Background: Traditional Medicines and Natural Products
Classical Doping Psychoactive Substances in Supplements
Novel Psychoactive Substances (NPS) in Dietary Supplements and Doping
NPS in the Prohibited List
Trends
Prevention Strategies
Conclusion
References
Untested Supplement Use Among Athletes: An Overlooked Phenomenon?
Untested Sport Supplements: A Growing Public Health Concern
Patterns of Supplement Use
Health Risks and Contamination Issues
Need for a Shared Global Regulatory Framework
An Alarming Netnographic Snapshot of the Supplement Market
Conclusion
References
Challenges Posed by Gene Manipulations and Sport Performance
Introduction
Advances in Gene Therapy and Their Potential Impact on Sport Performance
Gene and Cell Doping
Direct Detection of Nucleic Acids: Vector and Transgene Sequences
Gene Doping Detection by Next-Generation Sequencing
Deep Sequencing-Based Detection in Nucleic Acids from Peripheral Blood Mononuclear Cells (PBMCs)
CRISPR-Cas-Based Detection of Specific Sequences in Nucleic Acids from Blood: CARMEN
Indirect Detection
Immune Response Following In Vivo Administration of Gene Transfer Vectors
Rationale for Other Indirect Biomarkers
Strategies to Improve Detection
Cell-Free DNA (CfDNA) Analysis
Challenges Posed by the Detection of Gene Editing
From Suspicion to Conviction
Ethical Considerations
Conclusion
References
Part II: Navigating in a Difficult Regulatory Environment
The “Forced” Union of Science and Law
Introduction
Global Context
The Anti-doping Regulatory Framework
A Three-Level Anti-doping Regulatory Framework
The First Level
The Second Level
The Third Level
The Anti-doping Regulatory Framework and the Law
The Interaction of Science and Law
Perspective
Science in Support of Law
The Presence of a Prohibited Substance in an Athlete’s Sample
Establishing the Violation
The Prohibited Substances
The Detection of the Prohibited Substance in the Athlete’s Sample
Fixing the Sanction
Other Situations Where Science Supports the Law
The Substances of Abuse
The Therapeutic Use Exemptions
Law in Support of Science
Some Examples of the Legal Protection and Support of Science
Challenges of Decision Limits or Analytical Methods in Legal Processes
Retesting
Monitoring Programme
Changes to the List
Support to the Principle of “Related Substances”
Limits
Conclusion
International Drug Control: Protecting the Health of the Athlete
The International Drug Control System
The International Drug Control Conventions and the Welfare of Humankind
The Spirit of the International Drug Conventions
Scope of Control of the Conventions
The Treaty Bodies and International Scheduling
Role of UNODC in International Drug Control
The UNODC Mission and Mandate
Addressing Emerging and Current Threats
Novel Psychoactive Substances
Addressing Emerging Challenges: From Resolutions to Results
Conclusion
References
Tackling New Forms of Doping: The Legal Challenges
Introduction
Tools to Tackle New Forms of Doping
Prohibition by Categories
Prohibition of Metabolites and Markers
The Athlete Biological Passport
Re-analysis
Other Evidence
The Impact on the Sanctioning Regime
General Framework
Potential Reductions
Conclusion
Part III: Towards a Doping Society?
Olympism and the Idea of Anti-doping: Between the Thick and Thin Interpretations of Sporting Progress
Introduction
Olympism
Fundamental Principles of Olympism
Views on Sporting Progress and the Use of PED
WADA, Olympism and the Spirit of Sport
Criteria for Including Substances and Methods on the Prohibited List
Conclusion
References
Emerging Trends in Doping: Investigations and Field Operations
Introduction
Investigation Process
Organization
Collecting Information
Speak up! and the Role of Whistleblowers and Informants
Intelligence Process
Collate, Integrate and Interpret Information
Investigation
Interviews
Collaboration with Law Enforcement
Reporting
Conclusion
Anti-doping Stories Narrated by a Law Enforcement Investigator: Mind the “Good Guys”!
Introduction
Sugaring the Pill
The Performance Enhanced: Clinical Relationships Between Performance- and Image-Enhancing Drugs, Physical Exercise and Mental Disorders
Introduction
Case Reports
Case 1
Arrival at Our Unit
Anamnestic Information
Assessment, Intervention and Treatment
About Physical Exercise, BDD and Use of PIEDs
Case 2
Arrival at Our Unit
Anamnestic Information
Assessment, Intervention and Treatment
Physical Exercise and Use of PIEDs
Case 3
Arrival at Our Unit
Anamnestic Information
Assessment, Intervention and Treatment
Use of PIEDs
Conclusion
References
Part IV: Winning at Any Cost: Doping Experiences of World-Class Athletes
Faster and Dirtier for Russia: The Story of Yuliya Stepanova
Introduction
My Fight Against Doping in Russian Sports
Conclusion
Is It Worth Winning a Race If You Lose Yourself in the Process? An Interview with Olympic Champion Tyler Hamilton
Introduction
Where Did Your Desire to Become an Athlete Come From?
When Did You First Become Aware of Doping Occurring in Your Sport?
Can You Explain the Events that Led Up to You Beginning to Dope Yourself?
Introduction to Doping
Pressures to Engage in Doping
Risks and Concerns
In 2004, When You Originally Tested Positive for Doping Supplements, You Denied that You Had Intentionally Used Any Substances. Why Did You Do This?
Was Your Personal Life Impacted Upon by Your Doping and Subsequent Testing Positive?
Several Years Have Now Passed Since This Time in Your Life. Has It Had an Impact on Your View of Professional Sports?
In Your Opinion, Are There Any Ways in Which These Substances Could be Better Regulated in Your Sport and in General?
What Would Your Advice be to Individuals Considering Using Illegal Performance-Enhancement Substances?
Do You Regret Engaging in Doping?
Conclusion
A Hammer Thrower’s Journey with Doping: Being the Phoenix of My Own Life
Introduction
My Story
Conclusion
To Take or Not to Take? Why I Chose to Stay Clean
Introduction
From Videogaming to Cycling
Fast Wheel
Dream Coming to Life
From Dream to Reality…
Heartbreaking to Take the Right Decision
Cyclist Undercover
Home Alone
So, What Happened Next?
A Few Words About Clean Sport
Part V: Truth in the Test Tubes?
Forensic Analysis of Seized Drugs
Introduction to Novel Psychoactive Substances (NPS) and Forensic Analysis
Quality Assurance Practices
Uncertainty
Method Validation
Considerations for Qualitative Methods
Considerations for Quantitative Methods
Sample Selection and Preparation
Sample Selection
Powders, Tablets and Capsules
Liquids and Suspensions
Plant Material
Other Matrices
Instrumental Techniques
General
Colour Tests
Thin Layer Chromatography (TLC)
Gas Chromatography (GC)
Liquid Chromatography (LC)
Infrared Techniques (IR)
Mass Spectrometry (MS)
Nuclear Magnetic Resonance (NMR)
Other Instrumentation
Structural Elucidation
Challenges Associated with Seized Drug Analysis
Reporting Recommendations
Conclusion
References
Analysis of New Chemical Entities in a Sport Context
Introduction
Prohibited Substances in Sport
Origin of New Performance-Enhancing Drugs
Target Compounds and Biological Matrix of Choice
From Discovery and Method Development to Routine Analysis
Result Management
Conclusion
References
Hair Testing of Doping Agents: Potential and Limitations
Diagnostic Value of Blood, Urine and Hair
Renal Excretion vs. Hair Incorporation
Quantitative Interpretations of Hair Concentration
Hair Testing and Anti-doping Testing
Review of Empirical Forensic Data
Conclusion
References
Part VI: The Next Challenge
What Will the Next Challenges Be?
Striving for an Evidence-Based Approach
Key Partnerships with the Biopharmaceutical Industry
The Challenge of Global Harmonisation
Monitoring New Use of Old Drugs
Keeping up with the Supplements Industry
Misinformation and Popular Misconceptions
Evolving the Prohibited List in Response to Current Challenges
Intelligence and Investigations to Uncover New Doping Substances
Global Collaboration to Address the Challenges
References
Epilogue
Index