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W
hat
every
physician
should
know
about
doping
and
doping
control
R
ev
A
ssoc
M
ed
B
ras
2016; 62(2):101-105
101
COMMUNICATION
What every physician should know about doping and doping control
O
que
todo médico
deveria
conhecer
sobre
doping
e
controle
antidoping
J
osé
K
awazoe
L
azzoli
1
1
Adjunct Professor, Instituto Biomédico, Universidade Federal Fluminense. Specialist in Sports Medicine from Sociedade Brasileira de Medicina do Exercício e do Esporte (SBMEE) and Cardiology from Sociedade
Brasileira de Cardiologia (SBC). Former President of the Brazilian Society of Sports Medicine (2009/2011). Secretary General of the Panamerican Confederation of Sports Medicine (Copamede). Treasurer of the
International Federation of Sports Medicine (FIMS), Rio de Janeiro, RJ, Brazil
http://dx.doi.org/10.1590/1806-9282.62.02.101Probably the medical professional who is closer to the
daily life of an athlete, who participates regularly in com-
petitions, whether or not high-performance, is the expert
in exercise and sports medicine. However, occasionally
the athlete may need to resort to other medical profes-
sionals, for various reasons, such as a general practitio-
ner, a dermatologist, a cardiologist, an orthopedist or a
gastroenterologist. Therefore, every physician is subject
to come across a patient who is an intermediate level or
high-performance athlete, and will need to go through
doping controls throughout his sporting life. The pur-
pose of this article is to provide concepts and informa-
tion to medical professionals so that they can properly
treat their “athlete patients”, avoiding the use of substanc-
es that may harm them in a doping control situation.
H
istory
In the past, the list of banned substances was drawn up
by the Medical Commission of the International Olym-
pic Committee (IOC) and usually revised in the year pre-
vious to an Olympic game. The IOC list was used by in-
ternational federations of different sports, in many
countries. However, over time, alternative lists slightly
different from each other were created. This would com-
pel the experts in exercise and sports medicine to know
which authority was responsible for a given competition,
and what the list of banned substances adopted would
be. The problem was finally resolved with the creation in
1999 of the World Anti-Doping Agency, also known as
WADA.
WADA annually updates the list of prohibited sub-
stances and methods. The list is valid from January 1 of
each year and is usually updated and approved by WADA
Executive Committee in the last quarter of the preceding
year, then published on WADA’s website:
www.wada-ama.org.
C
oncept
of
doping
The concept of doping by WADA is based on three crite-
ria: enhancement of sports performance; risk to the health
of the athlete; and that use of the substance or method
violates the spirit of sport. When two of these three cri-
teria are present in a substance or a method, the theoret-
ical possibility of listing occurs.
Examples of artificial performance enhancement in-
clude anabolic steroids, which also cause serious risks to
the health of the athlete. This group of substances in-
cludes two of the three basic principles of the concept of
doping, and therefore makes the list.
The concept of “violating the spirit of sport” can give
rise to subjective interpretations, but these values are ex-
plained inWADAWorld Anti-Doping Code as follows: eth-
ics, fair play and honesty; health; excellence in performance;
character and education; fun and joy; team spirit; dedica-
tion and commitment; respect for rules and laws; self-re-
spect and respect for the other athletes; courage; solidarity.
Cannabinoids, such as hashish and marijuana, are
examples of substances considered doping because they
are harmful to the health of the athlete and contrary to
the fundamental values of sport, although they not en-
hance athletic performance.
D
efinition
of
doping
By resolution of the World Anti-Doping Code, doping is
characterized when there is/are one or more anti-doping
rule violations, which are as follows:
1.
Presence of a prohibited substance or its metabolites
or markers in the sample collected from an athlete;
2.
Use or attempted use by an athlete of a prohibited subs-
tance or prohibited method;
3.
Refusing or failing without compelling justification
to submit to sample collection after notification, or
otherwise evading doping control;
4.
Violation of the requirements regarding athlete avai-
lability for out-of-competition testing;
5.
Tampering or attempted tampering with any part of
doping control;
6.
Possession of prohibited substances and prohibited
methods;
7.
Trafficking or attempted trafficking of prohibited subs-
tances and prohibited methods;
8.
Administration or attempted administration to any ath-
lete in-competition of a prohibited substance or a prohi-