By Brian Hill, MD
I have a big interest in Sports Medicine, and I was recently chatting with someone who is involved in the field. We had a brief discussion on the topic of doping in athletics. This is an intriguing but unfortunate topic. It has been a part of sports for years and is ever-evolving. From blood doping and EPO to testosterone and performance enhancing drugs, there is a wide range of ways to get a leg up on the competition. Research studies are constantly being performed to find better ways of detecting banned substances and to perfect the “athlete’s biological passport”. However, as quickly as research is being done to expand detection, ingenuity and science work just as quickly to establish new methods of doping and ways to avoid detection.
It has always been fascinating to me to consider the variation in doping among different sports and countries. Historically and recently, certain thoughts come to mind when doping is mentioned. Because they have recently been in mainstream media, everyone is familiar with Lance Armstrong and the Russian Olympic Team scandal. Doping exists in some form or another, in all sports, and in all parts of the world. However, doping is intertwined with certain sports, while it is virtually non-existent in others. Some major sports like baseball and football often have players being suspended for doping, while others like soccer and basketball rarely do. Similarly in less mainstream sports, weightlifting, track and field, and speed skating have more frequent doping accusations, while rowing, swimming, and tennis are sports with similar physical demands but have much lower rates of doping. Arguably, the sport most tarnished by doping is cycling. Some have argued that during certain periods in professional cycling, doping was so rampant that cheating was necessary in order to be competitive. The physiology of certain sports lends to greater benefits from doping; but even so, a crossover sport (one that has a similar strength, speed, and endurance profile) may have significantly less doping. What is it that makes doping part of the culture of some sports, while it is viewed as unacceptable in others? What can be done to change the culture of doping-predominant sports?
Doping carries with it some obvious consequences. Athletes who dope are so caught up on winning that they are willing not only to cheat, but they are also willing to risk harm and deleterious health outcomes upon themselves. Studies have shown that athletes are very aware to these risks, and that they feel increased performance is well worth these risks. As Family Medicine providers, we stand at the forefront of evaluating and treating many medical conditions. I would argue that we also could make a difference in the culture of doping. We can screen for use and help counsel young athletes during well child checks and pre-participation physicals on the negative outcomes of doping and on the right way to perform and win. It would be relatively easy to add a question about performance enhancing drug use to a visit involving a patient involved in competitive sports. This could be used as an opportunity to educate athletes on the negative health effects associated with doping and to reinforce fair play in sports.
Brian Hill, MD is a second year Family Medicine Resident in the Department of Family & Preventive Medicine at the University of Utah School of Medicine.
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