Sports Drug Doping Part 1: What's banned?

In the wake of the recent controversy surrounding Lance Armstrong, and many other high profile cyclists from the 2000's, I thought it might be worth talking about how anti-doping authorities, such as WADA and USADA go about catching drug cheats. This area has been covered in the literature frequently, and this paper provides the basis for this blog, but unfortunately it'll be hidden behind a pay wall from many people. So firstly, what are they testing for?

 Well basically, any substance artificially introduced to the body which provides an advantage to athletes, whether natural or artificial. WADA (the World Anti-Doping Agency), in conjunction with the International Olympic Committee (IOC), have published a list of banned substances and techniques, which outlines the types of drugs banned, with examples of each.

Prohibited Substances:

Athletes are never allowed to test positive for these drugs, with an unexplainable positive usually resulting in a ban. The categories are:

1. Non-Approved Substances: If a drug hasn't been approved for human use by a government health authority, it can't appear in samples. The is to prevent athletes taking designer drugs, dangerous drugs which have been banned, or drugs only approved for veterinary use. This means drugs which aren't safe for humans (or the safety is unknown) should never be taken by athletes.
2. Anabolic Agents: Otherwise known as steroids, these are drugs designed to increase the size of muscles faster than is naturally possible. Examples include 1-androstenediol, a potent muscle building enhancer. These drugs mimic the effects of testosterone and other steroid hormones on the body.
3. Peptide Hormones, Growth Factors and related: Like steroid hormones, these are naturally produced in the body, but are also artificially introduced for a variety of reasons. This category is home to the infamous EPO (Erythropoietin). EPO aids in the delivery of oxygen to muscles, by increasing red blood cell production. This gives a significant increase in VO₂ max for the athlete.
4. Beta-2 Agonists: Many drugs in this category are actually prescribed for asthma, so afflicted athletes are allowed to test positive up to the recommended dose. Although, there is evidence (apologies for the pay wall) that the restrictions may actually hinder asthmatic athletes. These drugs are powerful bronchodilators, helping to open up the lungs (hence their asthma use). When inhaled, the drugs have only a significant impact on the lungs, but when injected or used in tablet form, they may act as anabolic agents, which is why they're banned.
5. Hormone and Metabolic Regulators: Actually some of these drugs are often used to treat breast cancer (such as Tamoxifen and Anastrozole), but would be taken by elite male athletes to disguise the physical impacts of increased testosterone levels. Abnormally high testosterone in the body is converted to estrogen, leading to gynecomastia (or man-boobs).
6. Diuretics and masking agents: Anything designed to give an artificially low test result, or increase secretion of drugs from the body, is banned. Infusing saline into the blood stream helps to dilute the blood, giving lowered test results.

Banned Techniques:

In additions to banned drugs, certain techniques are banned too. Reintroducing blood is the technique which has made the most headlines. Athletes have blood removed prior to an event, then reinfuse it at a critical moment, boosting performance. Other banned techniques are introducing artificial oxygen carriers to the blood, or manipulating the composition of blood. Gene Doping, introducing nucleic acid polymers, is banned, as is introducing genetically modified cells. It goes without saying that it's also banned to tamper with samples.

Drugs banned during events:

So the above drugs and techniques are banned at all times, whilst other drugs are only banned during events. These include stimulants (like Caffeine), narcotics (like morphine), Cannabinoids (natural Cannabis or synthetic THC), and glucocorticosteroids (prevent inflammation, helping injury management). In some sports, alcohol and beta-blockers are banned too.

So now we know what's banned, the next question is: "How do we detect them?", and hopefully the next blog will answer that.