protecting athletes from themselves

Monday, February 24, 2014

The list runs 10 pages and is updated every year. It is the compilation of what drugs are not allowed to be used in international sport and it is the bible of the Olympics. While athletic performance will be remembered and podium celebrations will fill the dreams of the next generation of Olympians, there are six athletes who embody the dark side of competition. The six ran afoul the World Anti-Doping Agency prohibited substance list and their Olympic aspirations were tarnished.

Sometimes the infraction seems petty, as seemed to be the case for Nicklas Backstrom, a forward for the Swedish hockey team. He was found to have pseudoephedrine in his urine, a common over the counter cold medications used as a decongestant. The team coach and doctor were aware of the medication, Zyrtec D, and Mr. Backstrom said that he had taken the medications intermittently for seven years to help with allergies. The International Ice Hockey Federation declared Mr. Backstrom “an innocent victim of circumstances” but the WADA specifically lists the drug as a prohibited stimulant if the levels in the urine are greater than 150 micrograms per milliliter. Backstrom’s level…195. Ignorance of the rule is not a defense and Mr. Backstrom was banned from the gold medal game.

Hockey is one of the marquis sports at the winter games, and the players will be in the spotlight within the week when they return to NHL action. For others who participate in less well marketed sports, the Olympics is their one time to make their national team and compete when the whole world watches, and perhaps it is a once in a lifetime opportunity. The risk reward for using performance enhancing drugs becomes more enticing. Ukrainian cross country skier, Marina Lisogor, tested positive for trimetazidine and Johannes Duerr, an Austrian cross country skier tested positive for EPO. Both drugs may aid an endurance athlete but there is significant risk.

EPO, or erythropoietin, is a hormone that helps regulate the number of red blood cells that the body produces. Red blood cells deliver oxygen form the lungs to the cells of the body; the more oxygen supplied, the longer a muscle can work aerobically, before running out of gas, turning to anaerobic metabolism (without oxygen) and forming lactic acid, the killer chemical when it comes to athletic performance. If an athlete injects EPO or its long acting cousin darbypoietin, the bone marrow can be stimulated to produce more than normal red cells. The same effect can occur by living and training at altitude or by blood doping, getting a blood transfusion. Better athletic performance is tempered by the potential of having too many red cells in the bloodstream, leading to the sludging of blood and clot formation. This complication may lead to stroke or heart attack.

Trimetazidine is a drug developed to help patient with coronary artery disease, angina and heart attack. It allowed heart muscle cells to use oxygen more efficiently and was approved as a second line heart drug, to be used only if other medications could not control angina. As well, the drug increased coronary artery blood flow to deliver more blood to the heart. It doesn’t take much of a leap to think that a drug that allowed one type of muscle cell (the heart) to use oxygen would not also be able to help other types of muscles. And perhaps for that reason, WADA lists it as prohibited. Perhaps another reason is the high potential for developing Parkinson like tremor, rigidity and gait instability.

Three Sochi athletes tested positive for methylhexanamine, a drug that looks like adrenaline to the body and was developed to help with allergies. It was withdrawn from the market because of the FDA

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