J . TOXIC0L.-TOXIN REVIEWS, 17( l) , 73-83 (1998)
TRENDS IN DRUG ABUSE IN COMPEllTIVE SPORTS, AND THE
INTERNATIONAL ANTI-DOPING MOVEMENT.
Makoto Ueki*, Tomomi Hiruma, Ayako Ikekita and Masato Okano
Doping Control Laboratory, Mitsubishi Kagaku Bio-Clinical Laboratories, Inc.
3-30-1 Shimura, Itabashi-ku, Tokyo 174, JAPAN
Tel:+8 1-3-5994-2990, Fax:+8 1-3-594-2990
E-mail: [email protected]
ABSTRACT
The results of our twelve years drug abuse survey in competitive sports is
discussed. The most typically abused drug among the Japanese general public is
methamphetamine, and the problem has been escalating during the last few years especially
among female adolescents. Throughout our survey period, the major dope agents abused
by sportsmen have been ephedrines and injectable anabolic steroids. As detection of
synthetic anabolic steroid is relatively easy, doping with naturally-occurring steroids has
become the major doping agent in sports.
In some countries, a governmental or non-governmental co-ordination agency has
been founded to promote, develop and co-ordinate the national anti-doping program in
73
Copyright 'C 1998 hy Marcel Dekker. Iiic.
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74 UEKl ET AL.
sports, and out-of-competition testing (oocr) is now frequently conducted by the agency
independently from sports federation. It is thought that it would be helpful for society to be
ready for the growing problem of hormone abuse among the general public if the
international anti-doping movement against doping in sport is taken into account
INTRODUCTION
According to an official report by the ministry of health and welfare, recently
misuse of methamphetamine among adolescents has been increasing in Japanese society
(1). The number of students arrested was 207, which was 96 larger than those in the
previous year. Other abused drugs were marijuana, cocaine, heroin and LSD (2). No
remarkable increase of hormone abuse in society was reported; however, various types of
biologically active hormones including melatonin, DHEA, pregnenolone, etc. are actually
brought into Japan by tourists as souvenirs. Another route of trafficking using the hternet
has become popular in Japan. Anabolic steroid use by world-class athletes was reported in
the early 1950s. Then the hormone abuse problem has spread to some European societies
and to the US society (3). The statistics on our athletic drug testing indicates that hormone
doping is escalating in other Asian countries without an exception.
The aim of this study is to review the international strategies against doping in
sports, and to seek any suggestions for countermeasures to growing hormone abuse in
society.
TRENDS OF DOPING TEST RESULTS IN JAPAN
Testing System
Drug screening testing in society is usually based on imrnunoassay with positive
results confirmed by gas chromatography/mass spectrometry (GUMS). On the other
hand, doping control tests in sports generally rely on G C I M S , and the analytical procedure
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DRUG ABUSE IN COMPETITIVE SPORTS 15
has been periodically modified in order to adjust to trends in drug abuse. The different
testing system is used in sports because of the large array of compounds that need to be
detected and the need for a rapid evaluation of test results. Workplace drug testing is
usually based on cost-benefit considerations, and is performed on a few target compounds
only, e.g., cocaine, amphetamines, opiates, PCP, and marijuana (4).
Laboratory Statistics
Figure 1 shows the results of our amphetamine class test done on suspects that was
requested by hospitals. AU these cases were confirmed methamphetamine positive. As
shown in Figure 1, the number of requests and the rate of positive tests have been
increasing gradually over the last five years. This is probably because of a trafficking route
via illegal immigrants, and a decrease in the price of amphetamines.
The current IOC definition of doping covers a large array of compounds (Table 1).
The author's laboratory has been responsible for undertaking international doping testing
since 1985 as an IOC accredited laboratory. Japan's official doping testing was initiated
with doping tests on 200 athletes (800 tests) per year, and the scale was expanded to about
2,000 subjects (14,000 tests) during the last several years. The purpose of the OOCT
program is educational and to follow the steroid profile of a candidate for an approaching
international sports event, because a few cases with elevated urinary testosterone to
epitestosterone ratio (T/epiT > 6 is indicative of testosterone doping) were considered to be
due to a normal physiologic condition (5).
Figure 2 shows the trends in the frequency of doping tests that were divided by
occasion; national games, international games, major sports events and OOCT of which
about 1% proved positive.
The major part of the testing earlier than 1995 consisted of international competition
and OOCT, whereas incompetition testing at national sporting events has been increasing
very rapidly since 1995. It was thought by the Japanese sports authorities that the doping
problem in Asian spots is relatively smaller than that in European countries and in the USA.
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76 UEKI ET AL.
e c
0 0 0 0 0 m m - t m
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DRUG ABUSE IN COMPETITIVE SPORTS 77
Table 1. Current IOC definition of doping
I. Prohibited classs of substances
A. stimulants
B. narcotics
C. anabolic agents
D. diuretics
E. peptide and glycoprotein hormones and analogues
II. Prohibited methods
A. blood doping
B. pharmacological, chemical and physical manuplation
ID. Classes of drugs subject to certain restrictions
A. alcohol
B. marijuana
C. local anaesthetics
D. corticosteroids
E. beta-blockers
All substances belonging to the prohibited classes can not be used even if they are not listed
as examples.
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2500
2000
1500
1000
500 0
1985
19
86
1987
19
88
1989
19
90
1991
19
92
1993
19
94
1995
19
96
Yea
Figu
re-2
Tr
ends
in th
e fre
quen
cy o
f dop
ing
test
div
ided
by
occa
sion
. C
rn B rn
4
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DRUG ABUSE IN COMPETITIVE SPORTS 19
However, actual circumstances of doping problems in Asian sports became known to the
public in late 1994 when the Olympic Council of Asia (OCA) gave information concerning
the test results in a press release. According to the OCA news the problem of hormone
doping is escalating also in some Asian countries. After that, in 1995, some Japanese
sports federations, both amateur and professional sports, intensified their anti-doping
program, and this has resulted in an increase in the frequency of the testing at the national
level.
Throughout the survey period, the major abused drugs have been stimulants and
anabolic steroids. Table 2 shows the partial list of the positive results broken down by the
name of compounds. At the national level, the major stimulants are ephedrine,
methylephedrine and phenylpropanolamine that are commonly contained in many over-the-
counter drugs. Interestingly, a l l positive results in the amphetamine class in sports are
confirmed to be due to amphetamine abuse by non-Asian citizens. In contrast, the positive
cases from Japanese addicts are all confirmed as methamphetamine positive. The most
frequently abused two of the identifed steroids, namely, nandrolone and testosterone m
usually prescribed for medical treatment as depot injection in the ester form.
Dihydrotestosterone @HT) is an active and most potent metabolite of testosterone, but the
commercial product had already been withdrawn from the Asian market over 10 years
because of side-effects. Only few DHT products in forms of cream are available in France,
etc. DHT abuse is, therefore, not likely to occur in Asia if any unofficial supply system of
the products does not exist. However, the problem of DHT doping in world-class athletes
was known to the public by our tests that were performed during the Asian Games in
Hiroshima 1995. The results indicated the need for immediate countermeasures against
natural hormone in this area (6). One determent and educational strategy against doping
with naturally occurring steroids is out-ofcompetition testing (OOCT), and the final
decision may be made by the review of previous and subsequent test results on steroid
profiles of a suspected athletes.
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Ta
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- 19
85 4 1 2 7 1 1 0 0
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Tota
l 2 3 2 26 1 2 1 1 11 1 9 2 3 2 66 2 17 1 1 4 5 2 32 3 1 1 19
00 5 1 6
160
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Pro
.-spo
rts
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82
INTERNATIONAL ANTI-DOPING MOVEMENT
UEKl ET AL.
A postal survey concerning the national anti-doping movement was undertaken by
the Japanese Olympic Committee in 1996 with the help of 24 IOC accredited Olympic
laboratories, of which 12 organizations sent back a positive response to our questionnaire
from 12 different countries (Table-3).
The twelve national sports authorities consist of three governmental and nine non-
governmental organizations. In eleven organizations, the fund is sponsored by their
responsible government in addition to their normal income. Nine of the counmes have
already enforced a special anti-doping law, and nine have co-ordination agencies which are
actively working in this field. In all countries, except South Africa, there is an exchange
agreement on the anti-doping movement with foreign countries. Thus, the international
OOCT program can be conducted without any difficulties. Eight IOC accredited
laboratories out of I2 are governmental and the others are universities or private
laboratories.
In the countries which have a co-ordination agency, the test results are sent only to
the independent co-ordination agency for further evaluation. In this way, the athlete's
privacy can better be kept and it will enable a more rapid conclusion of hearings and thus
avoid leaving the weight of suspicion on an innocent athlete for longer than necessary.
In summary, the major activities of the existing co-ordination agencies are testing,
education and information concerning sports doping. No serious problem of hormone
doping has been reported in Japanese society yet, but our sports drug test results shows
that some Asian countries are already in a worse situation.
In Japan, a provisional national co-ordination agency, the so-called "Japan Anti-
doping Agency" was established in 1996 at the institute of sports science of JASA. The
recent progress of the anti-doping movement in sports has promoted the overall anti-doping
program, and it may keep the drug abuse problem in sports to a minimum.
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DRUG ABUSE IN COMPETITIVE SPORTS 83
Acknowledgment
Part of this work was performed in co-operation with the anti-doping commission
of the Japanese Olympic Committee and that of the Japan Amateur Sports Association.
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1 .
2 .
3.
4.
5 .
6 .
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D. Scott, J. Wagner, T. Barlow, Anabolic steroid use among adolescents in Nebraska schools, Am. J Health Syst. Pharm, 53,2068-2072, 1996
US Department of Health and Human Services, Federal Workplace Drug Testing, Federal Register, 11970-11989, 1988
M. Ueki; Editors T. Matsuo, R. Caprioli, M. Gross, Y. Seyama, Chemical analysis in sports medicine, In Biological Mass Spectromeq "Present and Future", John Wiley and Sons, ChichesterJ994
M. Donike, M. Ueki, Y. Kuroda, H. Geyer, E. Nolteernstbg, S . Rauth, W. Schaenzer, U. Schindler, E. Voelker, M. Fujisaki, Detection of Dihydrotestosterone Doping: alteration in the steroid profile a.nd reference ranges for DHT and its 5-alpha- metabolites, J. Sports Med. Phys. Fitness., 35, 235-50, 1995
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