Die Liste der verbotenen Mittel und Methoden wächst und wächst, nicht zuletzt, weil in der Welt des Elitesports immer mehr Mittel und Methoden ausprobiert, miteinander kombiniert und alte Mittel wie anabole Steroride neu 'designed' werden, damit sie durch das Analyseraster fallen. Die Dopingjäger bemühen sich, Schritt zu halten und sind so gezwungen die Verbotsliste ständig zu erweitern und zu präzisieren. Das geht nicht ohne Fehlschläge wie die Ereignisse und Diskussionen um das Mittel Meldonium zeigen.

Gleichzeitig werden Medikamente, die in hohen Dosen in vielen Sportarten eingesetzt werden und nachweislich gesundheitsschädlich sind, nicht in die Liste aufgenommen. Hier sind vor allem die Schmerzmitteil zu nennen, insbesondere das opioidhaltige Tramadol.

Henk van ‘t Klooster, ehemaliger Direktor der Analytical Chemical Laboratories Division of the National Institute of Public Health and the Environment in the Netherlands (RIVM) hinterfragt diesen Komplex:

- Which substances should be banned?

- What are the criteria that support banning?

- On whose authority should decisions to ban substances be made?

- How should interactions between body chemicals and doping substances be taken into account?

- How should foods and food supplements contaminated with doping agents be hand led?

- How can masking agents and methods be revealed?

- What are the criteria for unequivocally demonstrating abuse?

- How should research methods and procedures be validated?

 

Zudem: Wie scharf sind die Grenzen zwischen den leistungssteigernden Effekten, die sich aus erlaubten Nahrungsbestandteilen und Nahrungsergänzungsmitteln ergeben und den Effekten der verbotenen Substanzen?

Henk van ‘t Klooster geht davon aus, dass diese Grenzen schwammig sind und fordert daher Schluss mit dem Anti-Doping-Zirkus.

 

Diese kompromisslose Haltung dürfte in Anti-Doping-Kreisen auf wenig Gegenliebe stoßen, doch diese Fragen werden durchaus häufiger diskutiert und für relevant angesehen.

 

Andy Brown: Why life bans for doping will not work

 

Andy Brown nennt Beispiele für die Unübersichtlichkeit der WADA-Verbotsliste, dafür, dass viele Substanzen und Produkte darin enthalten sind, die von den Sportler*innen nicht erkennbar und selbst von Experten nicht eindeutig zuzuordnen sind. Aufgrund dessen kann es leicht zu sehr unterschiedlichen Interpretationen und damit zu uneinheitlichen Sanktionen zwischen Freispruch und Sperren von mehreren Jahren kommen.

The exact number of substances on WADA’s Prohibited List cannot be stated. This is because nobody knows, including WADA. The reason for this is the way in which the List is written. For example, most athletes realise that anabolic androgenic steroids are prohibited, and the List names 42 of them.

However, at the end of Section S1 of the List, is also mentions that ‘other substances with a similar chemical structure or similar biological effect(s)’ are also banned. The same is also true of Section S2, S5, and S6.

 

The logic behind this is easy to see. If WADA didn’t include these disclaimers, determined dopers would simply slightly change the chemical structure of the substance and claim that as it is not on the List, it is not prohibited. However, such disclaimers also create serious issues for athletes.

 

If not all prohibited substances feature on the List, an athlete purchasing a supplement cannot check its ingredients against the List. Methylhexaneamine is a stimulant featured on the Prohibited List. Should an athlete be expected to know that it has alternative names such as Forthane, Geranamine, 1,3-dimethylamylamine (1,3-DMAA) or dimethylamylamine (DMAA), which are not featured on the List? If they test positive and a supplement lists these ingredients but not methylhexaneamine, should we ban the athlete for life?

 

Late last year, UEFA and WADA were forced into an embarrassing climbdown after this issue came to a head. Analysis of footballer Mamadou Sakho’s A sample revealed the presence of higenamine, a substance speculated to have fat-burning qualities. UEFA duly notified Sakho of an anti-doping violation, stating that Higenamine was banned at all times under the WADA Prohibited List, as a category S3, Beta-2 Agonist.

However, higenamine doesn’t feature on the Prohibited List, and there is considerable speculation about whether it is a Beta-2 Agonist at all. As such, following great personal expense, Sakho was exonerated.

 

Andy Brown hat diese Problematik in weiteren Fallrecherchen ausgeführt. Zum einen beschreibt er die unterschiedliche Handhabung in Fällen mit Ergänzungsmitteln, die Ostarin enthalten, eine illegale den Testosteronspiegel erhöhende Substanz, zum anderen stellt er zwei Fälle aus Sudafrika dar, denen den Sportlern, darunter ein Amateur, ein den Testosteronlevel beeinflussendes Mittel nachgewiesen wurde, das allerdings namentlich nur schwer zu identifizieren war.

Andy Brown: The trouble with Ostarine: Jimmy Wallhead’s story, 16.3.2018

Andy Brown: WADA overkill? The Gordon Gilbert case, 16.3.2018

 

Die Probleme, die sich aus diesen Unklarheiten und letztlich ziemlich uneinheitlichen, unverhältnismäßigen bis widersprüchlichen Behandlungen der Fälle ergeben können, fasst Brown wie folgt zusammen:

There are also many examples of successful athletes who have come to settlement agreements with anti-doping organisations. The fact that we cannot name them in this article underlines the problem. Rich athletes often have more money than the anti-doping organisation (ADO) attempting to sanction them. ADOs cannot risk undermining the anti-doping testing system through losing counter lawsuits launched by such athletes, so settle with them instead.

 

It would appear that the current anti-doping system is set up to punish athletes who do not have the means to defend themselves. They often do not have the resources, energy or inclination to fight back, and the announcement of a four year sanction can serve as proof that an ADO is doing its job. If you do have the means to mount a defence, it would appear that you can buy your way out of trouble. One of the IOC’s conditions for reinstatement of the ROC was the payment of a $15 million fine.

Career destroying

 

Another principle of the anti-doping system is that once a doping sanction is served, an athlete can return to sport. However, the indelible stain of doping is not so easy to clear.

 

For an elite athlete, this is less of a problem. Books recounting their doping experience often sell well, and TV interviews and speaking engagements can keep the money flowing in even whilst the sanction is being served. ...

 

Amateur athletes are hit by a double whammy. They often cannot find a job due to their doping record. The Sports Integrity Initiative has been contacted by many athletes pleading for articles relating to their spent sanction to be removed, as such articles are affecting their employment prospects.

 

The costs of defending yourself against a doping charge can also be severe. Rio 2016 Olympic weightlifter, Sonny Webster, spent his life savings attempting to discover the source of an ostarine AAF. He is likely to now face a battle similar to that faced by amateur athletes sanctioned for doping, as his four year ban means any sponsorship money he might have received is likely to evaporate, and he may have to seek other employment options.

 

Even in front of the CAS, athletes do not face a level playing field. Lawyers representing sporting bodies have expertise in such cases and are aware of any CAS judgments that may support their case (not all CAS judgments are publicly published). Lawyers retained by athletes face a steep learning curve in becoming experts in chemicals, manufacturing processes, laboratory protocol, and more. The strain that this can put on personal relationships is the elephant in the room.

Potential employers or sponsors will often conduct an internet search using an athlete’s name. The Sports Integrity Initiative has received numerous requests from athletes whose doping sanction has been spent requesting that we remove articles referring to the sanction, as they are affecting the athlete’s employment prospects.

 

If a doping or match-fixing case comes up in a Google search, companies may think twice about offering the athlete a job or sponsorship agreement. Often, they will not consider the circumstances of the case. For example, an athlete can be issued with a doping sanction for failing to correctly state where they will be available to be tested. A player can be sanctioned with a match-fixing offence for failing to report a suspicious approach, even if they are threatened.

 

“People have been mostly supportive, but some have called me a ‘roider’ and a cheat on instagram – my daughter’s on instagram!”, explains Wallhead. “My job is coaching. I coach at Loughborough University, I coach kids of 6-12 years old in town, and having to sit down and explain to parents what has happened is a bit shit. Luckily, now it’s all done and dusted.”

 

Olivier de Hon: STRIKING THE RIGHT BALANCE. Effectiveness of Anti-Doping Policies, 2016

 

Olivier de Hon nennt u.a. Beispiele von Mitteln, die nicht in die Verbotsliste aufgenommen wurden obwohl deren Effekte denen gleichen, die von in der Liste enthaltener Substanzen kommen. Er beschreibt das Dilemma, das sich ergibt:

Regarding the decision whether a substance or a method is performance enhancing or not, it is important to stress that established scientific methods to evaluate the effects of a substance will never be able to give 100% clear answers. This might be true for all scientific efforts but it is especially true in anti-doping related matters because of various intrinsic characteristics of doping research. Firstly, most doping substances are medicines, and medicines are developed to cure sick people. When healthy people seek a specific pharmacological effect for themselves, they most often need to substantially increase the dose of the substance involved. Such high dosages are unethical to give to subjects in a scientific experiment, and as such it is practically impossible to conduct studies with high methodological quality into real-life conditions. Secondly, it can be expected that the physiology of elite athletes is unique. As such, it is important to study the effects of substances in people with such extraordinary physiological conditions: in the elite athletes themselves. But it is prohibited to administer doping substances to elite athletes in periods when they are actively competing in sport; this would create an uneven playing field, which is exactly what anti-doping regulations try to avoid. This is an archetypical vicious circle: in order to determine whether a certain substance should be prohibited, it needs to be administered in a group of people where it cannot be administered because it is prohibited.

 

Diese Unsicherheiten betreffen auch Medikamente wie EPO.

 

De Hon gibt keine Empfehlungen zu den Inhalten der Liste, aber er stellt fest, dass der Inhalt der Verbotsliste der Schlüssel zur Lösung vieler Probleme sein könnte.

It seems that the contents of the Prohibited List International Standard holds the key, and perhaps the solution, to many doping-related discussions, despite the fact that it can be said beforehand that there will never be agreement between all scientists on what the prohibited list should contain, let alone agreement between all persons involved in anti-doping. There are two factors that are important in guiding these discussions: clarity (of opinions) and transparency (of decisions). Unfortunately, both are often lacking in practice.

 

Da die Auswahl der verbotenen Mittel und Methoden den Maßstäben Leistungsteigerung, Gesundheitsschädlichkeit und Verstoß gegen die Ethik des Sports unterliegen und sich alle drei Prinzipien nicht quantifizieren lassen und oft spekulativ bewertet werden, plädiert Olivier de Hon dafür, die Auswahl nach den Potentialen der Leistungssteigerung und der Gesundheitsrisiken zu beschränken.

It is true that many different opinions exist on the ideal contents of the prohibited list but in essence everyone is trying to construct a ‘relevant’ and ‘meaningful’ list following their own personal views. The current rules to consider substances and methods for the prohibited list allow for these individual differences to be brought in in each and every list-related discussion, and as such they are too broad to really guide the debate in this area. More focus is needed in order to streamline discussions. In this thesis it is proposed to promote the concept of the ‘spirit of sport’ away from the debates on the contents of the prohibited list into the core of anti-doping policies. By doing this, it is officially accepted that anti-doping rules are an ethical decision to limit the athletic potential of humans by any means to the potential by true means, or at least what is deemed true in the current timeframe. The next step is to debate the contents of the list, again and again, but now based solely on the potential enhancement and health-risk properties. It will hopefully guide discussions on the contents of the prohibited list towards what substances or methods can do – and not how they feel. After all, doping is prohibited in sport because it does not feel right in the first place.

 

Bengt Kayser steht der weltweiten Anti-Doping-Politik/Strategie seit Jahren kritisch gegenüber. 2008 fasste er die seiner Meinung nach wichtigsten Kritikpunkte und Unklarheiten in dem Text Globalisation of anti-doping: the reverse side of the medal zusammen, darunter viele Punkte, die aktuell verstärkt diskutiert werden.

 

Bengt Kayser sprach auf der INDR-Konferenz in Aarhus 2017, sein Text ist nicht online. Auf der Seite sportsintegrityinititive.com gibt es eine Zusammenfassung. Danach spricht er sich für eine Überarbeitung der Verbotsliste aus mit dem Schwerpunkt der Berücksichtigung von Gesundheitsaspekten. :

Professor Bengt Kayser of the University of Lausanne/Geneva opened by examining whether total prohibition of doping is the best approach, if the aim of anti-doping is to reducing the harm caused to the user, both in elite sport and wider society. He argued that now doping sanctions are so severe, total prohibition results in doping being pushed underground, which results in a greater health risk to the athlete.

 

Kayser argues that athletes adapt their behaviour to optimise performance anyway in terms of training regimes, nutrition, supplements, psychology and technology – none of which are prohibited. In such an environment, he argues, a potential approach to harm reduction might be a monitored gradual removal of substances from the World Anti-Doping Agency’s (WADA) Prohibited List, using permitted levels based on health risk to the athlete. Kayser envisages that a simplified List with cut-off points based on levels considered harmful to the athlete, with close monitoring of the effects, would be a better approach to harm reduction to the user.

 

Kayser considered that such an approach might put pressure on athletes to take substances they ordinarily wouldn’t consider, due to the knowledge that their competitors are also taking such substances. However, he argued that this stopped short of coercion. Also, an athlete still has the choice not to take such substances. He also pointed out that under the current system, similar pressures to dope exist, but based on suspicion rather than fact.

 

“Just say no is not an option”, Kayser concluded. “A partial relaxation of anti-doping rules based on harm reduction seems ethically defensible”.

 

Im Mai 2016 sorgte Paul Dimeo mit Äußerungen in der Timess zur Dopingverbotsliste für Aufsehen, die ihm als Plädoyer zur Dopingfreigabe vorgeworfen wurden. Der US-Radsportverband, der Dimeo als Vorsitzenden seiner Anti-Doping-Kommission berufen hatte, lud ihn wieder aus. Dimeo zeigte sich enttäuscht und beklagte die Schwierigkeiten, eine breit angelegte Diskussion mit stark kontroversen Thesen zu führen (Paul Dimeo, Opinion: Issues faced by critical academics in anti-doping, 6.6.2016, Paul Dimeo, Seven steps to reboot the fight against doping in sport, 1.7.2016 )

 

In dem Times-Artikel vom 27.5.2016 spricht er davon, dass die weltweiten Anti-Doping-Regeln nicht mehr aktuell und eher kontraproduktiv seien, Gedanken, die er schon früher zur Diskussion gestellt hatte. Die Regeln hätten in der 1960er Jahren ihren Ursprung und würden nicht mehr in die moderne Welt passen. Wir lebten in einer technologischen, kommerziellen und leistungsorientierten Welt, in der die Dopingmittel sicher zur Erholung und für Leistung eingesetzt werden könnten sofern die Regeln vereinfacht würden.

When WADA was created in 1999, the ideals, principles, practices, objectives and Utopian vision of drug-free sport – as laid out in the much simpler 1960s – should have been carefully dissected and reinvented for modern sport. Instead the IOC model was simply recycled and empowered in a global organisation. But we now live in a world of technology, commerce, and performance innovation; where drugs could be safely used for recovery and performance, if only the rules were relaxed. Of course, people react to such proposals with dismay, arguing that open drug use would mean young people being forced to take unsafe drugs just to take part in sport.

I agree, that is an unwanted outcome. However, given the ongoing crisis caused by the intensity of current anti-doping policies, a rational response might be to stop, take stock, assess the positives and negatives, engage athletes and fans, and come up with some fresh ideas that (if nothing else) are achievable, don’t harm innocent athletes, and treat “sanctioned” athletes with humanity, dignity and a constructive route of rehabilitation. ...

At the heart of such proposals could be health protection, encouraging the athlete’s voice, evidence use in policy making, transparency of the scientific decisions, protection of whistleblowers, a reduced cost appeals process, and some action to engage sports audiences in a mature way that explains what it is like to be a high performance athlete. (Paul Dimeo, 19.6.2016)

 

Er schlägt unter anderem vor, EPO unter bestimmten Voraussetzungen frei zu geben, da, richtig und schonend angewandt, es der Gesundheit nicht schade. Auch bei Bluttransfusionen sieht er wenig Gefahren.

 

Für eine Verschlankung der Liste treten auch Yannis Pitsiladis, University of Brighton und Roger Pielke, University of Colorado, ein (cycling weekly, 2.6.2016):

Question: Should the number of substances on the WADA prohibited list be reduced? What would be the effect of such streamlining?

 

YP: The prohibited list should be reduced to include only those prohibited substances and methods where there is evidence-based scientific support showing it benefits performance and/or causes athlete harm. This amendment would in time result in a more meaningful and enforceable anti-doping.

 

RP: Yes. In my forthcoming book The Edge I argue that a much simplified list, focused on those substances with significant performance-enhancing effects would aid implementation and help anti-doping agencies to better focus limited resources. I also call for a greater voice from athletes in determining which substances appear on the list.

 

PD: Potentially, yes, but any new list must have the backing of athletes. Streamlining might allow more athletes to stay within the rules and get better advice, but it would not be enough on its own, since the determined dopers will still focus on cheating and how to get away with it.