Understanding the health threats to athletes from doping

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The National Dope Testing Laboratory got approval from the World Anti-Doping Agency (WADA) to manage the Athlete Biological Passport (ABP) on December 6, 2024. ABP is an advanced anti-doping tool that enables longitudinal monitoring of biological markers to detect potential doping practices. ABP routinely collects samples (blood and urine) and monitors and analyses the athlete’s haematological, endocrine, and steroidal profiles in specified time intervals. This profiling could act as corroborative evidence of doping during anti-doping violation cases. The ABP is not a substitute, but complements traditional testing by providing indirect evidence of doping and enhancing detection accuracy. While doping is usually read as reducing from the spirit of sportsmanship, it is necessary to understand it from the health perspective of the athlete.

Doping, as described by the National Anti-Doping Agency Rules 2021, consists of violations such as the use of prohibited substances and the presence of the substance or their metabolites in the body sample, evasion or refusal of testing of banned substances, whereabouts failures during testing, possession or trafficking of prohibited substances without proper justification, administering these substances to others, complicity in violations, association with ineligible individuals, and acts or retaliating against whistleblowers.

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Doping is banned to uphold the integrity of sports by ensuring fair play and creating a level playing field for athletes. While these reasons are rooted in ethical concerns, the physical health of the athlete consuming these substances is a direct and often overlooked issue. Performance-enhancing drugs can cause several short-term and long-term health consequences for the athletes.

The practice of doping dates back to ancient Greece, when athletes consumed herbal stimulants to win competitions. By the late 19th century, the development of modern pharmacology led to the introduction of substances such as cocaine and strychnine. The mid-20th century saw the emergence of anabolic steroids, which were initially developed for medical purposes. The WADA Prohibited List categorizes substances into two types: banned at all times and banned during competition. Substances banned at all times are prohibited both in and out of competition due to their performance-enhancing or masking effects. The substances banned during competition are restricted only when athletes actively participate in events.

What are these substances then? Firstly, anabolic agents (e.g. testosterone). These substances mimic the effects of testosterone, enhancing protein synthesis and promoting rapid muscle growth and recovery. They allow athletes to train harder and recover faster, increasing strength, endurance, and muscle mass. The unfair advantage lies in the unnatural enhancement of physical capabilities, enabling athletes to outperform competitors who rely solely on training and natural ability.