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THE ROLE OF TRIBUNALS IN ELITE SPORT

Professor Emeritus Kenneth Hardy

Proposing to present a medico-legal case as a “who-dun-it” with interesting points of and medical diagnosis, treatment legal dilemmas and a controversial legal outcome, it was exciting to learn that as all evidence for the case had been given “in-camera’. The outcome of this was that the Australian Football League (AFL) solicitors said that I was on a “hiding to nothing” if I presented it. In simple terms, they would see that I was prosecuted! So we move from the judge’s chair to the athlete’s point of view of what happens in doping and drug testing, and will involve mainly the AFL.

Outline

This will cover what the code is, the educational programme, the drugs commonly used in doping and how taken and their side effects, the selection of athletes for testing and how tested, and the AFL results.

Getting Started.

In 1988 the Black Senate enquiry concerning drugs in sport made it necessary for Australian Rules football to put a doping policy in place. I was recruited to a 5 person subcommittee to set this up, the basis of my selection doing steroid research at the Howard Florey Institute in Melbourne. Protests that this was with foetal sheep and not with anabolic steroids were brushed aside, and I was in for the next 14 years, as Deputy and then Medical Commissioner.

What The Code Is

Doping Classes

• Stimulants
• Narcotics
• Anabolic Steroids
• Diuretics and masking agents
• Peptide Hormones

Doping Methods

• Blood doping
• Physical, chemical, or pharmacological manipulation

Variation By The AFL

• Sudafed
• Beta agonists, salbutamol, salmeterol etc.

These were deleted from the banned list at the request of the club doctors because bronchial asthma is common in Australia, and Sudafed is prescribed for sinusitis common from plane travel.

Implementation

This code was implemented by an Educational Program consisting of a yearly talk to each AFL club training list, coach, doctor and ancillary staff by the Commissioner and a representative of the Australian Sports Drug Testing Agency (ASDA); a booklet which contained the code, penalties and frequently asked questions by players and their answers; a 24hr phone “hot line”; instructions that no medicine or health potion be taken without consultation with their club doctor; that supplements and nutrients were not licensed by the Food and Drug Administration and what was on the label and what was in the bottle may not coincide; and they were told the side-effects of the common doping agents. The drug lectures included scenarios, which were scripted and were played out by the footballers.

Side effects of drugs

The side effects of anabolic steroids are death, stroke, heart attack, high blood pressure, cancer, liver disease, mood change and testicular atrophy (called shrinkage of the crown jewels for lecture purposes). In the following year the only side effect remembered was the latter. One must wonder whether this had some effect to the excellent record concerning steroids in the AFL.

Testing

This is run by the Commonwealth Government regulated body ASDA. Specimens are analysed by an International Olympic Committee accredited laboratory, of which there is only one in Australia (in Sydney). Testing is In Competition, which is match day and players are chosen at random from the numbers on their backs, and Out of Competition being at training, at home, out of season or targeted because of high profile.

Method: the ASDA team notify the player leaving the arena, who then stays under vision until the required specimen is collected. To date this is urine, and stripping from chest to knees is required. The sample is divided to A and B with notification of results within 6 weeks. The player may challenge the credibility of the result and go and watch or have watched the B sample be analysed.

Cheating at collection: overseas shaving cream, whisky etc. have mimicked urine. This is not possible with proper chaperoning. The bladder has been filled before athletic performance with others urine.

Doping

• Athletes, who wish to do this, do so in an organized manner. One method is to go on a steroid holiday and “stack” over 2 weeks taking a range of water soluble anabolic steroids starting with huge doses and tapering off. It is necessary to take the appropriate physical exercise to get a maximum response. Keeping the exercise will keep the anabolic muscular response. Water based steroids are detectable for only 10-14 days.
• Erythropoietin, Epo doping really requires the help of a medical attendant. This peptide hormone of the body raises the haemoglobin and so the oxygen carrying capacity of the blood. An increase in viscosity occurs with an increase in haemoglobin and the easiest way to measure this is by the haematocrit. This is a simple finger prick test with a result in minutes. In cycling this test is used, done on the day of competition, and if over a certain value, the cyclist cannot ride that day. There are also blood and urine tests for Epo, but are expensive and give a 3 day window. Within in the normal blood concentrations a change of 5% will give a 10% increase in oxygen carrying capacity. This is a huge advantage, and has been used by swimmers, cyclists and long distance runners. Complications are of clotting, such as DVT, or in lung or brain.
• Growth Hormone will promote muscle growth, but its’ other actions such as diabetes and gigantism have not made it popular. Suitable tests for this are not available.
• Insulin-like growth factor, of which there are a number, has a similar effect, but like insulin overdose produces a low blood sugar coma. Though used it is not popular, and it is very difficult to catch those using it.
• Caffeine is permitted to a small concentration in the urine, about 5 coffees an hour. Caffeine is a stimulant and has in big doses been shown to improve the performance of trained 800m athletes by about 2 seconds.

Excuses

Most have been heard: not cheating, just doing the same as others; inadvertent, didn’t know it was banned; my drink was spiked; took it to heal an injury; I couldn’t have taken it and you are wrong.

AFL Results

There have been about 8000 tests over 15 years. Four cases have gone to the Tribunal; an anabolic steroid taken for repeated muscle injuries, found guilty, receives a 16 weeks suspension plus having to give a lecture tour on steroid problems; an anabolic steroid (DHEA de hydro epi androsterone) confessed to taking on doctors recommendation but tested negative, found not guilty; a narcotic given under anaesthesia during surgery, found guilty but overturned on appeal; and ecstasy taken in a junior competition, not In Competition by an AFL listed player. Probenamide a masking agent was given with penicillin for a suppurative tonsillitis, the player detected not being charged.

Conclusion

The AFL takes doping in sport seriously, and has put a strong educational program in
place to prevent it, and named the code the Anti Doping Code.

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