DRUG FREE SPORT

Sport is about competing and performing to the best of your ability—the pursuit of human and sporting excellence.  Taking banned substances or using banned methods is cheating, unfair and contrary to the ethics of sport and fair play.  Doping undermines the fundamental spirit of sport and severely damages the integrity, image and value of sport.

Athletes are influential role models for young people.  The behavior and actions of elite athletes can have significant impact on young people as they admire and aspire to emulate their sporting heroes, especially their actions and attitudes. 

As the body responsible for administering Canada's Doping Control Program, a significant portion of the CCES' resources is devoted to promoting drug-free sport. This mandate is fulfilled through a comprehensive approach involving education, prevention, detection, deterrence and support of related research. The CCES works with national sport governing bodies, athletes, coaches and other sport organizations to achieve drug-free sport in the public interest and to protect the right of athletes to compete in a fair and ethical sport environment.

Testing programs are a necessary part of an overall anti-doping strategy—contributing to prevention, detection and deterrence.  The testing program for each sport will vary depending on factors such as competitive seasons, event calendar, training regimes, discipline and the potential for doping.

This section below will provide an overview of each class of substance or method that is banned in sport. 

Banned Classes of Substances
A. Stimulants (e.g. amphetamines)
B. Narcotics (e.g. painkillers)
C. Anabolic Agents (e.g. testosterone)
D. Diuretics (e.g. frusemide)
E. Peptide Hormones, Mimetics and Analogues (e.g. erythropoietin)

Stimulants
Stimulants are substances that increase alertness and reduce fatigue. They may also increase competitiveness and hostility.

Stimulants are banned because they can produce a psychological and physical stimulus that may improve athletic performance.

Some of the side effects include anxiety and aggression, increased heart rate and blood pressure, dehydration, and increased risk of stroke, cardiac arrhythmia and heart attack.

Narcotics
Drugs in this category are primarily substances that mask the effects of pain, some of which include morphine and its chemical and pharmacological analogues.

Narcotics are used to mask pain. A false sense of security may cause an athlete to ignore a potentially serious injury, and by continuing to train and/or compete, risk further damage. Also, narcotics may reduce anxiety that may artificially enhance an athlete's performance.

Most of these drugs have dangerous side effects such as loss of balance and coordination, sleepiness, nausea and constipation. Prolonged use can cause physical and psychological dependence. Excessive use could suppress the respiratory system and be fatal.

There are several permitted substances that may be used to treat slight to moderate pain. Check the CCES Drug Classification booklet to identify some of the permitted medications. You should contact your coach, team physician or the CCES Info Line if you require further information.

Anabolic Agents
Anabolic agents are synthetic variations of the male sex hormone, testosterone. Natural testosterone provides "anabolic" (muscle building) and "androgenic" (masculinizing) effects.

Anabolic agents are intended for medical purposes only, such as the treatment of cancer patients or patients with deficiencies in testosterone. Using anabolic agents to enhance athletic performance gives an unfair advantage and may result in serious health risks.

Anabolic agents interfere with normal hormone function and may produce harmful side effects such as an increased risk of liver disease, high blood pressure and increased levels of "bad" cholesterol, thereby increasing the risk of a cardiovascular incident. Perhaps as important are the mind-altering consequences of the use of these drugs. Abuse of anabolic agents may result in psychological dependence, depression and/or the potential for violence. The list of potential side effects includes:

• In Males: acne, shrunken testicles*, decreased sperm production which can lead to impotence*, enlarged prostate gland, breast enlargement, premature baldness, potential for kidney and liver dysfunction, increased aggressiveness, mood swings.
• In Females: masculinization, abnormal menstrual cycles, deepening of the voice*, acne, excessive hair growth on the face and body*, enlarged clitoris*, increased aggressiveness, mood swings
• In Adolescents: severe acne on the face and body, premature closure of the growth plates of the bones leading to stunted growth.

* These effects may be permanent with prolonged use.

Diuretics
Diuretics act on the kidney and cause the excretion of large amounts of urine to eliminate excess body water. They are commonly used by athletes for two purposes: quick, temporary weight loss to meet weight categories within specific sports and to "flush out" other substances or drugs from the body in an attempt to avoid detection of their use.

In addition to the health risks, the use of diuretics to reduce weight in order to compete in a lower weight class or to dilute a urine sample are manipulations that contravene the true spirit of sporting excellence.

The use of diuretics can cause dizziness, dehydration, muscle weakening and cramping, a drop in blood pressure and can lead to cardiac irregularities caused by electrolyte imbalance. Diuretics can also severely affect an athlete's ability to tolerate heat.

Peptide Hormones, Mimetics and Analogues
Peptide hormones act as messengers from one organ to another to stimulate various functions of the body such as growth, sex drive, behaviour and sensitivity to pain. Mimetics are substances that imitate the action of other related drugs. Analogues are chemically produced drugs designed to have similar effects to the naturally produced compounds in the body.

Common Analogues

Human Chorionic Gonadotrophin (HCG): HCG is a hormone that is produced in the placenta during pregnancy and can promote an increase in the production of natural male and female steroids. The administration of HCG in males leads to an increase in the body's natural levels of androgenic steroids and is equivalent to the administration of testosterone. The use of HCG is banned for males only. HCG use can cause headaches, irritability, depression, fatigue and gynecomastia (development of female breast tissue in males).

Adreno Corticotrophin (ACTH): ACTH is abused to increase the levels of naturally produced corticosteroids to obtain their euphoric effect. Any administration of ACTH is considered to be the same as an oral, intramuscular or intravenous application of glucocorticosteroids and is therefore banned.

Human Growth Hormone (HGH): Human growth hormone is a naturally occurring hormone that affects metabolism and muscle building. There are, however, dangerous side effects related to the abuse of this drug. Excess HGH use can cause acromegaly, which is characterized by distorted growth of internal organs, bones and facial features and the enlargement and thickening of fingers, toes, ears and skin. HGH can also cause diabetes, heart and thyroid disease, menstrual disorders, decreased sexual desire, impotence and shortened life span.

Erythropoietin (EPO): The hormone erythropoietin (EPO) is produced by the kidneys and stimulates the production of red blood cells by the bone marrow. In traditional medical practice, a synthetic form of EPO is used to treat patients with anemia of renal origin. Like blood doping, some athletes in endurance sports have abused EPO because it increases the number of red blood cells, thereby increasing the oxygen supply to the muscles. Abuse of the injectible drug EPO carries severe health risks, such as increased risk of blood clots, stroke and heart disease. There is also the risk of contracting infectious diseases such as hepatitis and HIV/AIDS if needles are shared.

There may be instances when an athlete needs to use a banned substance for a medically justified reason.  Athletes can apply to the CCES for approval to use a banned substance by submitting a completed Medical Approval Application Form. Call the CCES Info Line for more information or refer to the Banned Substance Approval section of our website.

Banned Doping Methods
A. Blood Doping
B. Administration of Artificial Oxygen Carriers or Plasma Expanders
C. Pharmacological, Chemical and Physical Manipulation of the Urine (substances or methods which may alter the integrity and validity of a urine sample)

Blood Doping
Blood doping, also known as "packing" "blood boosting", is intravenous administration related products in order to raise blood?s oxygen carrying capacity, thereby enhancing aerobic athletic performance. It may involve the use of blood previously withdrawn oneself or from another person.

The intravenous administration of blood to an athlete in order to enhance athletic performance gives an unfair advantage. Blood doping also carries dangerous health risks, including the development of allergic reactions (rash, fever, etc.) if the wrong blood type is used, jaundice, circulation overload, blood clots, and metabolic shock. There is also the risk of the transmission of infectious diseases such as hepatitis and HIV/AIDS.

Danger of sharing needles
Individuals who inject products by sharing needles increase the risk of contracting infectious diseases such as hepatitis and HIV/AIDS. This is as true for injecting steroids and blood doping as it is for injecting crack and heroin.

Artificial Oxygen Carriers and Plasma Expanders

Artificial Oxygen Carriers
Artificial oxygen carriers are chemicals used to increase the ability to carry extra oxygen in the blood (e.g. Perfluorocarbons (PFCs)).

There have been some reports of athletes using these products to increase the oxygen carrying capacity of their blood in order to enhance aerobic athletic performance.

The harmful side effects of artificial oxygen carriers can be extremely serious, as it is difficult to measure correct doses. Side effects of PFCs include a transient fever, reduction in the platelet count and potential overloading of the body's white blood cells.

Plasma Expanders
Plasma expanders are used to increase the water content of the blood.

Some athletes may use plasma expanders, such as hydroxyethyl starch (HES), to mask the effects of erythropoietin (EPO).

Harmful side effects of plasma expanders may include allergic reactions and anaphylactic shock.

Urine Manipulation
The IOC prohibits the use of substances or methods that alter the integrity and validity of a urine sample. Examples of banned practices include catheterization, urine substitution and/or tampering, the use of substances which modify kidney function (e.g. Probenecid) and the administration of epitestosterone.

Restricted Substances
The use of certain substances may require written declaration to the relevant medical authority in advance of a doping control test or competition.  In the Canadian domestic doping control program, the relevant medical authority is the CCES.  Failure to submit this declaration could result in a doping infraction.  For more information on declaring the use of restricted substances visit the section on Restricted Substance Declaration or call the CCES Info Line.

This section will provide an overview of the categories of restricted substances.  For more detailed information on restricted substances, please refer to the CCES Drug Classification Booklet.  Download now or click here to purchase.   

A. Local Anaesthetics
B. Asthma and Respiratory Ailment Drugs
C. Glucocorticosteroids
D. Caffeine
E. Beta-Blockers
F. Alcohol
G. Cannabinoids

Local Anaesthetics
Topical local anesthetics, such as creams, ointments, lozenges, sprays and drops, are permitted.
Systemic injections are prohibited.

Injectable local anesthetics are permitted only when medically justified and under the following conditions:

a) That bupivacaine, lidocaine, mepivacaine, procaine and related substances are used but not cocaine.
b) Vasoconstrictor agents (e.g. adrenaline, epinephrine) may be used in conjunction with local anesthetics.
c) Only by local or intra-articular injection.

Where the rules of a responsible authority so provide, notification of administration of a local or intra-articular injection may be necessary.

For testing conducted as part of the Canadian domestic program, the CCES does not require written declaration of administration of local or intra-articular injections of local anaesthetics.

Check with your International Sport Federation and/or Major Games Medical Commission to determine declaration requirements and procedures for international competition and out-of-competition testing conducted under their jurisdiction.

Asthma and Respiratory Ailment Drugs
The use of four different beta-2 agonists (by inhalation only) are permitted with written declaration prior to a doping control test or competition. These are:

    Salbutamol (e.g. Ventolin inhaler)

    Salmeterol (e.g. Serevent inhaler)

    Terbutaline (e.g. Bricanyl inhaler)

    Formoterol (e.g. Oxeze Turbuhaler) 

Oral administration (tablet or liquid form) of these medications is not permitted under any circumstances.  All remaining beta-2 agonists are prohibited.
 

Athletes must provide written declaration to the relevant medical authority in advance of a doping control test or competition.  Written declaration should be made at the time the medication was prescribed.

For the Canadian domestic program, written declaration of the use of inhaled, permitted beta-2 agonists must be made to the CCES prior to a doping control test or competition.  Written declarations are valid for one year and must be renewed annually thereafter.  It is the responsibility of the athlete to know when their declaration expires and to apply for renewal before this date.

Check with your International Sport Federation and/or Major Games Medical Commission to determine declaration requirements and procedures for the administration of inhaled, permitted beta-2 agonist during international competition and out-of-competition testing conducted under their jurisdiction.

Glucocorticosteroids
The systemic use of glucocorticosteroids is prohibited (e.g. when administered orally, rectally (internal) or by intravenous or intramuscular injection). The use of topical preparations containing glucocorticosteroids are permitted, including anal, aural (ear), dermatological (skin), ophthalmological (eye) and nasal (nasal spray).

Some examples of permitted glucocorticosteroids are listed in the CCES Drug Classification booklet.

When medically necessary, intra-articular and local injections of glucocorticosteroids are permitted.  An example is Depo-Medrol with lidocaine (methylprednisolone).  Where the rules of a responsible medical authority so provide, notification of administration of a local or intra-articular injection may be necessary.

For testing conducted as part of the Canadian domestic program written declaration of administration of intra-articular or local injection and/or inhaled glucocorticosteroids must be made to the CCES prior to a doping control test or competition or during the competition in matters of medical urgency.  Written declaration of administration of an inhaled glucocorticosteroid is valid for one year and must be renewed annually thereafter.  It is the responsibility of the athlete to know when their declaration expires and to apply for renewal before this date.

Check with your International Sport Federation and/or Major Games Medical Commission to determine declaration requirements and procedures for the administration of glucocorticosteroids during international competition and out-of-competition testing conducted under their jurisdiction.

Caffeine
The IOC restricts caffeine because it has a stimulant effect when consumed in large quantities. Athletes have attempted to improve their performance by using large amounts of caffeine. Large doses of caffeine can raise an athlete's metabolic level, body temperature, blood pressure and blood sugar level. At extremely high doses, it can cause nausea, diarrhea, insomnia, trembling, headaches and nervousness.

A positive finding will only be reported if the concentration of caffeine in the urine exceeds 12 micrograms/milliliter. Normal ingestion of coffee, tea or many caffeine-based drinks such as colas generally will not reach that limit. However, the ingestion of caffeine tablets or the use of caffeine suppositories or injections will likely result in a positive test.

Beta-Blockers
Beta-blockers are drugs commonly used for heart disease to lower blood pressure and decrease the heart rate. They may also be used in the treatment of migraines and to control tremors.

In sports such as shooting or archery, where a steady arm or trigger finger is important, beta-blockers are banned because they might be used to slow the heart rate and steady the nerves, giving an athlete an unfair advantage. Check with your sport governing body to determine whether beta-blockers are banned in your sport.

In addition to adversely affecting endurance performance capacities, abuse of beta-blockers can cause heart failure, asthma, depression, sleep disorders, and sexual dysfunction.

Alcohol
Alcohol above a specified level is banned in some sports. Tests for alcohol levels may be conducted at the request of an International or National Sport Federation, as has already been done in Fencing and in the shooting events of Modern Pentathlon. Check with your sport governing body about their policy on alcohol use.

Cannabinoids
Where the rules of a responsible authority so provide, tests will be conducted for cannabinoids (e.g. marijuana, hashish).

At the Olympic Games, tests will be conducted for cannabinoids. A concentration in the urine of 11-nor-delta 9-tetrahydrocannabinol-9-carboxylic acid (carboxy-THC) greater than 15 nanograms per millilitre is prohibited.

Samples collected as part of the Canadian domestic doping control program are generally not analyzed for the presence of cannabinoids.  However cannabinoids may be tested for at the request of an International Sport Federation whose rules ban the use of this substance. 
Should the CCES receive such a request it would apply to in-competition testing only, solely to the particular sport in question and if acted upon would involve a full and thorough notification to all athletes in that sport.

It is recommended that you check with your sport governing body or International Sport Federation to confirm the status of cannabinoids during international competition and out-of-competition testing conducted under their jurisdiction.

Important Information on Vitamins, Herbals and Nutritional Supplements (non-pharmaceutical ergogenic aids)
The use of natural health products has increasingly gained popularity among the general Canadian population as well as among athletes at all levels within the sport community. Some vitamins, herbal and nutritional supplements may contain banned or restricted substances, in particular ephedrine and caffeine.

Many of these products contain botanical or so-called "natural" sources of ephedrine. Ephedrine is an amphetamine-like stimulant that is banned in sport. Athletes should avoid all products listing ma huang, Chinese ephedra, ma huang extract, ephedra, ephedra sinica, ephedra extract, sida cordifolia, ephedra herb powder, epitonin or ephedrine as ingredients. Any one of these ingredients listed on the label indicates the presence of ephedrine in the product.

The herbal and nutritional supplement industry is not subject to stringent regulatory requirements. It is not possible for the CCES or any other organization to guarantee that all the ingredients in the product have been listed on the packaging and/or whether the composition has not varied from batch to batch, without notice. Therefore, the CCES cannot provide a definitive response to requests about the status of these products. Athletes are ultimately responsible for what they consume. If athletes are unsure of what they are consuming, they should not take that particular product.

A well balanced diet should provide athletes with the nutrients they require. For further information on sport nutrition contact your provincial Sport Medicine Council.

This Information was taken from The Canadian Centre for Ethics in Sport (CCES) website.