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Should athletes be allowed to use performance enhancing drugs?

BMJ 2013; 347 doi: (Published 22 October 2013) Cite this as: BMJ 2013;347:f6150

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Re: Should athletes be allowed to use performance enhancing drugs?

The use of performance enhancing drugs is on record as early as the games of the third Olympiad, when Thomas Hicks won the marathon after receiving an injection of strychnine in the middle of the race. Most sports organizations attempt to ban the use of performance enhancing drugs, such as steroids, by athletes. Despite these regulations, there continues to be wide-spread use of drugs in sports. People are using performance enhancing drugs because they want to take unfair advantage over the competitors. It is a major problem and health hazard to many participants. Yet there is no respite of this spiralling issue. Let us understand the reason. Let us understand what we call unfair.

People do well at sport as a result of the genetic lottery that happened to deal them a winning hand. The starkest example is the Finnish skier Eero Maentyranta. In 1964, he won three gold medals. Subsequently it was found he had a genetic mutation that meant that he “naturally” had 40–50% more red blood cells than average. Was it fair that he had significant advantage given to him by chance?
We take punitive approach but and a lot of effort is spent in outsmarting the screening process. There is a possibility that many participants are and coaches not sure about the status of their opponents. So the bias is tilted towards taking the unfair advantage but a major effort is focused to evade detection.

We need to debate on an experimental new normal. Participants won't be punished if they fail drug screening test. They will be simply put to a new group. Let us see the preference of participants and difference in records. A lot of levers should be in a perfectly aligned position to give someone an unfair advantage over opponents. Performance enhancing drugs may be just one of these with very little positive impact on performance. Reliance on performance enhancing drugs may reduce the body’s natural ability to respond to demanding physical requirement.

We need understand that performance enhancement is not against the spirit of sport; it is the spirit of sport. It is our desire to choose to be better is to be human. Athletes should be the given this choice. Their welfare should be given importance. But taking drugs is not necessarily cheating. The legalisation of drugs in sport may be fairer and safer. Moreover, according to a publication, permitting drugs in sport could reduce economic discrimination.(1)

We should just accept it as an inevitable part of sports and stop trying to regulate it. We have no double blind, randomized, placebo-controlled study on this and we also understand the complexity of getting it approved by ethics committee. Let us take an alternative situation to shed some light on this situation. It is now generally understood that high frequency traders (HFTs) are dominating the equity market, generating as much as 70% of the volume. According to one study, at the current phase of markets’ development, it is theoretically possible for algorithmic trading (and especially high- frequency strategies) to exceed the returns of index strategy. However, in terms of market volatility, it was not found any evidence for a detrimental impact of either algorithmic trading or high-frequency trading. That shouldn’t be a surprise. Technological advance makes super profits, capitalists are greedy, so technological advance spreads quickly, super profits disappear and the consumer benefits.(2) Well it is not a perfect analogy but we can debate on this unconventional or out of the box idea.

1. Br J Sports Med 2004;38:666-670
2. accessed on 04 April, 2015.

Competing interests: No competing interests

04 April 2015
Dr. Samiran Adhikari
12C Symphony Co Op Hsg Soc. Chandivali Farm Road, Sakinaka, Andheri East, Mumbai 400072