Microsoft word - getting up for the game.doc
James Christie Globe Sports - June 13, 2008 http://sports.theglobeandmail.com/servlet/story/RTGAM.20080613.wspt-drug-feature-13/GSStory/GlobeSports/home
A famous "little blue pill" is at the centre of a big grey area when it comes to performance enhancement in sports.
This week, the New York Daily News reported that Roger Clemens was among a growing list of athletes who found Viagra to help their performance in the field of play. The drug, marketed as a treatment for erectile dysfunction, is not on the banned list in Major League Baseball or the World Anti-Doping Agency. But experts expect it to turn up at the next Summer and Winter Olympics.
"Each time there's a seizure of banned drugs, you can be sure there's Viagra or Cialis found as well," Dr. Christiane Ayotte, head of the WADA-accredited anti-doping lab in Montreal, said this week.
Indeed, at the Giro d'Italia cycling race last month, the Gerolsteiner team suspended rider Andrea Moletta after Italian police searched the car of Moletta's father and found 82 Viagra pills as well as syringes hidden inside tubes of toothpaste, according to Italian newspaper La Gazzetta dello Sport.
As WADA closes doors in its hunt for steroids and blood boosters, nefarious athletes and trainers seek out other medications designed to avoid detection, to gain any edge that will make them better professionals or gold medalists in the Olympic year.
Caffeine, the stimulant found in coffee, was taken off the WADA banned list four years ago. Australian athletes, with the guidance of the Australian Institute of Sport, stoked up legally on caffeine, and Australian men's field hockey players credited a high caffeine intake for the country's first Olympic gold medal on the pitch in Athens.
In baseball, since the banning of amphetamines, energy drinks containing stimulants such as caffeine and guarana have largely replaced the use of the banned stimulant pseudoephedrine — commonly sold as Sudafed — as a way to get pumped up for a game. One Major League Baseball observer said he has seen the drink Red Bull being delivered to a major-league clubhouse by the pallet-load.
Another media report in USA Today cited an apparently sudden increase in the incidence of ADD — attention deficit disorder — among baseball pitchers. Requests for "therapeutic use exemptions" within baseball's drug-testing program quadrupled to 107 from 2006 to 2007 as players took the drugs Ritalin and Adderal to help them concentrate.
The International Olympic Committee — amid complaints from athletes about Beijing's polluted air and the refusal of Ethiopian star Haile Gebreselassie to risk his health in the marathon — reluctantly declared that asthma puffers would be allowed in the Summer Olympics if athletes need them to overcome the effects of polluted air around the Chinese capital and get the appropriate therapeutic-use exemption.
The IOC will conduct 4,500 tests at the Beijing Olympics from July 27 to Aug. 24 at 41 stations, looking for officially banned substances. That's up from 3,600 tests in Athens. Top five finishers in each final plus a further two competitors selected at random will be tested. Some 700 to 800 urine tests will be checked for the blood booster EPO (erythropoietin),while 900 EPO checks will be blood tests.
"The tougher rules serve as a clear demonstration of the IOC's commitment to ensuring that athletes play fair," the IOC said. The tests include pre-competition controls, and an athlete may be notified and tested more than once during the same day.
The search for steroids, stimulants, blood boosters and human growth hormone sounds serious, but the IOC and Beijing Games organizers can only ban athletes based on what's on WADA's prohibited list. Athletes and clandestine chemists make it their sneaky business to stay one step in front of detection.
The IOC has anecdotal news that a substance such as Viagra is being used by athletes for its performance-enhancing side effects in sport. WADA is even conducting tests of its own in a two-year study yet to be completed, but it won't act until it has evidence that it could defend in a court.
In the meantime, Victor Conte, founder of the designer drug house Bay Area Laboratory Co-Operative, boasted to the New York Daily News this week: "All my athletes took [Viagra]… It's bigger than creatine. It's the biggest product in nutritional supplements."
Viagra is the proverbial elephant in the room when it comes to drug testing.
The manufacturer knows athletes are interested in it as a potential performance enhancer that isn't on the banned list. A cycling study has been published indicating its effect on performance at high altitudes. WADA is studying the potential for the improved blood flow produced by Viagra to alleviate breathing problems in a polluted environment — say a hockey rink with a fume-spewing ice-resurfacing machine - or a place like downtown Beijing in August.
"We are aware it's an issue, but we don't promote Viagra in cases where it's not a recommended use," said Christina Antoniou, corporate communications manager for Pfizer Canada Inc.
"Its pharmaceutical use is for erectile dysfunction, and we don't encourage its use other than what it's approved for."
The Canadian Centre for Ethics in Sport, which administers Canada's anti-doping policy, keeps its ear to the ground.
"We take WADA's list and we apply it, but Viagra's not on the list," said Rosemary Pitfield, director of communications and marketing for the CCES. "We're certainly monitoring the research and discussions coming out about it, but we can only follow WADA's lead."
WADA won't have any interdiction about Viagra in Beijing, although researchers suspect some athletes will be using it in instances of heavy breathing — and here, we're talking about air quality, not passion.
An extract from the review of the WADA sponsored research project notes "profound improvement in pulmonary artery pressure, cardiac output … and exercise capacity in hypoxic conditions." That speaks to sport performance above sea level, such as the Nordic and Alpine skiing events of the 2010 Winter Games.
But the researchers are also looking at the effects of Viagra ingestion where the lungs have to work hard because of particulate matter, such as Beijing, London and enclosed arenas where fossil-fuelled machines cloud the air.
In June of 2006, the Journal of Applied Physiology, published by the American Physiological Society, carried an article that said sildenafil's ability to open blood vessels gave some athletes a major boost in performance at high altitudes due to the delivery of so much oxygen to muscles. But it didn't work for all athletes and was not a significant performance enhancer at sea level.
"Ten cyclists who took sildenafil at altitude collectively lowered the time it took to cover six kilometres by 15 per cent, compared to placebo trials at altitude," the report said.
Some athletes responded with an improvement of 39 per cent in a time trial, but not everyone responded, noted one of the researchers, Anne L. Friedlander, of the exercise physiology lab, clinical studies unit at the Veterans Affairs facility in Palo Alto, Calif.
"One of the messages of the paper is that not everybody benefits. … It should not be taken as an exercise aid by everyone."
Ayotte, of the WADA lab in Montreal, said there are other drugs much more potent than Viagra for vaso-dilation. But WADA has not yet gone after them despite her recommendations that it do so.
"I am much more concerned about what athletes can do to themselves by using these other agents," she said in an interview.
She said that Viagra is found in anti-doping tests, but because it is not on the list of banned substances, the frequency hasn't been tracked. "But I know it shows up, and it
could show up in women, too. It's a substance that should have the same effect [dilating blood vessels] in women.
"Now, that would be interesting, a female athlete trying to explain why there's Viagra in her sample."
Viagra (sildenafil citrate) has been on the market for 10 years and used by 35 million men in more than 120 countries as a treatment for erectile dysfunction. More recently, it has been approved by the U.S. Food and Drug Administration for treating pulmonary hypertension — breathing difficulties.
In 2007, combined sales of Viagra and younger competitors Levitra and Cialis totalled more than $3-billion (U.S.), a report in the Tampa Bay Tribune said.
An estimated 1.6 million Canadian men use the product.
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