Why are banned substances so confusing in professional sports?

A breakdown on banned substances in sports.

Amidst the news on Maria Sharapova and failing a drug test, I wanted to shed some light on the logistics behind performance enhancing drugs. Sharapova is the world’s highest-earning female athlete and one of the biggest sports stars. It was announced that she had failed a test for meldonium, a drug that she had been taking for years, at the Australian Open on March 7, 2016. On January 1, 2016 the WTA banned the medication. Meldonium would normally be prescribed for heart issues and to improve blood circulation. Interestingly, there is little evidence to suggest that this could be performance enhancing at baseline.

Athletes and physicians need to constantly check updates on the sports’ banned substance list to evaluate any new or current supplements or prescriptions. To give you a reference, here is the WTA file on prohibited substances: Substances. As physicians taking care of athletes we constantly take updates of players medications and supplements and ask them to inform us of any changes. The players have a responsibility to question the medications they are prescribed and understand their overall risks and benefits.

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The goal of the Anti-Doping Program is to 1. Maintain the integrity of tennis and 2. Protect the health and rights of all tennis players. Athletes are subject to urine and blood testing to evaluate evidence of banned drugs.

It is important to understand that some prescriptions may be used for medical reasons, but there has to be official permission granted to use the medication. Athletes with asthma, for example, would need written, formal permission to use certain inhalers when on the WTA Tour. They would apply for a Therapeutic Use Exemption. In professional tennis, a medication as common as pseudoephedrine (Sudafed) is banned from use. So, an athlete may come in complaining of a cold and pick-up an over-the-counter medication in a foreign country and think it is harmless when in reality it has a banned substance in it. Amidst all their effort training and strengthening, an athlete must be hypervigilant about what they put into their body.

Physicians always have a responsibility to talk to patients about a prescription or even vitamin that they are recommended. When working with athletes it of career-ending ramifications if a mistake is made. Fortunately, professional athletics’ organizations have accessibly resources to check what medications are “legal” and which are “illegal” to take.

Even though, from the outside, it seems like an easy issue to avoid, there are constant changes in substances that are banned. Just as any lay person has to understand what “miracle pill” they are ingesting, the same goes for professional athletes. Hopefully, it will be an educational opportunity for athletes, physicians, medical staff, coaches and managers.

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