Substance use in elite and recreational sport

Open AccessSubstance use in elite and recreational sportA socio-cultural, medical, regulatory field of tensionKatinka van de Ven, Bengt Kayser, Malte Christian Claussen, Samuel IffKatinka Venhttps://orcid.org/0000-0003-3026-9978 Centre for Rural Criminology, School Humanities, Arts, Social Sciences, University New England, Armidale, Australia Drug Policy Modelling Program, Research Centre, South Wales, Sydney, Human Enhancement Drugs Network (HEDN), Search more papers by this author, Kayserhttps://orcid.org/0000-0002-9776-7501 Institute Sport Lausanne, Switzerland Claussenhttps://orcid.org/0000-0002-8415-3076 Department Psychiatry, Psychotherapy, Psychosomatics, Psychiatric Hospital Zurich, Private Clinic Wyss AG, Münchenbuchsee, Adult Services Grisons, Chur, IffSamuel Iff, M.D., Sahlistrasse 1, 3012 Bern, [email protected]://orcid.org/0000-0002-4441-5465 Preventive Medicine, authorPublished Online:November 17, 2022https://doi.org/10.1024/2674-0052/a000030PDF ToolsAdd to favoritesDownload CitationsTrack Citations ShareShare onFacebookTwitterLinkedInReddit SectionsMoreThe sports world can be represented as a continuum rule-based play involving at least some physical activity skills, ranging from improvised soccer on the school playground all way Olympic level. Whereas are often promoted public health reasons, sports, affecting only small fraction population, drives maximization performance potential cost [1, 2]. Hence, athletes inhabit distinct environments. Since inception World Anti-Doping Agency (WADA) 1999, an international framework restricts various methods substances elite-level because they may enhance performance, represent risk and/or against ‘spirit sport’ [3]. also have issues necessitating treatment, exceptions made through so-called strictly regulated Therapeutic Use Exemptions (TUEs) [4]. Despite restrictions, however, medication athletes, or outside gym fitness goers is not uncommon rather tolerated society [5, 6]. In present special issue Sports series articles discusses related similarities differences substance between sports. Collectively these advocate “health-based” approach, especially sport. addition, instead current prohibitive zero-tolerance punitive environment created anti-doping movement sport – which increasingly encroaches into realm –, arguments presented favour fostering individual mental promoting unstigmatized access necessary including those who tested positive doping use.Elite example, just anybody else, vulnerable range issues, such anxiety, depression disorders. addition non-sporting factors (e.g. major life events), sporting triggers injury culture) [7]. For too, well there barriers seeking help stigma, limited literacy, negative past experiences with treatment-seeking [8, 9, 10, 11]. decade been increased calls develop comprehensive promote wellbeing respond at-risk developing experiencing [12]. Still lot needs done area better describing understanding different types goers. Pitt et al. [13] discuss their contribution that very little research exists Weightlifters. However, it quite plausible “iceberg profile”, originally described Morgan [14] hides less successful actually leading accelerated drop-out other unwarranted consequences. This profile characterises athletes’ tendency below population averages five mood states, one state (vigour) being standard deviation above mean. Indeed, we still know about aspects quitting high-level career.Similarly, raised Piffaretti [15] issue, under received sanction rule violation (ADRV) particular issues. As argue commentary, premiss behaviours foremost grave moral failures must harshly punished abandoned. strong opprobrium ADRV exposed difficult endure. so when intent dope clear, since large number likely did intend illicitly seek enhancement but fell victim harsh strict liability (up 40% ADRVs according De Hon [16]). note, need deserve help, important resign “moral” approach uphold safeguarding practice [15].Not do improve psychiatry services gym-goers people image enhancing drugs (IPEDs). There significant stigma around IPED [10, 11]; recent global study, 2385 men anabolic-androgenic steroids, 55% reported feeling discriminated [17]. discrimination lead individuals conceal presenting professionals could deter them help. non-prescribed adverse long-term effects, serious nature cardiovascular damage, liver toxicity infertility), reluctancy medical assistance problematic [18]. hindering provision quality care lack knowledge GPs IPEDs [17, 19], engagement patient group. Furthermore, Diethelm [20] fear criminal healthcare treating patients steroids non-medical purposes countries. Their specific commentary focussed dilemma discussed prescribers want treat group worried Article 22 Swiss Promotion Act (SpoPA). The prosecution leads refusing essential treatment causes unnecessary suffering patients.Just treated pharmacology. listed forbidden obtained means TUE framework. physician athlete file application then granted refused. intentions allowing good, give same art available any person problem. reason suspect TUEs hand underused, subpar unwarrantedly exploited purposes. letter Schneeberger remind us prevalence ADHD methylphenidate USA [21]. Athletes suffer stimulant, stimulant contentious purported effects risks. Scheeberger therefore psychiatrists involved continued work its application. Liebrenz, Smith Buadze report results inquiry among world-level cyclists optimal [22] issue. By analysing secondary, publicly data professional were monitored during years 2020 2021 matching otherwise prohibited medications, concluded undertreated cyclists. reasons undertreatment speculated include stigmatisation, conceptions allegations, possible medicolegal recriminations.This collection themed illustrates tension therapeutic extra-therapeutic well. While democratic societies psychotropic effect would seem course eventually normalised regulated, within dream “clean” has overhand. It drive totalitarian ring it, carrying spiralling towards dystopian features dynamic what Dimeo labelled dichotomy “good anti-doping” up “evil doping” [23]. consequences individuals, whether not, attention care. again real taken of. Let’s rise challenge.References1 Lebrun F, Collins D. Is Elite (Really) Bad You? Can We Answer Question? Front Psychol. 2017 [cited 2022 Oct 25];8. Available from: https://www.frontiersin.org/articles/10.3389/fpsyg.2017.00324 First citation articleGoogle Scholar2 Dijkstra HP, Pollock N, Chakraverty R, Alonso JM. Managing athlete: new integrated management coaching model. Br J Med. 2014;48(7):523–31. https://bjsm.bmj.com/content/48/7/523 Scholar3 Anti Doping Agency. Code [Internet]. 3]. https://www.wada-ama.org/sites/default/files/resources/files/2021_wada_code.pdf Scholar4 WADA. International Standard Agency; https://www.wada-ama.org/en/resources/world-anti-doping-program/international-standard-therapeutic-use-exemptions-istue Scholar5 Sagoe D, Molde H, Andreassen CS, Torsheim T, Pallesen S. epidemiology steroid use: meta-analysis meta-regression analysis. Ann Epidemiol. 2014;24(5):383–98. http://linkinghub.elsevier.com/retrieve/pii/S1047279714000398. Scholar6 Pereira E, Moyses SJ, Ignacio SA, Mendes DK, Silva DSDA, Carneiro Prevalence users non-users anabolic resistance training practitioners. 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Adverse service engagement, satisfaction users. Contemp Probl. 2017;44(1):69–83. https://doi.org/10.1177/0091450917694268 Scholar19 Rahnema CD, Lipshultz LI, Crosnoe LE, Kovac JR, Kim ED. steroid–induced hypogonadism: diagnosis Fertil Steril. 2014;101(5):1271–9. https://doi.org/10.1016/j.fertnstert.2014.02.002 Scholar20 Ege G, Claussen MC, Iff SpoPA. 2022;1(4):157–166. https://doi.org/10.1024/2674-0052/a000029 Scholar21 AR, Thackaberry Sietsma Ashbrook C, Koh Stimulant athletes. 2022;1(4):135–136. https://doi.org/10.1024/2674-0052/a000027 Scholar22 Liebrenz Pharmacotherapeutic cycling regulations. 2022;1(4):137–143. https://doi.org/10.1024/2674-0052/a000028 Scholar23 history drug 1876–1976: Beyond Good Evil. Sci 2007;6(3):382. https://europepmc.org/articles/PMC3787291 ScholarFiguresReferencesRelatedDetails Special Issue: Issues “Doping” SportsVolume 1Issue 4November 2022ISSN: 2674-0052eISSN: 2674-0052 InformationSports Psychiatry (2022), pp. 131-133 https://doi.org/10.1024/2674-0052/a000030.© 2022The Author(s)LicensesDistributed Hogrefe OpenMind article license CC BY 4.0 ( https://creativecommons.org/licenses/by/4.0)PDF download