Sports Pharmacists: A Noble Evolving Professional in Indian Pharmaceutical Arena

 

Sivakumar Kannan1, Anup Naha1*, Robindra Ramnarine Singh2, Punit Bansal3,

Vinod C Nayak4, Sandeep Goud5

1Department of Pharmaceutics, Manipal College of Pharmaceutical Sciences, Manipal Academy of Higher Education, Manipal, Karnataka, 576104, India.

2Robin Singh Sports Academy, Dubai, UAE.

3Department of Pharmacology, Manipal College of Pharmaceutical Sciences, Manipal Academy of Higher Education, Manipal, Karnataka, 576104, India.

4Department of Forensic Medicine, Kasturba Medical College, Manipal Academy of Higher Education, Manipal, Karnataka, 576104, India.

5University of West Indies-Bahamas.

*Corresponding Author E-mail: anupnaha.mahe@gmail.com

 

ABSTRACT:

In Sports, the use of Prohibited substance or Prohibited methods or breaking Anti-Doping Rules Violations (ADRV) is termed as Doping. Anti-Doping Administrative Management System (ADAMS) has reported an average increase of 5.81% per year in the number of overall samples analysed (Olympic Sports and Non-Olympic Sports) for Anti-doping tests over the last 15 years (2003-2017). Since Mexico-1968 Olympic to Pyeongchang-2018 Olympic, 140 medals were stripped from sports persons due to Adverse Analytical Finding (AAF) at various sports. In sports, there are seven broad classes of substance that are categorized under doping. Several Anti-Doping organizations like National Anti-Doping Agency and World Anti-Doping Agency are working together to prevent doping from sports, providing equal chance to each sports person and to protect health of the athletes. Court of Arbitration for Sport (CAS) is the final court appeal for any National Anti-Doping Organization or whichever athlete or stakeholders who are breaking the ADRV. Pharmacists are playing an important role in sports by counseling athletes, advising physician and athletic personnel and enlightening the community about the ill effects of Anti-Doping. Sports Pharmacist with their knowledge and expertise can contribute immensely for spreading awareness about anti-doping practices among sports person and hence there is need to develop the concept of Sports Pharmacist in Indian Pharmaceutical Arena.

 

KEYWORDS: Athlete, Doping, Organization, Prohibited substance, Sports pharmacists.

 

 

INTRODUCTION:

In Sports, the use of Prohibited substance Prohibited methods or breaking Anti-Doping Rules Violations (ADRV) is called Doping1

 

Prohibited Substances:2

·       Beta-Blockers

·       Glucocorticoids

·       Hormone and Metabolic Modulators

·       Stimulants

·       Anabolic Agents

·       Mimetics, Growth factors, Peptide Hormones and Related Substances

·       Beta-2 Agonists

·       Diuretics and masking agents

·       Narcotics

·       Non approved substance

·       Cannabinoids

 

Prohibited Methods:2

·         Chemical and physical manipulation

·         Cell doping and gene

·         Manipulation blood and its components

 

Anti-Doping Rule Violations:1

1.       Existence of a banned substances in the samples of the athletes.

2.       To utilize or trying to utilize by an athlete of any Prohibited substances or Prohibited methods.

3.       Avoid, refuse otherwise not submit in the direction of sample collection.

4.       Athlete avoiding or not providing whereabouts information.

5.       Forgery or attempted forgery of any doping control element.

6.       Athlete tenure of any Prohibited substances or Prohibited methods.

7.       Dealing or tried to deal with any Prohibited substances or Prohibited methods.

8.       Consuming or tried to consume any Prohibited substances or Prohibited methods.

9.       Any type of involvementin the Anti-Doping rule violation.

10.    Athlete and other person should not work with prohibited association.

 

Reason and Common substance for doping in Sports:3

In sport, there are seven broad classes of substance that are categorized under doping.

·         Substance that increase muscle mass and strength (e.g. anabolic steroids)

·         Substance that increase oxygen carrying capacity (e.g. erythropoietin)

·         Substance that conceal pain (e.g. opiates)

·         Substance that are stimulant (e.g. amphetamines)

·         Substance that are relaxant (e.g. beta blockers)

·         Substance used to control weight (e.g. diuretics)

·         Substance that mask the presence of other drugs (e.g. diuretics)

 

Doping Incidents:

In modern sport, doping has been reported since the 19th century (middle) and International Olympic Committee (IOC) mention doping control at Mexico Olympics of 1968. Table1, Since Mexico-1968 Olympic to Pyeongchang-2018 Olympic 140 medals were stripped from sports persons due to Adverse Analytical Finding at various sports4 (Athletics, Biathlon, Boxing, Cycling Road, Swimming and Weightlifting).

 

Table 1: Olympic Stripped medals Status (1968-2018).

Olympic Year

Gold

Silver

Bronze

Mexico 1968

0

0

1

Munich 1972

1

1

2

Innsbruck 1976

0

0

1

Montreal 1976

2

1

0

Los Angeles 1984

0

2

0

Seoul 1988

3

1

1

Sydney 2000

8

1

5

Salt Lake City 2002

5

3

1

Athens 2004

8

2

5

Turin 2006

0

1

0

Beijing 2008

7

20

19

London 2012

11

10

8

Sochi 2014

2

3

0

Rio 2016

0

1

3

Pyeong Chang 2018

0

0

1

Total Number of Stripped Medals

47

46

47

 

Doping Statistics:

The World Anti-Doping Agency (WADA) and the Anti-Doping Administrative Management System (ADAMS) has reported an average increase of 5.81% per year in the number of overall sample analyzed (Olympic Sports and Non-Olympic Sports) for Anti-doping tests over the last 15 years5-19 Figure 1: Describe the sample analysis status from the year 2003 to 2017.

 

Figure 1: Sample analysis status.

 

WADA- approved laboratories reports of Adverse Analytical Finding (AAF), identifies the existence of Prohibited substance or methods from the sample analysis and Atypical Finding (ATF) reports from WADA- approved laboratories, samples are required for further investigation or prior to determination of AAF. Figure 2: Status of last 15 years AAF and ATF form ADAMS testing figure 5-19

 

Figure 2: AAF and ATF Status.

 

Anti-Doping Organizations:

Various Anti-Doping organizations Table 2, working together for prevent doping from sports, providing equal chance to each sports person and to protect athlete health.

 

World Anti-Doping Agency:

In the year 1999 by 10th of November to coordinate, supervise and to promote the battle in opposition to the sport doping and all of its forms an international self-governing organization was created, which is the WADA 20

 

WADA Responsibility:

·       Developing and publishing Anti-Doping Code to prevent  Doping in sports.

·       Observing doping control, result management programs and monitoring doping control cases.

·       Promoting Anti-Doping education and research.

·       Evaluating and approve the laboratories to conduct the doping testing.

 

WADA Not Responsible for:

·       Conducting doping test.

·       Analyses of biological matrix. (Urine, blood)

·       Sanctioning of doping violations.

 

Table 2: Anti-Doping Organizations.

S. No

Anti- Doping Organization

Governing Bodies

Responsibility

References No

1

International Sports Organization

 

To collaborate with relevant Anti-Doping organizations

 

Process of Therapeutic Use Exemption

 

 

Promoting Anti-Doping research and education

 

 

 

 

21-23

 

1. International Federations (IF)

 

 

NO

2. Major Event Organizations (MEO)

·   Commonwealth Games Federation (CGF)

·   International World Games Association (IWGA)

·   International University Sports Federation (FISU)

·   International Olympic Committee (IOC)

·   International Paralympic Committee (IPC)

 

 

 

Yes

2

National Sports Organization

 

Working together with relevant Anti-Doping Agency

 

Ensure that their Anti-Doping regulations are confirm with the WADA-Code

 

Promoting Anti-Doping education

 

24

 

 

 

 

 

 

 

 

1. National Federations (NFs)

 

Yes

 

2. National Olympic Committee (NOC)

 

Yes

 

3. National Paralympic Committee (NPC)

 

Yes

 

3

NADOs and RADOs

 

Out-of-Competition and In- Competition sample testing

 

Result Management

Providing Anti-Doping education

 

Compliant with WADA-Code

 

 

 

25

National Anti-Doping Agency

 

 

Yes

 

Regional Anti-Doping Agency

 

Yes

 

4

Governments

 

Prop up national testing programs

 

Providing funds for Anti-Doping education and research

 

 

 

26

National Governments

Yes

 

United Nation Educational Scientific and Cultural Organization (UNESCO)

 

Yes

Council of Europe

Yes

Prohibited List:

Prohibited list are maintained and publishing by WADA, on every year first of January WADA will publish prohibited list on official webpage by English and French language. Prohibited list contain what are the substance or their molecule or methods are not for athlete usages. Prohibited list are classified as three types, all times substance and methods prohibited, during competition substance and methods prohibited and particular sports substance are prohibited 2

 

Dope Testing Process:

Athlete participate into international level or national level sport need to provide their urine sample and/or blood sample for dope testing at anywhere and anytime, to respective IF or National Anti-Doping Committee or Major Event Organizing Committee. Detailed procedure of dope testing is described on Table 3, approved trained personal will carry the tests. Sample analysis carried out in WADA accredited laboratories. Testing will be conduct all type of competition27

 

Table 3:Dope Testing Procedure.

 

Therapeutic Use Exemption (TUE):

Athlete may permit to take prohibited substance with specific condition in form of TUE. Athlete need to apply TUE from respective IF, NADO with appropriate channel28

 

TUE Process Steps:

1.     TUE form requesting from relevant Anti-Doping Organization.

2.     Only physician needs to fill the TUE form, athlete will send form to Anti-Doping Organization.

 

3.     TUE experts will review the application, TUE will be granted any of following cases:

·       Incase of serious health problem.

·       Those substance should bring you into normal health without increasing performance.

·       In case of not available alternative treatments.

 

 

4.     Anti-Doping Organization will say you need to use prohibited substance or not.

 

Results Managements:

Anti-Doping rules violating penalty start from short time to life time ban, it is totally depends on which type of prohibited substances, method used and what type of Anti-Doping rule breachis found. In case of AAF in athlete ‘A’ sample, athlete have a authority to request analyzing ‘B’ sample1

 

Doping Sanctions:

Sports Supreme Court are Court of Arbitration for Sport (CAS), CAS is an independent organization of any sports institution that offers services to aid the resolution of sports clashes through mediation or adjudication, through technicalregulationspersonalized to the particularrequirements of the sports world.29 CAS the final courts appeal for any NADO or any athlete or stakeholders are breaking the ADRV.

 

Initiatives to Prevent Doping:

WADA and NADA has providing doping awareness program to athlete and other supporting staffs to prevent doping20,25 WADA have created certificate courses for athlete, coaches, parents and other supporting staffthrough Anti-Doping e-Learning30. Since 2001 WADA will provide every year $73 million dollars to uphold education and research in doping and Olympic Committee will also help to promote the research on Anti-Doping31. In the year 2008, UNESCO established the fund for the eradication of doping in sport, which consists of voluntary financial contributions from member states26.

 

Health Care Professionals:

Pharmacy services at the 2018 Olympic and Paralympic Winter Games in Pyeongchang have shown that pharmacists play an important role in providing safe and effective pharmacy services based on their extensive knowledge of Anti-Doping in clinical use of drugs in sport32. Giving more education about doping to pharmacy students will help to educate athletes against doping33.

 

Pharmacists are needed to guide athletes to take medication and fight against doping34. Pharmacists play a role in sports by counseling athletes, advising sports staff and raising public awareness about the effects of prohibited substance and methods35. Before taking medications/supplements, WADA also recommends that athletes consult a Pharmacist or doctor36 and the International Pharmaceutical Federation (FIP) has agreed to declare the role of pharmacist in the battlein opposition to sport doping37.

 

CONCLUSION:

Doping  is unethical, unfair in sports and harmful for athletes. Pharmacists are playing an important role in sports by counseling athletes, advising physician and athletic personnel, and enlightening the public effect of Anti-Doping. Sports Pharmacist with their knowledge and expertise can contribute immensely for spreading awareness about anti-doping practices among sports person and hence there is need to develop the concept of Sports Pharmacist in Indian Pharmaceutical Arena.

 

ACKNOWLEDGEMENT:

The authors are grateful to following organizations for proving the facilities.

·       Olympic Studies Center- Lausanne, Switzerland.

·       Robing Singh Sports Academy-Dubai, UAE.

·       Manipal Academy of Higher Education, Manipal, Karnataka, India

 

CONFLICT OF INTEREST:

The authors declare no conflict of interest.

 

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Received on 17.04.2020            Modified on 30.05.2020

Accepted on 28.06.2020           © RJPT All right reserved

Research J. Pharm. and Tech 2020; 13(9):4213-4218.

DOI: 10.5958/0974-360X.2020.00744.1