Doping and Public Health Doping – the use of performance- enhancing substances and methods – has long been a high-profile issue in sport but in recent years it has also become an issue in wider society. This important new book examines doping as a public health issue, drawing on a multi- disciplinary set of perspectives to explore the preval- ence, significance and consequences of doping in wider society. It introduces the epidemiology of doping, examines the historical context, and explores the social, behavioral, legal, ethical and political aspects of doping. The book also discusses possible interventions for addressing the problem on organizational and societal levels. Doping and Public Health incorporates the latest research to provide a com- prehensive guide to the key aspects of doping as a social phenomenon. Divided into six parts, this collection of studies offers detailed insight into: • ideals of health and fitness in today’s society • reasons behind the use of doping • medical and social consequences of doping • the importance of a doping-free society • challenges to the detection and prevention of doping • the global anti-doping movement. This book is a valuable resource for sport students, instructors and sport profes- sionals, and will also be of interest to educators and policy- makers working in the areas of health, criminology, sociology and law. Nader Ahmadi has a PhD in sociology and is Associate Professor and Vice Pre- sident of the University of Gävle, Sweden. His research has mainly focused on areas such as welfare and social policy, international social work, identity and youth problems, coping strategies among cancer patients, socio-cultural percep- tions of the self and gender roles, etc. He has been consultant for the World Bank, UNICEF and the European Commission in many countries such as Russia, Croatia, Vietnam, Azerbaijan, Tajikistan, FYR of Macedonia, Kosovo and Bosnia and Herzegovina. He has also been leader of a nationwide research project on the health problems among the asylum- seeking children in Sweden commissioned by the Swedish government. Ahmadi has been guest lecturer in India, China and Russia. Arne Ljungqvist – medical professor, high jumper and sports manager – has devoted his life to the service of medicine and sports. He managed to become the Swedish champion in high jump as well as participate in the Helsinki 1952 Olympics. Among other roles he has been Chairman of the Department of Pathology and Cytology, Karolinska Hospital; Pro Rector at the Karolinska Institute, Sweden; President of Swedish Cancer Society; Chairman of the Inter- national Olympic Committee’s (IOC) Medical Commission; founder and Vice Chairman of the World Anti- Doping Agency (WADA); Chairman of the WADA Health, Medical and Research Committee. In 2014 he received an honorary doc- torate from the Faculty of Health and Occupational Studies at the University of Gävle, Sweden. Göran Svedsäter has a Specialization degree in Psychology and Science of Education and is currently Lecturer at the University of Gävle, Sweden. He has been Lecturer and Leader of Research and Development at the Faculty of Educa- tion and Health Care Education, Oslo College, and Lecturer at the Faculty of Health Care Education, College of Trondheim. He has also been consultant for International Doping Tests & Management (testing activities, recruiting, education and training of international sampling officers). He also has experience as doping control officer for the Norwegian Confederation of Sport and as an international doping control officer for several international federations. Doping and Public Health Edited by Nader Ahmadi, Arne Ljungqvist and Göran Svedsäter First published 2016 by Routledge 2 Park Square, Milton Park, Abingdon, Oxon OX14 4RN and by Routledge 711 Third Avenue, New York, NY 10017 Routledge is an imprint of the Taylor & Francis Group, an informa business © 2016 G. N. Ahmadi, A. Ljungqvist and G. Svedsäter The right of N. Ahmadi, A. Ljungqvist and G. Svedsäter to be identified as the authors of the editorial matter, and of the authors for their individual chapters, has been asserted in accordance with sections 77 and 78 of the Copyright, Designs and Patents Act 1988. All rights reserved. No part of this book may be reprinted or reproduced or utilized in any form or by any electronic, mechanical, or other means, now known or hereafter invented, including photocopying and recording, or in any information storage or retrieval system, without permission in writing from the publishers. Trademark notice: Product or corporate names may be trademarks or registered trademarks, and are used only for identification and explanation without intent to infringe. British Library Cataloguing-in-Publication Data A catalogue record for this book is available from the British Library Library of Congress Cataloging in Publication Data A catalog record for this book has been requested ISBN: 978-1-138-91855-9 (hbk) ISBN: 978-1-315-68842-8 (ebk) Typeset in Times New Roman by Wearset Ltd, Boldon, Tyne and Wear Contents List of illustrations vii Notes on contributors viii Introduction: doping and public health 1 NADER AHMADI, ARNE LjUNGqVIST AND GöRAN SVEDSäTER 1 Doping and public health: historical background 11 ARNE LjUNGqVIST 2 Social and behavioural science perspectives on drug use in sport 22 IVAN WADDINGTON 3 “The winner takes it all” – individualization and performance and image enhancing in sport and in society 38 NADER AHMADI AND GöRAN SVEDSäTER 4 Reflections on ‘doping in sport’ and ‘doping in society’ 49 DAVID HOFF 5 Adulterated nutritional supplements and unapproved pharmaceuticals as new sources of doping substances for fitness and recreational sports 64 HANS GEYER 6 The market for doping products: a quasi- illegal market and its suppliers 71 LETIzIA PAOLI vi Contents 7 INTERPOL and the fight against performance- enhancing drugs trafficking: a singular approach led by the intelligence and profiling method 94 CLéMENT DE MAILLARD AND ELENA TITOVA 8 Anti- doping, performance enhancement and ‘the spirit of sport’: a philosophical and ethical critique 111 SIGMUND LOLAND AND MICHAEL j. MC NAMEE 9 The ethics of doping from a public health perspective 124 THOMAS H. MURRAY 10 The doping tug of war – from an Olympic sport to an enduring challenge to Sport and to public policy 139 THEODORE FRIEDMANN Index 147 Illustrations Figures 7.1 INTERPOL’s definition of performance-enhancing drugs and the WADA Prohibited List 97 7.2 The intelligence cycle 100 7.3 Model provided to law enforcement as a reference standard for the transmission of information related to seizures 103 7.4 Illustration of the links between laboratories, product seizures and law enforcement agencies 104 7.5 Example of links between two separate investigations related to the same clandestine laboratory 105 7.6 Example of different types of link highlighted by the profiling method 106 Tables 6.1 Leading relevant professions of the suspects reported in the NAS Investigation Database 74 6.2 The types of suppliers of doping products in Italy 76 Contributors Nader Ahmadi has a PhD in sociology and is Associate Professor and Vice pres- ident of the University of Gävle, Sweden. His research has mainly focused on areas such as welfare and social policy, international social work, identity and youth problems, coping strategies among cancer patients, socio-cultural percep- tions of the self and gender roles, etc. He has been consultant for the World Bank, UNICEF and the European Commission in many countries such as Russia, Croatia, Vietnam, Azerbaijan, Tajikistan, FYR of Macedonia, Kosovo and Bosnia and Herzegovina. He has also been leader of a nationwide research project on the health problems among asylum- seeking children in Sweden com- missioned by the Swedish government. Ahmadi has been guest lecturer in India, China and Russia. Timothy Armstrong is a Coordinator at the Department of Prevention of Non- Communicable Diseases at the World Health Organization (WHO) in Geneva. He has managed the Global Strategy on Diet and Physical Activity within the WHO and is responsible for the WHO Commission on Ending Childhood Obesity. Nicolas Clark is a Medical Officer with the Management of Substance Abuse Team at the World Health Organization in Geneva and has published exten- sively on the topic of substance abuse. Clément de Maillard is a PhD candidate at the Ecole de Sciences Criminelles, Université de Lausanne, Switzerland, and project manager for INTERPOL Anti- doping Project. Theodore Friedmann is MD and Professor of Pediatrics at the University of California, San Diego, La jolla. He is also Muriel jeanette Whitehill Chair in Biomedical Ethics at UCSD. Friedmann has won many awards, among them the University of California Chancellor’s Association Award for Excellence in Research. He has been Consultant on Gene Therapy to the Swedish Royal Academy, Chairman, Scientific Advisory Board, L/N Syndrome Children’s Res. Foundation, Elected Fellow at the American Association for the Advancement of Science, and Member of the IOC, WADA, Committee of Medicine, Health and Research and the US Anti-Doping Agency. Contributors ix Hans Geyer is a managing director at the Centre for Preventive Doping Research, German Sport University in Cologne. He is also the deputy head of the WADA- accredited doping control laboratory in Cologne, Germany. Since 1983 he has worked in the field of doping research, especially in the develop- ment of methods for the detection of anabolic steroids and in the analysis of nutritional supplements for doping substances. David Hoff is Senior Lecturer in Social Work at the School of Social Work, Lund University, Sweden, and is also affiliated with the University of Gävle. Hoff has a PhD in Sociology of Law. His main research interests include dif- ferent perspectives on doping in sport as well as outside the sporting context (e.g. as a social issue). The focus of his research is on individual and social driving forces for doping in relation to processes and trends in society.