Stephen Watkins Brunel University London 1 An investigation into the factors that encourage Image and Performance Enhancing Drug taking behaviours in adult rugby players in England. Stephen R. Watkins A thesis submitted for the degree of Masters of Philosophy Brunel University Department of Life Sciences September 2019 COPYRIGHT Attention is drawn to the fact that copyright of this thesis rests with its author. A copy of this thesis has been supplied on condition that anyone who consults it is understood to recognise that its copyright rests with the author and they must not copy it or use material from it except as permitted by law or with the consent of the author. Stephen Watkins Brunel University London 2 ABSTRACT Pages Abstract 7 CHAPTER ONE - INTRODUCTION 9 1. Introduction 9 1.1 Introduction to IPED use in Rugby Union 9 1.2 Background to the World Anti-Doping Code 13 1.3 The need for research in Rugby Union 20 CHAPTER TWO – LITERATURE REVIEW 22 2. Review of Literature 22 2.1 Beginner or Young Person Studies 23 2.2 Gifted and Talented Studies 25 2.3 Performance Development Athlete and Performance Athlete Studies 26 2.4 Elite Athlete Level Studies – Attitudes and Prevalence of IPED use 27 2.5 Coach and Support Personnel Studies 33 2.6 Wider Society- Image & Performance Enhancing Drug Studies 38 2.7 Theoretical Concepts of Doping 40 2.7.1 The Push, Pull, Anti-Push, Anti-Pull Theory 41 2.7.2 The Gateway Use Theory of Doping 43 2.7.3 Moral Disengagement Theory 45 2.8 Literature Review Summary 50 2.8.1 Personal 51 2.8.2 Environmental 51 2.8.3 Performance 52 CHAPTER THREE - METHODOLOGY 53 3. Methodology 53 55 3.1 The Researcher Stephen Watkins Brunel University London 3 3.2 RFU Club Rugby Structure 56 3.3 Operational Definitions 56 3.3.1 Personal Factors - Moral Disengagement - Operational 57 Definitions. 3.3.2 Environmental Factors - The Push, Pull, Anti-Push Anti-Pull - 57 Operational Definitions 3.3.3 Performance Factors - Gateway Use Theory Operational 58 Definitions 3.4 Phase One 58 3.4.1 Protocol 58 3.4.2 Interview Guide 59 3.4.3 Mock Interviews 60 3.5 Phase Two 61 3.5.1 Protocol 61 3.6 Study Procedures 61 3.6.1 Ethical Approval and Permissions 61 3.6.2 Confidentiality 62 3.6.3 Consent & Interview Location 62 3.7 Data Analysis 63 3.7.1 Data Analysis – phase one 63 3.7.1.1 Participant - RP01 64 3.7.1.2 Participant – RP02 65 3.7.1.3 Participant - RP03 65 3.7.1.4 Participant RP04 66 3.7.2 Data analysis - Phase two 66 CHAPTER FOUR – RESULTS and DISCUSSION 67 4. Results 67 67 4.1 Phase One. 68 4.1.1 Moral Justification 69 4.1.2 Advantageous Comparison 70 4.1.3 Diffusion of Responsibility Stephen Watkins Brunel University London 4 4.1.4 Displacement of Responsibility 70 4.1.5 Euphemistic Labelling 72 4.1.6 Dehumanization of Victim 73 4.1.7 Attribution of Blame 73 4.1.8 Distortion of Consequences 74 4.1.9 Push, Pull, Anti-Push, Anti-Pull 75 4.1.10 Push 75 4.1.11 Pull 77 4.1.12 Anti-Push 77 4.1.13 Anti-Pull 78 4.1.14 Gateway Use Theory 79 4.2 Phase Two 80 4.2.1 Performance Stage 80 4.2.2 Justification for IPED use 82 4.2.3 Drug Types 82 4.2.3.1 Steroids and Growth Hormones 83 4.2.3.2 Therapeutic Drug(s) 85 4.2.3.3 Stimulants 85 4.2.3.4 Post Steroids Cycle Therapy Drugs 86 4.2.3.5 Recreational or Illicit Drugs 86 4.2.3.6 Other Anti-doping Rule Violations 87 4.2.4 Geography of Violations 87 4.2.5 Hearing Decision - Content Analysis 88 4.2.6 Positional Data 90 4.3 Discussion 91 4.3.1 Injury Recovery and Mental Health 93 4.3.2 Testing 95 4.3.2.1 Hypothetical Player’s Doping Regime 96 4.3.3 Prevalence of Image and Performance Enhancing Drugs 98 4.3.4 Connected Players 99 4.3.5 Body Image 100 Stephen Watkins Brunel University London 5 CHAPTER FIVE – CONCLUSION 101 5. Conclusion 101 5.1 Limitations 104 5.2 Future Research 106 5.3 Recommendations 106 5.3.1 RFU accredited Support Staff 106 5.3.2 Sanctions for Team and Coaches 107 5.3.3 Prevention Education for all players 108 References 109 Tables Table 1 - RFU Anti-doping Rule Violations 2012-2018 10 Table 2 - World Rugby Testing Statistics 2010-2015 11 Table 3 – Results - Phase One 67 Table 4 - Performance Stage of Rugby Union Players 80 Table 5 - Justification for IPED use 81 Table 6-12 - Prohibited Substance Types 82-87 Table 13 - Other Anti-doping Rule Violations 87 Table 14 - Geography of Violations 88 Table 15 - Hearing Decisions - Content Analysis 89 Table 16 - Positional Data from Phase Two 91 Figures Figure 1 - Photograph - Death of the Tour 14 Figure 2 - UK Anti-Doping base their education framework on the following model. 23 Figure 3 - Diagram RFU rugby education 33 Figure 4 - The push, pull, anti-push, anti-pull model 42 Figure 5 - Incremental model of doping behaviour 44 Stephen Watkins Brunel University London 6 Appendices 1. RFU Club Rugby Structure 126 2. Player identifier and ban length 128 3. Victor Conte’s letter to Dwain Chambers detailing doping. 131 4. Sample email from author to participants 134 5. Email from Player to author dated 9 October 2018 135 6. Email from Player to author dated 15 April 2019 136 7. Interview guide 137 8. Study Approval Letter from the RFU 139 9. Consent Form 140 10. Participant information sheet 142 Acknowledgements The author would like to thank for their support and guidance: Dr Simon Kemp, Angus Bujalski, Mark Bennett, Vassil Griginov, Jamie McDermott, Daniel Rhind, Amanda Hudson, Richard Nunn, Jake Shelley, Rebecca Watkins and all the players involved. Notes The author of this project is the RFU Anti-doping & Illicit Drugs Programme Manager and has worked in the field of anti-doping for over 10 years and dealt with some of the UK’s most high profile integrity matters from a variety of sports. This study has been funded by the author and the Rugby Football Union. The views expressed in this Thesis are those of the author and not of the Rugby Football Union. Stephen Watkins Brunel University London 7 ABSTRACT Abstract Over the last few decades, the use of Image and Performance Enhancing Drugs (IPEDs) has, according to numerous media articles, become more widespread in UK society and not just in Sport. This societal problem has been reflected across sport but in particular Rugby Union has seen a marked increase of IPED users. The use of IPEDs in Rugby Union has become a growing cause for concern for the Rugby Football Union (RFU) as a high number of players from England regularly appear on UK Anti-Doping’s (UKAD) banned list . There is limited doping research in adult Rugby Union from the male or female game relating to doping behaviours particularly with players who have tested positive for IPEDs. A reason for the paucity of research on this topic may be the difficulty in gaining access to players who commit violations as well as their reluctance to speak openly about their behaviour. This study’s objectives were to examine the factors, which encourage IPED use in English Rugby Union. By means of Operational Definitions, a lens was created to examine the phenomenon using a mixture of interviews and published anti-doping judgments. Four Rugby Union players who had previously committed Anti-Doping Rule Violations (ADRV) under the jurisdiction of the RFU were interviewed and this information was triangulated with the 66 published case files from the anti-doping judgments between the years 2001-2018. Issues such as coaching environment, injury, ease of access to drugs, physical nature of the game were all scrutinised for links to IPED use. The results showed a wide range of drivers behind IPED use amongst players, but common themes of injury, normalisation of drug use as well as body image were identified. Forwards were more likely to be IPED users and being isolated from your team mates by injury was identified as a high risk period for IPED use. Players also did not believe the current level of testing represented a big enough deterrent to IPED use. The final aim of the project was to make recommendations to the RFU for initiatives that could address this critical subject. These recommendations include better nutritional and injury support for players as well as structural changes to the sanctioning regimes. Stephen Watkins Brunel University London 8 Keywords: Anti-doping, Rugby Union, moral disengagement, gateway theory, push, pull, anti-push, anti-pull theory, doping behaviours, image and performance enhancing drugs. Stephen Watkins Brunel University London 9 CHAPTER ONE - INTRODUCTION 1. Introduction “And in the case of an athlete, no one is crowned without competing according to the rules” (the Second Letter of Paul to Timothy 2:5) The story of this research begins in a hot caravan just outside Barcelona in 1992 with the author excitedly watching the Olympic Games 100-metre final on a small portable television. On that day, Linford Christie of Great Britain took the gold medal, though, Linford Christie’s great achievement will be forever overshadowed, in the author’s mind, by his being caught using the anabolic steroid, Nandrolone in 1999.