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Madi Doepker
Thiele
English 101
23 November 2015
Necessity vs Performance-Enhancement of Drugs in Professional Sports
As all aspects of the athletic world develop and grow, it is an obvious statement that
certain things change for the better and others change for the worse. Drugs and their involvement
in elite sports, for example, have unfortunately evolved into a worse situation. Drugs in sports
started long ago, a lot longer than the famous Armstrong case in the 1990s that everyone
believed started the popular trend. They have intensified and the term doping has become more
common in the athletics world, especially in the professional athletics world. According to the
British Journal of Sports Medicine, the first ban on performance-enhancing drugs was put into
place in 1928 by the International Amateur Athletics Federation (Savulesca, Foddy and Clayton
666). Recent studies, found in the Human Kinetics Journals, show that as doping becomes more
familiar the range of drugs have increased and varies from your typical steroids all the way to the
new and commonly used nutritional supplement (Dietz et al. 623). Due to the variety of
enhancing considered drugs and the newest anti-doping policies, many athletes are now doping
without realizing it and some dont have another choice. It has created a fuzzy line that when
crossed unknowingly can ultimately put athletes at risk with their careers.
As of today that fuzzy, or rather blurred, line between the necessity of some drugs for an
athletes health and those same drugs being considered performance-enhancing, has become
more and more relevant. There is more harm being brought to athletes than good with the current
policy and the rules outlined are not fair between different types of athletes. It is important to

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draw a clearer line that will help athletes prevent crossing that line from necessity of a drug into
the performance-enhancement of it. With that being said, there needs to be a change to the antidoping policy that will allow athletes to take necessary medication that will improve their health
without any repercussions or punishment. Although the policy has worked somewhat in the past
it has not evolved with the progression of the sports world today.
One of the most important and talked about policies in the athletic realm is the World
Anti-Doping Code Implementation, also know as the anti-doping policy. Even though it is
slightly updated each year, it does not correlate with the current athletic time concerning drug
use. The purpose of this document is to lay out the rules and regulations concerning athletes
involvement with drugs. The drugs vary, as stated above, and the policy gives a list of drugs,
supplements, steroids, all the many types of medications that are considered performanceenhancing. The official WADA Prohibited List policies, that are worldwide known and followed,
are so in depth that it identifies the substances and methods prohibited in- and out-ofcompetition, and in particular sports (Prohibited List), as stated in the actual policy itself.
With tight regulations not only during but outside of competition, there is automatically a larger
grey area for mistake and misuse. This can also lead into the harm of athletes if they are not
allowed to take medication in order to say nurture an injury, prevent an injury or maintain a
healthy status because of possible punishment.
While the anti-doping policy works towards being efficient and helpful to athletes around
the world, in reality it is bringing more harm than good to the athletes that the policy is imposed
on. Athletes are not allowed to take certain drugs that they need in order to return to normal
health or supplements that are nutrient rich and give athletes their basic vitamins because they
are considered to be performance enhancing. One example of supplements that are now on the

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list are the commonly used nutritional supplements. There are multiple that are banned and they
are defined as concentrated sources of nutrients and other substances that have a nutritional or
physiological effect and that are used in high frequency among athletes (Dietz 623). According
to a study done by J. Sundgot, B. Berglund, and M.K. Torstveit, writers of the Scandinavian
Journal of Medicine and Science in Sports, on 1681 elite male and female athletes, most athletes
are clueless of what is being put into their bodies. 58% of the males and 52% of the females
used common Nutritional Supplements that were advised by their coaches. Their main reasons
for using it was to gain daily vitamins that they lacked. The interesting part of this study was that
nearly all of the athletes felt that they were well informed about the NS they were taking,
however the article states that out of all the athletes using NS, 8% of the NS users did not know
whether the NS they used was doping classified or not (Sundgot, Berglund and Torstveit 138).
Sundgot, Berglund and Torstveits study proves that there is that fuzzy line and that
athletes are not aware if they are crossing the line into doping, especially with these Nutritional
Supplements that a lot dont know are banned. The way in which this is physically harmful to
athletes is that those who know that the NS is banned and are not taking it, are losing valuable
vitamins that they lack. The main reason why NS is being banned is because even though it is
mainly used as a daily vitamin, officials believe that it paves a gateway for the use of illicit
drugs and doping substances (Dietz 623), noted in Dietz article in the International Journal of
Sport Nutrition & Exercise Metabolism, concerning the ban of healthy drugs. Although the drug
itself is not an illicit drug it is being banned. In result, the athletes that are using it for their health
and arent using other illicit drugs are not allowed to take it because of an unproved theory and
are most likely unaware that they are doping as well. There needs to be some sort of level ground
for athletes that are advised to take NS by professionals without risk of punishment.

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With talk about level ground that brings in the idea of level playing field between
different athletes. There are many different types of professional athletes. There are men, women,
athletes with prosthetics, and some even in wheel chairs. It is important to think of the health of
all the athletes the same, there needs to be fairness and equality concerning health. The antidoping policy currently has unfair rules regarding which types of athletes can take what type of
medication. An example of this is was outlined by David Ewing Duncan, a famous scientific
writer, when he compared a womens Olympic skier to an athlete with prosthetics. The woman
skier was injured during competition in one of her runs, because of her injury she was unable to
compete and needed medication to return to normal health and in order to compete the following
year. Due to the anti-doping policy she was unable to take the medication she needed that would
have helped her return to competition faster because that specific medication was considered
performance-enhancing.
The way this relates to the athlete with prosthetics is because that athlete was allowed to
take the same medication, even while competing, with complete consent and no legal
implications. From this you can see that the policy itself is standing in the way of certain
athletes health and careers (Duncan 1). For professional athletes competing is their way of life,
it is what pays for them to live. If they are injured and unable to compete they are taken from
competition and unable to make money. The policy is interfering with athletes careers and
money. The rules are unfair and the regulations are very tight. With all of that in mind, it brings
the question of level playing field and why there is an unfair rule that allows some athletes to
take drugs to improve health and while other athletes are not allowed. There also has to be
consideration regarding the trained medical professionals, also known as the doctors, opinion
on an athletes health at stake.

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With all the talk of drugs and medication, it is normal to think of the person prescribing
them, the doctors. In and article by Marcia Clemmett, a science major, research has shown that a
majority of the athletes that have been doping are using medication prescribed by doctors
(Clemmitt 837). It is not under a doctors job specification to prescribe illegal or recreational
drugs, which also happen to be under the prohibited list, but it is outlined that they must
prescribe what they believe to be the best medication to improve a patients health. An example
of a current situation where a needed and prescribed medicine is considered doping involves the
condition hypothyroidism. This condition is described as an early onset of hormonal imbalance,
as defined by Doctor Brown in Sara Germano and Kevin Clarks article, U.S. Tracks
Unconventional Physician. The issue in this event is that athletes with hypothyroidism need
certain medication known as levothyroxine, which happens to be a synthetic hormone. Athletes
are increasingly being questioned and shamed for taking the drug while competing because it is
believed to be performance-enhancing. The problem with this is that the athletes need this
medication in order to compete, without it they risk their health and the ends of their careers
(Germano and Clark). If athletes are taking prescribed medication and following directions given
by their doctor, their actions should not be considered doping. There is no sense in prohibiting or
shaming athletes for taking these drugs when they are a necessity and prescribed by doctors,
whose job is to prescribe the best possible medication.
According to the WADA anti-doping policy, in order for an athlete to possibly be allowed
to take a medication on the prohibited list, they must undergo a very long, time consuming
process. If all goes well, which is not always guaranteed; they will receive a TUE, Therapeutic
Use Exemption. Before they are granted a TUE there are multiple steps and criteria they must fit
in the first stage of the TUE process. After they go through the TUE process they must report to

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the International Federation where officials will determine if the athlete meets the ISTUE,
International Standard for Therapeutic Use Exemptions, criteria. If the athlete does not meet
criteria then they have 21 days they must return to the WADA, World Anti-Doping Agency, for
more observation (USADA TUE). With that lengthy process laid out, it is no wonder why
athletes are accidently crossing the line into doping territory.
As one could see, this is a very intense and long process for an athlete to go through in
order to take a medication necessary for their health and in order to compete. Not to mention that
the athlete cannot compete during the process if they need to take that necessary drug because it
is still considered a doping drug until it is officially approved. In order to make it easier and to
help athletes maintain their health, while continuing their competing careers, there needs be a
less technical process in order to grant a TUE. A simpler process could be that an athlete with a
prescribed medication and sufficient reasoning by their doctor brings the information directly to
ISTUE, where a basic criterion is presented. Then if the athlete and their prescription correlate
with one another fitting the criteria, they are granted their TUE. This would make it easier for
athletes that are in need of their medication to receive a TUE so that they are able to compete at a
normal level. This also insures that there is still somewhat of a process so that athletes looking to
enhance performance and clear illegal drugs such as steroids or unnecessary hormones are not
able to do so. This would better insure an athletes health and would also cut back on the time
they are taking out to get the TUE approved and return to competition faster.
While some choose to disregard the idea of improvement or change, athletes that
have been wrongfully punished and certain fans looking for a more elaborate show where
athletes compete on steroids, have come to the conclusion that the anti-doping policy is not
needed at all. In other words, the athletic world should completely remove the policy and

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regulations all together. In both cases the common belief is that the policy in place is too intense,
it does not do anything but harm unhealthy, injured athletes, and has just failed all together as
suggested by Aaron Smith and Bob Stewart, authors of an article dealing with reasoning for and
against anti-doping policies (Smith 123). Although there are definitely problems with the current
policy it should not be removed completely, but simply have changes made.
An official call for change in policy, not an elimination of, regarding doping is necessary.
Without a policy there would definitely be an unleveled playing field because athletes would be
doping unnecessary excessive amounts and those that decide not to dope would automatically be
at a disadvantage and left in the dust. Also, if policies were taken away and athletes were allowed
to take whatever drugs they wanted at any amount of dosage, the idea of hard work that has
surrounded the world of elite athletes would be gone. Instead, a new and improved policy should
be put in place. A policy where those that need certain medication for an injury or health related
condition are allowed to take that drug without going through a long and strenuous process. A
policy where different types of athletes are allowed to take the same drug because it is necessary
to their condition. A policy that would accommodate the health of all athletes and call for a level
playing field.
As stated throughout the essay, it is apparent that there needs to be a change in policy that
would eliminate the blurred line between the necessity of drugs and the performance
enhancement for those drugs. A new policy would limit the harm done to athletes caused by the
current one, there would be a more level playing field, and athletes will be allowed to take drugs
that they need without complicated processes and especially without being punished. A new
policy could potentially make the elite sports field safer and better for athletes, which would in
return make it more enjoyable for fans. The athletic world would improve as a whole.

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Annotated Bibliography

Clemmitt, Marcia. "Medication Abuse." CQ Researcher 9 Oct. 2009: 837-60. CQ Researcher.

Web. 16 Oct. 2015.
Throughout this article Clemmitt, not only a great writer but a science major,
addresses many instances of drug abuse ranging from recreational drugs to prescribed
medication. One of her powerful parts of the article involves prescription-drug abuse. She
explains that the abuse of these drugs is becoming more and more common. She also
mentions that a lot of these addicts are still getting the medication from their doctors.
Unlike other articles Clemmitt does not boldly state the idea of the blurred line between
necessity of medication and enhancements of it but she implies the idea with other
examples embedded in the article.
I plan to use this article to show that not every person that is addicted to these
drugs knows that they are addicts and also to present a solution for this problem. A
solution involving more tests and in-depth evaluations of medication receiving patients.
Dietz, Pavel, et al. "Prediction Profiles For Nutritional Supplement Use Among Young German
Elite Athletes." International Journal Of Sport Nutrition & Exercise Metabolism 24.6
(2014): 623-631. Academic Search Complete. Web. 16 Oct. 2015.
In this article the authors present the issue of elite athletes using NS, a nutritional
supplement commonly used by athletes as a concentrated source of nutrients, as a
gateway drug to doping. He also mentions that sometime athletes truly believe that the
supplement is bringing their body health back to its normal state when it is actually

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passing its normal state and beginning to enhance it. Different than other articles, this one
presents both sides of the complex argument, stating that some athletes do indeed use NS
irresponsibly on purpose but reassuring the readers that not all athletes do.
I plan to use this article to help validate feelings on opposing sides of the
argument, but also to show that there is a huge problem at stake for those who do need
NS but are being criticized by society for the medications poor reputation.
Dietz, Pavel, Rolf Ulrich, Andreas Niess, Raymond Best, Perikles Simon, and Heiko Striegel.
"Prediction Profiles for Nutritional Supplement Use Among Young German Elite
Athletes." Human Kinetics Journals. Human Kinetics. Inc, Dec. 2014. Web. 05 Nov.
2015.
This article gives reason for why Nutritional Supplements are considered negative
in the athletic realm according to the anti-doping policy. Its main points include:
Nutritional Supplements could be a possible gateway drug and younger kids tend to
misuse the drug. It also gives data from research regarding the Nutritional Supplement
and how it was used on young athletes. Unlike other article this one gives exact data
regarding a certain type of prohibited drug. Similar to others it talks about the misuse of
this drug and its correlation to elite athletes.
I plan to use this article to demonstrate the different uses of the common
Nutritional Supplement and to counter the anti-doping policy. I plan to do that by using
this article assumptions of the drug with the realistic data of the drugs.
Duncan, David Ewing. "The Cyborg Olympic Games." Newsweek Global 162.8 (2014): 110114. Academic Search Complete. Web. 16 Oct. 2015.

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In this article Ducan, talks about different types of athletes and their drug intake.
Duncan uses two athletes and their medical history to present the fact that it is illegal for
an injured athlete to use certain drugs to recover faster but completely legal for an athlete
with prosthetics to use performance-enhancing drugs. Similar to other articles, this one
talks about the blurred line of medication being necessary to athletes and then medication
enhancing performance but different in the way that it is approached.
I plan to use this article in my essay to show that there is an unfair blurred line
between different types of athletes and what kind of drugs they can take. Also to possibly
present a solution to clear up that blurred line so commonly talked about.
Germano,Sara,andKevinClark."U.S.Track'sUnconventionalPhysician."TheWallStreet
Journal,10Apr.2013.Web.24Nov.2015.
Thisarticleoffersupinformationaboutatypeofhormonalimbalancecalled
hypothyroidismthatisfoundinenduranceathletes.Itexplainsthatathleteswhotakethe
medicationnecessaryfortheconditionarebeingshamedandquestionedforpotential
performanceenhancementofthedrug.Likeotherarticles,thisonereferstotheWADA
officialantidopingpolicytomakeitspointsclear.
Iplantousethisarticleinsupportofhowathletesareunabletotakemedication
thattheyneedinordertocompeteatahealthystate.Ialsoplantousethisassupportfor
myclaimthatthereneedstobeachangeintheanitdopingpolicy.

"Prohibited List." World Anti-Doping Agency. WADA 2015, 14 Nov. 2013. Web. 05 Nov. 2015.
This article outlines specific criteria for prohibited drugs in elite athletics. It also
gives background information on past drugs used and the reason for policy, along with

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different reasoning for the types of drugs on prohibited list. Unlike other articles, this one
is a world wide article that is used by many different countries. It is a legal document to
what types of drugs elite athletes can and cannot use along with when and when they
cannot use them.
I plan to use this article to demonstartate what types of drugs are prohibited to
athletes. I also plan to use this to counter the policy and its strenuous process and broad
list of prohibited medication.

Savulesca, Julian, B. Foddy, M. Clayton. Why we should allow performance enhancing drugs in
sport. British Journal of Sports Medicine 38.6 (2004): 724. Web. 3 November 2015.
This article offers the background of sports related to drugs. It gives specific dates
on when policies were put in place, as well as concrete detail of why policies were put in
place. Unlike other article this one gives ancient information and relates it to the current
policies in place.
I plan to use this article to give examples of policies that were created and put into
during the first years of elite sports and relate that to how policies are being used today.
Also to outline criteria and new rules of a more sufficient policy.
Smith, Aaron C. T., and Bob Stewart. "Drug Policy In Sport: Hidden Assumptions And Inherent
Contradictions." Drug & Alcohol Review 27.2 (2008): 123-129. Academic Search
Complete. Web. 16 Oct. 2015.
This article offers up good reasoning for the anti-doping policies failing with
detailed responses. It states that the policy could potentially be harming athletes because
they are not letting them compete with drugs that they need to perform at a normal state

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of health. Different from other article referenced, this one openly addresses the failures of
the anti-doping policies and backs up their response with a solution to the failures.
This is a good article to help build a solution to the problem of athletes being
eliminated for drugs necessary for their performance and is a good building block to
explain to the reader the main problem that will be addressed in the essay.
SundgotBorgen,J.,Berglund,B.,Torstveit,M.K..NutritionalSupplementsinNorwegianElite
AthletesImpactofInternationalRankingandAdvisors.ScandinavianJournalof
MedicineandScienceinSports.13.905(2003):13844.Web.23November2015.
Thisarticleprovidesastudydoneoneliteathletesregardingnutritional
supplements.Itsmainpurposeittoshowthatalargeamountofathletesthataretaking
thesesupplementsdontknowiftheyareinthedopingcategoryornot.Unlikeother
sources,thisonegivepercentagesandactualdatafromresearchthatsupportsitsclaim.
Iplantousethisarticletodemonstratethatthereisdataproofofablurredline
betweenathletesandwhattheyareactuallyusingthenutritionalsupplementsfor.

"Therapeutic Use Exemption TUE Policy | U.S. Anti-Doping Agency (USADA)." U.S. AntiDoping Agency (USADA). US Anti-Doping Agency, 1 Jan. 2015. Web. 05 Nov. 2015.
This article informs the reader about the process of an athlete getting a TUE or a
therapeutic use exemption regarding medication and drugs. It explains the definition of
the code along with how it applies to different types and levels of athletes. It also gives its
reasoning for the process. Like other article this one gives its specific procedures when it
comes to policy. Unlike other articles this one gives each level of athletes its own set of
rules and how the code of the policy applies to them.

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I plan to use this article to show how difficult it is for athletes to take the drugs
necessary for their health. Also to show that there needs to be a change in policy and
procedure to increase the health of athletes and also to reduce their time from
competition.