Draft legislation is ready; dope-traffickers beware!

The draft of the anti-doping law is ready according to this TOI report:

Mercifully, there is no proposal to send athletes to jail as was widely speculated and claimed previously. Even the Athletics Federation of India (AFI) chief, Adille Sumariwalla, had given his thumbs up to the proposal to send athletes to jail for doping offences.

“For the last three years, I have been pushing the Government to do it.

“They should be giving credit to Adille Sumariwalla for this. I had said that anybody caught giving dope to athletes should be put in jail. The same for athletes, they should be in jail too,” Sumariwalla was quoted as saying.

 Traffickers, suppliers to be punished

The current proposal, going by the information given by the drafting panel chairman, Justice Mukul Mudgal (retd) is to punish the suppliers, traffickers and ‘syndicates’.

Justice Mudgal, talking to TOI, informed that the proposed legislation has been drafted with a view to “protect the athletes from the menace of doping.

“There are two things One is where athletes get involved accidentally because the World Anti-Doping Agency (WADA) keeps changing the list of prohibited substances every six months on its website. Many athletes have been caught in this web. Then, there is a lack of knowledge about many substances which athletes take. So, the key point is education. Educating the athlete is very important. The legislation tries to grab persons involved in doping or are part of these syndicates,” he was quoted as saying.

It is imperative that any legislation should go after the suppliers and people who abet doping. In any case, WADA’s stand on sending athletes to jail is well known. The world body does not like the idea of prison terms for athletes. Instead, it has encouraged stakeholders to punish the coaches, support personnel, suppliers etc. Several coaches, world-wide, have been black-listed through a published list, some of them banned for life. No Indian coach has, however, ever been sanctioned by NADA through an anti-doping rule violation case. Coaches have been sacked by the Government, though. Unfortunately, they are often brought back by the same government after a few years. There is no black-listing of such coaches.

It is a tough job, though. Pinning down a coach or a trainer or a physio or a masseur is not so easy unless there are credible witnesses, documentary or video evidence or a law-enforcement agency implicates him/her in a trafficking case. What can happen in a court of law is to be seen only. Needless to say, with our legal system taking its own time to dispose of cases, these dope-related issues can drag on. Unless there is a special court to try the offenders.  Let the Government and Parliament tackle the issue in the coming months.

One point that attracted the attention of anti-doping campaigners including this journalist was part of the above statement by Justice Mudgal: “There are two things. One is where athletes get involved accidentally because of the World Anti-Doping Agency (WADA) keeps changing the list of prohibited substances every six months on its website. Many athletes have been caught in this web.”.

This is debatable. Coming from an eminent retired chief justice who previously conducted an enquiry into the episode of six woman quarter-milers testing positive in 2011, who is an expert in sports law, formerly a member of the arbitrators in the Court of Arbitration for Sport (CAS), and now the chairman of the panel appointed by the Government to draft an anti-doping law, this is bound to add to the existing confusion about who is the real culprit.

Ever since WADA started publishing laboratory statistics (later testing figures) in 2003, anabolic steroids have topped the list of banned substances that athletes use the world over. The trend has continued. From 2004, when WADA took control of the Prohibited List, to date, there have been yearly revision of the Prohibited List through a detailed process. (Not every six months as Justice Mudgal has stated). The List is first published by WADA by October 1 every year to come into effect on January 1 next year.

Steroids top world-wide

Indian athletes have maintained the world-wide trend as far as choice of drugs for doping purposes is concerned. An overwhelming number of steroid cases come up every year. Anabolic agents contributed 1813 (44%) of the ‘positive’ cases in 2017 as per WADA figures published recently.

Of the total of 803 adverse analytical findings available on the NADA website to date, at least 510 cases are that of steroids/anabolic agents (63.5%). Stimulants (136, 16.9%) and diuretics and other masking agents (55, 6.8%) contribute the next major share.

From 2009 to this day, at least in the Indian doping context, there is not a single new steroid for which an Indian athlete has tested positive. It is the same old stanozolol, nandrolone, testosterone, methandienone, drostanolone and boldenone etc year after year. An occasional metenolone or mesterolone is thrown in to remind us that the Indian dopers are not entirely sticking to the beaten path.

In the NADA chart that contains 800-plus cases, there is not a single case of steroids methyltrionolone, methyldioneolone, methylstenbolone, oxabolone or methasterone, all added to the WADA Prohibited List post-2004.

Is it right then to presume that our athletes are unaware of the new drugs being added to the Prohibited List periodically and thus fall victim? Athletes often make you believe_and sometimes top sportsmen contribute to this line of argument_ that when they take medicines prescribed for common ailments like cold and fever or stomach upset they fear falling victim to anti-doping rules. This is not true. 
Paracetamol (for fever) is something everyone uses and an athlete can also use freely without apprehensions if it is just plain paracetamol. Among cough syrups, Ascoril Expectorant contains terbutaline, a banned drug in sports, but you can have Mucolite (Ambroxol) or Lupihist (diphenhydramine citrate) without breaching anti-doping rules. These are just a few examples among dozens of 'safe' medicines mentioned here not in an effort to guide athletes or to claim any knowledge, but to disprove the oft-repeated argument that athletes cannot even take cough syrups! An athlete can always approach a doctor, explain to him/her the need to be cautious about prohibited drugs and avoid worries.

Was there an instance during a hearing in India that an athlete claimed he/she was unaware of a particular drug having been added to the list only the previous year or two years earlier and hence had tested positive?

Athletes mostly tell hearing panels, if they do not say “I don’t know how it got in”, something like “I am unaware of the Prohibited List. No one told me about WADA or NADA rules.”

Steroids were added to the Prohibited List by the International Olympic Committee (IOC) in 1975. The IOC was the authority during those days to regulate anti-doping measures. WADA was born in 1999 but it took control over the Prohibited List only in 2004 the year in which the World Anti-Doping Code (Code) came into effect.

Athletes are generally unfamiliar with the long list of drugs included in the WADA list. Not just in India but in a majority of the rest of the world. Most of the drugs are unheard of unless you happen to specialize in WADA-prohibited drugs or else are an athlete who is interested in consuming a particular drug to enhance performance.

Just sample this: Oxymetholone, norboletone, oxabolone, oxymesterone, calusterone, methyldienolone, methylstenbolone, miboloerone, boladione and 19-noretiocholanolone among steroids, and methylenedioxymethamphetamine, norfenfluramine, mefenorex, 4-phenylpiracetam and phendimetrazine among stimulants.

Even if an athlete had seen the latest WADA list, will he/she be able to make out these above medicines? Unless he/she had been looking out for the choicest steroids or have heard about a new drug in the market that could "work wonders". Can a parent or a coach make out what are these drugs for without knowing the commercial equivalents? Will all doctors be able to relate the hundreds of drugs listed in the WADA document to medicines that they normally prescribe without referring to any book at all? NADA used to have a generic-name-commercial-name compilation on its website, but it looks to have been discarded.

Inadvertent ingestion of a banned substance by athletes is always a possibility. That is why authorities warn athletes of taking supplements and also about self-medication. Educating the athlete becomes important here. NADA has been putting in more efforts in this sphere during the past couple of years but there is always room for improvement. Private organisations including those comprising doctors or pharmaceutical companies can also contribute, not by holding seminars and inviting ‘experts’ to talk to a limited audience but by arranging such talks at national training camps or national championships.

NADA website needs improvement

NADA can, at the same time, help athletes by providing information on its website, about new substances, supplements, doping methods etc and the risks involved. There is no warning there, however, about latest contamination possibilities being discussed across the world. A drug reference online system has been in the pipeline and is expected to be implemented by the year-end, but the website contents remain below-average.

“Then, there is a lack of knowledge about many substances which athletes take. So, the key point is education,” the TOI report quotes Justice Mudgal.

Contaminated supplements seem to be the main villain in the “lack of education” theme. Obviously, we cannot expect athletes to prescribe medicines themselves and consume them. Many blame it on a colleague or coach or forgets to get a prescription from a doctor. Therapeutic Use Exemption (TUE) by which an athlete can use banned substances, if medically required, on an advance approval from a panel, is rare in Indian anti-doping.

Supplements can be tricky. No matter how many warnings are issued, athletes feel the need to take them. The Government spends money on supplements. Now, there is an attempt to provide “safe supplements” through a certifying system by the Food Safety and Standards Authority of India (FSSAI). We will have to see how far it works, not just in reducing incidents of “inadvertent doping” through supplements but also in providing the “boost” that athletes are looking for.

According to the TOI report: “Any person who indulges in supply of prohibited substance to an athlete on a regular basis for commercial purposes shall be guilty of the offence of ‘trafficking’ and shall be punished with simple imprisonment which may extend to one year and shall also be liable for a fine which may extend to Rs 10 lakh.”

It is good that traffickers would be chased and penalized. It might help reduce incidents of doping. But in a country where Winstrol (stanozolol, of the Ben Johnson fame) and Deca-Durabolin (nandrolone), to name just two commonly-abused steroids, are freely available in chemists shops, without prescription, why would any athlete go in search of a “supplier” to get his/her base quota of steroids?

Moreover, when confronted with a doping charge, athletes have produced prescriptions from bona fide medical parctitioners or hospitals in past hearings. Take the case of sprinter Sharadha Narayana in 2010. She was prescribed tablet Menabol (stanozolol) and injection Winstrol (stanozolol) by a Chennai hospital doctor for knee pain. The disciplinary panel accepted her explanation and reprieved her, but WADA’s appeal before an Indian appeal panel was upheld and she was suspended for two years.

Or take the case of Simarjit Singh, a kabaddi player from Amritsar, who tested positive for 19-norandrosterone (nandrolone) in March, 2016. He produced hospital outpatient registration document and doctor’s prescription for nandrolone decanoate (injection) and was given a reduced sanction of two years instead of the standard four. The panel accepted his argument that he suffered from acute back pain because of a prolapsed disc.

There have been dozens of cases like these from 2009 till now.

Easy access to steroids

Steroid preparations and other WADA-prohibited drugs are easily available around the NIS, Patiala. The Central Drugs Standard Control Organisation (CDSCO) or local health authorities have raided such shops in the past whenever major doping scandals have erupted. After some time, it is business back to normal.

The proposed law might require either strict enforcement of rules for chemists to sell prescription drugs or else new restrictions on sale of steroids or both. It is easy to say but almost impossible to implement.

One area where authorities might be able to penalize coaches, support staff and suppliers would be in the distribution of drugs imported illegally. Coaches and athletes are known to bring in mainly “Russian” drugs while on trips abroad for competitions or training. In the past there had been an attempt to co-ordinate efforts with the Customs to impound consignments at airports. But pre-publicity given by NADA to such a collaboration seemed to have alerted potential traffickers and nothing was heard of it later.

Despite all the talk of designer drugs and advanced technology and methods having contributed to increased levels of performance of the athletes abroad (“US, Russia and several European countries have advanced methods to dope, we suffer because of outdated methods and forgotten drugs” is an oft-repeated comment by “experts”), when a Lance Armstrong is exposed or a Floyd Landis is caught doping, it turns out they were onto trusted, age-old methods and drugs.

Those drugs, from stanozolol to testosterone, from nandrolone to methandienone and from stimulants to diuretics or Beta-2 Agonists (found in asthma medications) are all freely available in India. Neighbourhood gym instructors will provide you some steroids if you find it difficult to procure. Misuse had led to deaths according to reports.

The abuse of steroids has reached such proportions that an anti-doping law might find it hard to curb. Mere elimination of “suppliers” from sports camps might not work. No country has so far sent an athlete to jail though many have provisions for it. The Indian and foreign coaches might become more cautious, looking at the prospects of spending some time in jail if caught peddling steroids etc. A stricter steroid law might be required or else regular raids on gyms and chemists shops for the proposed anti-doping law to become more effective.

The wait now would be for the anti-doping law to come into effect. One can only hope that the supply system, if that is required for steroids to reach athletes, would be dismantled and Indian athletes would flourish on the world stage on their own steam without the aid of dope or being chased by WADA and others. Or for that matter, India would get out of the top-10 bracket of the world's dopers' list. In 2016 the country was joint sixth with Russia, after having occupied the third place for three years from 2013.
(Updated on 9 Aug, 2018)