Statistics from Altmetric.com
Doping refers to the use of prohibited performance-enhancing substances or methods in sport. It is considered a serious offence in sport that has many negative consequences, including titles being stripped, bans from participating, damage to reputation and ill health. As doping is assumed to be a pre-meditated action, engaging in this behaviour has been predominantly attributed to athletes’ decision-making processes and moral values or obligations.1 An increasing volume of literature has focused on the psychological factors associated with doping or doping intention, such as motivation, sportsmanship, moral disengagement and social-cognitive factors.1
These studies make a central assumption that doping is a consciously controlled and goal-directed behaviour. However athletes may dope unintentionally because they are not aware that food, drinks, supplements, or medications may contain doping substances.2 ,3 Therefore, one of the key antidoping strategies of WADA, apart from doping control, is to enhance athletes’ antidoping awareness and their capacity to avoid unintentional doping.
Why preventing unintentional doping is important?
Unintentional doping could lead to adverse analytical findings (AAFs) in doping controls (eg, testing positive for a banned substance after providing a urine or blood sample). A substantial number of medications, nutritional supplements, beverages and herbal products containing doping substances (reviewed by Yonamine et al3) can be obtained from the internet, drug store or supermarket, without prescription. These products present a serious risk for athletes. More than 10% of nutritional supplements (eg, multivitamins, minerals and amino acids) in the market contain doping substances such as stimulants and anabolic steroids.4 ,5
Unintentional doping is also possible when athletes are offered unfamiliar food, drinks, supplements or medication, with unknown ingredients, from their trusted social agents, such as coaches, parents or friends.6 ,7 These substances present athletes with a high risk of an AAF in antidoping procedures, which could lead to WADA investigation and media attention. At worst, it may result in a lengthy ban if the athlete cannot provide proof of the contaminated product.
Axiomatically, athletes who are blind to the potential of unintentional doping have a heightened risk of consuming doping substances. This is also true for athletes who use drugs that are on the banned list to treat their medical conditions. They may breach the antidoping code if there is no prior approval (ie, via a therapeutic use exemption). One might argue that the presence of doping substances in food or medical products can depend on governmental policy and legislation. A clear labelling system for product ingredients may make it easier for athletes to identify doping substances in food or drug products, but it is practically impossible to ensure all products’ ingredient tables would be updated according to changes in the WADA's list of doping substances. Furthermore, such ingredient lists would need to be enforced by law all over the world, which would be very challenging and costly.
How to help responsible athletes prevent unintentional doping?
Team physicians and coaches who see athletes on a regular basis are well-placed to take the leading role in preventing unintentional use of doping substances.6 ,7 But they are not always present to monitor athletes outside of training. Athletes must therefore be diligent in self-monitoring and regulating their own behaviour for the avoidance of unintentional doping. Developing self-monitoring and self-regulation skills is likely to be paramount in combatting unintentional doping.
To avoid unintentional forms of doping, athletes are advised to update their knowledge of doping substances and to be aware of their presence in food, drinks, supplements and medications, and, more importantly, to be ready to manage or avoid situations where they are likely to be offered unknown food, drinks, supplements or medications that could contain doping substances.6 ,8 These suggested behaviours for the avoidance of unintentional doping require conscious effort.2 ,8
We and others have reported that the awareness of, and intention or adherence to avoiding unintentional doping is related to a number of psychological variables such as motivation, social-cognitive variables and beliefs, and self-control.2 ,6 ,8 ,9 Extending this research would help sport governing bodies, antidoping agencies and sport professionals, to establish essential training and social environmental conditions that empower athletes to self-monitor and act appropriately to help prevent unintentional doping. Indeed, the research on this topic is still in its infancy because the primary concern in the field has been the psychological antecedents of goal-directed doping behaviours, rather than the factors relating to avoiding unintentional doping.1
Contributors DKCC made substantial contributions to the ideas, conceptualisation, critical analysis, drafting and revisions of the manuscripts, as well as coordination of the authors, and the approval of the final version to be published. NN, DFG, RJD, JAD, SJH, and MSH made substantial contributions to the ideas, conceptualisation, critical analysis, drafting and revisions of the manuscripts, and the approval of the final version to be published.
Funding This review is supported by the Australian Government Anti-Doping Research Programme (#01-CURTIN-2011–12) awarded to MSH (Curtin University, Australia).
Competing interests None declared.
Provenance and peer review Not commissioned; externally peer reviewed.
If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.