The use of foreign substances, special dietary supplements or other artificial means to gain an advantage over the opponent is as old as competitive sport itself. The IAAF (athletics) was the first international sports federation to ban doping in 1928. Since there were no effective testing procedures put in place, the abuse continued unabated. The situation was further aggravated when synthetic pharmaceutical drugs – such as hormones and stimulants – were made available on the open market. This led to the deaths of several elite cyclists which resulted in anti-doping becoming an important agenda item on the medical committees of sporting bodies. FIFA was the first international federation to introduce doping controls (during the 1966 FIFA World Cup in England). In 1967, the first list of prohibited substances was introduced by the IOC Medical Committee. The first doping controls were conducted at the 1968 Olympic Games. Over the years, the prohibited substances list has expanded into an exhaustive list of prohibited substances and methods. However, new substances are continuously appearing on the market which has required a complex detection methodology to be introduced and continuously developed.
There are more than 350 trained doping control officers worldwide who are all medical doctors. Doctors are bound by their Hippocratic Oath to maintain confidentiality, provide professional advice and ensure the practice of good evidence based medicine. The FIFA Doping Control Officers have an educational responsibility to players, officials and fellow medical staff and are bound to their respective medical boards.2 It is mandatory that all doctors involved in sport are aware of and conversant with the WADA Prohibited List of Substances or Methods at all times (both in and out-of-competition).
The care of athletes can be both demanding and complex. New treatment protocols for recovery and rehabilitation are continually being promoted, as well as other (often) questionable methods to gain competitive advantage through enhancement of performance. Doctors must maintain their professional responsibilities and need to confine themselves to the boundaries of good medical practice and be mindful of the WADA Prohibited List of Substances and Methods. Extreme caution needs to be exercised in the use of supplements and traditional or alternative therapies.