No Harm,No Foul? Justifying Bans On Safe Performance-Enhancing Drugs

Scholars such as Simon (2007; 2004) and Loland (2002) as well as the authors of the World Anti-Doping Code (2001) argue that using performance-enhancing substances is unhealthy and unfairly coercive for other athletes. Critics of the anti-doping position such as Hoberman (1995), Miah et al. (2005) and Tamburrini (2007) are quick to argue that such prohibitions, even though well-intended, constitute an unjustifiable form of paternalism. However, advocates for both of these positions assume that preserving good health and, conversely, avoiding health-related harms, lie at the centre of the debate. Given the apparent stalemate in the debate over the validity of health concerns on performance-enhancing drugs, in this essay, I investigate ethical issues of ‘harm-free’ pharmaceutical performance enhancement. Beginning with the hypothesis that a harm-free performance-enhancing drug may be produced in the future, I ask if there would still be compelling reasons for prohibiting such a drug. I address this question by providing two arguments against allowing athletes to use pharmaceutical performance-enhancing drugs – the damage to the testing and contesting of sport and the loss of internal goods that are intrinsically satisfying. These two arguments taken together, I argue, are sufficient to sustain the prohibition of pharmaceutical performance-enhancing drugs without citing their harmful side effects.     

Good Athlete – Bad Athlete? on the ‘Role-Model Argument’ for Banning Performance-Enhancing Drugs

The paper critically discusses a role-model argument (RMA) in favour of banning performance-enhancing drugs in sport. The argument concludes that athletes should be banned from using performance-enhancing drugs because if they are allowed to use such drugs they will encourage, or cause, youngsters who look up to them to use drugs in a way that would be harmful. In Section 2 the structure of the argument and some versions of it are presented. In Section 3 a critical discussion of RMA is presented. It is argued that we should be reluctant to accept the argument as it stands for at least three reasons: (i) it rests on an unsupported empirical claim; (ii) it also makes a false empirical claim; and (iii) the normative premise of the argument is too demanding morally. Further objections to the RMA are also discussed, but argued to be beside the point     

Medicalizing the drug war

Recent findings in the field of psychopharmacology pertain to the abuse of drugs and alcohol among criminal offenders and have implications for new management techniques. Drugs of abuse exert their effects on areas of the brain responsible for pleasure, providing a powerful reinforcement for drug usage. Furthermore, there is a prevalence of psychological, psychiatric and social dysfunctions that antedate drug use which are identifiable at an early age. It is suggested that drugs of abuse differentially influence users via these biological, psychological and social mechanisms, reinforcing the development of serious and chronic abuse in a vulnerable subgroup. Studies of drug abuse specially indicate that within this subgroup, antisocial behavior precedes and exacerbates drug abuse, and multiple risk factors contribute to the concomitant development of criminality and drug abuse. Early detection and comprehensive treatment of underlying disorders that may both precipitate and result from drug abuse promise to improve possibilities for prevention and reducing relapse rates. Furthermore, the inclusion of pharmacologic treatments may further enhance the success of conventional drug treatments. This article proposes that incorporating scientific data and medicalizing our approach to drug abuse is essential to win the war against drugs.     

Inhibiting doping in sports: deterrence is necessary,but not sufficient

The use of performance-enhancing drugs is a significant problem in sport. It cheats clean athletes of their hard-earned rewards from perfecting their skills though dedication and hard work. It defrauds fans by substituting a distorted playing field for a true competition. Anti-doping agencies have been charged with enforcing drug policies, primarily through the use of drug testing programs. We propose that drug testing, while important, is not sufficient to achieve deterrence. Engaging the principles of perceptual deterrence and development of a moral community of athletes can greatly enhance compliance with rules.     

Body checking behaviors in men

Males have been facing increasing pressure from the media to attain a lean, muscular physique, and are at risk for body dissatisfaction, disturbed eating and exercise behaviors, and abuse of appearance- and performance-enhancing drugs (APEDs). The aim of the current study was to examine the relationship between body checking and mood, symptoms of muscle dysmorphia, importance of shape and weight, and APED use in undergraduate males. Body checking in males was correlated with weight and shape concern, symptoms of muscle dysmorphia, depression, negative affect, and APED use. Body checking predicted APED use and uniquely accounted for the largest amount of variance in Muscle Dysmorphic Disorder Inventory (MDDI) scores (16%). Findings support the view that body checking is an important construct in male body image, muscle dysmorphia, and body change strategies and suggest a need for further research.     

Substance use and abuse among children and teenagers

During the past several years, there has been a renewed national concern about drug abuse, culminating in the current "war on drugs." In this review, we emphasize that even though child or teenage drug use is an individual behavior, it is embedded in a sociocultural context that strongly determines its character and manifestations. Our focus is on psychoactive substances both licit (cigarettes and alcohol) and illicit (e.g., cannabis and cocaine). We feel that it is critical to draw a distinction between use and abuse of drugs and to do so from a multidimensional perspective that includes aspects of the stimulus (drug), organism (individual), response, and consequences. Our selective review of substance use and abuse among children and adolescents covers epidemiology (patterns and extent of drug use), etiology (what generates substance use), prevention (how to limit drug use), treatment (interventions with drug users), and consequences (effects and outcomes of youthful drug use).     

Drug addiction finds its own niche

The evolutionary framework suggested by Müller & Schumann (M&S) can be extended further by considering drug-taking in terms of Niche Construction Theory (NCT). It is suggested here that genetic and environmental components of addiction are modified by cultural acceptance of the advantages of non-addicted drug taking and the legitimate supply of performance-enhancing drugs. This may then reduce the prevalence of addiction.     

Cognitive Sciences Research: More Than Thinking About Drug Abuse

On May 23, 1997, the National Institute on Drug Abuse and the American Psychological Society co-sponsored a conference titled "Cognitive Sciences Research: More Than Thinking About Drug Abuse." The conference highlighted important lines of research, both within and outside of drug abuse, that may elucidate the relationships between substance abuse and cognitive processes. This Special Section of Psychological Science presents a compilation of articles from that conference by scientists who are working in the forefront of this exciting new research area. The research questions posed by these articles take the following forms: What are the cognitive and developmental effects (i.e., the consequences) of substance abuse? What are the antecedents or precursors of drug use that render persons vulnerable to taking drugs? How do the effects of drugs, in turn, become antecedents for changes in perception, behavior, and cognition that further enhance vulnerability to drugs?     

Drug Use and Self-Harming Behavior Among Incarcerated Men: Does Childhood Abuse,Anger, and Executive Function Make a Difference?

Childhood abuse, anger, drug-related problems, and self-harm are commonly seen among incarcerated individuals. Forty-three young incarcerated males from an Istanbul prison were assessed for childhood abuse, anger, drug use, self-harming behavior, and executive function (EF). Further, 58% of the sample was using drugs, and 60.5% showed self-harming behavior. Performing a backward stepwise binary logistic regression model, it was found that the likelihood of using drugs was determined by EF measured by the Trail Making Test form A, childhood abuse, anger, and self-harm. On the other hand, self-harm was determined by childhood abuse, anger, and drug use.     

Processes of early drug involvement in three inner‐city neighborhood settings

The present paper explores the drug use of a sample of inner‐city junior high school youths by examining a hypothesized, interactive relationship between the perceived toughness/drug use in their neighborhood and the youths’ demographic, neighborhood orientation/involvement, and drug use context factors in regard to their drug involvement. In support of our hypothesis, discriminant analysis indicated that different processes were reflected in the correlates of the youths’ involvement with drugs in the three settings. Implications of these findings for drug abuse treatment and prevention strategies are discussed.     

Drug use and its relation to high school students' activities

In a high school in a suburb of Detroit, students' attitudes toward, use of, and money spent on drugs, as well as possible alternative activities, were investigated. The sample included 42 enrolled in alternative education designed for students at risk for drug abuse, pregnancy, etc., who might attend college if guided carefully, and 65 regular students who were a mix of college and noncollege bound. The two groups did not differ in actual drug use, most likely because those who recommended students to the alternative education program used low grade point average and not drug use as criterion. Very few "hard" drugs were used. Most frequently used were readily available drugs such as alcohol. Use of a drug, spending money on it, or believing that it is all right for adolescents to use the drug did not automatically indicate frequent use of the drug. Contrary to adults' expectations, "hangin' out" with peers decreased use of "soft" drugs. Family activities for some involved the use of hard drugs together or the condoning of use. To create effective drug-prevention programs, the effects of different activities need to be explored further, and admission criteria need to be well delineated.     

Performance-Enhancing Drugs,Sport, and the Ideal of Natural Athletic Performance

The use of certain performance-enhancing drugs (PED) is banned in sport. I discuss critically standard justifications of the ban based on arguments from two widely used criteria: fairness and harms to health. I argue that these arguments on their own are inadequate, and only make sense within a normative understanding of athletic performance and the value of sport. In the discourse over PED, the distinction between “natural” and “artificial” performance has exerted significant impact. I examine whether the distinction makes sense from a moral point of view. I propose an understanding of “natural” athletic performance by combining biological knowledge of training with an interpretation of the normative structure of sport. I conclude that this understanding can serve as moral justification of the PED ban and enable critical and analytically based line drawing between acceptable and nonacceptable performance-enhancing means in sport.     

Substance use/abuse as a predictor to illegal and violent behavior: A review of the relevant literature

The preponderance of the research evidence supports the conclusion that abuse of certain types of illicit drugs, separately from the abuse of alcohol, predisposes to subsequent violent behavior. The relationship of cocaine/crack to violent crime has been established more clearly for users of crack in inner city areas than it has for those who are users of other forms of cocaine in the general population.In regard to any race/ethnic or socioeconomic factors in the relationships between substance use/abuse and violent behavior, most clearly established is that a higher proportion of young Black males, compared to other race/ethnic groups, are actively involved in dealing cocaine/crack in some inner city poverty areas.As for gender differences, the research evidence indicates that alcohol abuse as a predictor to and a precipitant of violent behavior, is more clearly established for males than for females. Drug abuse, as distinct from alcohol abuse, has been found to predict subsequent violent behavior, for females as well as for males. “Co-morbidity,” the combination of substance use with and psychopathology, appears more likely to predict for females to later violent behavior. Psychopathology and mental health problems are less likely to predict occurrence of either violent or criminal behavior in the future than are either alcohol abuse or drug abuse.     

Substance use/abuse as a predictor to illegal and violent behavior: A review of the relevant literature

The preponderance of the research evidence supports the conclusion that abuse of certain types of illicit drugs, separately from the abuse of alcohol, predisposes to subsequent violent behavior. The relationship of cocaine/crack to violent crime has been established more clearly for users of crack in inner city areas than it has for those who are users of other forms of cocaine in the general population.In regard to any race/ethnic or socioeconomic factors in the relationships between substance use/abuse and violent behavior, most clearly established is that a higher proportion of young Black males, compared to other race/ethnic groups, are actively involved in dealing cocaine/crack in some inner city poverty areas.As for gender differences, the research evidence indicates that alcohol abuse as a predictor to and a precipitant of violent behavior, is more clearly established for males than for females. Drug abuse, as distinct from alcohol abuse, has been found to predict subsequent violent behavior, for females as well as for males. “Co-morbidity,” the combination of substance use with and psychopathology, appears more likely to predict for females to later violent behavior. Psychopathology and mental health problems are less likely to predict occurrence of either violent or criminal behavior in the future than are either alcohol abuse or drug abuse.     

Alcohol drinking parties and consumption of alcohol and other drugs in youth

The main aim of this paper is to analyze the relationships of involvement in the "botellon" (meetings of youth in public places to drink, chat, etc.) with alcohol/other drug abuse and vandalism in young people. A school survey was performed in centres of Compulsory Secondary School (E.S.O.), high school, professional training and University education in Lugo, NW Spain. The sample (aged 12 to 30) was split into three groups according to alcohol use and botellon involvement; drug abuse, drug-related problems and vandalism were assessed in each group. Results indicate that regular botellon attendants display more problems with alcohol and other drugs, as well as higher involvement in vandalism; this relationship is stronger among young students. The increase in adolescent risk associated with the practice of the botellon is explained by peer group pressure to use drugs and the greater accessibility of alcohol/other drugs in these contexts.     

Patterns of adolescent psychoactive substance use and abuse in Benin City, Nigeria

The pattern of use and abuse of psychoactive substances by Nigerian adolescents is investigated. Unlike previous epidemiological studies that used questionnaires to investigate university or postprimary school students, the present study used unobtrusive methods for data collection. The observed pattern of use was not different from that found in previous research. Adolescents tended to use the following drugs in decreasing order of frequency: alcohol, cigarettes, stimulants, cannabis (Indian hemp) and sedative-hypnotics. Polydrug use, especially of alcohol, stimulants, and cigarettes, is common. The use of hard drugs was not reported in this study. The implications of the findings can be appreciated only against the background of the known sequelae (psychological, physical, and socioeconomic) of psychoactive drug abuse. Finally, recommendations for controlling adolescent drug use are offered.     

School-community drug prevention programs

Much like the plague of days of old, the problem of drug abuse in the U.S. today is no respecter of age, social class, or ethnic background. Drugs are available in ever-increasing quantities, and the rate of increase is in direct proportion to the constantly expanding audience of youngsters sampling drugs. This paper presents a 10-point program for schools and communities, aimed at the prevention of abuse and rehabilitation of users. The program's thrust is a comprehensive endeavor involving key individuals and agencies in long-range efforts to dissuade youngsters from harmful experimentation with drugs. The author makes a plea for a united attack on the problem of drugs by all members and divisions of APGA.     

Aberrant learning and memory in addiction

Over the past several years, drug addiction has increasingly been accepted to be a disease of the brain as opposed to simply being due to a lack of willpower or personality flaw. Exposure to addictive substances has been shown to create enduring changes in brain structure and function that are thought to underlie the transition to addiction. Specific genetic and environmental vulnerability factors also influence the impact of drugs of abuse on the brain and can enhance the likelihood of becoming an addict. Long-lasting alterations in brain function have been found in neural circuits that are known to be responsible for normal appetitive learning and memory processes and it has been hypothesized that drugs of abuse enhance positive learning and memory about the drug while inhibiting learning about the negative consequences of drug use. Therefore, the addict's behavior becomes increasingly directed towards obtaining and using drugs of abuse, while at the same time developing a poorer ability to stop using, even when the drug is less rewarding or interferes with functioning in other facets of life. In this review we will discuss the clinical evidence that addicted individuals have altered learning and memory and describe the possible neural substrates of this dysfunction. In addition, we will explore the pre-clinical evidence that drugs of abuse cause a progressive disorder of learning and memory, review the molecular and neurobiological changes that may underlie this disorder, determine the genetic and environmental factors that may increase vulnerability to addiction, and suggest potential strategies for treating addiction through manipulations of learning and memory.     

Drug consumption and perception among Latin American immigrants

The aim of this study is to obtain information about drug consumption, leisure activities and knowledge of community services among Spanish-speaking immigrants to prevent drug abuse in this population. Quantitative methodology was used. The field work of this study has two phases: in the first stage (2003), a survey of social perception of drugs was administered to 147 subjects. During the second stage (2004), 610 surveys were administered. Data were analysed by bivariate analysis. Usual consumption of alcohol was 40.1%, usual consumption of tobacco was 31.3%, and usual consumption of cannabis was 3.4%. Drug users considered that the main reason for drug consumption was "to have fun" (p<.03). There is a relationship between leisure time and drug use. Family plays an important role in drug abuse prevention and preventive drug abuse programs must be adapted to this population.