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Salbutamol: why is testing so strict?

As most observers of sport are aware, the rules for drug testing can seem extremely strict especially in the case of athletes suffering from illnesses or risks of illness for which medicines must be taken. Many drugs needed to treat conditions like asthma, diabetes, and hay fever would cause a positive test, and would cause an athlete to be banned, if they are not declared to the organization's Medical Officer. Even if they ARE declared, the athlete should state this clearly on the doping control form (see below) if the call is made to carry out a test.

This then affords an added responsibility on "the accompanying person", often a team coach or authorized person permitted to "shadow" their teammate during testing. This accompanying person would do well to remind the athlete to declare ANYTHING they have taken that they suspect may cause a positive, no matter how convinced they are that it's OK. Only recently a prominent Irish Rugby player, Frankie Sheahan was sent home from a tour due to the strict enforcement of such a rule, and he now will miss an exciting tour and another paragraph to his glowing CV due to such a clerical error.

So were the authorities correct to be so strict? Of course they were, because many of the drugs used to treat conditions such as asthma, like Salbutamol (Ventolin is a common brand of this medicine) can be abused, may be anabolic (at the correct dose), but most of all could be harmful to a person taking them for no legitimate medical reason. So if the authorities tend to let a case go on such a technicality, sportspeople all over the world would interpret this as the IOC or other sports organizations being "soft" on drugs used for legitimate purposes. As a result we would see new "illnesses" cropping up all over the sports community, unless a stern message is given: You mess up, you carry the can. Because of the emergence of a high number of "asthmatic athletes" in the past decade, particularly prior to the last two Winter Olympics the IOC now insists declared asthmatics are independently examined to prove their need for such drugs prior to Olympic competition.

In most legitimate errors the punishment suffered by an athlete is no more than missing their intended event(s). There is though, one caveat: Salbutamol has TWO levels of testing: The first detects the drug in the urine, but the second "classifies" the infringement into a higher and lower concentration, and if the athlete tests positive for the higher level, (over 1000ng/ml urine) the misdemeanour becomes much more serious. Salbutamol, and many related chemicals at high doses are anabolic and stimulants, one very close relative, Clenbuterol being well known in Veterinary circles (Angel dust) for doping of food-intended animals, or of race-horses. It also is abused by humans in body-building, a very sinister and risky business!

Salbutamol is known as a "beta agonist", and acts on the nerves controlling the lungs, allowing them to open up a bit more and allows clearer breathing in an asthma sufferer. Many athletes (including myself!) would require this drug during, or immediately prior to exertion. Like almost all drugs though, it acts on other areas of the body too. Salbutamol slows labour in pregnancy (and is used as such to delay premature labour), and much more seriously, if taken in high dose, by injection or by mouth, it can cause tremor in the muscles, and in very high doses, heart-rhythm problems. It is side effects like these that cause drugs to be banned, not just for the cheating, but also for safety of athletes.

So, if you compete, and you have asthma:
· Do NOT stop taking your medication
· Declare it to your organizing body immediately
· If dope-tested, write it down as a medication you have used
· Try to have an "accompanying person" who is aware of these facts as the mind is not always clear after a competitive game
· Never exceed the doses recommended, because sport raises the heart-rate, and blood-pressure, as well as lowering the fluid levels, so drugs can have a much more significant effect during these periods