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Expert comment: banned substances in tennis

tennis comment Tuesday 8 March 2016

Dr Simon Marwood, Senior Lecturer in Physiology, discusses Maria Sharapova's admission that she took the banned drug  Meldonium, and asks how accountable she and others should be. 

Yesterday, former Wimbledon Champion, Olympic Silver Medallist and highly sponsored tennis poster girl Maria Sharapova admitted in a press conference, that was widely anticipated to be about her retirement, that she had failed a drugs test for Meldonium.

Meldonium is a drug that has demonstrated beneficial effects for the treatment of heart disease and diabetes via its inhibition of carnitine synthesis (a compound intimately involved in mitochondrial fat oxidation).  Meldonium was added to the World Anti-Doping Agency (WADA) banned list at the start of this year, probably due to a recent finding that 2.2% of elite athletes tested had the drug in their system.  Meldonium has been shown to improve exercise tolerance, but only in patients with stable angina; whether or not this would translate into enhanced performance in healthy, elite athletes is unknown and another question entirely.  Indeed, there are many cases in the scientific literature where the effect of an intervention on exercise performance is different with differing subject populations. 

Sharapova claims to have taken the drug for 10 years on Doctor’s advice given family histories.  However, it seems counter-intuitive that a young, highly trained woman would require pharmacological intervention to maintain their health, since exercise is such a strong protector from heart disease and diabetes.  It is also notable that the first clinical trial of meldonium was only completed in 2005 and is still not approved by the US Food and Drug Agency, where Sharapova resides. 

I highlight these issues as facts, rather than accusations, as only Sharapova will know what went into her system.  Indeed there are only two reasons why this drug test was failed: (i) Sharapova knowingly took the drug in order to improve performance or (ii) Sharapova took the drug in good faith on the advice of a Doctor, but did not stop taking the drug once it was added to the WADA banned list (or apply for some sort of therapeutic use exemption). 

Assuming the latter, I still have little sympathy since all athletes received an email about this addition to the WADA banned list and it is ultimately an athlete’s responsibility to ensure what goes inside their body is within the rules, regardless of their intentions.  If this principle is not adhered to, then the merry-go-round of weak excuses and explanations for failed drugs tests would multiply enormously.

On this basis I find it highly unlikely that Sharapova will compete at the Rio Olympics this year, indeed I would be very disappointed if she were able to since it is a matter of months away.  I am not somebody who feels that athletes should receive lifetime bans for any drugs offence, because athletes are people and people make mistakes. 

However, Sharapova should take responsibility (which she seems to be doing), and be banned from competing for a worthwhile period of time.  Moreover, given previous cases the public should reserve the right to be sceptical about any athlete claiming their innocence. 

Dr Simon Marwood - profile

Health Sciences at Liverpool Hope

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