Q&A: Doping outside of sports

Interview with Director of Prevention and Public Health, Fredrik Lauritzen, by Human Enhancement Drugs Network (HEDN).

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Fredrik Lauritzen is Director of Prevention and Public Health in Anti-Doping Norway. Photo: Stian Schløsser Møller

I: Antidoping Norway (ANDO) is one of the leading National Anti-Doping Organisations (NADOs) in the world, and like a few other NADO’s Antidoping Norway is also responsible for the prevention of doping use outside organised sport.

Q: How did Antidoping Norway’s work with the prevention of doping use outside sport come into existence, and how has it developed over time?

FL: The idea of working locally to prevent doping outside sports started in 2006 by a request from a local police station outside Oslo where they had experienced an increase in crime which they linked to doping. They wanted more information about the subject to be able to deal with the problem. A minor grant to Antidoping Norway from the Norwegian Directorate of Health the following year made it possible for us to arrange an educational seminar and establish a local network group on anti-doping there, as well as in three other cities. The concept of a local network group has since been evaluated and adjusted over time. Today, a systematic and comprehensive preventive approach with local ownership is the backbone of ADNO's preventive work on anti-doping in a public health context.

Since 2007, the annual funding from the Norwegian health authorities has increased substantially. This has made it possible for us to recruit personnel both on a permanent and project basis, and develop and run anti-doping programs for- and in collaboration with counties, municipalities, schools, fitness clubs and prisons, as well as to conduct educational activities for university students, teachers, fitness professionals, police, health personnel, parents and many more. In 2017 we held 613 face-to-face presentations for more than 32 000 people throughout the country. About 60% was related to doping and public health.

I: Among both researchers and practitioners there are concerns that doping use in fitness and strength training environments is increasing. For example, it was reported in 2016 that the use of anabolic- androgenic steroids (AAS) in Norway has more than doubled in six years, in particular amongst young people.

Q: What kind of actions does Antidoping Norway undertake to prevent doping use in these environments? And what kind of measures do you think are the most important ones in order to address this issue?

FL: Unfortunately, due to a lack of studies and known methodological issues related to self-representation bias when collecting data through standard questionnaires, there is no clear picture on current doping prevalence in fitness and strength training environments in Norway, nor its development over time.

Existing studies on average report a steady lifetime prevalence around 2-3 %. There is no scientific evidence that the use of AAS have increased substantially over the years, although we (ADNO) and our partners continue to experience an increased interest in the issue, and receive more inquires and concerns from both the fitness centre industry, public officials, and the public.

We do believe that the current prevalence is somewhat higher than research has been able detect, and that this in part may be linked to the sharp increase in social media use in the later years, and a greater interest in strength training, fitness, and a muscular appearance among youth. However, when discussing prevalence, we must also be careful not to make doping use a bigger problem than it really is, as this may induce a “false consensus” situation where doping may be perceived as common by the prospective users, and thus might lower the threshold for using doping among these individuals.

I: The doping substances that have received the most attention both inside and outside the world of elite sport are anabolic-androgenic steroids. But people in fitness and strength training environments also take other human enhancement drugs such as stimulants or metabolic hormones for weight loss purposes.

Q: How do you address the diverse category of ”fitness drugs” that people use to enhance their appearance and/or performance?

FL: ADNO has a comprehensive toolkit with tailor-made preventive measures for different target groups. Information on the wide range of drugs currently used by the fitness crowd is something we provide to some audiences, but not all.

Primary prevention targeted to youth between 15-20 years is the cornerstone of what we do. In this context we speak less about the specific substances that are used and rather focus on social media, group pressure, general consequences of doping, dietary supplements, and clean exercise.

I: As you may know, the use of doping controls among recreational sportspeople (e.g. fitness members) has been criticised for being intrusive and violating citizens’ right to privacy. But it also has been argued that such controls are a necessary means to ensure a healthy training environment (by removing bad ”role models”) in the fitness centres that want a doping free environment.

Q: What is your perspective on this matter? And do you believe that Antidoping Norway is the right organisation to be responsible for testing recreational athletes?

FL: Currently, ADNO may test recreational athletes at fitness centres who have joined our Clean Fitness Centre Program and completed the certification process. In such cases, the club must follow a strict procedure which may end up with ADNO testing the suspected member. The fitness club owns the test results and has the responsibility to take appropriate action if the test result is positive. ADNO is just a service provider.

As part of the Clean Fitness Centre program, we provide the fitness staff with knowledge and training on signs and

symptoms of steroid use, and how they may approach the member and engage in a meaningful discussion with him or her. We also encourage and facilitate co-operation between the fitness clubs and local police.

ADNO conducting doping testing on behalf of the fitness centre is usually the last option. In my opinion, combatting doping in fitness and strength training environments should be based on prevention and on building a clean exercise culture where the exercisers believe they may reach their fitness goals without using doping. Not on testing.

I: Unlike countries such as Denmark and the United States, who banned the possession of anabolic steroids in the 1990s, steroids were legal to buy and use in Norway until 2013.

Q: Did the criminalization of anabolic steroids impact the use and/or supply of these substances in Norway? And has Antidoping Norway changed its approach to prevention in this area since the 2013 ban on steroids?

FL: The criminalisation of anabolic steroids and other doping substances in 2013 was a game changer for our work. Since then, the awareness of doping related to public health, and the government funding to ADNO to prevent this behaviour have increased substantially. My impression is that most people think that when a government ban the use of a substance, it sends a strong signal to the public that this substance is not good for the individual nor the society. I believe this may have a strong deterrent effect. A somewhat restricted availability due to laws and regulations certainly also help in this matter.

I: Interestingly enough, despite the harsher measures concerning anabolic steroids, the Norwegian parliament, following the example of Portugal, has recently voted to decriminalise illicit drug use.

Q: Do you believe that a decriminalisation of steroid possession and use could in any way be beneficial when it comes to the recreational use of these substances?

FL: We have not discussed that yet. On a general basis, I guess there are pros and cons with a decriminalisation like it is with criminalization.

I: Thank you for taking the time to participate in this interview!

FI: Thank you! Keep up the good work!

This article originally appeared in HED Matters (volume 1, issue 1)published by the Human Enhancement Drugs Network (HEDN).

Published: 09.05.18