On Monday night (Aug. 8), American swimmer Lilly King won the gold medal and set an Olympic record in the women’s 100-meter breaststroke. Some fans, as well as King herself, also considered it a victory over doping. King both literally and figuratively wagged her finger at Russian swimmer Yulia Efimova, who placed second in the competition and is among the athletes implicated in the Russian doping scandal that loomed large over this year’s Olympic games. In the past week, a third of the Russian delegation was ejected from the games over allegations of state-sponsored doping. But the use of performance-enhancing drugs (PEDs) is not limited to Russia. The World Anti-Doping Agency told the BBC in 2015 that more than 10% of all elite athletes could be using PEDs. A 2015 review published in Sports Medicine puts that estimate at an even higher 15%-39% of all elite athletes.
Given the prevalence of PEDs, some have suggested that the Olympics and other athletic competitions should shift to a more lenient approach. But lifting the ban on PEDs could wind up penalizing anyone who didn’t dope, essentially coercing athletes into using drugs. While there are certainly changes we can make to better handle the problem of PEDs, to legalize doping entirely would be antithetical to the idea of sport.
Those who want the Olympics to accept doping as par for the course argue that athletes will use PEDs anyway, and that health risks to athletes would be reduced if they learned how to use them responsibly. When presenting this argument, people often point to how American attitudes toward recreational drug use have evolved over the years, with policies shifting away from mass incarceration to a more compassionate approach. Instead of viewing recreational drug use as a moral failure that should be punished, the US has become more understanding of the factors that lead to addiction, including poverty, prior trauma, lack of social connection, economic insecurity, and mental illness. Under the principle of “harm reduction,” American institutions provide drug users with medical and mental health treatment. They give them medications to prevent withdrawal, which thereby deters crimes committed to support their habits, and offer them clean needles and medications to help them avoid contracting HIV. They screen and treat them for infections that they may have gotten while using street drugs, and they help them become functional members of society.
There are some good takeaways here that can be applied to PEDs—particularly the idea of “harm reduction.” Many PEDs approved by the Federal Drug Administration, such as erythropoietin, testosterone, and human growth hormone, have been studied in patients with AIDS, cancer, or kidney failure. But balancing the risks and benefits of taking these drugs is a very different calculation for elite athletes: We don’t know how best to counsel athletes using PEDs because we haven’t done the studies.
So why not establish clinical trial centers through which athletes could get FDA-approved drugs while being monitored meticulously for side effects? While this wouldn’t be risk-free, athletes would be less likely to suffer from known problems affected by dosage, such as heart attacks, strokes or psychiatric disorders. That said, there would inevitably be people who will give themselves higher doses of PEDs under the table or seek out underground, unstudied PEDs. But rather than test for PEDs, which will continue to be a moving target, testing could be targeted at the outcomes of doping (e.g. hematocrit levels) to prevent dangerous health effects.
We should also mimic our shifting approach to recreational drugs with regards to age. PED use among minors is already all too common, so perhaps we should focus our policing efforts there. Just as we reserve tougher judgment for drug dealers and traffickers who distribute to minors, we should crack down on coaches and trainers who supply child and adolescent athletes with PEDs.
The issue of fairness is what makes the case of PEDs profoundly different from that of recreational drugs. Fairness is fundamental to good sportsmanship—we love sports because we enjoy seeing not only the limits of what’s physically possible, but also seeing the best in us.
If we were to lift the ban on PEDs, we would also be further entrenching the troubling class dynamics that already exist in sports. Professional sports are big business, but not all professional athletes are making the big bucks. It’s those at the top—the star athletes, as well as the suits who own the leagues and teams—who make the lion’s share. And the more dangerous the sport, as with football, the less likely the athletes are to come from wealthier, better-educated families. Legalizing PEDs could essentially push less privileged young people onto a dangerous path seeking fame and fortune. After all, desperate circumstances make people more willing to accept risks to their health in exchange for the possibility of big, albeit short-term, rewards.
Even the athletes who use PEDs—and the people who make money off them—probably don’t want the drugs to be legalized either. It’s the human element of athletic competition that inspires fandom. Audiences root for gymnasts who stick landings and pitchers who throw perfect games because they’re moved by what it’s possible for the human body to achieve. When drugs get involved, it’s a whole different ballgame.