Canada Games

TO DO
 Go to CCES website
 Use Global DRO to look up a drug and determine if it is prohibited
 Download the PDF of the banned substance list
 Download the PDF of the 2011 Annual Report
 Look at list of infractions
 Go to WADA website
 View the doping control/procedures video
 Read about Therapeutic Use exemptions
 Download the iphone app of Prohibited substances
 Educate athletes that marijuana is a banned substance in
sport
 Talk to young males about chew and binge drinking
 Volunteer with the Sports Medicine and Science Council
KEY DOPING RESOURCES
 World Anti-Doping Agency (WADA)
 www.wada-ama.org - Montreal
 Doping Video
 Prohibited substance list
 PDF
 APP
 Therapeutic use exemptions
 JADA
 Canadian Centre for Ethics in Sport (CCES)





www.cces.ca - Ottawa
Global DRO
Resource Cards
Yearly reports
Canadian Anti-doping Policy
RESOURCES
 Sport Medicine and Science Council of Manitoba
 925-5750 and web site
 Great video on humans as runners.
http://www.cbc.ca/video/#/Shows/The_Nature_of_Things/1242
300217/ID=2210700947
 Great Exercise Promotion video
 http://www.cbc.ca/news/canada/toronto/story/2012/01/11/toronto viral-video-doctor-health.html
 Illicit Drug Video – pre-release don’t distribute.
English production
http://vimeo.com/38093169
Password is pixel
SUBSTANCE USE IN SPORT
 Anti-Doping Program of Sport Manitoba
 Doping Control Procedures
 Substance Use Survey & Education
 Advice on fitness and nutrition
 Audience Response System (Turning Technology)
 Surveys
 Substance use
 Fitness
 Nutrition
 Athletes
 Manitoba Junior Hockey League (5 years) > 1000 players
 All Canada Games Athletes
 Canada Winter Games
 Canada Summer Games
 Over 400 Athletes surveyed from over 35 sports
 Select other sports and teams (football, hockey, rugby, etc)
CONTACT INFO
Dr. Dean Kriellaars
University of Manitoba
Faculty of Medicine
Department
Department
Department
Department
of
of
of
of
Physical Therapy,
Physiology,
Anatomy, AND
Surgery
Manitoba Institute of Child Health
Sport Medicine and Science Council of Manitoba
dean.kriellaars@gmail.com
204-688-0151 cellular
WHAT PERCENTAGE OF PEOPLE ARE
ACTIVE ENOUGH?
Age
Males
Females
6–11
48.9
34.7
12–15
11.9
3.4
16–19
10
5.4
20–59
3.8
3.2
60+
2.5
2.3
IN ONE GENERATION WE
HAVE ERADICATED A
HUMAN BEHAVIOUR
Wa l king to Sc h o o l
2 0 0 0 Ste ps / day g o n e
21 s te ps pe r k ca l
N o m o re un s t ruc t ure d pl ay – a l l s t ruc t ure d, i f a t a l l .
OVERWEIGHT AND OBESE ADULT
CANADIANS
65%
70
Percentage
60
50
40
30
20
10
0
ABC
OW
OB
OW+OB
Calories In
Calories Out
BREAKING UP WITH MISS VICKIE
 “In a very real and immediate sense, our
growing softness, our increasing lack of
physical fitness, is a menace to our
national security … such softness on the
part of the individual citizen can help to
strip and destroy the vitality of a nation”
(John F. Kennedy, 1960, Sports
Illustrated)
Osteoporosis
Cancer
Diabetes
Depression
Osteoarthritis
1968 Rewritten for 2012
Committing armchair suicide
Committing armchair suicide
Broadcast Date: July 16, 1968
Increased postwar affluence means the
nation eats more and walks less. These
days, Canadians with bulging bellies are
more likely to opt for a ride in the Chevy
instead. Passive recreation like TVwatching is also a problem. A fitness
expert in this 1968 television report says
people are committing "armchair
suicide." A man 33-pounds overweight is
three times as likely to die suddenly of a
heart attack. As a result, men begin lifting
weights at the gym and housewives
bounce along to TV exercise programs.
Broadcast Date: April 2, 2012
Increased postwar affluence means the
nation eats more and walks less. These
days, Canadians with bulging bellies are
more likely to opt for a ride in the VW
Chevy instead. Passive recreation like
screen time TV-watching is also a
problem. A fitness expert in this 2012
1968 television report says people are
committing "armchair suicide." A man 33pounds overweight is three times as likely
to die suddenly of a heart attack. As a
result, men begin lifting weights at the
gym and housewives bounce along to web
and DVD TV exercise programs.
Fool me once … fool me twice …. Fool me 44 years in a row!!!
We are knowledgeable …
… but we are not yet enlightened.
The function of protecting and
developing health must rank even above
that of restoring it when impaired
Hippocrates
SUBSTANCE USE IN
HEALTH
In the shadow
of the bulge &
dysfunctional
health
approaches
?
Immobile
Active
BORN TO MOVE
Better brain
Better muscle
Better bone
Better heart
Better body
Better social life
Low burden on health care
Improved effectiveness at work
SUBSTANCE USE IN
SPORT
2010 TOUR DE FRANCE
Contador on Clenbuterol on road to win.
WADA DOPING VIOLATION
 2 .1 . P r e s e n c e o f a P r o h ib i te d S u b s t a nc e o r i t s M e t a b o l ite s o r M a r ke r s i n a n
A t h l ete ’s S a m p l e
 2 . 2 . U s e o r A t te m p te d U s e b y a n A t h l ete o f a P r o h i b ite d S u b s t a n c e o r a P r o h i b i te d
Method
 2 . 3 . R e f us i n g o r f a i l i n g w i t h o ut c o m p e ll i n g j u s t i fi c a t io n t o s u b m it t o S a m p l e
c o ll ec t i o n a f te r n o t i fi c a t io n a s a u t h o r i z e d i n a p p l ic a b l e a n t i - d o p i n g r u l e s , o r
o t h e r w is e e v a d i n g S a m p l e c o l l ec t i o n
 2 . 4 . V i o l a t io n o f a p p li c a b le r e q u i r e m e n t s r e g a r d i n g A t h l ete a v a i l a b i li t y f o r O u t - o f C o m p et i t io n Te s t i n g , i n c l ud in g f a i l ur e t o f i l e r e q u ir e d w h e r e a b o ut s i n f o r m a t i o n
 2 . 6 . P o s s e s s i o n o f P r o h i b ite d S u b s t a n c e s a n d P r o h i b i te d M e t h o d s
 2 . 7. Tr a f fic k i n g o r A t te m p te d Tr a f fic k in g i n a ny P r o h i b i te d S u b s t a n c e o r P r o h i b ite d
Method
 2 . 8 . A d m i n i s t r a t io n o r A t te m p te d a d m i n i s t r a t i o n t o a ny A t h l ete I n - C o m p et i t io n o f
a ny P r o h i b ite d M e t h o d o r P r o h ib i te d S u b s t a n c e, o r a s s i s t i n g , e n c o ur ag i n g , a i d i n g ,
a b et t i n g , c o v e r i n g u p o r a ny o t h e r t y p e o f c o m p l ic i t y i n v o l v i n g a n a n t i - d o p in g r u l e
v i o l a t io n o r a ny A t te m pte d a n t i - d o p in g r u l e v i o l a t i o n
PRESENCE, POSSESSION, REFUSAL, WHEREABOUTS, ADMISSION
All Olympic Sports
& others
“Starts” at
Adverse Analytical Finding
Laboratoire de contrôle du
dopage
Pointe-Claire
Québec H9R 1G6
Canada
E-mail: christiane.ayotte@iaf.inrs.ca
DOPING IN CANADA 2011
 30 infractions in 2011
 21 were from football players (70%)
 100% were male
 Cannabis 13 OF 30 (43%)– REPRIMAND TO 4 YEARS
 Stimulants 5 OF 30 – REPRIMAND TO 2 YEARS
 PSEUDOEPHEDRINE, COCAINE , Methylhexaneamine
 Anabolic 6 OF 30 - 2 TO 3 YEARS
 Stanozolol, Testosterone, Tamoxifen, Methyl-1-testosterone
1 ST NORTH AMERICAN DETECTION: HGH
Socholotiuk , Matt
U of Waterloo
Now in MMA
GENE THERAPY
 Transfer genetic material into cells using a vector to repair
“bad” genes or replace “missing” genes.
 Genetic material (DNA – AGTC, RNA or even genetically altered cells)
 Vector – a deactivated virus or liposome (fat carrier) or engineered
protein (nanoprotein)
MUSCLES WITHOUT EXERCISE!
BEYOND DOPING: ATHLETE HEALTH
 Anti-Doping programs seeks to “level the playing field” rather
than enhance the health and well being of an athlete or sport
participant.
HEALTHY CHILD HEALTHY ATHLETE
 Anti-doping issues are minor in comparison to improper
substance use issues for children
 The real issues of substance are...








Illicit drugs
Alcohol
Tobacco
Supplements
Caffeine
Hydration
Caloric control
Sleep
 Approaches that look at the whole picture:
 Taking It- Informed Decision Making Model
DISTRIBUTED RESPONSIBILITY
AND CHILD HEALTH
INFORMED DECISION MAKING
Fair Play
Leg al
Performance
Health
Medi cal
Safety
Finan cial
TAKING IT
A simple model based upon informed consent
concept and decision analysis from decision
making theory.
A framework for entry of credible information.
Age independent for delivery.
Harmonizes approach by different groups
(coach, lawyer, police, health care, parent,
etc)
Absence of information results in tendency for
restriction in use.
CHEW
CANADA GAMES SMOKELESS TOBACCO
25.) Smokeless tobacco or chew.
Monthly
Weekly
Daily
Never
Totals
Responses
28 6.67%
18 4.29%
15 3.57%
359 85.48%
420
100%
14.5% smokeless tobacco users across all 25 sports.
14-20 years old.
All male.
2010/2011 MJHL
13.) Smokeless tobacco or chew.
Monthly
Weekly
Daily
Never
Totals
Responses
29 14.65%
14 7.07%
57 28.79%
98 49.49%
198 100%
50.5% smokeless tobacco users!
CHEW USE STARTED IN
5.1%
18.2%
3%
56.6%
9.1%
8.1%
In minor hockey
With non-hockey friends
In another sport
In school
With my family
In MJHL
CHEW CONSUMPTION
14.) Smokeless tobacco or chew.
Responses
1 tin a month
1 tin a week
2-3 tins a week
3-6 tins a week
1 tin a day
Totals
Average consumption = 1.37 tins per week.
$1285 per year.
21.69%
36.14%
27.71%
9.64%
4.82%
100%
WADA AND WORLD HOCKEY
 2009 Ice Hockey World Championships
 72 samples were collected
 Nicotine and/or metabolites were detected in every urine
sample.
 Concentration measurements indicated an exposure within
the last 3 days for
 eight specimens out of ten (80%)
 role models galore.
 The potential use of smokeless tobacco as a doping agent in
ice hockey requires further investigation
 "In certain sports we know that the use of nicotine is
widespread." According to Rabin (WADA Scientific Director),
scientific evidence suggests that using certain amounts of
nicotine is akin to using a stimulant.
CHEW AND MALE SPORT
 Males in baseball (54%), hockey (52%), rugby (38%) and football
(23%) demonstrated the highest smokeless tobacco use.
 Among smokeless tobacco consumers 45.9% used daily, 18%
weekly and 36% monthly.
 Smokeless tobacco consumption was 5.5% at a tin per day, 10%
at 3-6 tins/week, 25% at 2 -3 tins/week , 34% at 1 tin per week
and 25% at 1 tin per month.
 The majority of smokeless tobacco users reported starting using
smokeless tobacco at or prior to 15 years of age.
 The majority of smokeless tobacco users reported adopting
smokeless tobacco in a sport setting (71%).
CHEW AND MALE SPORT
 Athletes did not identify use of smokeless tobacco for per formance
enhancement.
 Athletes did not identify the conversion from smoking to smokeless
tobacco.
 Approximately 30% of smokeless tobacco user s attempted to quit with
negligible success.
 Non-smokeless tobacco user s identified disgust in the habit and cost
as the two reasons for not adopting use.
 Failure to maintain smokeless tobacco cessation was primarily
attributed to a return to a setting with alcohol and the spor t peer
group.
 Most athletes identified that their parents were not aware of their
smokeless tobacco use prior to 1 8.
2012 MONITORING PROGRAM
Nicotine placed on monitoring program
In order to detect potential patterns of abuse, nicotine has been placed on
WADA’s 2012 Monitoring Program.
It is NOT WADA’s intention to target smokers, rather to monitor the effects
nicotine can have on performance when taken in oral tobacco products
such as snus.
Nicotine is one of several stimulants added to the Monitoring Program,
along with the narcotics hydrocone and tramadol. Out-of-competition use
of glucocorticosteroids has also been included.
Under Article 4.5 of the World Anti-Doping Code, WADA is mandated to
establish a monitoring program regarding substances that are not on the
List, but which the Agency wishes to monitor in order to detect potential
patterns of misuse.
THE CHEW COMMANDMENTS
1. Monthly self-examination
2. Yearly exam by oral health care
professional
GENERIC QUITTING PLAN FOR CHEW
 Quitting Plan











Decide to quit
Reasons to quit
Pick a quit date
Get psyched up for quitting
Cut back before you quit
Right before your quit day
Quit day!
First Week: Coping with Withdrawal
Second Week: Dealing with Triggers
Tips for Going the Distance
Celebrate Your Success
MARIJUANA
PERFORMAMCE ATHLETES: MARIJUANA
8.2%
12.8%
2.6%
1.5%
75%
16.8 % more than once a year
14-16 YEARS OF AGE
I tried it once
More than once a year
Monthly
Weekly
Never
MARIJUANA – OFF SEASON
15.2%
42.1%
15.2%
18.8%
8.6%
43 % more than once a year
I tried it once
More than once a year
Monthly
Weekly
Never
INFORMED DECISION MAKING
Fair Play
Leg al
Performance
Health
Medi cal
Safety
Finan cial
DECISION MAKING
Information Framing
Time Pressure
Peer Pressure
Memory Prompt
Repetition
Cognitive Load
DECISION MAKING
Information Framing
Time Pressure
Peer Pressure
Memory Prompt
Repetition
Cognitive Load
DECISION MAKING
Information Framing
Time Pressure
Peer Pressure
Memory Prompt
Repetition
Cognitive Load
DECISION MAKING
Information Framing
Time Pressure
Peer Pressure
Memory Prompt
Repetition
Cognitive Load
DECISION MAKING
Information Framing
Time Pressure
Peer Pressure
Memory Prompt
Repetition
Cognitive Load
DECISION MAKING
Information Framing
Time Pressure
Peer Pressure
Memory Prompt
Repetition
Cognitive Load
Fair Play
Leg al
Performance
Health
Medi cal
Safety
Finan cial
PREPARING CHILDREN
 Consistent quality messaging
 Credible information
 Reduce hypocrisy
 Walk the walk
 You
 Others
 Role models
 Offer alternatives
 How do I avoid this?
 Pre-emptive
 Credible performance information
SPORT FOR LIFE




Long term athlete development model www.ltad.ca
A “must see” approach
Not a general health model
Does not include avoidance of negative behaviours associated
with sport
Making Better Athletes ...
ATHLETE MODIFIABLE
Sleep
Alcohol
Marijuana
Chew (males)
Fitness
•Aerobic
•Strength and
Endurance
•Flexibility
•Durability
Nutrition
•Fuel and H2O
• PRE
• DURING
• POST
•Protein
Technical
/Tactical
PERFORMANCE ENHANCED NUTRITION
50.) I would improve in my sport if I ate right.
Strongly Agree
Agree
Neutral
Disagree
Strongly Disagree
Totals
Responses
33.33%
40.87%
17.06%
3.97%
4.76%
100%
Athletes know they need to improve nutrition. More than 70% of
athletes self assess that they have inadequate nutrition.
BASIC PERFORMANCE ENHANCEMENT
Sleep
Water
Daily
Pre, during and post
Fuel
Daily
Pre, during and post
Protein
SELF RATED SLEEP QUALIT Y
31.) My sleep habits are excellent.
Strongly agree
Responses
5.52%
Agree
37.93%
Disagree
37.93%
Strongly disagree
18.62%
Over half the athletes are reporting disordered sleep!
SELF IDENTIFIED WEAKNESS
14.) To improve as an athlete I need to
Reduce alcohol
Improve off-season training
Get better coaching
Eat better
Sleep better
Totals
Responses
3.78%
25.95%
4.86%
24.32%
41.08%
100%
PROTEIN SUPPLEMENTS
(MALE AND FEMALE)
6.8%
8.5%
46.9%
15.8%
22%
I tried it once
More than once a year
Monthly
Weekly or Daily
Never
Male use averages 44% weekly or daily. Sport Specific. 79% in hockey.
Fair Play
Leg al
Performance
Health
Medi cal
Safety
Consistent quality training with good rest and nutrition.
Finan cial
CANADA GAMES - ADVICE ON SUBSTANCE USE
21.) I get my advice on supplements & vitamins from
coach
friends
team mates
trainer
therapist
family
nutritionist
other
Totals
Responses
54
28
13
57
15
137
54
64
422
Shifts to TRAINER at higher levels of sport.
12.80%
6.64%
3.08%
13.51%
3.55%
32.46%
12.80%
15.17%
100%
EPHEDRINE
& FRIENDS
EPHEDRINE AND PSEUDOEPHEDRINE
 A 2003 meta-analysis of all available studies and case reports
concluded that "ephedrine- and ephedra-containing dietar y
supplements [...] have harms
 In terms of a 2- to 3-fold increase in




psychiatric symptoms,
autonomic symptoms,
upper gastrointestinal symptoms, and
heart palpitations.
 More serious adverse effects from ephedra use cannot be
excluded at a rate less than 1.0 per thousand, and case
repor ts raise the possibility that a causal relationship with
serious adverse events may exist.
Fair Play
Leg al
Performance
Health
Medi cal
Safety
Finan cial
ENERGY
DRINKS
Fair Play
330 MG
Leg al
Performance
80 MG
Health
Medi cal
Safety
200 MG
Finan cial
ALCOHOL
CANADIAN STATISTICS (GENERAL YOUTH)
Hockey Wins GOLD
in every category
92.4% ETOH
60% Binge
43% Marijuana
HOCKEY BINGE DRINKING
4.8%
7.5%
28%
59.7%
Monthly
Weekly
Daily
Never
CANADA GAMES BINGE DRINKING
32.6%
38.8%
25.9%
2.8%
Monthly
Weekly
Daily
Never
Alarming level of binge drinking – 5 or more drinks a night
SUBSTANCE USE IN
HEALTH
In the shadow
of the bulge &
dysfunctional
health
approaches
Fair Play
Leg al
Performance
Health
Medi cal
Safety
Finan cial
Fair Play
Leg al
Performance
Health
Medi cal
Safety
Finan cial
Fair Play
Leg al
Performance
Health
Medi cal
Safety
Finan cial
Fair Play
Leg al
Performance
Health
Medi cal
Safety
Finan cial
Fair Play
Leg al
Performance
Health
Medi cal
Safety
Finan cial