SHARAPOVA AND THE MELDONIUM QUESTION: REWIND

by The Spin Team

Ever since the Press Conference when Maria Sharapova announced to the world that she had failed a doping control test for the banned substance Meldonium (Mildronate), there have been hundreds, nay thousands of articles written about Meldonium.  Within the same time period, approximately 140 other athletes from various countries have tested positive for Meldonium. Ms. Sharapova indicated that she started taking the drug 10 years ago for a variety of medical symptoms, including a family history of diabetes, magnesium deficiency and an irregular EKG. I have not seen any article which proposes Meldonium as a standard treatment for any of Sharapova’s listed medical issues,  nor have any of the other athletes indicated that they were suffering from angina (chest pains) and myocardial infarctions (heart attacks).

Why am I writing about this again?  I am writing because as more and more athletes test positive for Meldonium, the public has begun to question if this drug should have been placed on WADA’s list of banned substances. They appear to believe that all of the athletes who tested positive must have had legitimate reasons for using a drug meant to help patients suffering angina and myocardial infarctions. Some articles are even suggesting that there is a plot to discredit Russian athletes by having this non-performance enhancer drug be banned.  People are so eager to have Ms. Sharapova back on Tour that they are lobbying for the removal of Meldonium from the banned list and suggesting that WADA should have done more to provide information and explicit warnings to athletes.

In December 2015 a study in Drug Testing & Analysis stated that Meldonium benefits include “an increase in endurance performance of athletes, improved rehabilitation after exercise, protection against stress, and enhanced activations of central nervous system (CNS) functions" [Wikipedia].  The manufacturer of Meldonium has indicated that the drug is used to “prevent death of ischemic cells and not to increase performance of normal cells”. They suggest that “Meldonium cannot improve athletic performance, but it can stop tissue damage in the case of ischemia,” (lack of blood flow to the heart” [Wikipedia].

So, 140 athletes have used a drug which the drug manufacturer now states is not a performance enhancer, cannot be used as a performance enhancer and therefore, should not have been placed on WADA’S banned list.  Why then were these athletes using the drug? Performance Enhancing “relates to a substance, typically one banned for use in competitive events that is taken by an athlete or sports player to improve their performance”.  Most of the time when we hear about performance enhancing, we usually think about these huge muscle bound athletes, or in the case of tennis, athletes who can hit big booming serves, or who can run and run all day and never seem to get tired. This is the reason why players such as Serena Williams and Rafael Nadal are always accused of doping.

Did you know that there are different types of performance enhancement? The United States Anti-Doping Agency (“USADA”) website lists the following:  

·          Anabolic hormones – promotes muscle growth;

·          Peptide hormones, growth factors & related substances – stimulates growth and cell reproduction and regeneration in humans; aids in the production of oxygen carrying blood cells in the body;

·          Beta-2-agonists – used to treat conditions such as asthma & other respiratory ailments; evidence shows that some have been used as a performance enhancer;

·          Diuretics – expel water from a body; used by athletes with weight restrictions;

·          Masking agents – used to prevent the detection of other classes of drugs;

·          Stimulants – used to stimulate the body & mind to perform at optimal levels by increasing focus, energy & aggression; used to treat ADD (e.g. caffeine)

·          Narcotics – mask pain so that athletes can continue to compete & perform beyond their usual pain thresholds

·           Marijuana – slowed coordination & reaction time; distorted sense of time & place; increased heart rate

Apart from the treatment of angina and myocardial infractions, Meldonium’s own manufacturer suggests that it “improves physical capacity and mental function in the case of ischemia [an inadequate blood supply to an organ or part of the body, especially the heart muscles] and healthy people.”  Maybe this is the reason why so many athletes thought it would be beneficial to them. Wouldn’t such a reason justify why WADA considers it a performance enhancer? In addition, even if the drug manufacturer’s lied about Meldonium’s capacity (and there does seem to be conflicts about its real impact), WADA’s code doesn’t say the drug has to be a proven enhancer, it simply says that its presence in the athlete’s body is a violation once it has been listed on the banned list. In the case of Sharapova, one now has to wonder at the many times she was lauded for her mental toughness, all while using a substance she and other athletes were led to believe were having a profound impact on her physiology and her mentality.

In the course of writing this article, the New York Times printed an article indicating entire teams from the Russian Federation have been pulled from the upcoming Ice Hockey World Championships to be held in Grand Forks, North Dakota.  The article in its entirety can be found here.   It is alleged that some or all of the athletes have tested positive for Meldonium.