User:James.Groutsis/sandbox/Doping in Tennis

Doping In Tennis Defined as the use of banned athletic performance-enhancing drugs (PEDs) by competitors, doping has long been an issue in many competitive sports. In tennis, doping has largely gone unnoticed as, in the past the use of PEDs was not common as their benefits were not as clearly transferable to the sport in comparison to cycling, weightlifting and the like. The main use of PEDs in tennis is to increase stamina/endurance due to the requirement of high intensity output for extended periods of time, coupled with short recovery times and busy training/competition schedules. History With the growth of performance enhancing and recreational drug use across all sports in the 1970s and 80s, the Men’s Tennis Council (Tennis’ governing body at the time) began testing in the late 1980s, focusing on recreational drugs. Following the formation of the ATP in 1990, the scope of testing was expanded to include performance enhancing drugs. In 1993, the ITF, WTA and ATP formed a joint anti-doping program which covered all aspects of tennis, including each Grand Slam tournament through the ITF, this was later expanded in 2006 and 2007 to encompass all tennis events, management, administration and enforcement.

Substances The banned substances in tennis are stipulated by the International Tennis Federation (ITF), derived from the WADA banned substances, and are split into ‘in-competition’, ‘out-of-competition’ or totally banned. The full list can be found on the ITF website, courtesy of WADA: Banned Substances 2019 •	Anabolic agents: primarily anabolic steroids, any substance deemed to unnaturally increase levels of testosterone and other anabolic hormones. This substance is banned as it rapidly increases both muscle growth and recovery in its users, beneficial to players as faster recovery and increased strength result in longer performances. •	Peptide Hormones, Growth Factors, Related Substances, And Mimetics: are drugs and certain supplements which accelerate the growth of, or modulate production of human, protein-based hormones so as to increase recovery, muscle strength or alter various other aspects of performance. •	Beta-2 agonists: The β2 adrenergic receptor is a receptor causing smooth muscle relaxation, as such a Beta-2 agonist increases this, stabilising breathing, opening airways and in some cases increasing insulin levels. •	Hormone and metabolic modulators: are usually accompanying anabolic agents or related substances to control the body’s natural response to increase the antagonistic hormone, usually oestrogen. This results in increased testosterone without oestrogen to mask its effects. Such changes also affect the body’s metabolism, in addition to specific metabolic modulators which increase metabolic efficiency. •	Diuretics and masking agents: comprised of drugs having a diuretic effect, allowing increased fluid consumption, aiding red blood cell creation thus reducing fatigue. Diuretics are also used in combination with masking agents to reduce the evidence of other drugs in an athletes system. Anti-Doping In accordance with the World Anti-Doping Association (WADA), the International Tennis Federation (ITF) has a comprehensive list of substances which are banned for use either in competition, out of competition, or banned completely. To support such bans, the ITF, in conjunction with WADA require players to “submit on request” at any time for testing by the ITF or any other Anti-Doping Agency with control over such player (national agencies applicable to said player or similar).

There are three main reasons for collecting and analysing such samples: 1)	To detect evidence of prohibited substances, including their metabolites and/or markers 2)	To assist the ITF in profiling athletes, including for DNA or genomic profiling for future analysis and comparison (e.g. as part of the Athlete Biological Passport Programme (ABP)) 3)	Or for any other anti-doping purpose, including being stored for later examination when anti-doping technology improves/changes

All samples for testing provided by a player for the ITF anti-doping program then become the property of the ITF and as such the ITF is liable for the protection, analysis and proper disposal of players’ samples. Moreover, the ITF or any other agency cannot use any sample for research or benchmarking purposes without the corresponding player’s consent.

All players who hold an ATP or WTA ranking, or who enter or compete in events organised, sanctioned or recognised by the ITF are subject to testing. This includes: “Grand Slam tournaments, Davis Cup and Fed Cup ties, Olympic and Paralympic Tennis Events, ATP and WTA tournaments, ATP Challenger Tour tournaments, ITF Pro Circuit tournaments, ITF Junior events, ITF Seniors events, ITF Wheelchair events and ITF Beach Tennis Tour events.” In 2017, the ITF tested over 1,200 players and a total of 3,081 samples, with players being measured between 1 and 7+ times in competition (IC) and the same out of competition (OOC). Players with higher rankings and more frequent participation in tournaments tended to have higher levels of testing. In addition, the discrepancy between the numbers of samples collected from men and women is mainly accounted for by samples collected from Challenger events, which are for men only.

2017 Testing Statistics 2017	Total Samples	Men	Women IC (urine)	3,081	1,854	1,227 IC (blood)	415	205	210 IC (ABP)	313	158	155 OOC (urine)	841	432	409 OOC (blood)	819	419	400 OOC (ABP)	824	420	404 Totals	6,293	3,488	2,805

By Player Testing Statistics Player	In Competition (IC)	Out of Competition (OOC) Rafael Nadal	7+ 	7+ Simona Halep	4-6	7+ Roger Federer	7+	7+ Caroline Wozniacki	7+	7+ Novak Djokovic	4-6	7+ Angelique Kerber	7+	7+ Juan Martin Del Potro	7+	7+ Petra Kvitova	4-6	7+ Alexander Zverev	7+	7+ Elina Svitolina	7+	7+

Athletes can however circumvent the bans through ‘Theraputic Use Exemptions’, where an athlete may use a banned substance if: 4)	The prohibited substance or method in question is required to treat an acute or chronic medical condition, such that without said banned substance/method the athlete would have “a significant impairment to health”. 5)	The Therapeutic Use of the Prohibited Substance or Method is unlikely to provide any performance enhancement beyond the improvement seen by a return to normal health subsequent to treatment of the acute/chronic medical condition. 6)	There is no reasonable alternative to the use of a prohibited substance/method. 7)	The necessity for a TUE is not resultant from the use of another prohibited substance/method without a TUE.

In 2017, “A total of 120 applications for a TUE were received under the Programme in 2017. Of these, 64 (53%) were granted, 14 (12%) were denied, and 29 (24%) were for substances and/or routes of administration that were not prohibited. The remaining 13 (11%) were either cancelled (e.g. for a failure to provide further information on request) or withdrawn by the applicant. The average time from receipt of a fully-completed application to its grant or denial in 2017 was 4.6 days.”

Prevalent Doping Cases See List of Doping Cases in Tennis

Maria Sharapova See WADA substance controversy

Meldonium is an anti-ischemia drug which is usually prescribed to patients with coronary heart disease. The drug is primarily distributed in Eastern European countries, produced by Latvian pharmaceutical company Grindeks, developed originally by Ivars Kalviņš of the USSR Latvia Institute of Organic Synthesis.

Marin Cilic At Wimbledon in 2013, Marin Cilic tested positive for nikethamide and was subsequently forced to pull out of his second round match against France’s Kenny de Schepper. Though it was initially reported Cilic pulled out due to a knee injury, it became known a month later that it was due to this positive drug test result. As a result, on 16 September 2013, Cilic received a backdated 9 month ban, running until 1st February 2014. Cilic and his team claimed that the prohibited substance was detected as a result of consuming Coramine glucose tablets purchased by a member of his team at a London pharmacy. The ITF appointed independent tribunal found that Cilic “inadvertently ingested the nikethamide as a result of taking the tablets and did not intend to enhance his performance in doing so.” The ban remained until Cilic appealed the decision at the Court of Arbitration for Sport, who reduced the ban from nine to four months on the 25th October. They noted that "the degree of fault committed by the athlete was inferior to that established in the (tribunal) decision and the sanction imposed was too severe in view of the degree of fault". Cilic, whose ranking had dropped to number 47, immediately increased as results at the French Open, Queen's and Wimbledon were included.

Others Andre Agassi, Richard Gasquet, Martina Hingis, Dan Evans