By Kyle J.D. Mulrooney & Katinka van de Ven

Doping in sport has become progressively viewed as a social problem and a number of actors have been successively identified as the ‘carriers of this social harm’ (Ellis, 1987; in DeKeseredy & Dragiewicz, 2012). As a result the list of ‘folk devils’ (Cohen, 1985) has grown and so too have the control mechanisms employed to combat them. Performance and Image Enhancing Drugs (PIED) are deemed morally reprehensible by the general population, and considered a practice that should be banned and criminalized (Coomber, 2013; Coakley, 2014). However, there seems to be a tendency amongst policy makers to frame steroid or PIED use outside of elite sport as an issue within sport, and to call for the same types of policies that are being used in anti-doping (Kimergård, 2014). This paper will briefly explore the PIED policies of three countries, Sweden, Belgium and Denmark, highlighting the ways in which anti-doping in elite sport is informing national drug policy and encouraging a zero tolerance approach to PIEDs as a social health issue.

The anti-doping movement consists of multiple actors and organizations operating on a variety of levels, from national and supranational governments, to regional, national and global agencies. Consequently, anti-doping policy is not necessarily the result of a coherent and consolidated movement as often times stakeholders take their own direction. Nevertheless, the World Anti-Doping Agency (WADA) has facilitated ideological unification and advanced the harmonization of anti-doping policy around the world. As Goode (2011) explains, “some crusades become institutionalized into or leave a legacy or routine, hegemonic, organization rules, policies, practices, and clearly, WADA, with its enormous sanctioning power, is the manifestation of one such successful effort”. Therefore, we suggest that the consistent escalation of punitive mechanisms in the ‘war on doping’ around the world are often ripple effects of the sport movement (Cohen, 1985). For instance, while the WADA professes not to support the criminalization of athletes, the increasing number of athletes being criminally charged (e.g. U.S. track and field star Marion Jones, Flemish cyclist Johan Museeuw, and the Swedish ice hockey goalie Robin Rahm) by select governments is indicative of the movements foundations in zero tolerance buttressed by all-out repression (Kayser & Broers, 2012).

The most recent expansion of the anti-doping movement transcends the boundaries of sport by targeting traffickers of PIEDs through the use of criminal law (Hoberman, 2012; Paoli & Donati, 2014). Support for criminalization of producers and suppliers is clearly evidenced by the rhetoric of the anti-doping movement and the policy action and legislation enacted to this end. The media, sport officials and other authorities suggest that the black market for PIEDs is driven by economically motivated individuals and dangerous groups, in particular (‘mafia-type’) organized crime (see Fincoeur, van de Ven & Mulrooney, 2014; Van de Ven & Mulrooney, 2014). Subsequently, sport officials have called for action from governments around the world and have shown their own determination to tackle the supply side of the market. For example, in 2008 the WADA signed a cooperation agreement with Interpol, exchanging liaison officers. Moreover, the latest revision of the WADA Code 2015 (WADC) introduces a number of new anti-doping rule violations, which focus on the athlete’s support personnel. The WADC also now stipulates that every anti-doping organization must have the resources to obtain, assess and handle anti-doping intelligence and information from a variety of sources, including law enforcement, to assist in the development of their test distribution plans (UKAD, 2013 November 15). On a global level the 2005 UNESCO Convention against Doping in Sport represents the first time that governments around the world have agreed to apply the force of international law to anti-doping (UNESCO.org). Most importantly, the Convention provides the legal framework under which governments can address specific areas of the doping problem that are outside the domain of the sports movement. For example, the Convention calls for states to adopt measures against trafficking and, requires them to implement measures to control the production, movement, importation, distribution and sale of PIEDs. It is also telling that the Convention against Doping in Sport was the most successful convention in the history of UNESCO in terms of rhythm of ratification after adoption and is the second most ratified of all UNESCO treaties (UNESCO.org). Similarly, in the White Paper on Sport, the European Commission (2007) recommends that the trade of illicit doping substances be treated in the same manner as trading in illicit drugs throughout the European Union (ec.europa.eu). On the national level, the United States and several European Union countries (e.g. Denmark and Germany) are enacting and intensifying legislation against the consumption, possession and/or trafficking of PIEDs. For instance, several countries such as Belgium and France, have established specialized anti-doping police units (see Fincoeur, van de Ven & Mulrooney, 2014), while other countries such as Sweden and Denmark have established anti-doping initiatives apart from elite athletics and in the public arena (see Christiansen, 2011). Given the power of National governments to apply legal force in doping matters a closer look at developments in the anti-doping initiatives of several countries is warranted.

Efforts to curb doping outside of elite sport appear motivated by traditional anti-doping health concerns (Christiansen, 2011). Thus, policy initiatives tend to focus on prevention and deterring users with drug tests and monetary sanctions or suspensions. The National Anti-doping Agency’s (NADO) of Sweden, Belgium and Denmark all undertake doping controls on citizens in public gyms. Doping controls in Sweden are undertaken solely on members of sports associations that are affiliated with the Swedish Sports Confederation. Private gyms, which are not affiliated with the Swedish Sports Confederation, however do not fall under these policies but are at times controlled by the police when suspicion arises. The Flemish Anti-Doping Authority has the power to conduct doping controls in gyms across Belgium, regardless of anti-doping or sport affiliation. In Denmark, any individual training in a gym that is a part of the national anti-doping testing scheme is subject to doping controls. The scheme, which costs around 1.600 Euros a year to be a part of, incentivises participation through the use of ‘sad face’ and ‘smiley face’ stickers (see picture 1).

Those who are a part of the scheme receive a smiley face sticker that reads: “We test for doping in collaboration with Anti-Doping Denmark”. Alternatively, those who choose not to be a part of these schemes receive a sad face sticker that reads: “We DO NOT test for doping in collaboration with Anti-Doping Denmark”. Both stickers are required by law to be posted at the entrance to the gym. However, not everyone is pleased with the system as reflected by the altered anti-doping sticker (see picture 2).

These doping controls follow the international standards for testing and sanctioning of athletes, as laid out in the World Anti-Doping Code (WADC). Thus, a citizen training at a controlled gym may be subject to the WADC, the list of banned substances and the associated sanctions. A first offence (e.g. positive test) results in a ban of two years from every gym and any other form of organised sport (e.g. local soccer), and in Belgium an additional fine of 500-2.000 Euros. As of 2015 the minimum ban for doping increased from two years to four.

As supply reduction initiatives are gaining in popularity, the police are beginning to pay some attention to the illegal distribution of PIEDs in and around gyms and the activities of the NADOs and the policing of PIEDs overlap. While there is no official co-operation between the police and anti-doping in Sweden and Denmark, both police forces have prioritized PIEDs within their drug enforcement activities and a few police districts have chosen to focus on PIEDs with other drug investigations (Anti-Doping Denmark et al., 2012). This has resulted in a more frequent dialogue between the police and the NADOs, including advice in connection with the seizure of substances. In Belgium, doping controls are undertaken in co-operation with a specialized police unit, the Hormonencel. If a Belgian citizen tests positive the police are able to legally intervene and conduct house searches in an attempt to discover trafficking activities. Indeed, police interrogation and information sharing between NADO’s and legal authorities appear to play a central role in the future of anti-doping (Møller, 2013).

At the national level it is often bodybuilders and other ‘hard-core’ fitness and weight-trainers who are the target of anti-doping and police investigations concerning PIED trafficking. It is not unusual that PIEDs are strongly associated with bodybuilding. In the media PIEDs are often referred to as ‘bodybuilding drugs’ and competitive bodybuilders together with elite athletes are one of largest using groups in the PIED market (e.g. see Delbeke, Demet, Debackere, 1995; De Boer et al., 1996; Meinik, Jansen & Grabbe, 2007; Kanayama et al., 2008, 2010; Paoli & Donati, 2014). In bodybuilding subcultures both the use and supply of PIEDs is often ‘normalized’ (Monaghan, 2001). While the consumption, possession and trafficking of PIEDs may be considered unethical, morally wrong and even illegal by society at large, these activities are a normal feature of ‘the everyday life’ (South, 1999) of many bodybuilders. Therefore, a wide variety of PIEDs are often easily accessible through these subcultural groups (Maycock & Howat, 2007; Kraska et al., 2010) and consumption and sale often intertwine (Fincoeur, van de Ven & Mulrooney, 2014).

In addition, the unusual look (size) of many body-builders and the ‘suspect’ nature of their subcultural affiliations often raise suspicions (Monaghan, 2001). As a result ‘Lombrosian practices’ are often employed whereby police and anti-doping officials are ‘muscle profiling’ to identify PIED users and dealers. The Swedish police have been noted to arrest under suspicions of steroid use. In 2007, for example, a man was arrested for having “unusually large muscles” and “particularly large arm muscles”, which the police report stated, “are a sign of steroid use” (The Local, 2007 August 13). More recently, the police arrested a man “because his muscular physique led them to suspect steroid use” (The Week, 2014 August 7). A famous case amongst bodybuilders is operation Liquid (2009-2010), which led to the arrest of the world famous American IFBB professional bodybuilder Tony Freeman (see picture 3). Police chief Henrik Blushi also made it clear that bodybuilders are not welcome in Sweden when he stated, “if you are a professional bodybuilder you should not come to Sundsvall. We are very well informed here. We are currently conducting the largest doping trial in Europe, and then one should understand that we have an eye out for these things now” (Sundsvall, 2010 August 12). Likewise, the doping controls outlined above tend to target gyms where there is a suspicion of PIED use and/or trafficking practices. In the majority of the cases targeted gyms specialize in (competition) bodybuilding, and/or weight-training sports (e.g. power-lifting) (Flemish Parliament, 2013 July 2). While in principle doping tests are meant to be administered randomly, it is often male weight-trainers with a more muscular appearance who are likely to be subject to these control (see also Christiansen, 2011).

While the WADA may not advocate for the criminalization or sanctioning of ‘recreational users’ the fact that certain countries employ the WADC outside elite sport level speaks volumes of the power and influence of the sport movement to shape anti-doping as a social issue. Further, the anti-doping movements’ expansion to target suppliers of PIEDs and push for police co-operation has deep running implications beyond the boundaries of elite athletics and lends itself to the criminalization and sanctioning of users outside elite sport. This is particularly relevant to bodybuilders as ‘muscle profiling’ appears to be an accepted practice of some police units and NADOs. The use of PIEDs by recreational users has a different purpose from the use of doping in elite sports. However, when the concept is transferred directly from elite sport to describe the use of PIEDs in gyms, policy naturally attempts to tackle the issue with the same punitive approach as is done in sport (Christiansen, 2011). Further, the convolution of PIED use in society with doping in sport thwarts the creation and/or implementation of other demand- and harm-orientated approaches (e.g. giving advice on injecting, testing quality of PIEDs), as they may be perceived as a sign of approval. So long as national efforts to curb PIEDs use stay interwoven with sport policy, measures are inclined to adhere to the zero-tolerance mantra of the anti-doping movement and the punitive policies that flow from it, hindering the exploration of alternative approaches. It is time to rethink our approach to curbing PIED use in society. A good place to start would be to move away from ethically and morally charged sport driven anti-doping policy towards the development of local policy centred around public health and founded in the proximate realities of PIED dealing networks and consumption patterns.

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