Harm Reduction and History

Ian Ritchie, Department of Kinesiology, Brock University, Canada

I hope followers of the INDR Newsletter can accept this commentary for what it is: part reflection on the recent INDR conference in Aarhus, and part commentary on one interesting theme that emerged at the conference, based on some of my own observations and research.

Once again we had a celebration of scholarship at the biennial INDR conference, held August 24-25 at Aarhus University. The major theme of this year’s conference – “Doping in Sport, Doping in Society” – attempted to make links between efforts to control, police, and intervene in criminalized social drugs (such as heroin, cannabis, and so forth) and the same relatively recent attempts to criminalize performance-enhancing drugs (PEDs) in sport, while also broadening the discussion about PEDs to the varied non-elite sport settings in which, it has been discovered, the use of PEDs, and performance and image-enhancing drugs (PIEDs) are quite common. A great example of bridging these knowledge gaps similar to what many of the presentations attempted to do during the conference, can be found in the recent co-authored publication by two INDR members, April Henning and Paul Dimeo. In their insightful “The new front in the war on doping: Amateur athletes,”[i] Henning and Dimeo argue that increasingly harsh restrictions and policing at amateur levels of sport has brought with it unintended consequences for what are often less informed amateur athletes. Some risk testing positive for drugs, including medications and various lifestyle products, leading to disqualification, stigmatization, or potentially even criminal prosecution, for drugs they sometimes are not even aware are on banned list in the first place. Amateur sport, Henning and Dimeo point out, seems to a degree to be following the bad example of elite sport in that the prohibition-testing-punishment (and increasingly criminalization) system has not yielded the intended results, as the recent Russian allegations attest. The authors propose a harm reduction model be applied to the amateur sport settings, as this would move resources from punishment strategies towards research and services for athletes to make their competitive lives safer. It would, in their words, also “move away from a focus on ‘clean’ sport and towards one on healthy sport.”[ii]

INDR members of course will be aware of the harm reduction model, as this model has been suggested as one that should be followed at the elite levels as well.[iii] Indeed, during this year’s conference keynote speaker Bengt Kayser from the University of Lausanne gave us a model for harm reduction that was advanced, nuanced, and adaptable to changing information and inevitable discoveries of new substances and technologies.[iv] When placed alongside a “pragmatic, non-essentialist approach to enhancement behavior” – one that accepts human enhancement without resort to notions of, for example, sport’s “spirit” as of course the world anti-doping establishment currently does – the model Kayser proposes could provide a safer environment for athletes at both elite and non-elite levels.

However, many may not be aware just how old harm reduction ideas are, or for that matter the fact that harm reduction has been discussed at the highest levels of sport administration. For the INDR conference this year I presented on a rare and largely forgotten document, one that I feel is more than worthy of being dusted off from history’s proverbial dustbin. After Canada’s ‘Ben Johnson embarrassment’ at the 1988 Seoul Summer Games, the country’s government embarked on a year-long inquiry into the use of drugs in the Canadian sport system. What became known colloquially as the ‘Dubin Inquiry’, based on the name of presiding Justice of the Peace Charles Dubin, directly affected Canadian and international policies.[v] Somewhat buried in the Inquiry, in a list of public submissions, is the document “A brief to Mr. Justice Charles Dubin” by Rob Beamish and Bruce Kidd.[vi] Both Beamish and Kidd were, and remain, important sport sociologists and historians, in addition to having been high-performance athletes competing within the Canadian national sport system, and involved after their athletic careers with various important national and international social and political initiatives. Written in 1989, their brief is a fascinating read, not least because it predicts most of the major themes in doping and anti-doping research in the social sciences and humanities, discussed much later in time by sport scholars. Indeed, their discussion includes the idea of harm reduction, an option they implore Dubin to consider as he deliberates evidence from the Inquiry for his recommendations.

As part of my research, I communicated at length with both Beamish and Kidd. Kidd pointed out to me the interesting fact that around the time of Johnson’s disqualification there were, as he put it, ‘sotto voce’ – hushed, quiet – discussions at the highest levels of sport administration, including leaders within the Olympic movement, to consider normalization: some form of harm reduction model and to seriously consider reducing the banned list in order to bring doping out in the open in order to help protect athletes’ health. Quite famously, at one international meeting Canadian Jean Grenier – Secretary General of the Canadian Olympic Committee, Chief Coroner of the Province of Québec, and a pioneer in the sport of speed skating in Québec – told then IOC President Juan Antonio Samaranch that one day either he or one of his successors would hand the gold medal back to Ben Johnson or one of his descendants in the same way that the gold medal had been recently re-awarded to American Jim Thorpe.[vii] The fairly obvious parallel Grenier was making between the historical contradictions in amateur restrictions and those of prohibitions against doping is itself fascinating. But equally so was the premise of the argument: as a respected physician Grenier knew full well that the presumption that doping was ruining the health of athletes was based on wild exaggerations, and to truly protect the health of athletes, including from certain drugs that might bring harm because of excess use or lack of information on the part of users, the issue of doping had to be discussed openly, with normalization considered as a viable option.

Of course, since that period of time, the vast international infrastructure of anti-doping has only increased, making discussions of harm reduction or other forms of normalization largely mute, at least within the formal anti-doping community. But academics and other activists in INDR are having that discussion; not a ‘sotto voce’ one, but one that is open, informed, and even at times loud. To entertain such discussions and ideas was one of the goals of this year’s INDR conference, and it was one that I believe was achieved.

[i]                     Henning, April and Paul Dimeo, “The new front in the war on doping: Amateur athletes”, International Journal of Drug Policy

(2017), doi.org/10.1016/j.drugpo.2017.05.036

[ii]                    Ibid., p. 7.

[iii]                    There are now several sources for this but an early and often cited one is Kayser, Bengt, Alexandre Mauron, and Andy Miah, “Legalisation of performance-enhancing drugs”, Lancet (2005), 366:S21.

[iv]                    Kayser, Bengt, “Regulating human enhancement: Extending anti-doping policy beyond sport?” Presented at the INDR Conference, August 24-25, 2017.

[v]                    Beamish, Rob and Ian Ritchie, “Ben Johnson, Charles Dubin, and ‘the spirit of sport’: Canada’s role in international anti-doping policies”, Olympika: The International Journal of Olympic Studies, XXIV, pp. 47-72.

[vi]                    The brief is very difficult to access because only libraries and government archives with the full transcripts from the Dubin Commission include the document. However, I can easily make it available for anyone who is interested: iritchie@brocku.ca.

[vii]                   Personal communication with Bruce Kidd, University of Toronto, Toronto, Canada, May 4, 2017.