A fresh look at doping based in the history of sports and performance enhancement


Andrew J. Bloodworth
Swansea University


April Henning & Paul Dimeo
Doping: A sporting history
237 pages, hardcover, ill
London: Reaktion Books 2022
ISBN 978-1-78914-527-4

I was pleased to be asked to review this book, Doping: A Sporting History by April Henning and Paul Dimeo. I have taught modules in anti-doping for the past 10 years and continue to conduct research in the area. Interestingly, I tend to focus on the ethics of current anti-doping policy, and have made only fleeting reference to the history of doping during my teaching. Having read this text I will rectify this. The book is a great demonstration as to how current anti-doping policy has developed, and indeed how we might seek to address the flaws with such policy. In the below I will offer a brief synopsis of the book, including a couple of my own observations.

The introduction offers a clear account of how the book will progress, and of the key arguments that will be made. We see from the outset that the book will argue for greater athlete involvement in the development of anti-doping policy. This argument is made throughout the text, but most significantly in the final chapter where recommendations for future policy are made. This seems an entirely sensible line, anti-doping policy does seem to have developed without proper reference to the athletes’ voice. Of course, greater athlete involvement in anti-doping policy does not guarantee good policy overall. There are problems with the collectively bargained policies in some North American sports for example. It would though be sensible to properly incorporate the athlete voice in policies that are in the main targeted at athletes.

Chapter One documents the origins of organised sports. The book is carefully researched throughout and is also very fluid and engaging. We see the role of social class throughout the history of doping on offer. As the text progresses, a distinction is made between richer athletes, who have time to compete as amateur athletes, and professional athletes, who are likely to be from less wealthy backgrounds. Mainly amateur athletes and sports organisers seemed to be concerned with the taking of substances to enhance performance, whereas the professional athletes appeared less perturbed by such developments. Indeed, this is captured perfectly in the summary of the chapter, where it is said that two opposing views of sports were in operation ‘dirty, artificial, professional working class as opposed to clean, natural, amateur, middle/upper class’ (p, 37).

The authors argue for a realistic rather than idealistic anti-doping policy, however, and thus, while it is not stated in the text explicitly, accepting the fact that some who are determined to dope might evade the testers might be a part of that more realistic approach.

The second chapter documents the development of amphetamine and steroid use after the Second World War. During this period there were no rules against drug use in sport, and stimulants in particular were widely accepted in society. We see claims of widespread use of steroids in the 1968 Olympic Games, within the US track and field team (p. 55). The chapter concludes by pointing out that amphetamine use during this time was common outside of sport, and that it is only when looking back at the 40s and 50s from a point at which anti-doping has grown into a movement that we view it differently. The authors illuminate the concern of anti-doping in the penultimate page of the chapter, arguing that anti-doping has never just been about the injection of pills and liquids, ‘it was about the meaning of that drug use’ (p. 62). That meaning is unique to sport, the authors state. This is clear, sport offers a unique kind of test of physical and mental ability, and drugs interact with these abilities in ways that may be less significant outside of sport.

The following two chapters document the early stages of drug testing during the early 1960s and beyond, and ‘How Doping Became an Epidemic’ in chapter four. Here the authors claim that steroids in particular were changing the face of elite sport during the 70s and beyond. In chapter five, titled ‘The End of Innocence’ the East German organised doping system is detailed, along with the positive test of Canadian sprinter Ben Johnson. Johnson’s test is described in stark terms. ‘It was the consequence of a systematic failure of sports organizations, national and international, to confront the issue. There was no testing outside of competitions, and very few in-competition tests, and the sanctions for being caught were not enough to deter users’ (p. 124). It is interesting to ask whether anti-doping testing is a great deal more successful present day. Despite the ability to test top class athletes all year round, in and out of competition, the number of positive tests is very low, and when the you look through the UK statistics in particular it is noteworthy that a number of these athletes are sub-elite.

In chapters six and seven the development of our current anti-doping structure is documented. This includes the formation of the World Anti-Doping Agency in 1999, a response in part to a doping scandal in the 1998 Tour De France. In chapter seven we see how WADA’s new approach may be seen as a more systematic and global line, with the formation of the 2003 WADA Code, but can also be criticized for the increased surveillance of athletes, the lengthy punishments for those who have doped accidentally, and the increasing infringements on the privacy of athletes. Indeed, this latter point is made at a number of times in the book. The process of testing itself – watching someone pass urine when they are exposed from midriff to knee – is of course invasive and potentially distressing. In addition to that, we have for top athletes in a registered testing pool, a system of out of competition testing that requires them to detail their availability for testing for one hour a day, 365 days a year.

(Shutterstock/Piotr Swat)

Chapter 8 sees the authors make their own recommendations as to how anti-doping might move forward. They first document the ways in which the current approach is failing. The low numbers of positive tests of athletes recorded by WADA are in stark contrast to some academic literature citing prevalence rates of up to 40% in some competitions. While the authors acknowledge potential methodological issues with such studies, it seems clear that prevalence is comfortably higher than the official figures WADA reports. This is despite increasingly invasive measures. The inadvertent doping cases, where athletes are still receiving lengthy bans despite successfully demonstrating the ingestion of a banned substance was accidental, are troubling and the authors note this throughout the book. There have also been a number of instances in which those in anti-doping organisations or governing bodies have been found to have assisted dopers, or tried to cover up doping. The Russian Scandal, that involved a more organised system of evading positive tests, is also described, and is concerning not least because we might have hoped the formation of a world wide anti-doping agency, and the worldwide governance that has followed, might protect against such happenings.

Interestingly and perhaps unusually for academic work of this nature, there are a number of practical recommendations as to how anti-doping might move forward with the athlete at its core, and with more sensitive and indeed successful policy. The authors had earlier in the text described the three part criteria for adding a substance to WADA’s prohibited list. For a substance or method to be banned it must meet at least two of the three criteria: That it must enhance or potentially enhance, damage health or potentially do so, and be contrary to the spirit of sport. It is argued that the spirit of sport criteria should be removed. This would certainly reduce the controversy we see where athletes receive bans for the use of non-enhancing recreational substances. (These bans are at least lighter under the 2021 Code, but it is still a doping offence that carries a sanction). A number of recommendations the authors make concerning the testing system mark a radical shift in the thinking that underpins anti-doping. They suggest athletes should be allowed holiday periods from testing, and that drug control officers should not go into athletes homes. WADA are also urged to deviate from the rules regarding the direct observation of the passing of urine. A promising line is described that involves drug testing using hair samples. It is also suggested that sanctioning is revised to account for those instances where athletes might technically have doped, but not gained a performance advantage. It is also suggested that formal communication makes clearer that an offence was inadvertent. After some recommendations in terms of testing being conducted equally across the globe, and an independent agency to review the activities of sport bodies, the key recommendation that all policy is developed in conjunction with athlete representative groups is made. The authors go further in citing the collectively bargained arrangements of some professional US sports.

These recommendations indeed offer a new direction for anti-doping policy. Holidays from testing and avoiding direct observation of the passing of urine might be recommendations that help those determined to cheat. The authors argue for a realistic rather than idealistic anti-doping policy, however, and thus, while it is not stated in the text explicitly, accepting the fact that some who are determined to dope might evade the testers might be a part of that more realistic approach. My only criticism of the book, if it amounts to a criticism, would be that I would have liked to have seen these recommendations expanded upon, and in particular tested out or challenged, and defended against such challenges. I appreciate, however, that this might be the task for subsequent publications.

Overall, this is an excellent book that offers an illuminating history of doping, a history that certainly sheds light on current anti-doping policy. It makes a number of interesting and thoughtful recommendations and would be a great read for students of the area, but also importantly academics and those working in anti-doping more directly. I would heartily recommend it and have enjoyed the opportunity to review it.

Copyright © Andrew J. Bloodworth 2023

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