Diffusion of NPS amongathletes: a laboratory

perspectiveFrancesco Botrè

“Sapienza” University of Rome, and

Laboratorio Antidoping FMSI

Overview

• The WADA, the Labs, the List

• The activity of the WADA-accredited labs

• Diffusion of prohibited drugs (including NPS) in elite sport: statistical data

• Conclusions, perspectives and proposals

The WADA, the Labs, the list

• The WADA (World Anti-Doping Agency) is the world Authority to fight doping in sport (more from Irene!)

• The analytical activities are carried out by accredited anti-doping laboratories, whose activity /performance is constantly monitored and evaluated

• The list of prohibited substances and methods is constantly reviewed and periodically updated (at least yearly)

• Most of the new psychoactive drugs are included in the classes of substances prohibited in sport (although only for “in competition” tests)

The WADA accredited Laboratories

• Africa: South Africa (Bloemfontein)

• Americas: Brazil (Rio de Janeiro), Canada (Montreal), Colombia (Bogota),Cuba (La Habana), Mexico (Mexico City), United States (Los Angeles, Salt LakeCity)

• Asia: China (Beijing), S. Corea (Seoul), India (New Delhi), Japan (Tokyo),Kazahstan (Astana), Qatar (Doha), Thailand (Bangkok)

• Europa: Austria (Seibersdorf), Belgium (Ghent), Finland (Helsinki), France(Paris), Germany (Cologne, Kreischa), Greece (Athens), Italy (Rome), Norway(Oslo), Poland (Warsaw), Portugal (Lisbon), Romania (Bucharest), RussianFederation (Moscow), Spain (Barcelona, Madrid), Sweden (Stockholm),Switzerland (Lausanne), Turkey (Ankara), United Kingdom (London)

• Oceania: Australia (Sydney)

The WADA accredited Laboratories

• Africa: South Africa (Bloemfontein)

• Americas: Brazil (Rio de Janeiro), Canada (Montreal), Colombia (Bogota),Cuba (La Habana), Mexico (Mexico City), United States (Los Angeles, Salt LakeCity)

• Asia: China (Beijing), S. Corea (Seoul), India (New Delhi), Japan (Tokyo),Kazahstan (Astana), Qatar (Doha), Thailand (Bangkok)

• Europa: Austria (Seibersdorf), Belgium (Ghent), Finland (Helsinki), France(Paris), Germany (Cologne, Kreischa), Greece (Athens), Italy (Rome), Norway(Oslo), Poland (Warsaw), Portugal (Lisbon), Romania (Bucharest), RussianFederation (Moscow), Spain (Barcelona, Madrid), Sweden (Stockholm),Switzerland (Lausanne), Turkey (Ankara), United Kingdom (London)

• Oceania: Australia (Sydney)

The current WADA List

The activity of the WADA-accredited labs

• ISO17025 + WADA accreditation

• Working in compliance with the WADA International Standard for Laboratories (ISL) and related Technical Documents

• Interacting via the World Association of Anti-Doping Scientists (WAADS)

• Authorized to screen exclusively for the substances/methods, and/or their metabolite(s)/markers, included in the WADA list, reporting as positive only those samples matching the criteria (e.g. thresholds, decision limits) to issue an “adverse analytical finding” (AAF)

Some statistical data

• Referred to the last 15 years (2003-2017)

• World data from the WADA statistics

• Presented for the classes “S6” (stimulants), “S7” (Narcotics) and “S8” (cannabinoids)

• For a preliminary assessment of the “local significance” of the global data, a comparison with the statistics of the anti-doping laboratory of Rome is also outlined

Some statistical data: global trend

Some statistical data: Italian trend

Some statistical data: Stimulants (all)

Stimulants (most commonly reported)

Stimulants (less commonly reported)

Stimulants: Italy

Some statistical data: Narcotics (all)

Narcotics: Italy

Some statistical data: Cannabinoids

Cannabinoids: Italy

Possible future insights? In the lab

Possible future insights? Out of the lab

Possible future insights? Out of the lab

Conclusions (and hints for discussion)

• NPS are diffused also among elite athletes, although their detection (and characterization) is a tough scientific challenge

• Data from the WADA accredited laboratories, although useful as a starting point, at present may only provide limited data, underestimating the diffusion of NPS among athletes (not all NPS are prohibited in sport, only elite athletes are monitored, and an AAF is issued only if the concentration is higher than a reporting threshold)

• Nonetheless, the potential and expertise of a highly qualified network of 25-35 laboratories, operating worldwide, should not be neglected

• Parallel strategies may be developed to maximize the overall statistical accuracy of the “anti-doping information”

• In a rapidly evolving scenario, sharing of knowledge is a must

Acknowledgements

• The organizers of the symposium for the kind invitation

• The FMSI, for providing support to our laboratory

• The WADA, for the constant attention to the abuse of new drugs, timely addressing the risks of NPS

• The World Association of Anti-Doping Scientists (WAADS), for facilitating the sharing of knowledge among the labs, and for facilitating the circulation of reference standards/materials (whenever possible!)

• My colleagues Drs. Monica Mazzarino and Xavier de la Torre, for the many discussions and useful suggestions

• My students Claudia Chieffi and Sara Samperi, for their interest, motivation, and productive enthusiasm

Thank you for your attention