A paper published in the British Journal of Sports Medicine on March 8, 2016 reveals that the use of the now-banned drug meldonium has been “excessive and inappropriate” in 2015 and has been used by generally healthy athletes.
The laboratory study undertaken during the Baku 2015 European Games held in Azerbaijan from June 12-28, 2015 revealed that 66 of 762 (8.7 per cent) samples tested turned out to be positive for meldonium; the samples were analysed during and prior to the Games.
Since all athletes were not tested during the Games, the actual usage may be much higher than what has been determined by the study. According to the authors, there has been “significant under-reporting” of the use of the drug by athletes as 43 of the 66 (65 per cent) athletes who tested positive for the drug did not declare taking the drug in the last seven days prior to the date of providing samples.
The drug has been registered for medical use in seven Eastern European countries — Latvia, Russia, Ukraine, Georgia, Azerbaijan, Belarus and Moldova.
Extrapolating the 8.7 per cent prevalence of meldonium drug to 1,306 athletes from seven Eastern European countries would add up to 114 athletes testing positive for the drug; extrapolating it to all 5,632 athletes who participated in the Games would work out to 490 positive samples. “The estimated number of athletes taking meldonium during the 2015 Games is likely to lie somewhere within this range,” they write.
“This study highlights the widespread and inappropriate use and prescribing of this prescription drug in a generally healthy athlete population. Subsequent to these findings, WADA has included meldonium as a prohibited substance on the 2016 List of Prohibited Substances,” the authors note.
Only 23 of 662 athletes tested during June 8-28, 2015 declared using it, including 13 winners of competitions — six gold medal winners, five silver medal winners, and two bronze medal winners. The drug was used by athletes competing in 15 of the 21 sports staged during the Games.
Benefits of the drug
Besides other benefits, the drug helps in improved peripheral blood circulation and increased stress tolerance. “The use by athletes could potentially result in enhanced personal performance and a shortening of the recovery period after physical activity,” the authors note.
Meldonium is reported to have cardioprotective and anti-ischaemic effects and has been used for a range of disorders including for the management of ischaemic heart disease and ischaemic cerebrovascular disturbances. Though hard data on performance enhancing properties of the drug in the athlete population is “limited”, given the fact that the drug is used for cardioprotective and anti-ischaemic effects, its widespread use in otherwise healthy athletes defies logic and is clearly not for therapeutic reasons, the researchers argue.
The drug was added to the World Anti-doping Agency’s (WADA) Monitoring programme in January 2015 based on “anecdotal reports of use” by athletes during the London 2012 Olympic and Paralympic Games. During the London Olympics five teams had declared using the importation and possession of the drug for legitimate purposes by the respective medical teams accompanying the athletes.
Still, hard data on performance enhancing properties of the drug in the athlete population is “limited”. One study found decreased motor dysfunction and an improvement in work capacity and physical and psycho-emotional overexertion in humans. However, there is some evidence of its beneficial effects in rodents.