0 200 400 600 800 1000 1200
2000 2001 2002 2003 2004 2005 2006 2007 2008 2009
Figure 9.1: Number of cases relating to the Act concerning the Prohibition of Certain Doping Substances. Source: The Danish National Police (IDAN, 2010: 46)
Year Reports Charges Indictments
2006 650 669 (Unknown)
2007 703 708 622
2008 888 891 738
2009 1,019 1,025 949
2010 1,087 1,070 1,077
2011* 633 611 529
Table 9.1
* 1 January – 30 June 2011 Note:
The charges include charges which were settled or pending in the year in which the charge in question was brought.
This is calculated on the basis of the number of people charged per case number.
This assumes merely that the people charged are charged according to crime code 86245, irrespective of whether the charges are later settled according to a different crime code.
The reports are stated based on the year in which the report in question was made.
In the case of reports, calculations are done on the basis of unique case numbers. In other words: irrespective of the number of people charged for each case number, the case number will be counted only once.
The indictments are stated based on the year in which the indictment in question occurred
Decisions 2006 2007 2008 2009 2010 2011*
Decisions made in court,
finding guilty** 317 356 361 527 640 359
Decisions made in court,
acquitting*** 10 5 10 9 26 10
Decisions made out of
court, finding guilty**** 242 214 268 331 379 305 Decisions made out of
court, cases closed to due lack of evidence*****
39 25 31 50 61 37
Total 608 600 670 917 1,106 711
Table 9.2:
* 1 January – 30 June 2011
** Unsuspended sentence, fine, sentence/conviction (Penal Code § 68-70), suspended sentence, suspended sentence and fine, partially suspended sentence, judgment by default, agreement to be fined summarily in court, warning in court
*** Acquitted
**** Ticket fine, withdrawal of charges, etc.
***** Action dropped Note:
The decisions are stated on the year in which the decision in question was made This assumes merely that the case is settled according to crime code 86245, irrespective of whether the people charged are later charged according to a different crime code
may occur as a result. In terms of the long-term consequences, there are in particular detrimental effects on the heart and blood vessels, and the carcinogenic properties of some sub-stances must also be taken into consideration. In an inventory of the available literature, various physical complaints were also described. In addition, a range of psychiatric problems are associated with doping use. This involves both the addictive ef-fect of the substances and their influence on mood (depression) and behaviour (aggression). The harmful effects of doping per se are not disputed, but there is a lack of clarity regarding the extent of harm.
There are no precise epidemiological details of the consequenc-es of the use of doping substancconsequenc-es on the burden of disease and healthcare consumption. However, the commission considers that, in view of the existing knowledge regarding the harmful-ness of the use of doping substances and its potential serious-ness, it is worthwhile to investigate which areas of current
doping policy could be amended and/or improved. In this way, potentially serious harm to the individual users’ health could be prevented and/or restricted whenever possible.
On the basis of known side-effects of steroid abuse, it can also be presumed that the abuse results in a loss of production each year due to illness and death. There is, however, no avail-able data on early retirement and death relating specifically to steroid abuse.
Crime – the Police and the Prison and Probation Service
According to Italian researcher A. Donati, the global doping market is enormous and comparable with the drug market, and the manufacture and sale of steroids generate huge profits (Donati, 2007).
The combination of huge profits on the sale of steroids and – for must countries – the much more lenient punishment for manufacture, import, export, sale and possession of steroids compared with the drug legislation can also act as an incentive for crime involving steroids. In fact, the Danish National Police reports that intelligence and investigations indicate that crimi-nal organisations and groups already known in connection with drug crimes (see 7.7) are involved in the distribution, purchase and sale of anabolic steroids. In its report “Handlingsplan for bekæmpelse af motionsdoping” (Action Plan to Combat Fit-ness Doping) (2008), the Ministry of Culture concluded that the financial gain from the manufacture and distribution of doping substances tempts criminal organisations, and that the maximum penalty in this area (see 2.3) is insufficient to act as a deterrent (Ministry of Culture, 2008: 12).
The European Commission’s White Paper on Sport from 2007 proposes focusing on prevention and law enforcement to combat doping. In this white paper, the Commission recom-mends that the trade in illegal doping substances be treated on the lines of illegal drug trade throughout the EU (European Commission, 2007: 10).
Statistics from the Danish National Police on cases relating to the Act concerning the Prohibition of Certain Doping Substances (see 2.3) show a marked increase in the number of police cases between 2001 and 2009. The figures cover cases the police have been able to identify by searching their POLSAS case management system1 (IDAN, 2010: 46) (see Figure 9.1).
According to the Danish National Police, it is not known why there were so few cases prior to 2002, followed by a marked in-crease in the following years. The Danish National Police points out that the increase in the number of cases from 2002 to 2008 could reflect a societal development in which body ideals have changed, a growing number of people train at fitness centres, and doping substances have become more readily available thanks to the Internet. The Danish National Police explains the increase in the number of cases in recent years (since 2008) by its special focus on crime in gang and biker environments, as illegal doping substances are often found in these environments during raids and other investigations (IDAN, 2010: 46–47).
Figures from the Director of Public Prosecutions, Denmark for the number of reports, charges and indictments relating to the Act concerning the Prohibition of Certain Doping Substances also indicate an increase (see Table 9.1).
1 There is no special code in POLSAS for cases relating to the Act concerning the Prohibition of Certain Doping Substances, and the statistics are therefore based on free text searches and are subject to a certain degree of uncertainty (IDAN, 2010: 46).
Figures from the Director of Public Prosecutions, Denmark also show decisions made in cases concerning charges based on the Act concerning the Prohibition of Certain Doping Substances (see Table 9.2).
Known side-effects of steroid abuse include aggression, lack of impulse control and reduced empathy (Moberg et al., 2006:
96). This can translate into criminal or violent behaviour among users (Klötz et al., 2007 and Lundholm et al., 2010) and an increased risk of violent crime, resulting in additional costs for the police, the legal system and the Prison and Proba-tion Service.
Public sector costs to fight fitness doping
The use of AAS affects many sectors of society and include cost for the public sector in many areas. Unfortunately, there have been no studies to estimate the total public sector costs for fighting fitness doping. The Anti Doping Denmark has in the text below tried to estimate their cost in 2010 from public funding. Anti Doping Denmark is the main organization in Denmark in the fight against abuse of steroids.
In Denmark, the Ministry of Health and Prevention (now the Ministry of Health) and the Ministry of Culture presented the Action Plan to Combat Fitness Doping in 2008. The initiatives outlined in the plan included support for Anti Doping Den-mark’s information campaign to combat doping among fitness members (see 6.1), implementation of the compulsory Smiley scheme for fitness centres (see 2.1) and increased penalties for distribution of doping substances (see 2.3). In the action plan, the two ministries allocated slightly more than DKK 4 million/EUR 538,000 over three years and, in addition, sports organisations also supported the project to the extent of DKK 1 million/EUR 135,000 over three years. This support was additional to the fixed annual amount allocated to Anti Doping Denmark (Ministry of Culture, 2008: 5–9).
In 2010, Anti Doping Denmark received a total of DKK 5.4 million/EUR 726,000 in public funding.2 Combating steroid abuse was initial not one of Anti Doping Denmark’s main tasks, but considerable resources have been allocated to this area since the action plan was launched. A survey of the amount of time spent by the secretariat on different daily tasks shows that approximately 40–45% of the secretariat’s time was spent on the fitness/steroid abuse issue in 2009 (Anti Doping Denmark, 2010: Preface). These figures are also representative of the time spent by the secretariat in 2010.
2 In 2010, Team Denmark and the main Danish sports organisations provided approximately DKK 8.4 million in funding to Anti Doping Denmark pursuant to the Act on the Promotion of Doping-Free Sport. Team Denmark and the main Danish sports organisations are primarily funded by the Ministry of Culture’s share of gambling and lottery funds, but as they are private organisations, their funding for Anti Doping Denmark does not count as a public expense.
In 2010, a total amount of DKK 2.2–2.4 million/EUR 300,000 from public funding was spent on steroid abuse via Anti Doping Denmark.
In regard to the near future, the Ministry of Health has ap-proved Anti Doping Denmark’s application for funding of its continuing work to combat fitness doping in the amount of DKK 600,000/EUR 80,700 per year for a four-year period from 2011 to 2014. In addition, the membership of the National Network against Anabolic Steroids (see 7.1) is seen as an important factor that reflects the general recognition of the problems in this area.
Being a relatively new focus area, steroid abuse and its fund-ing is not given high priority. The different anti-dopfund-ing and preventive organisations are therefore working proactively to maintain the focus on the issue.
Summary of Chapter 9
The lack of available data makes it difficult to measure the economic impact of steroid abuse on society. The authorities do not keep records of diseases or deaths caused by doping, so deaths caused by doping-related health issues are not recorded.
There are also no records showing how often perpetrators of violent crime are under the influence of steroids, and no estimates of the amount of money criminal organisations earn from the production and sale of steroids. To gain a better understanding of the scope of the problem and to set the right priorities, there is a need to develop statistics in the field. It is clear, however, that steroid abuse can have a major impact on social costs relating to the health sector, the police, and the prison and probation service, and that illness and death related to steroid abuse also contributes to a loss of production.
Chapter 10 provides a coherent overview of the situation in terms of the use of AAS and other similar doping substances.
How different subsystems such as consumption, distribution and sale, social norms, legal sanctions and social, economic and health consequences interact is analysed. This chapter is inspired by Harold D. Holder’s system theory approach to achieve a coherent insight in terms of prevention of abuse.
How do we prevent further abuse of doping in the future? Not much research has been conducted related to prevention of doping abuse. Instead, we need to look to research of related areas such as use of alcohol, tobacco and drugs, especially the use of tobacco and alcohol has been analysed intensively during the years. The focus of prevention research can be divided into two groups: Supply and demand. The research focused on supply looks into the availability regulated through legislation, whereas the demand side researches the factors that have an impact on individual and group behaviour and therefore leads to informative, opinion-building and/or educational prevention efforts (Swedish National Institute of Public Health, 2008: 5-6) Traditionally, prevention efforts have been based on the idea, that if a certain action is taken (e.g. young people are educated about the dangers of alcohol use), a specific predictable result will follow (e.g. they will not start drinking). However, evalu-ation of such efforts often shows that the desired results have not been obtained due to influence by other factors outside the control or concern of the project (Holder, 1998: 14).
The data collection in this report supports this experience, as it points to the fact that many factors and many players, not to mention their reciprocal influence, have to be taken into ac-count in the fight against the abuse of AAS and related doping substances (PIEDs). Therefore, a holistic model is needed when planning preventive initiatives in the future.
The American researcher Harold D. Holder, PhD, from Berke-ley University, USA, is a leader in the field of the system theory approach to the prevention of abuse, and the material he has written on this subject includes “Alcohol and the Community:
A Systems Approach to Prevention” (1998). The book describes a broad, holistic approach to preventive work in the field of alcohol abuse; a model, which has later been extended to a gen-eral model for psycho-active substances, including all relevant parameters relating to both the individual and society rather than isolated initiatives targeting abusers or potential abusers.
Having a system theoretical approach entails a premise that the individual and the system influence each other intersubjectively, i.e. the individual (and individual behaviour) is affected by the society in which we live, which in turn is influenced by our behaviour.
Abuse and strategies to reduce abuse should therefore be viewed in a broad perspective (Holder, 1998: 4). In this context, as Holder states, the following views are fundamental:
• Drug problems are the natural result of dynamic, complex and adaptive systems called ”communities”
• Working only with high-risk individuals or small groups produces, at best, short-term reductions in drug problems, because the system will produce replacements for individu-als who leave high-risk status, and the system will adapt to changes in the composition and behaviour of subgroups and populations
• Interventions in complex adaptive systems do not always yield the desired results, and they often produce undesired and unexpected outcomes that are counterintuitive
• The most effective prevention strategies are those that seek to alter the system that produces drug problems
• Historically, prevention strategies have been “single solutions”
attempting to accomplish a goal by means of one massive programme or strategy, rather than concurrent, mutually reinforcing approaches
• Without an understanding of the community as a dynamic system, it is unlikely that effective long-term prevention of drug problems will occur in practice (Holder, 1998: 8-9).