What do we know about meldonium (drug Aregawi was busted for)?

mark b wrote:

Are any of the PEDs on the banned list really dangerous to health if they are taken under medical supervision as part of a closely supervised programme?

Read up on athletes from East Germany. Full-on programme. Grave health problems.

You will always find a doctor (you pay yourself anyway) who also lets you take that extra pill or injection to have the edge over the competition. Because they are throwing back just the same.

Have to agree! the thing about "grey areas" is that, by definition, they are not capable of precise deliniation. One athlete might have a moral code- inherited from parents, imbibed during education, passed on by a revered older athlete whatever- that excludes any and every artificial aid including such things as any dietary supplements, vitamin injections, sleeping in altitude chambers etc., etc. Another athlete may well take the view that if it is not explicitly banned it is legal and I am going to do anything and everything to make myself the fastest I can possibly be.

We can argue all day as to which approach is the most praiseworthy but according to the rules of the sport both are equally acceptable. Going back to my original point it is hard on the athlete if the sport suddenly decides that something hitherto perfectly legal is now banned and if the test can pick up on this substances use during the "legal period". I am not saying that this is what has happened in this case but IF this is indeed the case it is possible to feel a certain sympathy for athletes caught in this way.

Arajeni wrote:

It's funny how we make statement such as "we know who the real champion is". You do not know what Jenny has done in the past. She may well have used this or another substance which is not recognized as a banned agent (yet). Because Jenny is a pretty white innocent looking girl, we put a halo on her head and call her the real champion.

0/10

I mostly agree with you - great post. However, it's hard to view any potentially enhanced performances before the IOC banned anabolic steroids in 1975 as fair and within the spirit of competition, even though it was technically legal.

As I posted in the other thread, this was probably circulating in Russia well before 1991 (http://www.ncbi.nlm.nih.gov/pubmed/1771844), and it looks like it's in the same category as AICAR and insulins, so it seems pretty serious (http://list.wada-ama.org/list/s4-hormone-and-metabolic-modulators/#meldonium). I don't really know anything beyond that, though.

Many prescription drugs are banned because they enhance performance. I know many team mates that have intentionally gotten prescribed certain pills simply for the exercise benefits.

Yes, but the point is that the medical people were well aware of the long term damage they were doing but continued anyway. the nature of the regime meant that their relatively privileged place within East German society depended on them producing gold medalists/WR holders. If they had been at all concerned about the athlete's health they would have intervened, stopped the treatment or, at the very least, reduced the dosage.

Perhaps my original post should have said "medical supervision by someone at least as concerned with athlete's well being as faster times"! And are you really saying that Armstrong, Hamilton and all those other endurance athletes who have taken EPO have damaged themselves? I know there have been fatalities attributed to the taking of EPO but those were in relatively unsupervised situations.

I'm generally of the opinion that taking something like meldonium is against the spirit of the sport, but I'm willing to accept it on the basis that is is legal in a technical sense (or was legal, until Jan 1). But my feeling is that if an athlete is going to be stuffing themselves with all kinds of substances, the onus is on them to make sure all that crap is legal. If you are serious enough about your sport to research which substances are going to give you a boost, then you should be serious enough to keep track of what is and isn't legal.

Nonsense about Aregawi just missing news about them banning it and there being nothing wrong with her using this prior to its being banned. If you take substance A that markedly aids oxygen-carrying capacity, say, and no one has ever heard of it, it is still illegal. That is why they have a clause banning performance-enhancing drugs and other clauses banning whole categories of drugs. Do you realize what a huge exception that would be, what an incentive to design your own new drug, if all you needed was it not to be banned yet?

Arajeni wrote:

It's funny how we make statement such as "we know who the real champion is". You do not know what Jenny has done in the past. She may well have used this or another substance which is not recognized as a banned agent (yet). Because Jenny is a pretty white innocent looking girl, we put a halo on her head and call her the real champion.

Fine, those who worship the myth of the angelic, genetically superior East Africans don't have a clue. The rest of us know who the real champion is.

yeah, butter wrote:

Taking prescription medicines that are aimed at improving capacity to improve cardiac functioning or oxygen use without medical basis, without filing a therapeutic exception, without reporting such is doping pure and simple.

The grey area is when a doctor enters the picture and claims that the athlete needs the medicine to function normally. But, to surreptitiously procure and use a prescription medicine is clear cut cheating.

THIS!! Too bad not everyone has your moral and ethical standards.

ROIDnato CaCERA wrote:

Fine, those who worship the myth of the angelic, genetically superior East Africans don't have a clue. The rest of us know who the real champion is.

Was Jim Ryun genetically superior to most with respect to middle distance talent?

update: it appears that meldonium was also the cause of the doping positive for Negesse Endeshaw, the Ethiopian who has run 2:04:52 and won the 2015 Tokyo Marathon.

With more Ethiopian positives supposedly on the way, should we expect more of them to be for meldonium? Seems fairly likely...

Anyway, having at least one more case of a meldonium positive clarifies things to a degree. It implies that Aregawi's positive wasn't just some random, one-off accident. It suggests that use of the drug is probably relatively widespread. And it also suggests that the drug is especially popular among Ethiopians (although maybe it is popular among many nationalities, and it just happens that the authorities are targeting Ethiopians for whatever inscrutable reason at the moment).

I would imagine it's either that it is wide spread world wide or that these 2 are genuine accidental cases (IE it's an ingredient in some headache tablet sold in Ethiopia)

Probably option 1 is more likely. But the chances that a new wonder drug is available in Ethiopia and not elsewhere seems unlikely to me.

Aregawi has forfeited the "I didn't know it was banned" defense by claiming she has no idea how it got in her body. So the "big ignorance" defense instead of the "little ignorance mistake".

My question is what was she doing in 2013 that made her look Dibaba-like v. the 2015 version, who was just another mid-packer.

According to this story, before the ban 18% of Russian athletes were taking Meldonium:

http://www.dn.se/sport/var-femte-rysk-idrottare-anvande-meldonium/

After reading this thread, I wrote a post on what I know about Melodonium. It seems from the initial research that WADA did before banning it, that it's use may be quite widespread.

Taking a new drug that has not been approved by the FDA, and is typically only recommended for people with heart failure, seems to be a pretty clear case of trying to cheat the system. If she can prove that she has heart failure (which pretty much all of us highly doubt), then she should probably be given a pass. If she is completely healthy and taking it, I think it is pretty clear she was trying to gain an advantage. It will be interesting to see what kind of a drop off we will see in performance across the sport in general now that this drug is banned.

The WADA list bans drugs in 2 different ways. For some categories, it bans everything in that category - an "open" category. For other categories, it only bans specifically named drugs - a "closed" category.

Category S.0 includes drugs not "approved by any governmental regulatory health authority for human therapeutic use." Meldonium isn't approved in the US or Sweden but has been approved in various eastern European countries so it doesn't fall under the "open" category in S.0.

For 2016, Meldonium was added to category S.4., which reads like a "closed" category so only drugs actually listed are banned:

The bottom line is that I read this as saying that Meldonium wasn't banned under any broad "open" category before it was specifically listed for 2016. So from a technical standpoint it was permitted, regardless of the "spirit of the sport" or more general concepts.

Maria Sharapova busted for same drug!!