I agree with your use of "blaa blaa" - it reflects much of what you have to say.
Semantic arguments you use of the kind that rekrunner employs, such as saying all decisions, including doping, are "speculative", misuses a term that is typically applied to that for which the outcome is highly uncertain, rather than that for which the outcome can be reliably predicted through appropriate evaluation. I suggest the evidence suggests the latter rather than the former for doping. Though there can be uncertainty about the exact effect of a given drug there is enough of a track record with many of them now to know that they will have a performance enhancing effect of some kind. The only thing that is speculative is how much of the doping iceberg is concealed, and how much difference doping will make for the individual athlete. The athletes who dope will know that far better than any ivory tower researcher, who has never spoken to any of them.
So what if there can be placebo effects? That doesn't logically suggest that doping may be no more effective than a placebo. Indeed a placebo effect may be because users know that doping confers benefits. A billion Euro black market in doping wouldn't be able to be sustained by a mere belief that doping works.
The rest of your comment merely underscores my previous point that the exact effect doping will have on performance cannot be known, even though it is known there will be an affect. But the same also applies to training. Yet only a fool would say training does not have an affect and indeed may only be a "placebo".
My essential point is the the practice of doping has developed over the years into a very sophisticated industry and that is because athletes (and their coaches, trainers and physicians) know that it will give them a benefit even if the precise measure of that benefit will not necessarily be known. So - yes - in that context, prevalence in this case assumes effectiveness. If it were not so then so many athletes have adhered to a practise for decades that is no more soundly based than that of a Q'Anon conspiracy. I don't happen to think sportsmen are a bunch of deluded nutjobs.