Q & A with Dr. Wade Exum

28.07.2003

By Janet Heinonen
Knowledge bank: Dr. Wade F. Exum served as Director of Drug Control Administration for the USOC, 1991-2000. He earned both his MD (1977) and MBA (1986) at the University of Colorado and did his psychiatry residency at the University of California-Davis and Yale (1991). He is also a Diplomate of the American Board of Forensic Examiners. An advocate of reform in the way sports doping is handled, Exum is currently involved in litigation with the USOC. He answered Keeping Tracks questions via e-mail

KT: What are the dangers and consequences of drug abuse in sports? When does it become addiction?

Dr. Exum: Theres both long and short-term damage to the body, mind and spirit, as well as addiction. (WADA president) Dick Pound recently stated that drug abuse in sport is not unlike alcoholism. It is exactly the same as alcoholism. Addiction is a medical diagnosis defined as "continued use despite adverse consequences and withdrawal upon cessation of use." All of the substances abused in so-called athletic "doping" meet the above criteria.

KT: Our culture seems to place sports drug abuse in a category separate from other kinds of drug or alcohol abuse. Is there really a difference?

Dr. Exum: Drug abuse is drug abuse. The eventual outcome is the same for all abusers. The only difference is that sports drug abuse is cloaked in the term "doping" which makes it sound like its something different from other drug abuse.

KT: We use the terms "denial," "rationalization" and "enabling" to describe aspects of other addictions. How do they apply to sports doping?

Dr. Exum: The word "rationalize" is actually two words: rational and lies. All of the words you have expressed and more are used to describe a primary dynamic of all addictionsthe use of rational thinking in order to lie to oneself about the truth. In sports there are so many people who gain from the improved performances (as the result) of drug abuse that they lie to themselves and others about the damage they do in order to justify their successes. They invent plausible explanations for their lies. Regardless, they are still lies.

KT: What are the systemic problems that have created a culture which condones and enables this kind of addiction?

Dr. Exum: The system values performance, celebrity and financial gain to the detriment of the athlete. The system operates like a sick family. Family members enable drug users by denying, covering up, rationalizing, blaming, scapegoating and making excuses. Inevitably, DUIs (Driving Under the Influence) occur, relationships are destroyed, careers slip away, disasters strike, accidents happen, catastrophic or unusual illnesses are suffered and ultimately, (theres) death. In the drug abusing system processes are set up to allow and encourage the user to continue to use. The user is often the economic source (for the system). This is almost certainly the case in the "doping" world. Tragically, unless an intervention occurs, things only get worse.

KT: Interventions are used to confront individuals with their addictions. What kind of interventions are we talking about for sports drug abusers?

Dr. Exum: There is only one kind of interventionto confront the user and the system with the truth. This must be done in a caring and objective way by people with expertise who have nothing to gain or lose from the system.

KT: You have been critical of the lack of input from drug abuse experts in the writing of protocols for anti-doping groups. How can these experts help?

Dr. Exum: You cant look for a solution with the same eyes that caused the problem. The only way for a drug abuse program to be effective is for it to be developed and run by experts with proven track records in diagnosis, treatment and rehabilitation. Those who understand drug abuse are the only ones qualified to do an effective drug abuse intervention. Experts from outside the system will have to intervene to force the system to get over its denial and realize that it is powerless over drugs. They are the only ones who can teach, apply and practice the proven techniques and steps that can result in recovery. Otherwise the progressive nature of drug abuse will cause the system to eventually and inevitably hit rock bottom.

KT: Within the past year the Court of Arbitration for Sport decided by a 2-1 vote to "let sleeping dogs lie" and not pursue several USA Track & Field doping cases that should have been forwarded to the IAAF for review. Just recently, a UK track official said "we cant afford (financially) to take a moral stance" on Ekkart Arbeit, the former East German who oversaw much of that countrys state-run doping program and is now coaching Britains Olympic heptathlon champion, Denise Lewis. "Its time for rehabilitation rather than recrimination," added another UK official. Would you care to comment on those positions?

Dr. Exum: We cant afford not to take a moral stance. The lives of athletes and the very survival of sport is threatened. Anyone who has participated in "doping"activities should never be allowed to work in the field in the same manner that a rehabilitated pedophile should never be allowed to work with children. Anyone with any knowledge knows that relapse is a common phenomenon. If you sit around the barbershop long enough, youre gonna get a haircut.

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