Yesterday I was reading about the fact that Rafaela Silva has tested positive for fenoterol. Rafaela Silva is a is a Brazilian judoka, the first Brazilian gold medalist at Rio Olympics. I don't follow judo, it's not my favorite sport but was interested to see the case and learn about this substance as I've never heard of it till now.
So I ran a search to see what on earth is fenoterol. Fenoterol is an inhaled bronchodilator asthma medication.
Fenoterol is a short-acting β2 agonist that also stimulates β1 receptors. Fenoterol has more cardiovascular toxicity than isoprenaline or salbutamol. Fenoterol was widely used in New Zealand in the late 1970s and the 1980s until it was removed from the New Zealand drug tariff in 1989 because its introduction and widespread use was associated with an epidemic of asthma deaths. A series of case-control studies demonstrated that asthmatics using fenoterol were more likely to die of asthma compared with controls treated with alternative beta agonists; this risk of asthma deaths was particularly high in severe asthmatics. The mortality rate declined following withdrawal of fenoterol without evidence supporting an alternative explanation for the abrupt rise and fall in asthma deaths. Data did not support confounding by severity as the explanation for the excess mortality. There are alternative short-acting beta agonists that have not been associated with increased mortality e.g. salbutamol. source
If you read the text above I believe you'll be a bit surprised, just like me. So if this substance was removed from the New Zealand drug tariff because it was considered dangerous, how and why is among banned substances or better yet, why was Rafaela Silva using it?
After further digging I found out that it's a banned substance but it can be legal if an athlete has a therapeutic use exemption (TUE). Rafaela Silva did not have one.
She claims she's innocent, she says she's been in close contact with her seven month old baby who has asthma. I don't know what's the truth, it's not my job to determine if she's innocent but she is in my eyes until she's proven guilty.
I'd like to point out a few things I don't understand here. The first one is how is it possible for one substance to be banned for some athletes and legal to others? My logic says if it enhances your performance, then it should be banned for everyone, without exception. What's the justification for those who have asthma? I don't understand this.
Digging deeper I found out that many athletes turn to common nasal spray, asthma inhalers, for edge. Ziga Jeglic, the Slovenian hokey player has tests positive for fenoterol and was suspended for rest of 2018 Winter Games, he had to leave in 24 hours. Fenoterol facilitates breathing by opening up the airways, thus athletes can get more oxygen, which is crucial.
At the end of my post I am not smarter then when I started. I've read a bunch or articles and found no information about why it was banned in New Zealand and why is it available in other countries. Better yet, why is the seven month old child using it if it's so dangerous. And of course the main question remains. Why is it allowed for athletes with asthma and prohibited for others. It's a shady business.