Modafinil and Sports | Legal Performance Enhancer?

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Modafinil and sports?

An odd combination or a match made in heaven? Well, that depends on who you ask. No matter how you see it, we’ve seen world-class competitors getting caught using Modafinil in sports over the years.

While the smart drug offers a wide variety of benefits for mental performance such as increased focus and longer-lasting alertness, it can also boost the physical performance of athletes looking for a competitive edge.

And as any good athlete knows, a superior mindset can be the slight edge that makes the difference between 1st place and 2nd place.

So how exactly does Modafinil help athletes stay “in the zone” and boost their ability to perform in the spotlight? Furthermore, why is Modafinil a banned substance?

This article will answer all of those questions, showcasing how using Modafinil in sports became a widespread phenomenon.

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I am not a doctor. Nor am I a lawyer. This article was strictly created for your entertainment. There is no advice here. Always consult a medical professional before consuming any smart drugs or pharmaceutical drugs – like Modafinil. Please read my disclaimer.

What is Modafinil?

First, let’s understand what Modafinil is and how it became a popular doping drug amongst athletes at the highest level of competition. Modafinil (brand names: Alertec, Provigil) is a wakefulness-promoting drug that is known to treat excessive daytime sleepiness. It is approved by the FDA to do so for three specific medical conditions [1]:
  • Narcolepsy
  • Obstructive sleep apnea
  • Shift work sleep disorder
It has also been examined for reducing fatigue, drowsiness, and tiredness in other conditions such as cancer, depression, and multiple sclerosis. However, Modafinil has been used off-label since the 2000s to help smart drug enthusiasts enhance their cognition. This claim was purely anecdotal and it wasn’t until 2015 where scientists had enough evidence to say that Modafinil can do so in a safe and effective manner [2]:
“…in the face of vanishingly few side effects in these controlled environments, modafinil can be considered a cognitive enhancer…and that we need to figure out better ways of testing normal or even supra-normal cognition in a reliable manner.”
With respect to “enhancing cognition,” this can include tangible benefits such as increasing productivity, heightening focus, and easily working 10-12 hours way past midnight. Since Modafinil could potentially keep its user sharp and completely eliminate even the slightest form of mental fatigue, athletes were curious to see if they could use Modafinil in sports to enhance their performance.

Modafinil in Sports | Legal Performance Enhancer?

To understand how using Modafinil in sports is banned worldwide, we have to take a glimpse into what constitutes a “banned substance.”

The World Anti-Doping Agency (WADA) uses three criteria to determine what substances enter their prohibited list [3]:

“It has the potential to enhance or enhances sport performance: Before adding a substance or method to the Prohibited List, WADA examines emerging doping threats and reviews research from scientists around the world

It represents an actual or potential health risk to the athlete: The use of prohibited substances for performance enhancement and injury recovery reasons can pose health risks ranging from immune and toxicity reactions, to infection and death.

It violates the spirit of sport: …the pursuit of human excellence through the dedicated perfection of each person’s natural talents. Only when the playing field is level can people experience the true value of sport, including its power to inspire joy, build character, teach teamwork, and instill respect.”

Furthermore, these substances are categorized into classes of drugs and the extent of their prohibition:

“The Prohibited List outlines substances and methods that are prohibited at all times, in-competition only, and in particular sports.

The substances and methods on the Prohibited List are identified under various categories, including Anabolic Agents, Hormone and Metabolic Modulators, Stimulants, and others.”

Modafinil, in this case, falls under the “Stimulants (S6)” category on WADA’s Prohibited List for in-competition use across all sporting events.

Here is how researchers have come to define a “stimulant” in the context of a drug that’s prohibited from in-competition use [4]:

“…refers to agents that stimulate the central nervous system (CNS) and have marked effect on mental function and behaviour, producing excitement and euphoria, reduced sensation of fatigue, and an increase in motor activity.”

According to the paper quoted above, stimulants were the 3rd-most detected class of banned drugs (right behind cannabinoids and anabolic steroids) in 2008-2009. And between 2004 and 2010, nearly 1/5th of all positive drug tests contained at least one stimulant.

Modafinil’s rise towards being a banned substance came about in the 2003 US Track and Field Championship when six athletes tested positive for Modafinil.

The International Association of Athletics Federation (IAAF) had a hard time believing all these athletes suffered from narcolepsy, which affects 0.02-0.05% of the American population.

Therefore, as of 2004, Modafinil was added to WADA’s list of prohibited substances [5].

With all of this in mind, one might wonder why caffeine isn’t a banned substance in The Olympics or other major competitions.

It was initially a banned substance between 1984-2004 if you had sufficiently high concentrations of caffeine in your urine upon testing. This would equate to roughly 8 full espressos (or 12 μg/mL).

It may become a banned substance in the future, but it was removed from the “prohibited list” for two specific reasons [6]:

“Because performance-enhancing doses of the stimulant were found to be almost indistinguishable from normal consumption, the WADA pulled the caffeine restrictions to prevent penalizing athletes unfairly”

“…According to a WADA spokesperson, the organization determined that caffeine no longer met at least two of three criteria for inclusion on the prohibited list”

So now that we have an understanding of why Modafinil is banned in competition, let’s dig deeper into how Modafinil in sports can provide an unfair advantage.

How Modafinil *Can* Benefit Athletes

Here’s a brief list of the ways in which athletes claim Modafinil helps their performance [7]:

  • Increase heart rate and blood flow
  • Lower fatigue
  • Improved endurance
  • Suppressed appetite
  • A heightened sense of focus and alertness
  • Greater energy levels

In more informal times, Modafinil lets you sustain 100% concentration over several hours and helps you give your undivided attention to a task.

Modafinil can give an athlete a psychological edge over someone who is “natural,” while helping them compete for much longer and reducing the likelihood of making costly mistakes at the same time.

But what does the scientific research published to date have to say about the use of Modafinil in sports?

Staying in the zone

When an athlete gets “in the zone,” here’s what they’re talking about [8]:

“The “zone” is a state of supreme focus helps athletes in all sports perform at their peak potential. It is when your mind fully connects with achieving a goal, such as getting a hit, or stealing a base.”

Imagine being able to consistently operate at 100% of your potential and replicate your performance over and over again. That’s what Modafinil can do for athletes.

This was confirmed in a review of numerous studies involving the use of Modafinil military soldiers who are chronically sleep-deprived [9]:

“Military studies have repeatedly demonstrated that modafinil has the ability to promote wakefulness and improve cognitive performance during sustained periods of sleep deprivation associated with military operations.”

“In a study conducted by the U.S. Army, volunteer helicopter pilots were given 600 mg of modafinil or placebo during two 40-hour periods of sleep deprivation.

The results of that study showed that modafinil attenuated sleep deprivation effects during simulated flight maneuvers and lessened subjective problems with mood and alertness, compared with placebo.”

Eliminating mental fatigue

Modafinil can eliminate the mental and physical fatigue that comes from back-to-back days of intense competition.

In one 2004 study involving healthy male adults who engaged in vigorous aerobic activity, Modafinil increased the time it took for participants to feel exhausted [10]:

“Acute ingestion of modafinil prolonged exercise time to exhaustion at 85% VO2max and reduced RPE [ratings of perceived exertion]. The RPE results suggest that the dampening of the sensation of fatigue was likely a factor responsible for the enhanced performance.”

Modafinil’s fatigue-reducing ability is also observed in patients with multiple sclerosis, which makes it useful for both athletes and those suffering from diseases where fatigue is a common symptom [11].

Shorter reaction times

Athletes know that a split second difference in reaction time is more than enough to create an unbeatable gap between themselves and their opponents.

While more human clinical trials are needed to confirm this, rat studies seem to provide some support for Modafinil’s ability to lower reaction times [12]:

“Modafinil produced a dose-dependent pattern of improved response accuracy and impulse control (fewer premature responses) and shorter response latencies, without affecting omission errors, motivation or motor control.

Although the biochemical mechanism of modafinil is unknown, these results suggest a profile differing from typical psychostimulants (e.g., amphetamine)”

Both the scientific evidence and the anecdotal reports clearly show how (and why) Modafinil and sports cannot co-exist.

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High-Profile Athletes Taking Modafinil

 

Modafinil isn’t just some rogue pharmaceutical drug that has been banned because one desperate athlete came up with the idea to take it before competing.

In fact, there are many cases of high-profile athletes getting caught with Modafinil in their systems.

Wikipedia has a comprehensive collection of all the athletes who were penalized for using Modafinil up to its eventual ban in 2004 [13].

However, here are some prominent examples of champions who used Modafinil in sports and suffered the consequences.

Kelli White

After failing multiple drug tests for Modafinil usage, this American sprint champion lost all her placings between 2000 and 2004 (1oom and 200m) while also receiving a 2-year ban from competing.

She was caught in the 2003 World Championships, the same competition mentioned earlier where six other track and field athletes tested positive for Modafinil [14].

Barry Bonds

Major League Baseball (MLB) legend Barry Bonds was under investigation for steroid use by the Bay Area Laboratory Co-operative (BALCO) in 2004.

Additional documentation found he was taking Modafinil, but Bonds vehemently denied having used Modafinil or ever knowing about its existence.

However, many people speculate he used Modafinil as the heightened focus could have easily contributed to his impressive track record [15].

Dwain Chambers

This champion sprinter from the United Kingdom was banned for life from competing in the Olympics when he tested positive for Modafinil use in 2003.

In his autobiography released in 2007, he admitted to using Modafinil for increased mental alertness and faster reaction times [16].

Diana Taurasi

This Women’s National Basketball Association (WBNA) powerhouse was banned from competing in Turkey in 2010 when both of her drug tests came out positive for Modafinil use.

However, she vehemently denied the accuracy of the tests. Taurasi was able to contest these tests in 2011 and it was discovered that both tests were false positives.

Apparently, the laboratory that ran the tests did not meet WADA’s quality standards for testing. Therefore, they lost a significant amount of credibility [17].

Is Modafinil a Banned Substance? | NCAA, Olympics, and More

Modafinil is unquestionably a banned substance, but who exactly are the major sporting organizations that have banned the use of Modafinil in sports?

World Anti-Doping Agency (WADA)

As mentioned earlier in this article, WADA banned Modafinil in 2004 from in-competition use as a non-specific “S6. Stimulant” [18].

National Collegiate Athletic Association (NCAA)

When it comes to NCAA and Modafinil, they banned the smart drug somewhere between 2005 and 2006 [19].

The NCAA does allow a “therapeutic use exemption” (TUE) for athletes who take Modafinil and other psychostimulant medications. However, this is a very lengthy process with an extremely low chance of success [20]:

“The policy requires student athletes with ADHD who take psychostimulant medication to provide “evidence that the student athlete has undergone clinical assessment to diagnose the disorder, is being monitored routinely with use of psychostimulant medication and has a current prescription on file.”

“…The NCAA Committee on Safeguards and Medical Aspects of Sports has issued a new mandatory reporting form that contains criteria, including any known history of substance abuse, to help differentiate legitimate use worthy of medical exemption from use that is abusive.”

United States Anti-Doping Agency (USADA)

The USADA operates under WADA rules, which means that Modafinil is an automatically banned substance [21].

The Olympics

Like the USADA, The Olympics also follows the WADA’s criteria to determine which drugs are banned substances.

However, athletes can also apply for a TUE if they meet three specific criteria [22]:

  1. the athlete would experience significant impairment to their health if the medication was withheld;

  2. the prohibited substance would not increase the athlete’s performance other than from restoring their health to normality;

  3. the athlete could not use a permitted alternative

Should You Take Modafinil During Sporting Events?

If you have to ask whether you can use Modafinil in sports, you can safely assume the answer will always be a resounding NO!

Any athlete who competes collegiately or professionally will be subject to random drug testings from their respective sport’s organization body. Any time money is on the line (scholarships, contracts, etc.), you can bet that Modafinil is a banned substance.

Anybody who thinks they can outwit the latest drug-testing science for Modafinil is naive at best.

100 mg of Modafinil lasts in your system for at least 80 hours and is easily traceable via a blood or urine test.

You would be best off abstaining from Modafinil use altogether for at least one week prior to a drug test if you don’t want to test positive.

Even if you apply for a TUE and have a legitimate doctor’s prescription for Modafinil, “WADA retains the right to overturn any international sports federation decision on a TUE” [23].

And with the recent surge in TUE applications from athletes who are obviously trying to “cheat” the system and jump over anti-doping rules, there’s a very high chance your application will get rejected outright [24].

On the off chance that you overcome all these obstacles, beat all the drug tests, and successfully use Modafinil to beat your competitors, you can still get caught [25]:

“WADA rules permit samples to be stored for up to eight years so they can be subjected to new tests that are developed well after an event.

…This kind of retrospective testing cost Rashid Ramzi his 1,500-meter run gold medal from the 2008 Olympics after he came up positive for [Continuous erythropoietin receptor activator] months after the Games had ended”

Long story short, don’t try it. Don’t risk your reputation and career over a one-time use of Modafinil.

Modafinil and Sports | The Verdict

It should be fairly obvious to any competitive athlete that Modafinil and sports do not mix together.

Modafinil indeed possesses several cognitive and physical benefits for its users, which is why competitors have fought tooth and nail to get away with using Modafinil in sports.

Is Modafinil a banned substance for these competitors? Yes, and across virtually every sporting organization in existence.

This smart drug is considered illegal and you could be banned from competing if they find traces of the pharmaceutical drug in your system.

Furthermore, it is extremely unlikely for athletes to get a therapeutic use exception for using Modafinil in-competition. Examiners are starting to catch on to people who use this tactic, and they have the final say in approving your exception.

For these reasons alone, athletes should avoid using Modafinil altogether during competition.

They should also abstain from Modafinil use altogether a week before any drug test to avoid testing positive for it.

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References

  1. Murillo-Rodríguez E, Barciela Veras A, Barbosa Rocha N, Budde H, Machado S. An Overview of the Clinical Uses, Pharmacology, and Safety of Modafinil. ACS Chem Neurosci. 2018;9(2):151‐158. doi:10.1021/acschemneuro.7b00374
  2. Hawkes N. Modafinil does enhance cognition, review finds [published correction appears in BMJ. 2015;351:h4852]. BMJ. 2015;351:h4573. doi:10.1136/bmj.h4573
  3. How Does a Substance Become Prohibited? Retrieved May 31, 2020. usada.org
  4. Deventer K, Roels K, Delbeke FT, Van Eenoo P. Prevalence of legal and illegal stimulating agents in sports. Anal Bioanal Chem. 2011;401(2):421‐432. doi:10.1007/s00216-011-4863-0
  5. Kaufman KR. Modafinil in sports: ethical considerations. Br J Sports Med. 2005;39(4):241‐244. doi:10.1136/bjsm.2004.016303
  6. Can Olympic Athletes Have Caffeine? Retrieved June 2, 2020. nationalcoffee.blog
  7. Docherty JR. Pharmacology of stimulants prohibited by the World Anti-Doping Agency (WADA). Br J Pharmacol. 2008;154(3):606‐622. doi:10.1038/bjp.2008.124
  8. Understand THE ZONE in Sports. Retrieved June 1, 2020. sportpsychologytoday.com
  9. Westcott KJ. Modafinil, sleep deprivation, and cognitive function in military and medical settings. Mil Med. 2005;170(4):333‐335. doi:10.7205/milmed.170.4.333
  10. Jacobs I, Bell DG. Effects of acute modafinil ingestion on exercise time to exhaustion. Med Sci Sports Exerc. 2004;36(6):1078‐1082. doi:10.1249/01.mss.0000128146.12004.4f
  11. Shangyan H, Kuiqing L, Yumin X, Jie C, Weixiong L. Meta-analysis of the efficacy of modafinil versus placebo in the treatment of multiple sclerosis fatigue. Mult Scler Relat Disord. 2018;19:85‐89. doi:10.1016/j.msard.2017.10.011
  12. Morgan RE, Crowley JM, Smith RH, LaRoche RB, Dopheide MM. Modafinil improves attention, inhibitory control, and reaction time in healthy, middle-aged rats. Pharmacol Biochem Behav. 2007;86(3):531‐541. doi:10.1016/j.pbb.2007.01.015
  13. List of doping cases in athletics. Retrieved June 1, 2020. wikipedia.org
  14. Doping for Seconds. Retrieved May 29, 2020. thenewatlantis.com
  15. What Bonds told BALCO grand jury. Retrieved May 29, 2020. sfgate.com
  16. Performance enhancement: Superhuman athletes. Retrieved May 29, 2020. nature.com
  17. Who is Diana Taurasi? The Basketball Powerhouse Is A Force To Be Reckoned With. Retrieved June 3, 2020. bustle.com
  18. WADA PUBLISHES THE 2004 PROHIBITED LIST. Retrieved June 2, 2020. olympic.org
  19. Ambrose PJ, Tsourounis C, Olander R, Uryasz F. Characteristics of drug and dietary supplement inquiries by college athletes. Sports Health. 2010;2(1):12‐18. doi:10.1177/1941738109347978
  20. Perrin AE, Jotwani VM. Addressing the unique issues of student athletes with ADHD. J Fam Pract. 2014;63(5):E1‐E9.
  21. Understanding the Testing Process. Retrieved June 1, 2020. usada.org
  22. Fitch K. Proscribed drugs at the Olympic Games: permitted use and misuse (doping) by athletes. Clin Med (Lond). 2012;12(3):257‐260. doi:10.7861/clinmedicine.12-3-257
  23. Reardon CL. The sports psychiatrist and psychiatric medication. Int Rev Psychiatry. 2016;28(6):606‐613. doi:10.1080/09540261.2016.1190691
  24. Athletes need performance-enhancing drugs to treat illness. Retrieved June 1, 2020. theconversation.com
  25. The Top Athletes Looking for an Edge and the Scientists Trying to Stop Them. Retrieved June 4, 2020. smithsonianmag.com

Table of Contents

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