This article is part of a ParaSport News series of articles looking at doping in the Paralympic, Deaflympic and disability sports movement.

Type of doping violations since boosting was banned at the Paralympics in 2008.

Type of doping violations since boosting was banned at the Paralympic Games in 2008.

Lately, boosting has been identified as a potential issue for Rio 2016. Boosting, formally known as autonomic dysreflexia, allows sportspeople with a spinal cord injury above mid thoracic vertebral level to create an artificially maintained flight or fight response through the infliction of what for the rest of us would be lots of pain in the pelvis, lower extremities or genitalia. For example, a wheelchair sportsperson could stick a small needle in their foot. A number of media reports since the late 1990s have identified boosting as a hidden scourge in Paralympic wheelchair sport, with some research suggesting it gives wheelchair track and field racers a decrease in time of 9-10%, with better results over longer distances such as the 10,000 meters and the marathon. Various studies have estimated that anywhere between 30 and 50% of wheelchair sportspeople have used boosting to improve their performance. At the London Paralympics, when it came to questions about doping and cheating, most journalists were asking about allegations by wheelchair sportspeople saying the problem of boosting was rampant. There have been sensationalist headlines highlighting this problems, including ones talking about scrotum squeezing to get that boosting related performance benefit.

Boosting has been against the rules in the Paralympics since 2004 and has been tested for at the Paralympic Games since 2008 in Beijing, when doping control was done to conducted immediately following cycling and track events. While not explicitly called Autonomic Dysreflexia in WADA’s rules, boosting appears to be covered under rule M1, which relates to “Manipulation of Blood and Blood Components” and subrule M1.3 which prohibits “Any form of intravascular manipulation of the blood or blood components by physical or chemical means.”
Since boosting was first checked for at the Paralympic Games in 2008, ParaSports News has been unable to identify a single sanction related to boosting featuring 166 known violations.ParaSport News has been unable to identify a single case of a doping violation related to doping methods period. There have been 7 sanctions related to evading or failing to test, one for competing while sanctioned, one for whereabouts failures, and one for complicity by a para-alpine skiing coach in assisting a South Korean in evading testing. The biggest category of known doping violations from 2008 to 2016 was for anabolic agent with 46 violations, peaking in 2013 with 11. Diuretics and Masking Agents, classified as S5, were the next highest category of violations with 37 known incidents. S5 peaked in 2012 with 9 violations. Marijuana, categorized as S8, was the third biggest category of violations with 26. Cannabis violations peaked in 2010 with 7. The S6 category, which includes cocaine, was the next biggest category of violations with 27. It peaked in 2011, with 9 violations each year. The remaining categories all had 5 or fewer identified violations. If boosting is occurring at the elite level of wheelchair sport and it is being tested for, it is not being identified.

Boosting was first identified as a cheating issue in Paralympic sport in 1994, and has been most commonly associated with wheelchair rugby, track events and powerlifting. Despite not being formally banned until 2004, there are reports that testing took place in 2000 with no one being detected as boosting. Testing for autonomic dysreflexia includes looking at an athlete’s demographics (gender, country of origin), classification and blood pressure measurements. If an athlete has systolic blood pressure above 180mm Hg immediately after their event, they would get tested 10 minutes later and if their blood pressure was still 180mm or above, they’d be withdrawn by rule from the competition under the suspicion of boosting. Going into Rio, the IPC was considering changing the way to detect boosting, lowering the 180 mm of mercury threshold to detect it.

The data collected by ParaSport News for this report is available here for the benefit of other journalists and the sports community.