The shockwaves of Kory "Semphis" Friesen's innocuous doping confession are still shuddering their way through the eSports industry this week.
ESL spokesperson Anna Rozwandowicz confirmed that the league – which hosted the Katowice tournament Friesen allegedly took Adderall at in March – would be deferring to the World Anti Doping Agency's banned substances list ahead of their last CS:GO major of the year in Cologne this weekend.
"Our main goal is and always will be to maintain the fair play spirit and the integrity of our competitions," Rozwandowicz wrote in an announcement post on Reddit. "It is a small, but in our eyes essential and meaningful step forward for professional gamers across all games, ESL as an event organiser, and the eSports industry as a whole."
The speed with which the industry, and ESL in particular, has responded to what was a fairly throwaway admission betrays the extent to which drug-use was prevalent in competition – either as an active practice, or a looming threat.
However, as scaffolds are rapidly deployed around the issue, constructing a drug-testing framework to maintain eSports' purity, the more serious health and privacy threats doping – and testing – pose have been overshadowed.
So-called Cognitive Enhancement Drugs, or nootropics, like Adderall and Ritalin (methylphenidate) belong to a class of clinical treatment drugs similar to amphetamines. They are Central Nervous System stimulants and are most often used in the treatment of severe cases of Attention Deficit Hyperactivity Disorder.
"I've been very interested in the role of these drugs in improving attentional function," says Professor Barbara Sahakian of the faculty of Clinical Neuropsychology at Cambridge University. "Obviously my own work is geared towards helping people who have difficulties in this area but we do a lot of studies in healthy normal people, and we find that these drugs like methylphenidate and modafinil also improve their cognition, including sustained attention."
Professor Sahakian is a Fellow of the Academy of Medical Sciences and current President of the International Neuroethics Institute. From this position, she has campaigned for many years for recognition of the ethical and safety issues involved in drug use in another field.
Academic misuse of nootropics has gone equally unfettered for the best part of a decade, with students and even Professor Sahakian's colleagues using narcolepsy treatment Modafinil as a way to stay awake and study or deliver lectures after red-eye flights.
"In the states you can essentially go to the GP and say that you have sleep disturbance due to shift work and get Modafinil via that route, whereas it is only prescribed for narcolepsy in the UK," Sahakian said. "There have been reports that up to 90% of Modafinil is used off-label. Because of the nature of the health service in America, where it's private, I understand there's frequently more access to these drugs."
However this problem is not just localised to the States, says Professor Sahakian: "The care quality commission pointed out that there's been a rise of 56% in prescriptions for Ritalin in England in the past five years, and they actually said that some of this increase will be 'potential for diversion and misuse', as they called it."
On top of this, nootropics are also obtainable through internet back-channels, which Sahakian believes is unsafe, as the drugs could be 'anything at all'.
Though not completely analogous with eSports, nootropic use in academia is far better studied and understood, and a good place to start looking for answers on where to turn next, and the hidden issues that doping brings with it.
"Issues like coercion," Professor Sahakian said. "I frequently have people say to me that they don't want to use these drugs, students say they don't want to use them but they feel pressure put upon them because they know other people are using them which pushes up the curve."
A 2008 report from the Academy of Medical Sciences concluded that even as small as a 10% improvement in memory scores could lead to a better A-Level grade or degree class, making the prospect certainly enticing.
This coercion could be a potent force among the young and impressionable, be they with the weight of academic success on their shoulders, or the fame and fortune of eSports glory.
However it is one thing for substance abuse to be unethically forced upon a young person, and quite another for it to be actively unsafe to do so.
Adderall, Ritalin and – to a certain extent – Modafinil all have dangerous, though largely understudied, implications for long-term misuse in otherwise healthy, young brains.
The average age of an eSports athlete straddles the 20th birthday mark, with many retiring from active play before 25 – and this age range is crucial for brain development.
"We used to think the brain was more or less developed [by then] but we now know that brain development goes on until around the ages of 24 or 25," Professor Sahakian said. "Especially the front part of the brain, which is slower in development. One has to wonder, particularly in young adults or older adolescents, what the effects are of taking these drugs when your brain is still in development."
The frontal lobe is the main area of the brain implicated in planning, social and emotional abilities. It also contains the highest concentration of dopamine-sensitive neurons – the brain chemical affected by Adderall and Ritalin use. That this area is still in development during the period of their lives that eSports athletes are most at risk of taking neuroenhancements has dangerous implications.
Altering brain chemistry in the long-term while it is still growing can cause it to rely on these external dopaminergic agents, like Adderall or Ritalin, or change aspects of its function. In the case of the frontal lobe, that includes personality changes, social skill deficiencies or even counter-intuitively harming their ability to make sound decisions during matches.
The decision, then, to step in and declare nootropic use as illegal in terms of exam preparation is an essential first step in a process that could have an additional medical imperative.
However no educational establishments have yet taken the bold step the ESL has in randomised, invasive drug-testing – and possibly for good reason.
"Many feel the actual test is an invasion of privacy, though obviously it depends on the type of test," saysBryce Blum, a Seattle lawyer who consults for several eSports bodies, including recently launced betting site Unikrn.
"The cheek swabs ESL plans to use aren't particularly invasive, but there are still privacy implications there," Blum said. "Then there is the concern surrounding what happens with the data that's collected. where is it published? What is made public? How is the data stored and protected? On the flipside, ESL is a private company and there is no right to compete in an ESL event they can set up whatever barriers to entry they want, within reason."
To determine if a player has breached doping rules, the ESL will need, at the very least according to the details released so far, a positive saliva sample and medical records to determine if the player is prescribed a controlled substance.
The process is somewhat fraught with legal questions, as is most of eSports given its relative youth and ability to slip between the cracks of common case law. The closest place the ESL could look for hints on how to conduct their handling of testing and – inevitably it seems – handing out punishments is to other sporting bodies who have adopted WADA guidelines.
However problems arise when you consider the ESL is just one among many large tournament organisers, without the absolute control over their competitive sport that other associations like the NFL or FIFA enjoys.
If, for instance, a CS:GO player is found doping at an ESL tournament, and banned for two years as they are proposing, will that ban also apply to a Gfinity tournament, or ESWC? And if so, are data privacy laws being upheld when communicating reasons to apply that ban to that player?
"You raise a really important pointand that's something I'm working on behind the scenes," Blum said. "There needs to be more collaboration between tournament organisers, particularly on points like this. Apunishment doesn't mean much if the player can simply go play elsewhere,that's true if they're banned for PEDS, or something else entirely.I think ESL carries enough weight that the program will be effective on its own, but I'd love to see a united effort."
The effectiveness of an ESL ban can still be devastating to a player's career, however. Take, as example, former HellRaisers rising starAlexander"s1mple"Kostylev, who was banned from ESL CS:GO tournaments in January for racist remarks.
The Top 10-ranked team was forced to drop Kostylev or forfeit their entry to any of this year's Majors, leaving the young Ukrainian to find a place in lower tier team Flipsid3, though he recently left due to team hostility.
Despite the cautionary tale, there will still be some willing to flaunt the rules and fly below the radar, as we are reminded every time a fresh wave of VAC bans shows up who has been using hacks without anyone's knowledge.
The difference here is that installing an aimbot or trigger doesn't have the potential to cause serious psychological damage.
"I do wonder sometimes about our society," Professor Sahakian said. "There are other ways to boost your brainpower, like exercise or education but it seems everybody just wants to take a pill."
All images courtesy of Professor Sahakian, Cambridge Press and Bryce Blum.