By now the entire world has heard that famed Russian tennis champion Maria Sharapova has tested positive for a banned substance. According to a March 9 Reuters article, she has been suspended, lost major sponsors and there is a possibility that she will miss the upcoming Olympics. The substance she was taking is Meldonium or Mildronate.

This is a heart medication that is most commonly used in Eastern Europe. This medication has been banned effective only this past January. Meldonium works by regulating the energy metabolism pathways. It has been used for treatment of heart failure, arrhythmia, heart attacks and diabetes. It has not been approved for use in the United States.

What prompted the ban on the sports use of Meldonium is a December 2015 study in the Journal of Drug Testing and Analysis. The study came out of the Center for Preventative Doping Research in Cologne, Germany. The study concluded that the cardiac drug Meldonium allows for increased endurance performance in athletes and enhanced activation of the central nervous system. It also protects against stress and improves rehabilitation after exercise.

Prior to the study the drug was on the World Anti-Doping Agency (WADA) monitoring list. What may have prompted the all out ban is that the authors of the 2015 study pointed out that there is "wide prevalence of Mildronate (Meldonium) in international elite sports and demonstrates the alarming extent of administered dosages." The study further, frankly, recommended to ban the drug because of medical aspects, as well as preserving the integrity of the sport.

Why would such a successful athlete, that has so much to lose, even consider taking such a drug? According to Leon E. Popovitz, MD, co-founder of New York Bone & Joint Specialists and an Attending in the Department of Orthopedic Surgery at North Shore LIJ Lenox Hill Hospital in NYC, who has years of sports medicine experience treating athletes, the answer is many reasons, but they all hover around the incessant drive to succeed in sports at all costs. This goliath of accumulated pressure on athletes has amassed over decades.

“The pleasure of the actual play of a sport has evaporated and what remains is a perpetual satiating drive to succeed,” Popovitz said. “Is this what we want to be instilled in our children? Unfortunately, this is the current state of sports and it has diffused down to all levels.”

“Thus, so many kids that simply would enjoy, and benefit, from participating in athletics for both mental and physical reasons are turned off. Unfortunately, the pressure from all directions (coaches, parents, peers, etc) thins away the pleasure all too often and replaces it with that unyielding drive to win at all costs. This is promoted on all levels with the ultimate grand reward of achieving professional success. This professional success is now, all too often, measured by more and more lavish sponsors.

So, is Maria Sharapova fully to blame here? Certainly, she must take responsibility and she has openly done just that. Nonetheless, though, that gormandizing snowball of drive for success has been accumulating for years by nearly everything around her. I believe that environment holds some responsibility. The ultimate prevention may be to reevaluate how we nurture our young and growing athletes.”