Drugs in Sport, Part I: The Inconvenient Truth

Regardless of what you have heard since Lance Armstrong staged his confession on Oprah, drugs are everywhere in sport. And regardless of where you stand, they're not going anywhere. And there's a good reason they're not going anywhere either: drugs work and they work very well.

Regardless of what you have heard since Lance Armstrong staged his confession on Oprah, drugs are everywhere in sport. And regardless of where you stand on the ethics on the issue, they're not going anywhere. They have played a big part in the success of athletes for decades.

Government-sponsored drug programs have been endemic since the 1960s. Many recall the shaming of Ben Johnson's disqualification for drugs after his 100m victory at Seoul 1988; few realise that, of the seven other sprinters that ran that day, five have since been exposed as users of performance-enhancing drugs. During Beijing 2008, bodybuilders across the globe lamented the disturbance to their supply chain of growth hormone; but this is what happens when 11,000 athletes gather in the place where 90% of the world's grey-market growth hormone is produced.

And there's a good reason they're not going anywhere either: drugs work and they work very well. The only people that will tell you otherwise are athletes coming back from a drugs ban; with a sheepish grin, they tell anyone that will listen how they are actually running their best times now they are 'finally clean'. If you believe this, then I have a bridge to sell you.

Most people outside of professional sport assume that a negative drug test equals a clean athlete. Not so. Testers can only look for metabolites of a steroid, rather than the steroid itself; if you create a new designer steroid, you create a brand new metabolite. This is why THG was referred to as 'The Clear' until the US Anti-Doping Agency received an anonymous syringe in 2003. Although a test for the drug was then formulated and a host of athletes subsequently tested positive, it seems impossible that this was the only designer steroid in circulation.

The problems hardly stop with steroids. Testing for growth hormone abuse remains difficult. A test didn't even exist until 2004, although the effectiveness was laughable. The improved biomarker test introduced at London 2012, features flaws that will change the way athletes use growth hormone but not eliminate it. Equally, endurance athletes can use blood transfusions and synthetic erythropoietin (EPO) if they do their homework; transfusions are spotted by looking for suspicious haematocrit levels; however, cyclists facing a test can inject saline to dilute their blood. This procedure can take just 20 minutes. They can beat tests for EPO through microdosing; while this still creates the glycosylated isoforms that testers look for, it means that they are only detectable for several hours instead of three days. Microdose at night, wake up clean.

But beyond these procedural difficulties in detection, a bigger problem is that most authorities simply don't care whether their sport is clean or not; they only care about the perception that it's clean. Sure, the rhetoric is now well-rehearsed; on the eve of each Olympics we are treated to a speech about how drug-testing technology is more advanced than ever and how this will be the 'cleanest Olympics yet'. But the truth is that they know the weaknesses of tests they do. And they know that their medical advisers move in the same circles as the doctors that consult athletes on ways to beat the tests.

The World Anti-Doping Authority (WADA) and the others could improve the testing procedures if they wanted. Not just through the metabolites they choose to test, but also by not tipping off preferred athletes as to when their 'unannounced' test will be. But herein lies the biggest issue of all. History shows that they don't actually want to catch athletes, especially the top guys that pull in the crowds. Occasionally catching a lesser-known athlete from a small country is great, but the elite remain largely untouched. Cue the now infamous quote, allegedly given off-the-record by a WADA official: "If we were that good at our jobs, we wouldn't have jobs."

And he's right. The reality is that, if they were that good at their jobs, we would have very few elite athletes left. We would have a host of junior sprinters competing in half-full stadiums. We would have tennis players hitting slower serves and much shorter rallies, in front of a bored crowd. And cyclists unable to sustain the superhuman demands of touring, much to the disappointment of the fans that line their route. And they know it.

This is the reason why the PGA refuse to test their players, despite the perennial rumours of steroid and beta-blocker abuse. It's the reason that elite tennis players can go over two years without a drugs test, then hide from testers that turn up unannounced (as alleged in the now famous 'panic room' incident involving Serena Williams). It's the same reason that the UCI, cycling's regulatory body, implicitly tolerates doping by allowing a haematocrit level of 50% throughout the duration of each tour, something only achievable with the use of EPO or blood doping. It's the reason why track and field athletes have long boasted about their 'protected' status, whereby their national authorities advise them when they will be tested and for what substances.

These authorities know that their athletes are doping. This is as clear in the Lance Armstrong scandal as any other: the 38 samples taken from the rider in 2009 show irregularities in haematocrit, immature red blood cell and liquid content of his blood. The USADA knew this at the time, but have only made it public since the tide turned against the former golden boy. Why keep this information secret for so long?

The authorities know that the sponsors pay their money because of the star appeal and fans remain committed because they want to be enthralled at the level of competition. Suspending your top stars does not fit this model. The more successful your drug-testing program, the more PR disasters you have to handle. Just look at Major League baseball in 2002. Under Government pressure in the wake of the BALCO scandal, the league introduced widespread drug testing for the first time. Stars ended up with bans, the rates of home runs dropped significantly and fan apathy increased (averages attendances dropped almost 7% between 2001 and 2003).

As long as the attitudes of the public and the sponsors remains the same, honest discussion of doping in sport remains taboo. Regardless of your moral stand on performance-enhancing drugs, the debate is rendered completely trivial if we insist on indulging in our naïve fantasies. Even if it upsets the loyal fans, the reality remains: if the authorities really want a clean sport, then they need to come clean themselves.

Next week: In part 2 of the discussion, I analyse the morality of drugs in sport, and question if we even care what substances our heroes take.

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