The US Anti Doping Agency on October 10 made public hundreds of pages of documents of evidence including financial payments, emails, scientific data and laboratory test results that further prove the use, possession and distribution of performance enhancing drugs (PEDs) by Lance Armstrong and the US Postal Service team that won seven Tour De France crowns. Included was testimony given by eleven of his teammates that Armstrong and the other riders used steroids and growth hormones. Further, they performed transfusions of their own blood in a well organized program to enhance their performance over the grueling three week event. Despite hundreds of tests performed in and out of competition over many years, these men evaded detection. How did they do that?
History of Performance Enhancing Drug usage
Doping in sport is not a new phenomenon. Ancient Olympians were reputed to eat a lizard meat that provided a special edge. The popularity of endurance sports at the turn of the 20th century gave rise to open usage of various substances, including cocaine, that might keep competitors upright. In the modern Olympics, the winner of the 1904 marathon was given brandy and strychnine by his coach during the race. During World War II, US soldiers and airmen were routinely given amphetamines in order to better endure long hours in combat operations.
Steroid usage in sports was first utilized by East German weightlifters in the late 1940s and was later expanded to swimmers and track and field athletes. Following widespread calls for action, the International Olympic Committee finally banned PEDs in 1967. Enforcement was inconsistent until athletes, sports governing bodies and international organizations formed the World Anti Doping Agency (WADA) in 1999 to codify what substances were to be banned and to administer uniform testing methodologies for possible violations. As the creators of PEDs continue to improve their sophistication, potency and transparency, WADA and its constituencies also innovate new ways to detect these drugs. It publishes an updated “Prohibited List” annually. Because WADA is unable to anticipate all possible new developments, the first page of the list states
“Any pharmacological substance which is not addressed by any of the subsequent sections of the List and with no current approval by any governmental regulatory health authority for human therapeutic use (e.g drugs under pre clinical or clinical development or discontinued, designer drugs, substances approved only for veterinary use) is prohibited at all times.”
What drugs/procedures are prohibited and why?
The drugs taken by athletes differ widely based on the performance needs of the sport. Erythropoietin (EPO) is largely taken by endurance athletes who seek a higher level of red blood cells, which leads to more oxygenated blood, and a higher VO2 max, which increases the body’s ability to transport oxygen to the blood during exercise. EPO has become popular among athletes who choose to juice because it has a low degree of detectability when compared to other methods of doping such as blood transfusions. EPO is believed to have been widely used by athletes in the 1990s, in large part because there was not a way to directly test for the drug until 2002. EPO is very dangerous because it increases the viscosity of blood, leading to seizures and heart attacks, and has been linked to the deaths of 18 pro cyclists in the last fifteen years.
In sports which physical strength is favored, athletes have resorted to anabolic steroids, known for their ability to increase physical strength and muscle mass. The drugs mimic the effect of naturally occurring testosterone in the body. Anabolic steroids were developed as a solution to the extensive side effects of testosterone use, although they are far from completely safe. Their many negative side effects in men include, but are not limited to, acne, impaired liver function, impotency, breast formation (gynecomastia), erectile dysfunction and baldness.
Athletes seeking to avoid testing positive for doping use various methods to cheat on the drug tests. The most common methods include urine replacement, diuretics (which are used to cleanse the body before having to provide samples) and blood transfusions, which also increase the blood’s oxygen carrying capacity (in turn increasing endurance without the presence of drugs that could trigger a positive test result.)
Some Other Considerations
Despite the health problem brought by PEDs, some athletes point to the already dangerous environment in sports like football and martial arts and wonder if there is a double standard. Health concerns brought by the aggressive nature of these sports is deemed acceptable but PEDs are not. They point out that protective headgear results in both more dangerous and greater numbers of head and neck injuries in football than if no helmets were used.
Many top athletes also believe the doping rules are somewhat arbitrary. Changes in diet such as consuming whole grains or eating gluten free are acceptable choices while the sweetener Stevia (found in energy drinks) was once prohibited. Ill athletes are generally loathe to take anything more than aspirin because decongestants and asthma medications require specific WADA waivers. Sleeping in a hyperbaric chamber to increase the supply of oxygen in the blood is acceptable, though not accessible to most, while low cost drugs to achieve the same effect are banned.
The Morality Issues
The world governing body of professional cycling, the UCI, recently stripped Lance Armstrong of his record seven Tour de France titles. The UCI decided that no winners would be declared for those years because the use of PEDs was so pervasive that it was likely that anyone near the top of the standings was similarly tainted. Lance won those races by spending countless hours training and six or seven hours on the saddle most days of those Tours. If he had not “juiced” with PEDs, it is almost certain that he would not have crossed the finish line a winner. If he wanted to win, he had to juice. Because everyone else was too. He could simply have walked away, and refused to participate. Every elite athlete has a precious window of time in which to potentially dominate. This was his time. So is he guilty or is he a victim of circumstance? Don’t the governing bodies have an obligation to provide for a “level playing field” so that athletes who abide by the prohibitions have a reasonable chance to win?
What of the future? In London last July, Oscar Pistorius of South Africa became the first double amputee to run in an Olympic track event after winning a court appeal against the IAAF (track and field’s world governing body). The IAAF had maintained that his carbon fiber prosthetic legs gave Pistorius an unfair advantage over other athletes.
The reasons for the ban on PEDs are primarily the health risks of usage and the desire for equality of opportunity for athletes. In the coming years sports governing bodies will be forced to deal with genetic enhancements and other mechanical changes to the human body. Authorities will be hard pressed to decide what regulations to enforce when changes made by athletes are both permanent and not health risks. Violators of any standards will almost always be one step ahead of the testers, and regulatory bodies would do well to use a light touch rather than a heavy hand. The moral issues are far from straightforward, and there will be many valid opinions as to what is right or wrong. What do you think? How far would you go to be a champion?