Citius, Altius, Fortius. Faster, higher, stronger. The modern Olympic motto was first proposed by Pierre de Coubertin when the International Olympic Committee (IOC) was formed in 1894. It spoke of the qualities that sport was based upon, that striving for the absolute limit was fundamental to the very essence of competition. Athletics was an amateur event, and spectators admired their spirit and application as much as the outcome. Competition by nature requires gaining some form of advantage over your competitors as the key to success; exploiting your strengths and/or your opponents’ weaknesses is essential. One method of attempting to gain an advantage is through doping.
Attempting to gain an advantage by using substances is not new. The Ancient Greeks used alcoholic stimulants in their training, which evolved to concoctions of strychnine, brandy and cocaine in the 19th Century. Moving into the 20th Century scientists had identified and synthesized testosterone and anabolic steroids began to appear. Cycling began to see more and more amphetamines used, resulting in the first televised doping fatality in the 1967 Tour de France (TDF), when Tom Simpson died with high levels of methamphetamine in his system. This practise was later replaced by Erythropoietin (EPO) and blood transfusions, with records of Finnish middle distance runner Kaarlo Maanika admitting to their use in 1980, which was not illegal at the time.
Doping in sport is prohibited for two primary reasons: the use of performance enhancing drugs is harmful to the athlete, and using them makes competition unfair. However, athletes who choose to use them may be enticed by the high financial stakes, TV broadcasting revenue, corporate sponsorship, an increased understanding of PEDs, their desire to win, and a lack of an effective policing mechanism. The financial aspect of sport has exploded over the last several decades. In 1971 Kevin Keegan was paid £50 a week by Liverpool football club, and Lionel Messi has a contract that pays him 10000x that each week. According to Forbes, Floyd Mayweather has earned $915 million during his career; Cristiano Ronaldo has earned $800 million, and LeBron James $680 million. Today, more than ever, sport rewards winners. Every sport needs its heroes-they excite us, and the sponsors flock to the latest record-breaking sensation. Greatness has a price, and in today’s market that price is an eight-figure annual income.
The benefits of doping can include increased muscle mass, strength and power, quicker recovery times-which enable more frequent high intensity training sessions, weight reduction/fat loss, and improved oxygen utilization and delivery. Training at higher intensities and greater volumes whilst still recovering adequately leads to greater adaptation, which is the usual double-edged sword for most elite athletes. In short, performance enhancing drugs help athletes push harder for longer. There has been some suggestion that doping can have benefits long after their use discontinues, with Androgenic Anabolic Steroids (AAS) potentially increasing the number of nuclei in cells permanently, which can lead to greater increases in muscle mass, and potential greater strength and power development. Growth hormone has been suggested as an aid athletes to keep their increased muscle mass after the steroid cycle has ceased, and is renowned to be extremely difficult to test for by doping authorities. EPO stimulates red blood cell production, improving the oxygen carrying capacity to the muscles, which prevents fatigue and improves recovery. Testing itself usually involves collection of a urine or blood sample, depending on the body administering the test. One or more metabolites are targeted, and an upper limit of normal must be established. This is effectively where the athlete’s biological passport comes into play.
In the 2012 BBC documentary “Catch me if you can”, reporter Mark Daly attempted to beat the Biological passport. Daly was a keen amateur cyclist, and suspected doping occurred even at those levels. A passport was created for him initially: blood tests that measure various hormones, blood markers and other individual aspects which capture their current profile. This test is repeated at various intervals, which build longitudinal profiles and look for fluctuations that may suggest the use of substances. Essentially, it is an attempt to capture a video of an athlete’s biochemistry, rather than a snapshot at any given time which the standard methods used. Daly spent 6 weeks self-administering EPO he had ordered online, which led to a 7% performance improvement over 7 weeks in total (It is worth noting that the performance difference between a gold medal and fourth place is often less than 2%). He was retested and was deemed clean by WADA. He approached WADA’s founding chairman, Dick Pound, with his confession and concerns. The passport’s weakness is towards microdosing; if the hormones and markers do not spike or fall by an athlete taking a large dose of a substance once a week but instead taking smaller doses every few days, the profile does not raise suspicion. Pound admitted that less than 2% of doping tests are positive, and that insiders (whistleblowers) and not tests are the key to catching dopers.
History of doping
The sport most synonymous with doping is cycling. Specifically, the TDF has produced some of the greatest doping scandals over the years. The event lasts 23 days, and covers a variety of distances around 3500 kilometres over ascending and descending terrain. Lance Armstrong was the highest profile athlete, winning seven TDF titles in a row from 1999-2005, which were later stripped after a lawsuit deemed him guilty of doping in 2012. Although Armstrong admitted to using Erythropoietin (EPO), Human Growth Hormone, Diuretics, Testosterone, Blood Doping, Cortisone and Actovegin, he wasn’t convicted due to a failed doping test. Instead, he was convicted due to a Federal investigation initiated by the evidence provided through a full confession from team mates. Armstrong was the most drug-tested athlete of all time during the height of his fame, although anti-doping was unable to stop him from taking a large array of banned substances.
Victor Conte and his Bay Area Laboratory Co-operative (Balco) scandal was devised to stay one step ahead of the testing procedure. The drugs themselves did not need to be more effective, they just need to be modified to move around the tests and stay undetectable. The synthetic steroid Tetrahydrogestrinone (THG) was created by Conte’s partner Patrick Arnold. The colourless liquid became known as “The Clear” due to its ability to go undetected in drug tests. THG was uncovered due to a whistleblower that alerted USADA about its existence and allowed them to catch multiple high-level athletes.
In a review by Ulrich et al (2018), 44% of athletes at the 2011 World Championships admitted to doping in an anonymous survey. In contrast to this only 1.4% of samples collected test positive. Such a huge discrepancy begins to suggest the enormity of the challenge ahead, or the reality that clean sport is simply no longer an option.
The International Olympic Committee (IOC) is a non-profit organisation, even though it generates $5.7 billion during each Olympic cycle, with nearly three-quarters of that income coming from TV and broadcasting revenue. The IOC formed two independent bodies for sport; the World Anti-Doping Agency (WADA), and the Tribunal Arbitral du Sport (TAS)/Court of Arbitration for Sport (CAS). WADA is a relatively small organisation, with an annual budget of $27 million and around 120 employees. Of those, only 7 are tasked with running investigations into doping schemes. Due to this they are highly reliant on acts of goodwill. The IOC, WADA and CAS/TAS are highly interlinked with one another, with WADA receiving 50% of its funding from the IOC, and the organisations have had several members in multiple roles at any given time. IOC President Thomas Bach also chairs the appeals division of CAS, Craig Reedie was WADA President alongside being IOC Vice-President, and John Coates President of CAS and IOC Vice-President. This suggests a conflict of interests in the overall scheme.
For the pubic, the doping procedure has always been marketed as athletes are clean, and the few that are not get caught by the system. I would suggest this is nothing more than keeping the public and the sponsors happy, as the evidence shows beating the tests may not be all that difficult. Lance Armstrong abided by the following rules; wear a watch (USADA would not turn up after 10pm or before 7am. He joked by saying 10:05pm was a busy time in cycling households), keep your phone handy, know your ‘glowtime’ (how long you will test positive after taking a substance), and at a push you had three strikes. If someone turned up to drug test you when you knew the glowtime was still active, simply hide. If you don’t answer the door, you can’t be tested.
Another method involves keeping the concentration of the substance below the limit of detection (microdosing), or using a masking agent to hide its presence. Diuretics dilute the metabolites that are required for the tests, flushing them out of the system and bringing the levels below that of a positive test, as all substances have upper limits established. In the TDF one such reading that was essential for performance and doping controls was Hematocrit (the ratio of the volume of red blood cells to the total volume of blood), which had its upper limit set to 50%. All this meant was everyone had a target to aim for, such as 48-49%. The boundaries between the therapeutic and ergogenic use of drugs is blurred at best, with many examples of athletes testing positive for a substance which is immediately put down to an underlying health issue (asthma, low testosterone, pain etc). All drugs were initially developed from a medical perspective, and so there is always a reason that can be accounted for in a backdated manner, via the team doctor.
Dave Brailsford oversaw Team GB’s cycling squad from 1997-2014, and was Programme director for the highly successful Team Sky 2010-2014. Struggling to win back what were now sceptical cycling audiences, Brailsford discussed overcoming what he felt was a 15% deficit in performance if they were to remain clean. His approach was to focus on nutrition, recovery and strategy. As innovative as this approach sounds, it would suggest that for the 15% gap in performance to be resolved, those areas would have to be somewhat ground-breaking. However, team Sky’s doctor, Richard Freeman, recently admitted to 18 of the 22 charges brought against him at a tribunal, including one that admitted to ordering 30 sachets of testosterone sachets.
Open doping is bad for business, it turns away fans and sponsors. As testing regimens evolve, the substances used or the way they are administered changes for the athlete to avoid detection. WADA admits that the doping procedures are ineffective, and are highly reliant on whistle-blowers to catch dopers. As the rewards for winning continually rise, doping may always stay a step or two ahead of the doping controls. Is the aim to catch the doping, or is the system designed to keep the sponsors and tv revenue happy? Much like Lehman Brothers in 2008, are those at the top of sport’s pyramid too big to fail?
In this author’s opinion, our current views of what it takes to be an elite athlete should be adjusted, and doping is simply a requirement to compete at the elite level, and should not be considered cheating if everyone else is using the same products. Tyler Hamilton stated that a highly talented cyclist that raced well, but was racing clean, would do well to finish in 50th place in the TDF. With the current doping system, we assume that the athletes that dope will get caught, but the evidence suggests this is a fallacy. Altering the chemical structure of a compound, microdosing and raising your natural hormonal profiles to those at the tested limits are all prudent methods to aid the training process and performance required today for elite level competition. Doping is banned for the reasons of it being unfair and harmful to the athlete, however, it cannot be viewed as unfair if it is done across the board. If athletes were to remain free from harm then this would also outlaw more events such as combat sports. If both issues were waived then doping would be openly allowed, but may make little difference to the highest level of sports where this has likely been a mainstay for many years already.