On June 15, 2016, the International Weightlifting Federation (IWF) announced positive anti-doping results from the re-test of 2012 Olympic samples (IWF’s official disclosure). Ten (7 female, 3 male) lifters, including seven medalists, from five countries tested positive for anabolic agents. The IWF has been notified of an additional 10 positives from the 2008 Olympic Games. Over the next few months, OLift Magazine will feature a series of blogs dealing with the topic of doping controls, a topic likely to remain in the headlines as we move toward the 2016 Olympic Games in Rio de Janeiro.
Controlling the use of banned ergogenic aids is a constant challenge.
Among the many sociology classes I taught at the University of Colorado during the 1990s was one entitled “Sport, Drugs, and Society”. This followed my eight years heading USAW where I’d been a keen observer of the progress made during the early years of modern anti-doping control. One thing is certain: controlling the use of banned ergogenic aids is a constant challenge.
At the 2016 USAW National Championships, I had the opportunity to accompany a lifter to doping control. It had been several years since I had done so, and it proved enlightening to see some of the changes now in place.
One change is that an athlete’s representative is no longer allowed to enter the control room after the athlete’s initial arrival. I discovered this as a young lifter who I worked with at Nationals was whisked off to doping control, but did not have her father accompany her. Coaches and athletes need to be familiar with this process of doping control so as not to be caught off guard when they meet a U.S. Anti-Doping Agency (USADA) representative in the warm-up room after their last lift.
Coaches, don’t let a lifter go to doping control unattended.
Early Doping Controls
The televised death of Tommy Simpson, a British cyclist, during the 1967 Tour de France was the impetus for the introduction of doping controls at the 1968 Summer Olympics in Mexico City.
Initial efforts at doping control were directed at detecting exogenous stimulant usage, something relatively simple to determine. At the 1970 World Weightlifting Championships in Columbus, Ohio, nine medalists (only the top three were tested) in the first four weight categories popped positive for amphetamine use.
The use of anabolic androgenic steroids (AAS), then relatively new to the performance-enhancing world, was on the rise during this time, but testing technology had not kept up. It was at the Montreal Olympics (1976) that AAS testing first took place. Among the athletes found positive for this category of doping were eight male weightlifters and one female discus thrower.
Since these initial efforts, the world of doping control has been a continuous cat-and-mouse game. Laboratories are challenged to maintain the upper hand over methods used by coaches, athletes, and state-sponsored programs dedicated to circumventing the rules.
Why Doping Controls?
Attempts at gaining an advantage over a competitor (more simply called cheating) go back to the original sporting challenges of ancient times. Famous quotes abound telling us basically that “… winning is everything.”
So with that focus it’s not difficult to grasp the idea of cheating at sport. And that’s one of the two oft-stated criteria to have a substance or practice included in modern doping control programs — ethics.
The second frequently referenced reason for controlling drug usage in sport is that such substances may be injurious to one’s health.
Basically, if those two criteria are not met a substance or a practice is not banned. As an example, as the USAW National Coach I queried early doping control experts on the viability of electro-stimulation. While this is often used as a remedial, or therapeutic, method of recovery there are also references to having an athlete “hooked up” during sport in order to achieve greater muscular contraction than may be available voluntarily.
What about carbohydrate loading for endurance sports? What about hypnosis?
I was told that in the case of electro-stimulation, since a lifter could not walk on the platform wired this was a not cheating. Relative to nutrition and psychological aids I was told there were no health concerns with either practice, so they were acceptable.
Often not mentioned is an additional criterion for the possible banning of a particular substance: its legality. Marijuana, an illegal substance to possess and/or use in some countries, is legal in others. Similarly, alcohol is not legal in certain countries.
Marijuana might be considered ergogenic (performance enhancing) in the case of sports requiring a relatively relaxed state of mind (shooting or archery, for example), but it would be unlikely to see use in strength or power sports. Metabolites of THC (the active ingredient in marijuana) have been detectable for up to six weeks post-usage, so more likely its use was detected from a non-performance-enhancing usage scenario (recreational use, even weeks before).
Marijuana was selectively banned for some sports in the past. Such is still the case with alcohol and beta-blockers. Currently USADA has marijuana listed under Categories of Substances Prohibited In-Competition Only.
Walking a Fine Line
After stricter doping control methods were put in place in the early 1980s, we saw a rush from the other side to get around the newest testing methodology.
IOC reiterates zero tolerance policy on doping
A generally accepted universal truth is that pharmacology develops substances that initially serve a good purpose, with little thought to possible nefarious applications. Such was the case with AAS. This is also the case with beta-blockers, designed to treat high blood pressure and some cardiac disorders.
Beta-blocker usage results in two concerns: 1) there are documented health issues associated with the use of beta-blockers and 2) some Olympic sports, notably shooting, could benefit from the use of beta-blockers to reduce tension.
Not banned by the IOC at the time, beta-blockers were permitted at the 1984 Summer Olympic Games in Los Angeles, provided medical declarations were in place — what today is referred to as a Therapeutic Use Exemption (TUE). While Weightlifting would certainly not be expected to benefit from the use of beta-blockers (although this question has been raised in masters’ ranks, due to health, not enhanced performance), in modern pentathlon (a multi-day sport consisting of swimming, running, shooting, fencing, and equestrian), entire teams showed up at doping control with medical TUEs. Numerous medalists, none previously reported to be suffering from high blood pressure, tested positive for this permitted substance. Afterwards, modern pentathlon thought they overcame this problem by having the cross-country running event follow the shooting competition, sort of a natural remedy to the situation. However, several teams simply switched to a beta-blocker with a shorter life. Subsequently, beta-blockers were added to the list of banned substances for which athletes are tested.
Other legitimate products have been used for reasons other than their primary purpose. Probenecid, an anti-gout medication popular with athletes (with no history of gout) in the late 1980s was reportedly used as a masking agent, allowing AAS to remain in the system and avoid detection. The same is true of furosemide, or Lasix, an otherwise fairly innocent diuretic reportedly used to mask the presence of other drugs.
Surely there are potential health issues with excessive amounts of these substances (and athletes are known to push limits). This fulfills the concern for an athlete’s health. And, if taken for the purpose of masking the presence of other drugs we also satisfy the topic of questionable ethics.
Recent headlines have highlighted the use of meldonium, a substance not currently approved by the U.S. Food and Drug Agency (FDA) that is linked to the treatment of coronary heart disease (CHD). Generally speaking, one would not expect a world-class athlete to suffer from CHD, but who knows? Prior to the January 2016 ban on meldonium by the World Anti-Doping Agency (WADA), this drug could be used if prescribed by a doctor. This suggests that there is no adverse health concern with this item.
The second criterion is whether or not there is a performance enhancing quality associated with its use. Suppose two competitors, neither suffering from CHD, one uses meldonium and the other does not. Does the user have an unfair advantage over the non-user? It seems likely that this drug may have other ergogenic effects. Wikipedia lists at least 124 athletes from many different sports (not all of them endurance-based) determined by WADA to have produced traces of this drug since it has been banned. The distribution of countries does not appear random. The International Weightlifting Federation (IWF) has posted the following statement relative to several lifters testing positive for meldonium (http://www.iwf.net/2016/04/25/updates-on-meldonium/)
And so it goes, back and forth between the two parties, those that wish to cheat and those that wish to discourage and/or prevent cheating. The games go on, but it is incumbent upon our athletes and coaches to keep up with the ever-changing world of doping control, lest anyone be caught off guard by policy changes and new substances being added to the list.