The (Literal) Costs of Doping
Jeff Shilt, M.D.
On the tails of pro cycling's doping scandals, the buzzword in triathlon has been age group doping. I have to admit, I've been equally curious about the incidences of doping amongst age group athletes. I remember an Outside Magazine article a few years back describing the author’s experience when he obtained performance enhancing drugs (PED’s) from an “anti-aging” doc. He discussed the performance benefits and downsides to the variety of PED’s available.
As a practicing orthopaedist who has prescribed drugs considered “performance enhancing” for patients with problems for whom the drug was created, I found this an intriguing article. I have no experience with the performance enhancement aspects of the PED’s. I was involved in a pharmaceutical company’s research in the early 90’s on the use of growth hormone (GH) to accelerate the recovery of elderly patients who had sustained hip fractures. I’ve cared for patients who required GH for a variety of short stature syndromes. I’ve known patients who require Erythropoetin (Epo) because they are practicing Jehovah Witness (religion that bans receipt of blood transfusions) and are undergoing a surgical procedure with a large expected blood loss, or patients with cancer, whose blood cell counts are low because of their cancer therapy. I can’t really tell you how the “performance” of children with diseases, old people with hip fractures, and cancer patients was affected by the use of these critically needed medicines…their recent 40 k time trial times were rarely the topic of conversation!
So, I was likewise educated as were most who read the Men’s Health article. I’m a firm believer in competing cleanly and since the resurgence of the topic coincided with my interest in endurance sports, I decided to find out what is required to ensure that athletes that I train with and advise are clean. Team Good Guys unanimously were in favor of pursuing the approach, so I set off in search of finding a regimen for us to follow, demonstrating our commitment to clean competition.
I have to admit I was shocked at my findings. Upon the advice of the cycling team physician that has taken one of the most well-known stances against doping, I contacted their lab about pricing and protocols. First, there is not one simple test that ensures with 100% accuracy that an individual is not taking ANY exogenous product. For most PED’s, year-round, weekly testing is required to follow trends of metabolites and blood markers. This testing protocol requires 2 blood and 2 urine tests per week. If you do a less stringent regimen, the protocol is ineffective as people can schedule use around known tests and avoid detection. Second, as you might imagine, this is expensive. This protocol costs about $10,000/ a year.
The lack of stringent testing is responsible for the sad state that cycling and track/field are in now. To date, no sport has required this level of testing. I applaud the cycling teams that are adhering to this principle. It really is shameful that high revenue sports, such as basketball, football, and baseball have failed to require stringent testing. Is this a rampant problem in these sports…you betcha. I don’t believe any of them are clean until they adopt this regimen.
For triathlon, and specifically, age groupers, this testing regimen is not practical. As much as I hate to admit it, if people want to cheat, they can. Although not infallible, random testing is still useful in detecting less sophisticated athletes who cheat. A negative random test doesn’t mean you don’t dope, it just means you didn't get caught. A positive test, however, proves with reasonable certainty that you have cheated. As much as I would like to believe in a couple of guys that have turned up positive, it is highly unlikely given the knowledge I have now.
Certainly for the age groupers in our team, we can’t literally afford to prove our clean approach. And even for the pro’s, who's yearly winnings rarely exceed the $10,000 required for testing, it is a stretch. In the future, I hope we see the costs decrease and the protocols improve so that we can ensure a clean sport.
Cheers to all of us out there who train and race for the healthy body and mind our activity gives us. Shame on the rest of you.
J
No Zeros…
On the tails of pro cycling's doping scandals, the buzzword in triathlon has been age group doping. I have to admit, I've been equally curious about the incidences of doping amongst age group athletes. I remember an Outside Magazine article a few years back describing the author’s experience when he obtained performance enhancing drugs (PED’s) from an “anti-aging” doc. He discussed the performance benefits and downsides to the variety of PED’s available.
As a practicing orthopaedist who has prescribed drugs considered “performance enhancing” for patients with problems for whom the drug was created, I found this an intriguing article. I have no experience with the performance enhancement aspects of the PED’s. I was involved in a pharmaceutical company’s research in the early 90’s on the use of growth hormone (GH) to accelerate the recovery of elderly patients who had sustained hip fractures. I’ve cared for patients who required GH for a variety of short stature syndromes. I’ve known patients who require Erythropoetin (Epo) because they are practicing Jehovah Witness (religion that bans receipt of blood transfusions) and are undergoing a surgical procedure with a large expected blood loss, or patients with cancer, whose blood cell counts are low because of their cancer therapy. I can’t really tell you how the “performance” of children with diseases, old people with hip fractures, and cancer patients was affected by the use of these critically needed medicines…their recent 40 k time trial times were rarely the topic of conversation!
So, I was likewise educated as were most who read the Men’s Health article. I’m a firm believer in competing cleanly and since the resurgence of the topic coincided with my interest in endurance sports, I decided to find out what is required to ensure that athletes that I train with and advise are clean. Team Good Guys unanimously were in favor of pursuing the approach, so I set off in search of finding a regimen for us to follow, demonstrating our commitment to clean competition.
I have to admit I was shocked at my findings. Upon the advice of the cycling team physician that has taken one of the most well-known stances against doping, I contacted their lab about pricing and protocols. First, there is not one simple test that ensures with 100% accuracy that an individual is not taking ANY exogenous product. For most PED’s, year-round, weekly testing is required to follow trends of metabolites and blood markers. This testing protocol requires 2 blood and 2 urine tests per week. If you do a less stringent regimen, the protocol is ineffective as people can schedule use around known tests and avoid detection. Second, as you might imagine, this is expensive. This protocol costs about $10,000/ a year.
The lack of stringent testing is responsible for the sad state that cycling and track/field are in now. To date, no sport has required this level of testing. I applaud the cycling teams that are adhering to this principle. It really is shameful that high revenue sports, such as basketball, football, and baseball have failed to require stringent testing. Is this a rampant problem in these sports…you betcha. I don’t believe any of them are clean until they adopt this regimen.
For triathlon, and specifically, age groupers, this testing regimen is not practical. As much as I hate to admit it, if people want to cheat, they can. Although not infallible, random testing is still useful in detecting less sophisticated athletes who cheat. A negative random test doesn’t mean you don’t dope, it just means you didn't get caught. A positive test, however, proves with reasonable certainty that you have cheated. As much as I would like to believe in a couple of guys that have turned up positive, it is highly unlikely given the knowledge I have now.
Certainly for the age groupers in our team, we can’t literally afford to prove our clean approach. And even for the pro’s, who's yearly winnings rarely exceed the $10,000 required for testing, it is a stretch. In the future, I hope we see the costs decrease and the protocols improve so that we can ensure a clean sport.
Cheers to all of us out there who train and race for the healthy body and mind our activity gives us. Shame on the rest of you.
J
No Zeros…
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