Doping Tests

Doping is the generic term used to describe a broad variety of prohibited or unethical acts involving the use of a drug or a blood product to improve athletic performance.

While doping in a number of forms has received widespread international publicity since the 1960s, the use of performance-enhancing substances has a much longer athletic history. Long-distance swimmers in the nineteenth century experimented with stimulant use. Road-racing cyclists in the early days of European racing employed caffeine, ether, and sugar mixtures, and in the 1960s, barbiturates use was common among cyclists to delay the onset of fatigue and to sharpen their reflexes. The use of "greenies," or amphetamines, was commonplace in many team sports in North America; major league baseball players in the United States were a prominent example of such users until such stimulants were banned in 2005. Doping in many respects has represented a reflection of the desire of athletes to find the limit of their performance capabilities.

The science of doping tests, as an enforcement mechanism, has typically lagged behind the ability of athletes to take a performance-enhancing substance with impunity. The International Olympic Committee (IOC) banned the practice of doping in 1928; at that time, the IOC had only the word of the competitor that they were not taking any illegal substances, as there were no reliable scientific tests available, nor was there a protocol for the administration of any tests. The chasm between the ability of athletes to secretly use performance-enhancing substances, and the power of governing bodies to regulate the practice through detection narrowed in the 1970s as various international sports bodies, including the IOC and the International Amateur Athletics Federation (IAAF), began to provide organizational resources to develop efficient and trustworthy testing processes.

International scandals such as the positive steroid test of 100-m sprint champion Ben Johnson at the Seoul Olympics in 1988 created an impression that doping primarily involved steroid use. Doping tests can involve the detection of the following types of performance enhancing substances: anabolic steroids (in a multitude of formulations); stimulants (including amphetamines and cocaine); tetrahydrogestinone (also known as TGH, a growth hormone); modafinil (a sleep disorder medication with stimulant properties); erythropoietin (also called EPO, a synthetic form of a naturally occurring hormone produced in the kidneys that is essential to the production of red blood cells; EPO is known as a blood-doping agent); diuretics (used to increase the creation and excretion of urine, and to flush out the traces of various substances otherwise detectable in doping tests); and gene doping (the modification of muscle structure through genetic means).

In its first formulation, doping was a cottage industry without formal scientific research or experimentation. Athletes, through individual trial and error, ingested substances that today seem unbeliev-able—an example was the combination of strychnine (a poison believed to have stimulant qualities) and alcohol taken by an Olympic marathoner during the 1904 Games. When the approach to doping became a scientific endeavor, doping testing acquired a greater importance. The use of substances such as steroids was a part of prescribed athletic schedules, carefully scrutinized in the same fashion as event technique and diet. Not only was testing necessary to ensure the hypothetical level playing field for all athletes in a particular competition, testing was seen as an instrument to preserve the broader ethical aspects of fair play in sport.

In recent years, the rationale behind doping tests has expanded to the preservation of athlete health. There is a clear intersection of competitive fair play, ethical purity, and athlete safety and education in the practices and procedures in modern doping tests.

Doping tests are a highly scrutinized process themselves. Testing science has been made a cornerstone of many athletic institutions, including the IOC, WADA, the IAAF, the international soccer body FIBA, and many professional sports organizations. National championships conducted in most sports throughout the world also provide for a form of doping testing. In the national and professional examples, it is the competitive pressure to succeed to the next lucrative and professional level of the sport that often has prompted performance-enhancing drug use. The commercialization of sport has created a downward pressure on amateur athletes to engage in doping practices; doping testing is not common in amateur team sports such as North American college football, club rugby, or cricket. Athletes at some levels believe that if they can achieve professional status, doping will no longer be necessary and the testing to which they are likely to be exposed will not be a serious hindrance to their career.

After it was formed in 1999, WADA took the international lead in the formulation of anti-doping policies and procedures. WADA invited all major international sport organizations to sign its codes of practice regarding doping testing, both in and out of competition. After some resistance, particularly from the international cycling body UCI, the WADA standards of practice became the accepted world standards of doping testing as regards the physical procedures used, the substances sought for detection, and the process to resolve complaints or appeals. The umbrella document that organizations sign as indicative of their agreement with WADA-prescribed practice is the World Anti-Doping Code.

There are two broad types of doping testing conducted. "In competition testing" are those tests conducted under the authority of the event organizers, such as an Olympic Games, World Cup, or Tour de France competitions. The event publicizes in advance its rules regarding who will be tested, for what substances, and in what circumstances. Typically in an athletics competition, there will be some measure of random testing of competitors, as well as specified testing of the top finishers in each event. In team sports, most testing is by way of random selection of representative team members for testing after each game.

Most international events now work in conjunction with WADA regarding both testing procedures and the determination of the substances that shall be banned from a particular competition. WADA publishes a list of prohibited substances on a yearly basis, with updates or modifications where required. The time lag between the publication of the targeted substances and the competitions to which they shall apply is to ensure that no athlete has been using a substance that is legitimately believed to be legally employed. An example of such a substance is ephedrine, the naturally occurring stimulant found in ephedra plants and elsewhere. Banned by WADA, ephedra formed a part of many herbal and other supplements that may not have been as clearly marked regarding composition. The publication of the WADA rules encourages athletes to make appropriate due-diligence investigations as to the contents of all foods and supplements that they ingest.

The second type of doping testing employed is "out of competition testing." This test is carried out in the same technical fashion as the testing conducted at the athletics event venue; the purpose of this testing is to monitor athletes to ensure ongoing compliance with national and international doping rules. Athlete monitoring throughout of competition testing has a number of possible applications. Effective and transparent doping testing by a national sports organization that sends teams or athletes to international events provides credibility to the organization. In many countries, the sponsorship and support of the athlete by state or federal governments is tied to the athlete's regular participation and compliance with random doping testing. Increasingly, the collective bargaining agreements between major professional sports and their player associations make provision for random, out of competition testing. It is clear that in North American professional sport, such testing is as much to secure favorable public opinion as it is engaged for competitive, fair play issues. American

Doping control sign at the 1996 Summer Olympics.
football and major league baseball have been the subject of widespread public commentary regarding a perceived lack of institutional desire to combat steroid and amphetamine use by players.

Doping testing can technically be carried out with samples of blood, tissue biopsy, or other bodily products such as feces or semen. However, international WADA-sanctioned testing will center on the securing of a urine sample, or less commonly, a blood sample, from an athlete immediately after the completion of the event. The typical in competition doping test follows precise procedures. All testing is conducted under the authority of a doping control officer, who has authority regarding who is tested and the chain of custody over the physical sample, from production by the athlete to publication of a result. WADA procedures are predicated upon a principle of no-advance notice to the subject athlete. A chaperone escorts the athlete to a doping control station, where the urine sample is physically collected from the athlete. Prior to testing, the chaperone is responsible for verifying the identity of the athlete.

The athlete, once notified after an event that he or she will be tested, is responsible for any foods or fluids consumed, as well as notifying the doping officials of any medications consumed (certain medications that may legally be consumed by athletes may impact upon the testing process). The athlete may also have a representative present to assist with any forms to be completed. Then the sample collection team obtains two samples of urine, designated as the A and the B samples, using sterile equipment and approved scientific methods. A witness or other member of the collection team must be permitted to observe the urine enter the collection equipment; 100 ml of urine is the desired testing volume. Each athlete must personally seal both the A and the B containers.

The samples are stored in an appropriate facility under the direction of the doping control officer. A WADA-accredited laboratory is assigned to test the samples. International organizations, in accordance with WADA guidelines, each determine what the limits of performance-enhancing substances that may be permitted in the system of an athlete. Designated A samples are tested first; when a positive test results with the A sample, the athlete is notified and the B sample is then tested.

With increased attention paid to proper scientific procedures, the defense of mistake and lab error are extremely rare where a positive test is indicated. The penalties for a positive doping violation are significant: disqualification, loss of awards, team disqualification, suspension from competition, and loss of government support are all likely consequences of a positive doping test.

The next frontier for doping testing is that of genetic manipulation of the athlete, a practice known as gene doping. The genetic manipulation of a human system such as the production of erythrocytes (red blood cells), with a corresponding increase in oxygen-carrying capacity, is a science in its infancy. As was the case with steroids, EPO, and other doping mechanisms, the determined gene-doping athlete will likely have a jump start of detection.

SEE ALSO Anabolic steroids; Blood doping; Out-of-competition testing; Stimulants; World Anti-Doping Agency (WADA).