Pubdate: Wed, 22 September 1999 Source: Washington Post (DC) Copyright: 1999 The Washington Post Company Address: 1150 15th Street Northwest, Washington, DC 20071 Feedback: http://washingtonpost.com/wp-srv/edit/letters/letterform.htm Website: http://www.washingtonpost.com/ Author: Amy Shipley, Washington Post Staff Writer WITH DRUG TESTS, ANSWERS ARE FEW The IOC Says It Is Cracking Down On Doping, But To Critics, The Problem Is Only Getting Worse With their credibility under attack during the Olympic bribery scandal last winter, International Olympic Committee officials said they were eager for the world's attention to return to the athletes. A year from the start of the 2000 Olympics in Sydney, that has happened. But the new focus is merely another cloud of innuendo: questions about pervasive use of performance-enhancing drugs. Many of the questions come from athletes themselves. Carl Lewis, a nine-time Olympic gold medalist who is considered one of the greatest athletes in U.S. history, asserts that drug use is widespread among top track and field athletes. He decries what he calls a lack of commitment to catching those who cheat. "It really isn't about drugs--it's about the lies," Lewis said. "Federations at every level are covering up drugs and covering up for people. ... It's a joke. It's a credibility factor and it starts at the top. Sadly enough, America is right in the middle of it. ... The commitment to find drugs is not there. There are much better ways to test than they are doing, but ... they don't want to catch anyone in the first place." Lewis's strong words demonstrate the skepticism surrounding Olympic sports entering the 21st century. Although science has advanced to the point that a sheep can be cloned in a test tube, drug-testing technology has evolved little in the 30 years since formal testing began at the 1968 Winter and Summer Olympics. With the 2000 Summer Games in Sydney on the horizon, it seems that only cheaters are ready to enter the next millennium. "We have to concede that, if you really know what you are doing, [an athlete] can go right through and around all of these things," said Donald Catlin, head of the UCLA lab that has handled drug testing at several Olympics. "If you turn my hat around and ask me to figure out how to cheat, my gosh, you'll never catch me." Users of performance-enhancing drugs such as muscle-building steroids or the endurance-aiding erythropoietin (EPO) apparently believe they are more likely to reap the fame and fortune accorded Olympic or world champions than they are to flunk a drug test. With the legitimacy of drug testing at a breaking point, the year leading up to the Sydney Olympics will be a telling one. The last seven months have produced a lot of tough talk from the IOC and government officials about cracking down on athletes using performance-enhancing drugs, but the major problems that have hampered drug testing in Olympic sports for years remain. Although the IOC has committed $3.5 million in recent years to drug research, IOC Medical Commission chief Prince Alexandre de Merode said the 2000 Olympics likely will not include mandatory tests for two powerful drugs believed to be widely used by athletes--EPO and human growth hormone (hGH). Such tests, de Merode said, are not expected to be reliable enough to withstand legal scrutiny by next September, when the Games begin. Falling Behind Without such tests, those attempting to police drug use are left with the same weapons they've used for decades, which include a test for steroids that can be circumvented by cheating athletes or nullified by shrewd lawyers. The only thing testers feel certain they can detect are stimulants, such as amphetamines and excessive caffeine, taken on the day of competition. But athletes are believed to be relying on far more powerful stuff: steroids, EPO, and hGH and other hormones, as well as masking agents that can cover up the appearance of the drugs in their system. Further muddying the issue are unanswered questions--or puzzling explanations--that remain about drug-testing mishaps at previous Summer Olympics. Critics question the IOC's determination to fight drug use, partly because of drug test results that have been mysteriously mishandled or disregarded in the past. In February, the IOC pledged to take the lead in creating an independent drug-testing agency that would oversee testing internationally and be up and running in time for the Sydney Olympics. However, U.S. national drug policy director Barry McCaffrey harshly criticized the IOC's agency blueprint last week, and said the United States and a host of other nations would not support the plan. The IOC's vision of the anti-doping agency, should it ever get off the ground, would use $25 million in IOC funds to conduct unannounced tests and contribute to drug research. A major flaw--one even de Merode acknowledged--was that the agency would not interfere with or revise the established systems of drug-testing, which have long been criticized. The IOC is responsible for testing at the Olympic Games and the world governing bodies of the various sports are responsible for testing at their own world championships. National organizations, such as the U.S. Olympic Committee and USA Track & Field, are generally responsible for national events. Many critics of drug-testing practices say such arrangements raise concerns. There is little incentive for governing bodies to find or announce positive drug tests among the athletes they support through stipends and depend upon to attract sponsorship revenue. Revelations of positive drug tests generate bad publicity, and they often require thousands of dollars in legal fees to adjudicate. McCaffrey and Lewis say such flaws in the current system require a central, independent and authoritative drug-testing agency, one that could eliminate the patchwork of rules and procedures that vary from one sport to another. De Merode said it was unrealistic to expect a new agency to govern all drug testing. "We would need probably $100 million each year" for that, de Merode said. "That's a perfect dream. . . . It's not a realistic approach. The international federations would not submit to [any] rules but their own rules. . . . We cannot destroy all of what has been before." Almost uniformly, Olympic sports officials assert their commitment to drug-free competition and to punishing cheaters. USOC President Bill Hybl said his organization has "been a leader in the development and implementation of" anti-doping procedures. Of the nearly 2,000 drug tests taken during the Atlanta Games in 1996, only two positive results were announced. That was fewer than the five positives in 1992, 10 in 1988 and 12 in 1984. The decline did not offer much satisfaction to athletes suspicious that some of their peers were cheating. Some athletes even dubbed the Atlanta Olympics the "growth hormone Games." "Any time an athlete competes well, people assume he's on drugs," said U.S. middle-distance runner Johnny Gray, the 1992 Olympic bronze medalist in the 800 meters. In a 1990 report, Canadian Judge Charles L. Dubin accused the IOC of "misleadingly" citing the relatively few positive drug tests from major competitions "in various attempts to show that drug abuse affects only a small percentage of athletes." Others share Dubin's view. "I can use a lot of drugs and a lot of steroids" and pass the current drug tests, said Chuck Yesalis, a professor of health and human development at Penn State University and expert on Olympic doping. Robert Kerr, a California-based physician who admits to supplying steroids and other drugs to Olympians in the 1980s, agreed that the current tests are no match for the savvy athlete. "It is so easy," he said. "You just call the right" doctor or drug guru. Sometimes an athlete doesn't even have to call. U.S. marathoner Mark Coogan said he was surprised when a doctor who he alleged had ties to USA Track & Field showed him a selection of steroids during an office visit. Coogan declined to identify the doctor. "I just said, 'That's not for me and that was the end of it,' " he said. "I always wonder what would have happened if I had said, 'I'd like to know more about that.' " With relatively few positive tests, the biggest recent drug scandals have unfolded outside the lab. It was only after French police opened the trunk of a car filled with performance-enhancing drugs last year that widespread drug use in the Tour de France was revealed. In early 1998, Australian customs agents found 13 vials of hGH carried by a Chinese swimmer, which led to suspensions and lent legitimacy to years of suspicion surrounding the Chinese women's swim team. In 1994, for example, China's women had won 12 of 16 events at the Rome world championships, results that left competitors skeptical. "I had never seen anything like it," U.S. swimmer Josh Davis said. "You had to giggle--it was so blatant and there was nothing anybody could do about it." At the 1996 Olympics in Atlanta, Irish swimmer Michelle Smith raised eyebrows when she came out of nowhere--at age 26--to win three gold medals and a bronze. She passed drug tests at the time, but last year received a four-year ban after submitting a urine sample spiked with lethal levels of whiskey. Even the widespread doping of East German athletes in the 1970s and 1980s was not discovered until old records of the country's secret police were opened. At drug trials that opened in Berlin in March, it was alleged that female athletes' excessive body hair, beards and deepened voices resulted from unwitting, systematic doping with anabolic steroids. Testing itself has uncovered relatively little wrongdoing. In the 30 years since the IOC began testing for drugs at the Olympics, 52 athletes have been caught using banned substances--an average of just over three per Games. The only true superstar who failed an Olympic drug test was Canadian sprinter Ben Johnson, who at the 1988 Olympics was stripped of his 100-meter gold medal after testing positive for the anabolic steroid Stanozolol. "I would argue that a huge percentage of world records broken in the last 30 years were drug-assisted," Yesalis said. "There are more loopholes than walls" in drug testing. Possession or distribution of anabolic steroids became a federal crime in 1990. EPO and hGH are available only by prescription. Yet drug experts say athletes have no trouble obtaining these drugs through team or private physicians. "In the last 20 years, I've interviewed literally a thousand drug users, from kids to world champions," Yesalis said. "It is my opinion that no athlete, elite or at another level, has to go to the black market. A physician will help you." Kerr once claimed to have given performance-enhancing drugs to 20 athletes who won medals at the 1984 Olympics. He said he no longer engages in the practice, but said of his past activities: "They were all doing it anyway. My idea was: Well, at least maybe I could make it a little safer." A Cheater's Best Friend Several experts said steroids still are a cheater's best friend because they are so affordable--just a few dollars a week, compared to the hundreds or thousands of dollars a month EPO and hGH can cost. Additionally, athletes who use the steroid testosterone, which is naturally produced in the body, can claim in the event of a positive test that their levels of testosterone vary for reasons other than drug use. In existence since the early 1980s, the urine test for testosterone records an athletes' ratio of testosterone to epitestosterone (T/E ratio). Athletes with an unusually high ratio--greater than 6 to 1--are flagged. The test presents two problems. Athletes with a normal ratio of 1 to 1 or less can use testosterone at a moderate level, avoiding detection by keeping their levels below the point at which they are flagged. Such a test actually might encourage doping among athletes with normal T/E ratios. Second, athletes caught with high ratios have argued--with varying degrees of success--that the test is unreliable. "As a physician, the test is remarkable," Catlin said. "As a bulletproof legal test, no." Blood tests are considered the only option for eventually identifying EPO and hGH, which cannot be detected through urine testing. IOC officials say they would like to employ blood testing in Sydney for the 2000 Olympics next year. However, plans by the IOC to send a group of scientists around the world to validate tests that some believe are effective in detecting EPO and hGH were abruptly canceled in recent weeks--meaning there is almost no hope such tests will be approved in time. "We are working hard on those tests for EPO and growth hormone," IOC medical director Patrick Schamasch said. "But no one can tell us yes or no that it's ready, first; that it's validated, second; and, third, that it can be put in front of any court." Challenging Test Results IOC officials say they are wary of positive test results that won't stand up in court. During the 1996 Atlanta Games, a previously unknown substance called Bromantan, a stimulant and masking agent that is now banned, was discovered in the urine of about seven athletes, including two Russians who had won bronze medals. The Russian delegation successfully argued to the Court of Arbitration for Sport--the designated arbitration board for the Olympic movement--that the athletes took the stimulant to strengthen their immune systems for the heat of Atlanta rather than to enhance their performance. All the positive results subsequently were overturned. There have been other positive drug tests at the Summer Games that received far more puzzling treatment. At the Atlanta Games, about five positive drug tests discovered by the drug lab on the last weekend of competition were never announced by the IOC. Catlin, the director of steroid testing, said he eventually disclosed the unannounced results so he would not be accused of a cover-up. "We had several cases sitting there," Catlin said. "We were poised to do [further analysis]. . . . [But] they were declared negative and thrown out." De Merode said the IOC executive board decided not to announce those results for fear they would not stand up in court. The names of the athletes--to which Catlin was not privy--have not been revealed. De Merode said the IOC lacked confidence in the accuracy of the results from the testing technology it had selected for use at the Atlanta site: a high-resolution mass spectrometer that by 1997 was considered standard equipment in Olympic testing labs. De Merode said the IOC executive board was wary of legal challenges because of its experience with the Bromantan cases. "We didn't have any chance to win against the court," he said. Twelve years earlier, at the 1984 Summer Games in Los Angeles, between five to nine positive test results from the last weekend of competition were never announced. De Merode said he believed papers containing athlete identification codes corresponding to the urine samples were taken from his personal safe and mistakenly shredded by members of the Los Angeles Olympic Organizing Committee as they cleaned house at the end of the Games. Tony Daly, who was the chief medical officer for the organizing committee, said the shredding may have occurred, but that de Merode ultimately was to blame for losing track of the codes. "When [de Merode] left the hotel, he didn't take them with him, and they got lost or shredded or whatever," Daly said. " . . . We were not going to save volumes and volumes of stuff. The policy was to shred documents, not necessarily drug documents. "If anybody's at fault, it's the prince. His job was to keep the codes." De Merode said he didn't tell anyone about the destroyed records until it was leaked to the press in 1994, because, "Nobody asked me." He added: "I believed people would not be happy, and it would perhaps destroy credibility." How the Urine Test Works 1.Chemists extract drugs from urine and convert them to gas. 2.The gas travels through a narrow coil. Each drug travels at a different speed according to its physical and chemical characteristics. Chemists know when each will come out of the coil and drop into the mass spectrometer. 3.The mass spectrometer shatters the molecule with a beam of electrons, much like dropping a porcelain plate, except the pieces are exactly the same every time. 4.When a molecule is shattered, the mass spectrometer records a spike. Chemists know that is boldenone pieces are present, they'll spike at about 12 1/2 minutes as shown at right. 5.Once a spike is detected, the mass spectrometer counts and weighs the pieces and creates a "fingerprint" of the shattered molecule. If the time of the spike and the fingerprint match what the chemist knows about boldenone, the test is then declared positive. Landmark Events In Drug Testing Ancient Greece An Olympic victory was worth the modern-day equivalent of about half a million dollars. The large rewards led to a professional class of athletes who were susceptible to corruption. Some tried to gain any competitive advantage, using concoctions of mushrooms and plant seeds. One of the reasons for discontinuing the ancient Games was drug use. 1886 A cyclist named Linton dies of an overdose of tri-methyl, becoming the first recorded drug death in sports. 1930s Mass-produced amphet-amines become the athlete's stimulant of choice, replacing strychnine. 1940s The first steroid appears on the market, an injectable liquid called aqueous testosterone 1960s Several competitive cyclists die suddenly -- including Knut Jensen of Denmark at the 1960 Summer Olympics in Rome after taking amphetamines and nicotinyl tartrate -- causing the first cries for drug bans and testing. 1967: British cyclist Tommy Simpson drops dead during a televised stage of the Tour de France. . . . The International Olympic Committee establishes a commission to study doping. 1968, Mexico City: The Olympics begin drug testing. Only one athlete is caught -- a modern pentathlete who tested positive for alcohol. 1970s 1972, Munich Olympics: Urine testing on a large scale occurs for the first time. Seven athletes test positive for banned drugs. 1975: Anabolic steroids are added to the IOC's banned list. 1980s 1982: Caffeine and testosterone are added to the IOC's banned list. 1983, Pam Am Games, Caracas, Venezuela: No drug testing had been announced. When a German doctor sets up a testing lab, many U.S. athletes leave without competing, and 19 athletes fail tests. The U.S. Olympic Committee immediately institutes testing for the 1984 Games in Los Angeles. 1984: A third of the 24-person U.S. cycling team receive transfusions in a Carson, Calif., hotel room before the Olympics to load their blood with muscle-fueling red cells. This "blood doping" is now banned. The U.S. team wins a record nine medals. The doping is discovered months later. ... On the last day of competition, five to nine positive tests are lost. Officials said the results were stolen or shredded. 1988: Seoul Olympic gold medal sprinter Ben Johnson, left, tests positive for a steroid, and along with his lost medal went the public perception that drug use occurred only in fringe 'muscle' sports like weightlifting. 1990s 1996 Summer Games, Atlanta: A few positive tests on the last weekend of competition are discarded by the IOC. When news of the discarded tests leaks, the IOC explains that it was concerned about "technical difficulties" in the drug-testing machinery used -- a high-resolution mass spectrometer. 1998: The entire sport of cycling is sullied as prominent teams, riders and trainers are thrown out of the Tour de France for drug violations. Others quit in protest. Summer 1999: The IOC announces that blood testing may be introduced at the Sydney Games in 2000 to supplement urine tests. Leagues Apart A violation in the Olympics may not be a violation in a professional sports league, and some leagues do not have drug testing. However, every league except the NHL specifies drugs or categories of drugs that are prohibited. Banned in the NFL League tests for all banned substances Anabolic steroids and related substances (such as androstenedione) Growth hormones and beta-2 agonists (such as some asthma medications) Diuretics and other masking agents Illegal drugs Supplements containing any of the above Banned in Baseball League has very limited drug testing Cocaine Marijuana Amphetamines Opiates PCP Banned in the NBA League to begin testing for all banned substances in October Amphetamine and its analogues, including cocaine and methamphetamine Opiates, such as heroin, codeine and morphine Marijuana and its byproducts Phencyclidine (PCP) Steroids LSD Banned in the NHL League has no drug testing There is no list of banned substances, but if a drug is against local laws, it is prohibited by the NHL. Banned in Major League Soccer League tests for illegal drugs and will begin testing for steroids next year Stimulants other than caffeine and medications approved by the league Human growth hormone and chorionic gonadotrophin Anabolic steroids Erythropoietin Illegal drugs Diuretics Banned in the NCAA League tests for all banned substances Anabolic steroids, including androstenedione Street drugs: heroin, marijuana and tetrahydrocannabinol (THC) Peptide hormones and analogues (HCG, HGH, EPO) Other drugs are restricted or banned in specific sports Stimulants Diuretics Banned in the Olympics There are five classes of substances that could make an Olympic athlete fail a drug test. Most have medical uses and are not illegal drugs, and some do not even require a prescription. STIMULANTS Examples: Amphetamine, cocaine, ephedrine, caffeine NARCOTICS Examples: Heroin, morphine (Less potent narcotics such as codeine permitted if declared before the test.) ANABOLIC AGENTS Steroids Examples: All synthetic steroids, such as Nandrolone and Stanozolol; plus natural steroids such as testosterone and androstenedione Beta-2 Agonists Examples: Clenbuterol, salbutamol DIURETICS Examples: Water pills Peptide and glycoprotein hormones, mimetics and analogues Growth Hormone (hGH) Erythropoietin (EPO) human Chorionic Gonadotrophin (hCG) SOURCES: IOC; "Doping," published by the IOC; Dr. Don Catlin; NFL; NHL; NBA; NCAA Division I Manual; Major League Baseball; International Cycling Union; Major League Soccer; Canada's Commission of Inquiry into the Use of Drugs and Banned Practices Intended to Increase Athletic Performance; Australian Sports Drug Agency. EPO and Cycling: A Cautionary Tale The Tour de France, pro cycling's premier event, was left in shambles last year after a drug bust revealed widespread abuse of erythropoietin. Cyclists inject EPO to raise the percentage of red cells in their blood, boosting the amount of fuel their muscles receive. EPO is naturally produced by the kidneys. A synthetic version was developed in the late 1980s, mainly to fight anemia in kidney patients. Athletes soon discovered that EPO could improve endurance. However, the balance is delicate. Blood with too many red cells is gummy and difficult for the heart to pump, and the consequences can be heart attack and stroke. The deaths of several elite cyclists in the past decade have been thought to be related to EPO, although no link has been proved. Tests for the markers of synthetic EPO are being developed. The current "test" measures the percentage of red cells in blood but cannot determine if a high level is caused by doping. (Dehydration and altitude training also raise the percentage.) Blood is made of red cells and serum, a yellow liquid. When a blood sample is put in a centrifuge, red cells sink and serum rises to the top. The percentage of red blood cells is called the hematocrit. A normal hematocrit is about 42, which means 42 percent of the blood is red cells. The World Cycling Federation has set 50 percent as the maximum at which an athlete is allowed to compete. This doesn't mean an athlete with more than 50 percent red cells is using EPO; it just means that his hematocrit is deemed too high for safe competition. Unfortunately, said Don Catlin, head of the UCLA drug-testing lab, 50 percent is being seen as a kind of speed limit. Many cyclists' tests reveal hematocrit levels of about 49 percent -- far above normal but still under the limit, he said. "Everybody is forced to be at 49 percent or you're not competitive," Catlin said. Professional cycling is the only sport that requires a hematocrit test. The IOC may introduce a different blood test for the Olympics. - --- MAP posted-by: Jo-D