Pubdate: Wed, 22 September 1999
Source: Washington Post (DC)
Copyright: 1999 The Washington Post Company
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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.

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