With the occasional sports star or celebrity getting busted by Australian customs officers for trying to bring performance-enhancing drugs into their country (think Chinese swimmers about a dozen or so years ago, or Sly Stallone more recently), who would guess that another professional sportsman would make the same mistake? Apparently, American tennis pro Wayne Odesnik wasn’t paying attention to Stallone’s legal faux pas, and must not have heard about the Chinese swimmers. Of course, Odesnik is only 24, so for him, the whole Chinese swimmers incident in the 1990s was half a lifetime ago. And who could blame a 12-year-old kid for not following that story?
What does it say about the current anti-doping regime that this is another sports scandal that begins with solid police work, rather than testing? As Bonnie D. Ford writes on ESPN.com:
Once again, a law enforcement agency has proven more effective in rooting out a doping suspect in sport than anti-doping tests themselves.
From what Bonnie Ford reports, the 24-year-old Odesnik was nabbed by Australian authorities in January, while en route to a tournament in Brisbane. At the time he was caught, Odesnik had eight vials of human growth hormone in his luggage. Odesnik pleaded guilty on Friday, and was ordered to pay $8230 in fines. He also faces a possible two-year suspension courtesy of the World Anti-Doping Agency, and an investigation by the International Tennis Federation.
The bust certainly raises questions about the anti-doping program implemented by the ITF. But it also raises questions about the HGH test itself. As in, given the relatively short window that the current test has for detecting the banned substance, can it effectively catch cheaters. So far, only one athlete has actually be caught via drug testing. So perhaps Odesnik thought he could get away with using HGH, as long as he could just get it past customs.
Oops.
And, if this New York Times article is correct, athletes using HGH have a new test to fear, though it may not be ready for prime time for a few more months. As Michael S. Schmidt reports:
A test similar to one used in cancer treatments has antidoping officials encouraged that they have found a new, and important, way to catch athletes using human growth hormone.
The test uses the same science that detects bone and breast cancer. A laboratory technician takes several milliliters of blood and spins the sample in a centrifuge. The blood is then mixed with chemicals, a reaction occurs and an instrument is used to measure the illumination in the blood.
The intensity of the light, antidoping experts say, signals whether the person has used H.G.H. over the past 10 to 14 days. The procedure is known as the biomarkers test.
WADA’s director general, David Howman, thinks this new test will defuse arguments made by players in the National Football League or Major League Baseball that HGH testing is not reliable.
“The [current] test is scientifically reliable, and so is the new one,” Howman said. “Anyone who tells you otherwise hasn’t looked at the science.”
Of course, other than stating that this is so, Howman doesn’t offer up any proof. But to give the devil his due, maybe it just wasn’t included in the story. The problem, of course, isn’t whether the test can detect what the creators say. It’s whether it can not only catch those cheating but also whether the test will not catch those who aren’t. And it’s that second part of the equation that is often lacking in the publicly-available information about anti-doping tests.
To put it another way, the test has to have a minimal number of false positives and a minimal number of false negatives. Perhaps this is the fine-tuning occurring in the next few months. But WADA is not exactly transparent on their methods, so it may be difficult to gauge just how effective the new test will truly be.
Howman told the Times’ Schmidt:
“H.G.H. has been used with great impunity since the 1970s,” Howman said. “It’s very available to athletes. They use it freely, and they usually don’t use things that can’t help them.”
That’s not entirely true. Back in the 1970s, HGH came from cadavers. It was hard to come by and expensive — not that the expense would stop someone hell-bent on doping. But there wasn’t enough around to use HGH with impunity. It was also somewhat dangerous. The cadaver extract was pulled from the market in the early 1980s, as I recall, due to several young people being treated for growth deficiencies coming down with Creuztfeldt-Jacob disease. (Never heard of CJD? A variant of CJD is what a human who consumes meat infected with mad cow disease gets.) HGH didn’t really come into widespread use until a safer, synthetic form was developed in the mid-1980s.
As for athletes not using things that don’t help them, that also isn’t true. There is a whole lot of snake-oil on the market, aimed at athletes at all levels of competition. Some of it works, some doesn’t. But there’s also the placebo effect. If people believe something works, they will use it. (Including, perhaps, those charged with catching cheats? Perish the thought.) Now, one can argue that using a banned substance — whether it works or not — is breaking the rules. Right you are. And those who knowingly break the rules should suffer the consequences. Hard to argue against that, too.
The question about the biomarkers test is this: Does it accurately screen for the use of the synthetic drug, or could it incorrectly identify a person with a naturally high level of HGH as a cheater?
According to antidoping officials, the creators of the test said that they set the threshold for a positive extremely high, similar to other levels used in tests conducted by WADA.
I’m not sure what tests “the creators” are referring to, but I certainly hope that this new HGH screening test has both the sensitivity and specificity needed to accurately separate out the cheaters from those who are playing it straight.
Mr. Rant –
Long time no time.
I’m now an official contributor on the NY Yankees blog, appropriately titled It’s About The Money (Stupid). Not surprisingly, I’m supposed to write on doping issues, and HGH is the number one hot button topic. So I’ve spent time over the past 24 hours trying to figure out what this new test is about. Care to help me? I have a few good leads, and we can do some back-and-forth here.
Also … what’s the latest you have on whether HGH is actually performance-enhancing? From my research, there’s no evidence whatsoever that HGH is performance-enhancing, and only sketchy evidence that HGH can help an athlete recover from an injury.
I’d be more convinced if David Howman provided data/proof, on WADA’s behalf, with regard to the test’s efficacy. Just the standard stuff like false positive/false negative rates, ability of WADA labs to properly carry out the testing, harmonized values for declaring an AAF, and independent (of WADA) verification that the tests do what WADA purports they do. Those seem to be legitimate questions, though I don’t expect WADA world to be forthcoming with honest answers.
Also, good questions from Larry. I’ll echo. Where is the data that proves HGH is performance enhancing? I’m not saying it may not be performance enhancing. I’d just like to see proof. Further, if HGH aids in recovery from injury, how is that a bad thing that needs banning???
Jeff, one point of interest, Don Catlin (ex-head of UCLA WADA lab) says that WADA’s existing HGH test is “not a useful test.”
Go back to what we learned from Berry’s article in Nature. Any test that catches one guy in six years is probably inherently defective.
Hey Larry,
Long time, for sure. I’ll have to check out the blog and see what you’ve been up to. Regarding whether HGH really enhances performance, I’m not sure if there’s any research that shows HGH directly enhances performance. It’s said to speed up recovery from injuries, but whether that’s true for working out, or in other applications, I’m not sure.
The link quoting Catlin was very interesting. It certainly makes me wonder how useful or effective the test is, if it’s only caught one person in 6 years.
And, to echo Jeff’s question, if it turns out that HGH merely speeds recovery from injuries, and not much else, I’m not sure about why it should be banned. If one can demonstrate that it speeds recovery from intense training, then it may be a different matter. Either way, I’d like to see some actual, published, peer-reviewed, replicated research on the matter.
I kind of wonder if HGH is more like snake oil in how it’s being characterized and pitched — not only by anti-doping authorities, but by those who would help people dope.
Rant –
The folks at WADA — and at least one scientist I’ve read — take seriously the anecdotal evidence from bodybuilders and cheating athletes that HGH is performance-enhancing. But from what I’ve read, the more accurate statement is that the scientists HAVE studied HGH and HAVE concluded that it does NOT enhance performance. In fact, there’s a bit of evidence to suggest that it degrades performance. So we’re into one of those situations that we’ve debated here before: who are you going to believe, the scientists or the athletes?
Some are arguing that the scientists have not found the right way to test for the performance-enhancing effects of HGH. This looks like nonsense to me. HGH is supposed to build muscle and make you stronger. That should be easy to measure. The scientists have looked, and have seen HGH build muscle on their test subjects … only the test subjects do NOT get any stronger.
What I haven’t seen is testing on the way HGH is used in the real world, in a cocktail with other PEDs.
On whether HGH speeds recovery from injuries: there’s no hard scientific evidence for that, either, though at least there’s no hard evidence to the contrary. If HGH is approved by the FDA and other comparable medical authorities as a medicine to promote recovery from injuries, then you’d have a big mess with the ADAs. Would it be possible to get a TUE to take HGH? Would athletes fake injury to get HGH, so they could use HGH to enhance performance? Yucch, I don’t even want to think about it.
As for snake oil … well, off-label use of HGH is big business. You have thousands, maybe millions of people taking HGH to combat the effects of aging. It’s an expensive course of treatment. I have not done the research to comment on this.
Larry,
Interesting points. Off-label use of HGH is a pretty big business, especially with the whole anti-aging thing. Then there’s the idea that lower levels of HGH later in life serves a protective function, by not helping rogue cells (like cancer cells) grow. So taking HGH for anti-aging purposes could leave people more susceptible to various cancers, and the cancers could be more aggressive. Talk about unintended consequences.
What it seems to boil down to is that the ADA folks get wind of anecdotal stories about performance enhancement and then they ban whatever drug or technique the story says works. It would be better to determine whether or not that is the case first, but research takes time, after all.
Of course, by responding to the anecdotal evidence, the ADAs can say they’re keeping up with the cheaters, and then the governments and agencies that fund them will think they’re doing a good job. Which leads to more funding, which leads to …
I’m pretty interested in the Placebo effect that you touched upon Rant. If you THINK it helps, then it DOES help (but that also extends to physical items…such as wearing your super-good-luck socks for every race, etc). But that is a true pandora’s box. Banning anything that athletes could possibly take to improve their performance (whether or not it physically does that) would be a nighmare. Where would that course of action end? Gatorade/Cytomax/etc (energy drinks)? Yep. Banned. Energy gels? yep. Banned. Bananas? of course! Banned! Food and water? Of COURSE it enhances performance! Banned. Oops…thats also necessary for human LIFE! Hmmmm. dilemma dilemma dilemma. And who decides which things to ban?
Pretty soon we’ll just have all the athletes locked up in a little prison type place, eating/drinking exactly the same items/amounts of provided items…and then do their event with only supplied substances (food/water). All in the exact same amounts too. Oh…all using the exact same equipment. Because thats the only way to REALLY know who is best. Kind of like when they took a bunch of supposedly identical race cars and plopped a bunch of different drivers in them, and gave them all the exact same tires and gas. Hey….I think I’m onto something here…hmmmmm……let me contact WADA!
While banning drugs based on anecdotal rather than scientific evidence sounds bad, there is perhaps some logic to it. It is widely believed that WADA is always a step or two behind the dopers; if WADA waits until an alleged PED is scientifically tested, dopers get additional time before risking being banned. Maybe what is needed is a provisionally banned list, with WADA willing to drop substances from the banned list if and when science determines there is no performance benefit.
Banning things simply because some athletes find (or think they find) a benefit is absurd, in my opinion. Hey, if you think that ratty pair of socks you haven’t washed since you won the East Podunk TT in 1975 really helps you, go for it. You can’t beat me, I got my lucky T shirt from 1967.
As to nutritional products, like Gatoraid, powerbars, bananas, etc., I think the same sort of rational used in TUEs applies, where one condition of a TUE is that the treatment only puts you back in the condition you would be in if you didn’t have the medical condition being treated. Sure, eating and/or drinking helps you avoid the deleterious effects of dehydration and glycogen depletion, but, regardless of advertising hype, I doubt that they actually enhance performance above what you are capable of when you are not hungry or thirsty.
William, I think there’s a cost-benefit analysis involved in any drug testing. The costs are the obvious ones: the time and money it takes to develop a test and do the testing, the “cost” to the athlete in terms of inconvenience and loss of privacy, plus the “cost” we know too well from the Landis case, which is the risk of a false positive. The primary benefit should be that the drug testing promotes fair competition in sport. But if the drug we’re testing for has no performance-enhancing benefit, then it doesn’t seem worth the cost to do the tests.
The bigger issue is whether we’re willing to assume a performance-enhancing benefit for HGH, despite the fact that the scientists have run the tests and find that there is no such benefit. The ADAs seem to want to have it both ways here: we’re supposed to trust the scientists when the science favors the ADAs, and when the science runs against the ADAs, we’re supposed to proclaim that the scientists don’t know what they’re talking about.
But in fairness, the scientists may not have run the right tests yet. Maybe the HGH doses need to be higher. Maybe the HGH needs to be given over a longer period. At least one scientist believes that we should trust the athletes, and not his fellow scientists, to know that HGH enhances performance.
MY personal feeling is that, unless or until the scientists can prove that a substance enhances performance, we shouldn’t bother testing for that substance, and we should focus our time and resources on the other stuff. My feeling is that the entire anti-doping effort must be based on solid science, or else the effort is invalid.
Larry, thank you for the cite. Interesting reading.
I tend not to trust people or entities who say, “you’ve got to trust us”, as it’s often a broad hint that they are not trustworthy. Cheney’s blog quotes at least a couple of well respected scientists, who cannot remotely be accused of being pro-doping, that say WADA does precisely this. The excuses for not publishing their data and not having the “science” behind WADA approved tests be peer reviewed is BS and promotes junk science.
Politics aside, I agree with Sonksen that WADA was “ah, too thick to understand it” when they cast aside the bio marker scan when they chose the isoform. (This assumes HGH needs to be tested for, which I’m not yet convinced is the case.) Wolfram Meier-Augenstein seems to have the same view as Sonksen that WADA is sometimes too thick to understand the implications of semi-complicated science. WADA declares a test a success when it catches 1 who does not contest the result after testing 1,500? Trust WADA? Not me!
I think the most distressing thing about any drug testing is the false positives. As Floyd has proven, it’s nearly impossible to prove your innocence (for 1: assuming he is in fact innocnet as I believe, and 2: I actually thought he DID prove his innocence in Malibu…but it seems the panel and the CAS didn’t agree with my unprofessional opinion).
I think the testing needs to be compared to the death penalty for murder (a bit extreme but bear with me). ONE innocent person put to death is one too many. Well, in the professional athletes life, and given the zero tolerance AND the harsh sentencing from WADA(especially if you fight it), a false positive can be the death sentence of your pro career. If you are indeed innocent, what is your recourse? You are caught by the system, and cast aside. Your reputation is tarnished or ruined outright. Lose your job. Fined even. And no matter what test they (WADA) have, there IS going to be a certain amount of false positives..unless they set the bar so unbelievingly low as to ALMOST guarantee this can’t happen (which I don’t believe they do). So which ones are the FALSE positives, and which are the TRUE positives? How do THEY tell them apart? It seems they can’t, and all positives get the same treatement. Even for tiny, NON performance enhancing amounts of a substance (can’t remember the case right now, but an athlete was caught and it turned out that a supplement he was taking had an EXTRA ingredient that he wasn’t aware of. The CAS even admitted it was of a non-PE amount, yet they gave him the full 2 year ban).
I surely don’t know what the answer is, but WADA won’t ever admit that sooner or later they will have (or already have?) ‘convicted’ an innocent athelte.
As to the athletes, I think it’s human nature to always be looking for ways to do something better. So they will always be searching for the next big thing to help them do better, longer, faster, safer. Some of these things will be pure snake-oil, and some will be the real deal. The ‘bad guys’ will always be ahead of the ‘good guys'(?) who are trying to figure out what will be allowed and what won’t be. Which ones are ‘cheating’ is in the eyes of who makes the rules.
You’re right Larry, there is a cost/benefit thing, but perhaps WADA is either ignoring it or not using it properly. It seems that right now they are (in theory, at least) testing for substances for which there is only anecdotal evidence for performance benefit.
Seems to me there are 2 possible routes here. 1. We test for anything anyone thinks is a PED and possible eventually remove it if enough scientific testing to our (WADA’s) liking shows it is not a PED. 2. We wait until the science shows it to be a PED, and then test for it.
To my thinking, the latter approach has a better cost/benefit ratio. WADA can spend lots of money to develop and implement a test for HGH, but if it doesn’t help performance, what’s the point. If I spread a rumor that banana peel is a PED, should WADA then ban bananas and develop a test for banana peel?
But then WADA is probably trying to be, or at least appear to be, pro-active here. HGH has been rumored to be a PED, so WADA wants to be on record as against its use.
Matt, I agree completely. If we’re going to have PED testing (and I am in favor of PED testing), then we’re going to have to tolerate a certain number of false positives. The inevitability of false positives leads to two conclusions: (1) we should not go overboard in our reaction to an adverse analytical finding, and (2) we should only test for substances that we know are performance-enhancing. Of course, there’s no constituency in sport (not the fans, the teams, the ADA, the journalists, not even the athletes) who see things this way.
William, great post.
I am pretty sure that WADA people are as good as others.
Even Lance is persuaded of that since he killed his own personal anti-doping program which would have been set to protect him of “evil” French who could have tampered his 1999 samples.
If they have done that in 1999, they could have repeated it easily in 2009, but Lance didn”t take his joker proving his confidence in the system, the fairness of LNDD and probably their inabilities to catch him for doping : autologous transfusion are not detectable, even if funny blood values would indicate blood doping.
And in surprise news, Rossi’s B sample comes back negative for CERA. For those unfamiliar, speculation about her guilt was rampant following the release of her A sample results, in no small part due to her close association with Ricco. I’m still not sure why her A sample results were released? Their release seemed key in causing a substantial upset to both her domestic and professional life. You have to love this quote: “CoNI’s prosecutor will re-examine the case before deciding what further action can be taken.”
(I adjusted the “o”in CoNI. No upper case o’s for me in regard to the word “olympic”, spell check be damned)
http://www.cyclingnews.com/news/rossis-b-sample-negative-for-cera
Wow! Even this jaded writer is somewhat astonished by CoNI’s/Torre’s enthusiasm for sanctioning Rossi, even though the A and B samples don’t correspond, indicating the CoNI CERA urine test appears to be less than ready for prime time.
http://www.cyclingnews.com/news/rossi-still-facing-investigation-for-possible-cera-use
Anyone else get whiplash from this quote: “However the presence of CERA in the A sample could be enough to allow the investigators to accuse Rossi of attempted doping, which can still be punished with a two-year ban.” ???
Jeff,
There’s a WTF moment, eh? Interesting that the article speaks about a rapid degrading of CERA. There’s a similar problem with the original urine test for EPO — what they look for degrades quickly. (And, according to none other than Christiane Ayotte in 2005, even with proper storage an old sample might be useless when it comes to discerning whether EPO was really used because the EPO would have degraded by the time the sample was tested.)
Looks like Ettore Torre and Francesco Botre are hedging their bets, investigating further. Anyone want to bet that Rossi gets some form of sanction? I’m guessing that’s the eventual outcome of her case.
If there really is a short window to do the detection, then the obvious solution is to test the B sample very soon after the A sample results are in. This may be the lesson learned. Of course, it’s also possible the first result was a false positive. But that never happens in WADA-world — does it? 😉
Does anyone know what the reason was for the delay in testing the B sample? As I recall, the athlete has 5 days after being notified of a positive A test to request the B testing, else the A result stands. If Rossi requested the B test in a timely manner, you can’t blame her for the delay. Was the lab so backed up that it took that long to get to this test and if so, is this an example of poor priorities? If the delay was due to some action/fault of the lab or WADA or whoever on that side of the equation, and the B negative was due to degradation; then I’d say the just have to eat it and learn from the experience. Get your B tests done quicker.
If the window for detection is so small, perhaps this test is not ready for anti-doping enforcement, at least yet.
Good question, William. I’ve been under the impression that an athlete has only so long to request a B sample test. Depending on how long it takes for the first results to be interpreted, that could account for a significant delay.
Imagine a test that can be done in a few days or a week, but then it takes several weeks for the experts to agree on what the results mean. By the time an athlete is informed, at least a month goes by. Now imagine that the degradation happens faster than that.
If all this happens, the B sample might come back negative, even though the A sample came back positive. Like you said, perhaps this test isn’t quite ready for prime time.
Rant:
In the scenario you describe, any athlete aware of this situation would seem to be guaranteed a free pass: even if he is using CERA, the B sample will be negative and won’t confirm the A results. CONI is undoubtedly aware of this possibility and this is one possible explanation why they want to still go after Rossi.
Of course, this assumes our idea that it is necessary for both A and B results to be positive (unless the athlete chooses not to contest the A results). Perhaps we are wrong, we missed the boat on the home country jurisdiction thing. Is we are wrong, CONI may have a legal leg to stand on if they attempt to sanction Rossi bases on only the A sample results. Then again, if we are right, they just may be making noises. Or they might figure WADA might ignore the regs and buy their argument that the A results are enough to sustain a charge of attempting to dope. It’s an interesting argument, but I fail to see the logic.
Here’s where it gets interesting — and disturbing. If I recall correctly (and memory is a hazy thing), there was a change in the latest WADA rules regarding the requirement that the B sample confirm the A. I don’t remember the specifics, but the change left the door open to prosecuting someone solely based on an A sample result. I don’t think it spelled out what conditions have to be met to prosecute someone based only on the A sample.
Perhaps this is a case meant to test that concept.
Well, it doesn’t surprise me. Somewhat out of necessity, WADA’s strategy is “We may not be able to catch every doper, but it we do catch you, we’ll nail you to the wall, and meantime, we try as much as possible to expand how we get you.” As I recall, WADA has not been forthcoming with statistics like how many A samples are not confirmed by B samples, but my feeling is that if there is even the possibility that someone has “gotten off” if a B sample fails to confirm a positive A result, WADA would regard that as one too many.
Be that as it may, either the A samples results for Rossi show that she doped or, legally speaking at least, they don’t. If the results are good enough, whatever that might be, then she should be guilty of doping. If the results are deemed not sufficient for that, then how can you find her guilty of attempted doping? Imagine a DA who says “I don’t have enough evidence to convict you of bank robbing, so I will get you for attempted robbery.”
This wouldn’t be so bad if the penalty wasn’t so severe.
Multiple regulators conspire to make agreements on reduced suspensions unreliable. Kopp is a case on point. The guy didn’t fight the charge, was given a reduced suspension, served his time, secured a team to race for, trained/raced, and then had the rug pulled out from under him. Makes the “harmonization” WADA preaches in the Code a joke and UCI quite the flip flopper:
http://www.cyclingnews.com/news/uci-extended-kopps-ban-by-a-further-year
William,
I’m not convinced it’s out of necessity. I’m leaning more toward laziness, ineptitude, graft, and/or corruption. Most riders don’t possess the equivalent of a high school education. Same goes for the DS’s. How does WADA, with highly educated scientists/doctors/technicians/bureaucrats, routinely get out foxed by a group of racers and their team leaders, with average educational levels at or below high school graduation? A handful of “doping docs”, some massage therapists turned drug runners, and a gyno transformed doesn’t seem much of a match for the Anti-Doping System. What are they doing wrong and why are they widely reported to be loosing the war, and why are they reduced to having to cheat their own system?