Elite and Age-Group Doping

The recent implementation of the 2011 World Anti-Doping Agency (WADA) prohibited list affects all athletes that fall within WADA's oversight. The list applies to any participant who falls under the regulations of their specific sport and governing body (ie. USAT for triathlon) both amateur and pros alike. In 2005, the World Triathlon Corporation (WTC) that owns the Ironman brand accepted the World Anti-Doping Code. In 2009 WTC announced age-group testing as well. Knowing what's on the WADA prohibited list is also important because many of these substances, while conferring a performance-enhancing benefit, are also unproven in terms of overall health and well-being. Every athlete is responsible for the listed material's presence in his or her body, whether intentional or not.

The inaugural anti-doping testing for a USA Triathlon Age Group National Championship took place in 2010 in Tuscaloosa, Ala. This event marked the first time age group athletes were tested in-competition, with the program conducted by the U.S. Anti-Doping Agency (USADA). USAT reports "Competing athletes supported the efforts, praising the program as well-organized and professional, and welcomed the added level of confidence in fair play that testing for performance-enhancing substances can provide. In addition, USA Triathlon is pleased that results returned to tested athletes have all been reported negative for the presence of banned performance-enhancing substances". Yet, with over 3000 USAT-sanctioned events and over 130,000 members in 2010, apparently a handful of age group athletes were tested at a single event.

Some updates to the WADA prohibited list
The WADA list is updated each year to reflect changes in the understanding of the ergogenic effects of certain materials and the benefits they can impart (or not) within certain sports. The major changes in 2011 are as follows:

New banned category
A new category was added: S0. NON-APPROVED SUBSTANCES defined as follows: "Any pharmacological substance which is not addressed by any of the subsequent sections of the List and with no current approval by any governmental regulatory health authority for human therapeutic use (i.e. drugs under pre-clinical or clinical development or discontinued) is prohibited at all times". In layman's terms, this broad category allows WADA to cover, in a broad swath, any non-prescription drug or over-the-counter product that is available for purchase. As a result, all drugs in clinical trials, designer drugs, experimental drugs would be banned from use at all times.

The most significant challenge with enforcing this new category is that analytical science has evolved only to a point where, by and large, only substances that have been previously identified are likely to be detected. An unknown substance present in a test sample has a significant chance of being overlooked. Nevertheless, by adding this category, WADA has taken a decisive step in eliminating the use of novel and unregulated drugs in sport. By implementing this category, it would also appear that the border between drugs and unregulated nutritional supplements could be blurred. It would seem likely that in future revisions this category will be further clarified.

Platelet-Derived Preparations
Platelet-derived preparations (commonly referred as PRP or blood spinning), was prohibited in 2010 when administered by intra-muscular route. Due to the lack of current ergogenic evidence, PRP have been removed from the List for 2011. Current studies on platelet-derived preparations do not demonstrate a potential for performance enhancement beyond a potential therapeutic effect.

Declaration of Use
Previously, athletes were required to file a Declaration of Use for specific substances (such as albuterol, salmeterol, glucocorticosteroids). This declaration requirement has been removed for 2011. However, Therapeutic Use Exemption (TUE) documents must be filed prior to using any prohibited substance or method.

Athletes are still advised to declare all medications, dietary supplements, and blood transfusions on the doping control official record.

The full 2011 WADA prohibited list is available on click.

Athlete Testing: Who Gets Tested?
Although not infallible, random testing is still useful in detecting less sophisticated athletes who cheat. It’s a bit like the random TSA security searches that have been said to be largely a display of deterrence. Pros, especially those chosen to be within a testing pool, are tested with greater frequency, both in and out of competition. In the US, age group athletes are not in the testing pool. Pro athlete whereabouts are submitted to a database allowing testing agencies to pay athletes a visit at any time. Biological passports are another step in the right direction towards drug-free sport: Essentially a document that provides a historical snapshot of various biomarkers and parameters that would allow for abnormal excursions to be easily detected. However, testing is costly and labor intensive, and difficult to scale to the population at large: so where do amateur athletes stand?

Where Does USAT Stand on Amateur Doping?
USAT presents a united front against doping in triathlon by all participants: age group and pros alike. Their website describes their commitment to drug-free sport and the possibility of all athletes being tested in and out of competition. However, the reality is that few age group athletes would ever be tested at any time, simply due to the overwhelming number of participants and the limited exposure of the testing conducted. Their ideals lend themselves to fair play: "…just as the temptations and pressures to cheat aren’t limited to elite athletes, the right to compete on a fair and level playing field shouldn’t be limited to elite athletes either. Athletes of all levels should have the reassurance that they do not need to cheat in order to compete and succeed in their sport. USADA continuously works to protect these rights and works closely with USA Triathlon to understand where the potential for cheating exists." Strong words but clearly not backed up by a significant amount of action yet. It will be interesting to see if USAT expands its efforts to testing age-groupers at additional races outside the National Championship in 2011.

What About Ironman's WTC?
WTC announced in 2010 that all athletes competing in Ironman and Ironman 70.3 events would be eligible for in- and out-of-competition testing. This effort appears to be a solid start although the details bring up some concerns. Only athletes on a "whereabouts list" would be tested out of competition. This list currently includes only pros. As well, with tests running around several hundred dollars each, you can be sure the focus on testing will always be at the pro level.

As described by WTC's official policy, even if an age-group athlete were to be found to test positive, reading the rules below allows athletes plenty of opportunity to seek a pardon: "An age-group athlete who has a first AAF caused by the Use of a Prohibited substance will not have committed an anti-doping rules violation provided the rules below are followed:

1. The Age-group Athlete has a medical condition which was well documented in his or her medical records prior to the date doping control was performed.

2. The Age-Group Athlete, at the Athlete’s expense, promptly undergoes any additional medical examination and testing requested by the WTC.

3. The facts and circumstances of the case put to rest any reasonable suspicion that the Athlete used the substance for the purpose of enhancing the Athlete’s performance. Completing the “Declaration of Use” shall be considered strong proof that the use of the substance was not intended to enhance performance.

4. If the Age-Group Athlete intends to compete further in any IRONMAN® Triathlon event that may be drug tested by the WTC, the Athlete must apply for a TUE for any prohibited substance in advance of any IRONMAN® Triathlon event."

Historical Sanctions
A very interesting historical list of USADA sanctions is available. It is not surprising to note, consistent with all the media publicity, that cycling as well as track and field have shown some of the greatest number of sanctions over the years.

So What Do You Think?
This topic has a scientific component and a significant social aspect. While this article focused mainly on the WADA list from a scientific standpoint, and introduced how WTC and USAT treat age-group doping, I would like to encourage readers to provide their comments and feedback in particular on some of the related social issues. Should we be promoting ethics as well as anti-doping? Should an age-grouper get banned for cannabis? What about age-groupers taking a medication to treat an injury, with an ergogenic side effect? Should age-group athletes be self-policed: Those taking ergogenic substances for other reasons could still complete but would self-exclude themselves from awards? Would most races even have the capabilities in place if an athlete were to announce he or she should not be eligible for an award? What are the ethical responsibilities of athletes on medication

On a related topic, while most pros are already hyper-aware of the need for vigilance as to what enters their body in terms of food and supplements, are most age-groupers ready to undertake a similar level of vigilance?

This being AG drug testing week on Slowtwitch, comments and feedback would be welcome in the comments below or on the Slowtwitch forum.

Jonathan Toker is the Slowtwitch.com science editor and an elite-level runner-triathlete who hails from Canada and lives in Southern California. He received a Ph.D. in organic chemistry from The Scripps Research Institute in 2001. Jonathan invented the SaltStick products in 2002, with each lot of SaltStick products tested for WADA-prohibited substances. www.SaltStick.com