PEDDLING DRUGS TO THE PEDAL PUSHERS

"The Tour de France: a broken legend" shrilled Le Monde's headline. "Tour de
Farce" is how others put it. The field in this year's gruelling 21-day
cycling race was decimated by drug raids, inquiries, and arrests by the
French police, and walkouts by some of the teams. The race itself saw
sit-down strikes and go-slows by the cyclists, voting with their pedals. The
first raid was 3 days before the tour began, a team masseur being stopped at
the France-Belgium border with a car-load of doping products, including
epoetin (recombinant erythropoietin). The doping raids and inquiries then
accelerated like a racing team itself, with hotel rooms searched and riders
forced to give samples of urine, blood, and hair. Cyclists and team
officials, including doctors, are waiting to be charged or questioned
further by the French authorities.

This year's preferred booster for the Tour de France was epoetin. Such
pharmacologically enhanced endurance athletes may have the edge over their
physiologically normal competitors. The use of epoetin is well recognised by
the sport's international controlling authority, which has set a cutoff for
packed-cell volume of 0B750 as the limit of normality. Above this, epoetin
use is assumed and the rider is banned, there being no generally accepted
assay for this hormone.

But defining "normal" is always going to cause problems, as research
published on page 451 shows . Two of 46 elite athletes (thought to be free
of epoetin use) and four of 278 controls had a packed-cell volume over
0B750. In addition, setting a limit of 0B750 simply stimulates
self-titration to 0B749. It is almost human nature to find ways of bending
rules without being caught, especially in competitive international sport.
In this journal on July 4, we featured the drug cocktails favoured by
athletes , and the catalogue of side-effects that each class of ergogenic
agent can carry. Clearly, competitors at all levels are under pressure from
many directions to win, but too many are succumbing to the use of drugs to
meet that end. A meta-analysis from France last year showed that 3-5% of
youngsters and 5-15% of adults taking part in sport reported using drugs.

The President of the International Olympic Committee, Juan Antonio
Samaranch, told the Spanish newspaper El Mundo during the height of the Tour
de France revelations that he sees two types of drug abuse. One harms health
and should be banned while the other merely augments performance. This
looked like a U-turn compared with his previous strong line about the use of
drugs in sports--he later said that he had been misinterpreted. The IOC was
quick to limit the damage to its reputation by announcing last week an
international conference to be held next January on doping in sport.

Many sports writers, often former participants, have pointed out that the
Tour de France is so physically draining that it is impossible to take part
without the use of drugs. Did the pedallers of old take drugs--or were the
mountains lower then? There may be something extra-demanding about endurance
cycling, but that is no reason to treat it differently from other sports.
Drug taking in sport has become so widespread, and its detection so open to
unfairness (the Diane Modahl case, for instance) and loss of dignity
(witnessed urination, venepuncture, hair sampling), that some are beginning
to think the unthinkable.

Samaranch did receive some support, and separate drugged and drug-free
sports were mooted. If science influences how athletes eat and train, and
how bicycles are designed for weight and aerodynamic advantage, then why not
drugs to build muscle, enhance oxygen carriage, calm nerves, and so on?
Today's elite competitors are, in reality, highly paid or sponsored
professional entertainers, some of them in commercial markets in which fair
play is becoming an old-fashioned idea. While we might like to oppose
unconditionally all use of drugs in sport, the real world cannot be so
certain. For instance, what makes an aid to an athlete artificial enough
that it should be banned? Where is the line between a nutritional supplement
and a drug (ginseng versus ephedra, say)? How can the dignity of athletes be
preserved during testing? Why should an adult competitor not be allowed to
make an informed choice about a substance, provided it is legally acquired?
The January IOC meeting has difficult choices to consider.

Checked-by: Melodi Cornett