The Pharmaceutical Journal
Vol 273 No 7315 p320
4 September 2004

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The war on drugs in sport — a perspective from the Athens Olympics

In this article, Mark Stuart, a doping officer at the Athens Olympic Games, describes the anti-doping operation at the games

New drug technologies series

The ruthless desire to compete and win is as old as humankind. Ancient Greek Olympians are known to have used stimulating potions and high protein diets to improve athletic performance and Greek gladiators were doped to make their fights more vigorous and bloody for the spectators. It seems doping in sport has gone full-circle, with Greece having just undertaken the largest, and one of the most successful, Olympic doping-control operations to date.

In the year preceding the Athens games, the war on drugs in sport was well under way. The sporting world was rocked by a number of positive drug tests and allegations of drug use by elite athletes. Britain’s favourite for a gold medal in Athens, sprinter Dwain Chambers, was suspended for two years following detection of the “designer” steroid tetrahydrogestrinone (THG). Another British Olympic hopeful, cyclist David Millar, withdrew from the British team only weeks before the games after admitting to a French judge he had used erythropoietin (EPO). Vials of the drug were found by police in a raid of his home just before the Tour de France. He was to compete in at least three Olympic events: the time trial, road race and team pursuit.

Also in the weeks before the Olympics, Australian cyclist Sean Eadie was cleared of allegations that he had imported prohibited substances into Australia and, in the US, the owner of the Bay Area Laboratory Co-operative, Victor Conte, faced charges of supplying performance enhancing drugs to a number of American athletes. Although triple Olympic gold medallist Marion Jones has never failed a drugs test, she was also fighting to clear her name from suspicion of cheating after her ex-husband claimed she injected performance enhancing drugs while competing at the Sydney Olympics.

Two Greek sprinters, Kostas Kenteris and Katerina Thanou, hit the headlines during the games after failing to turn up for a random drugs test following an alleged motorcycle accident. The pair had already missed two drug tests in the past month and, according to International Association of Athletics Federations rules, three “no-show” means an automatic two-year ban. During an International Olympic Committee hearing the pair decided to withdraw from the games and now face an investigation by the IAAF.

With each Olympics, drug-taking and drug-testing gets more sophisticated. Anti-doping authorities are constantly developing more advanced ways to keep ahead of the cheats. At the Sydney 2000 games EPO testing was conducted for the first time. Both a blood and a urine test were used at these games to identify EPO use. The detection of EPO can now successfully be done by a urine test alone and the Athens games was the first Olympics to use such technology.

Also, for the first time, human growth hormone testing was carried out at Athens using a test developed by scientists at Southampton University. Although human growth hormone has been on the list of banned substances since 1989, until now its detection has not been possible. An initial test can detect if human growth hormone has been used by an athlete in the past 36 hours and a second test can detect if it has been used in the previous 84 days. During the games period, Olympic athletes were randomly selected to provide a blood sample to test for possible abuse of human growth hormone.

Doping control operation
The doping control operation in Athens was one of the biggest in Olympic history, with the number of staff exceeding 500. The International Olympic Committee was responsible for a total of around 3,500 urine and blood tests over the period of the Olympic Games and the test events. The World Anti-Doping Agency sent independent observer teams to the Athens games, to ensure that the doping operations were conducted in a fair and unbiased manner.

The “in-competition” period of the Olympics was considered to be from the opening of the Olympic village on 30 July to the day of the closing ceremony on 29 August. During this time, tests were conducted for all prohibited substances, which include stimulants, narcotics, cannabinoids, anabolic agents, peptide hormones, beta2-agonists, anti-oestrogens, masking agents and corticosteroids. A further 650 tests are expected to be conducted for the Paralympic Games in the weeks to follow.

Both the IOC and WADA conducted random tests from the doping control station within the Polyclinic at the Olympic village in the two weeks before the start of the games. After this time the IOC was responsible for the collection and testing of samples. Then each of the gold, silver and bronze medal winners were required to provide a urine sample at the doping control station at each venue for testing. Another athlete within each event was also randomly selected to provide a sample and athletes were randomly selected during the qualifying heats.

Each morning, in the two weeks before the start of the games, the names of athletes selected for testing would be randomly drawn and one athlete’s name would be assigned to a doping-control escort. The escort would then have the often difficult job of locating the athlete in the village and notifying the individual to report for a blood and urine test. The escort would then observe the athlete closely until he or she reported for testing to ensure that the athlete did not partake in any activity that may hinder the detection of banned substances.

The doping control laboratory was located at the Athens Olympic Centre and was accredited by WADA to conduct the laboratory tests for the games. This was the first time in games history that accreditation of testing facilities was assumed by WADA. In previous years the IOC has been responsible for laboratory accreditation. The laboratory was capable of processing 180 samples daily, with the negative results available within 24 hours and the positive results in 36 hours.
If an adverse laboratory result was found, the IOC Medical Commission was immediately notified. It would then inform the IOC president who would set up a disciplinary commission. The athlete would be informed and could request the analysis of the second sample with the right to be present for the opening and analysis of the second sealed container. The athletes had the opportunity to defend themselves at the disciplinary hearing after which the IOC executive board would make the final decision. An appeal for this decision could further be made to the Court of Arbitration for Sport.

World Anti-Doping Code
The World Anti-Doping Code was introduced by WADA for the first time at these games. It was mandatory for participating countries to accept and implement the code by the day of the opening ceremony. The code aims to harmonise anti-doping regulations across all sports and all countries. The new code provides a uniform basis for anti-doping policies, rules and regulations for sporting organisations around the world. It also provides requirements for sanctions and hearings should an athlete test positive. In addition, it outlines testing procedures and allowances for therapeutic drug use exemptions.

Before the opening of the Olympic village, WADA carried out worldwide testing on athletes who qualified for the games, paying particular attention to athletes who do not have national anti-doping agencies in their home countries. Within the village WADA also conducted an athlete outreach programme, where representatives were present to provide information and education about anti-doping and to encourage fair, drug-free sport.

A doping control guide, produced by the Athens 2004 organising committee, was distributed to all national Olympic committees and international sporting federations before the games. The guide outlined the doping-control rules, doping-control programme, and detailed sample collection procedures for the games. It also included the most recent list of prohibited substances and methods, which was updated in March this year.

British athletes competing in Athens were given a medical kit to treat minor ailments while away from home. The aim of the kits was to prevent the occurrence of positive drug tests from over-the-counter medicines, as happened to Alain Baxter at the 2002 Winter Olympics after using an OTC inhaler. The kit contained anti-doping information from UK Sport and a selection of permitted medicines, which included paracetamol, throat lozenges, a nasal spray and anti-diarrhoeal medication.