On 24 February, UK Anti-Doping (UKAD) formally appointed Nicole Sapstead as Chief Executive, a role she had been holding in an interim capacity since the departure of former CEO, Andy Parkinson, to British Rowing in December last year. Nicole has worked in anti-doping for 18 years, having previously held roles at UK Sport. She spoke to the Sports Integrity Initiative about some of the major current issues in doping (prior to the release of the Cycling Independent Reform Commission report earlier this week).

In the interview below, Sapstead discusses how doping organisations, faced with potential spending cuts, should concentrate their resources. She also explains how steroid and supplement use has now become an issue that goes outside of sport, and affects the whole of society. She also explains that at present, athletes do not face a level playing field in terms of doping, as resources for tackling drug use in sport differ from country to country, as well as – understandably – sport to sport.

Sapstead also discusses the challenges faced by anti-doping organisations in detecting new forms of doping and new methods, such as micro-dosing (where small amounts of a substance or multiple substances are used to remain within the thresholds permitted under the World Anti-Doping Code). She also deflects criticism of the low number of positives reported through in competition testing, by highlighting that such testing is not designed solely to catch cheats, but to have a deterrent effect. Sapstead also expresses her view that not enough anti-doping organisations store samples for retrospective testing for new and emerging substances. Other topics discussed include the possibility of athlete revolt against the anti-doping system; how supplement use could be regulated and how reformed dopers should be treated by sporting organisations.

SII: Congratulations on becoming a permanent replacement for Andy Parkinson. Is this something of a dream role for you, given your background at UK Sport?

NS: I have been working in anti-doping since 1997! I think that in terms of career progression, absolutely. I wanted to make that next step from Director level to a CEO post. Timing was on my side. Andy left, and I was presented with an opportunity. I am thrilled to be heading up an organisation that has such a phenomenal reputation, and is world leading in what it does.

SII: What challenges are you expecting in the coming year?

NS: Inevitably, the most obvious one is our potential new government, and the potential for there to be further spending cuts. The challenge for us as an organisation will be, whether we are hit with further cuts or not – hopefully not – is to demonstrate value for money to the taxpayer, and to constantly be finding new, innovative, creative ways of doing what we do, whilst having the same – if not a greater – impact on our stakeholders.

SII: What is the biggest emerging issue that you can see coming up in anti-doping?

NS: The past three or four months have highlighted that there is an issue emerging that straddles sport, education and health. This is the increasing use of steroids that we are seeing in younger individuals, particularly the under-18s and boys. They are using it not necessarily for performance-enhancing effects – although there are some that are. They are using it to look ‘buff’. They are using it to look good in front of their friends and to look attractive. This stuff is dangerous. We are all different and we all respond to things that we take in different ways. But the health consequences of taking steroids are just enormous.

SII: I have noticed an increase in the amount of adverts on the internet urging people to use these products…

NS: Absolutely. The power of the internet is such that if you do a google search for steroids, you’ll find many internet sites where you can buy steroids. If you go onto YouTube, there’ll be somebody demonstrating how best to administer steroids, or to ‘stack’ them, so that they have the greatest benefit to you physically. It is absolute madness. It is a challenge that will never go away. I’m not sure it is a challenge that we’re ever going to conquer, but as an organisation, hopefully working with the Department of Education and Health in the future, we have to say that this is an issue that we have a responsibility to address, primarily through education. We need to demonstrate to these individuals the consequences of what they are doing, even if it’s not at a sporting and competitive level.

SII: Historically, rugby has had issues with supplements. This is especially true in rugby union, where the professionalisation of the game has placed greater demands on individuals to become bigger and stronger. Rugby has also recently faced a number of allegations regarding drug use in France and Australia. Does rugby have a drugs problem?

NS: I think that there is a problem within the sport. However, I caveat all of this by saying that I don’t think that there’s any one sport that could say that it doesn’t have a problem. The attention that is put on a sport is relative to how open they are to putting themselves under scrutiny – i.e. the amount of testing that is done.

There are some very obvious sports where a huge amount of investment has been made by international federations and anti-doping organisations. Inevitably, this skews the figures as there are other sports which do virtually no testing at all. It is very easy to say that rugby has a problem, but so do a number of other sports. Rugby is just under the limelight at the moment and inevitably, in six months time, the focus will move to another sport.

The problems are different in different sports, and the issue that we are seeing with rugby has cemented our realisation that there is something bigger going on here that is a public health issue. The statistics are showing that the problems within rugby are not at an elite level, it is at a lower level, and at school and university level too. I think that it ties in with the whole steroid use and body culture issue. I am not sensing that it is a systemic or institutional team issue. I think that there are some individuals that have pressure on them from some aspects of their lives. It might be that their coach is telling them that they need to be bigger, stronger, faster in order to make the first 15. They act in isolation, for example by going onto the internet and ordering steroids and taking them. It is therefore not something that would make us consider completely re-deploying our resources and focusing on a particular level or team.

SII: Has the situation in Russia impacted UKAD at all?

NS: Everybody is waiting to see the outcome of the investigation that is being undertaken by Dick Pound and his team. Nobody likes to hear that a country that does pretty well in the medal table is coming under such intense scrutiny. It hasn’t impacted us directly, because here at UKAD, we are proud of the robust and rigorous, intelligence-led anti-doping programme we deploy, and the fantastic range of education that we undertake across various sports and different levels. We have to continue to ensure that our athletes make themselves eligible for testing, that they can be tested at any time and any place, so that the world can see that we don’t have any kind of institutionalised problem that may exist somewhere else in the world.

SII: A study in the Netherlands recently suggested that between 14% and 39% of athletes are doping, yet testing results typically return between 1% and 2% as positive. Are we doing enough to catch the cheats?

NS: This is a big question. There are countries around the world who have yet to build a robust testing programme. That is going to skew the figures. If you go looking for a problem, you’re either going to find that there is or isn’t a problem, but if you don’t go looking at all, then you’re not going to find anything. WADA’s Regional Anti-Doping Organisation programme and the collaboration that continues to grow between international federations and national anti-doping organisations will mean that at some point, when we have our athletes on the start line and they look down the line and they see ten other athletes from ten different countries, they will be able to confidently say that they get subject to the same kind of testing. The reality is that this is not the case right now.

There are always going to be substances that athletes are finding, or using, for a performance-enhancing effect, which we don’t know about. We have to find ways of testing for those substances. Athletes can micro-dose using particular substances, which makes detection incredibly difficult. It’s wrong to say that we should just do more testing, because anyone can do that. If we had the money, we could do 20,000 tests – no problem at all. However, the thing that UKAD are really striving to demonstrate is that you have to give great thought to the way in which you are planning those tests. Unless you have timed your administration of a drug very, very badly – or perhaps you’re just a bit foolish or naive, positive tests from in-competition testing are never going to be commonplace. On that basis, you’ve got to focus your efforts on out-of-competition testing. Even then, what you’ve got to look at when is the right time to test an athlete, and consider if it is the sort of sport where they are going to benefit from doping during the off-season, as compared to whilst they are competing.

It’s very complex. I think we’ll never answer the question about whether the number of findings that we have worldwide is because athletes are educated well and are scared of being caught and it is genuinely only one or two percent of athletes that do dope, or is it because testing programmes around the world should be called into question? Once we reach a state where we can say that everybody is doing what they need to be doing, then we might be able to reach a conclusion on that in a more informed way. Half of the anti-doping organisations are not resourced like we are. Testing costs money, and until governments and countries start standing behind this issue, we are going to have to accept that country ‘x’ can only do 200 test per year.

SII: Are we doing what we need to do in terms of testing?

NS: Absolutely. It’s just about being smarter. We have to use all of the resources that are available to us to try and time those tests close to where we think that doping will occur. That in itself is not a straightforward process. It is time consuming, and it is also about using all of the different tests available to us. It’s about saying that yes, you do need to do blood testing here and yes, you do need to do additional analysis in certain situations – for example to analyse for EPO. It’s about using those tools well, including the athlete biological passport.

SII: High profile doping prosecutions have often come from investigations, rather than testing. Historically, there have been a lot of successful prosecutions of athletes through analysis of past samples. Budgets for anti-doping are often tight. Would anti-doping organisations be better off spending more money on investigations and less money on testing?

NS: I think it’s a fine balance. You can’t just back off from testing. We have to remember that testing is not just there to detect – it also serves as a deterrent. If you back off from testing, it rather undermines that general premise. However, I do agree that not enough anti-doping organisations store samples and go back retrospectively to test for new and emerging substances.

There are always issues about storage capacity, cost and targeting – for example there is no point storing all of your samples and then going back to look for a substance that may only be relevant in endurance sport or weightlifting. It is about using all of the information that you have at your disposal to try and fine tune what you do already.

SII: I am increasingly concerned about the possibility of athlete revolt against the anti-doping regime. Athletes often protest their innocence, unless they accept that they might get a reduced sanction for a prompt admission. However there have been a number of cases recently where athletes have continued to protest their innocence, such as with the Dutch cross-country runner, Adrienne Herzog. Players are becoming sick after being made to wait in sweaty clothes, as was the case with Ahmad Hayel. You also have people such as Jonathan Tiernan-Locke, Claudia Pechstein and Roman Kreuziger who continue to protest their innocence. I know that athletes accept the anti-doping regime, but is there a danger that cases such as these could cause a revolt against the system?

NS: I hope not! I hope that common sense will prevail. When you decide to become a professional athlete, you sign up to a certain degree of intrusion. The majority of athletes support the system and often publicise that they are being tested. Demonstrating that you are available and haven’t objected to testing serves to quieten the critics.

If we move to a situation where organisations such as ourselves are not able to access athletes, this would undermine the whole system. By and large, most anti-doping organisations are not in the habit of trying to disrupt athletes lives. We are very sensitive to the lives that athletes lead.

If we see an athlete who’s drenched, or muddy or cold, of course we will accommodate their need to strip off and change. I’m not going to get in to a debate about showering, but putting some warm clothes on, absolutely, as long as they continue to be chaperoned. We’re there to accommodate the athlete as much as we possibly can without affecting the integrity of the process.

With regards to athletes who protest their innocence, there is a process in place which allows them to submit evidence and there is a due process to be followed. That’s why it’s there. Demonstrate your case, and don’t leave it until after you’re sanctioned.

SII: How do you see the Claudia Pechstein case affecting what anti-doping organisations do?

NS: I think that it’s too early to tell. This is being debated now in Europe – I think we’ll have to see how this one plays out – ask me in six months’ time!

SII: What is doping? For example, taking an energy drink given to you by your coach at half time? Sleeping in an oxygen tent? Using high-tech swimsuits?

NS: I am not sure where you draw the line. The Code is very much about substances and methods. I know that there are some methods – such as blood doping – that are difficult to police, but I am not sure that the Code was ever intended to start looking into things such as wearing a swimsuit. That’s not what UKAD is here to focus on.

SII: Doping is entering amateur sport. People post on social media what they are taking. There are numerous adverts on social media targeting not only the young, but also middle-aged people approaching the mid-life crisis stage urging them to ‘get ripped!’ I noticed that in Australia, they have changed their definition from performance enhancing drugs (PEDs) to performance and image enchanting drugs (PIEDs). Are we entering an age where supplementation is seen as part of exercise? Is this OK or do we need to send out a message that this isn’t OK?

NS: The use of supplements is now part of exercise at both a professional and amateur level. If you go into any gym, people are often mixing some kind of shake. If you’re an elite athlete and you have that infrastructure behind you – our starting point has always been that you have individuals who are there to ensure that you are eating a properly balanced diet that suits your training schedule. Do you really have to then resort to a supplement of some description to enhance that?

The answer should be no – not if you’ve got the right diet. However, the reality is that we can’t stop people from taking supplements. We have to tell people that if you are going to, then you have to understand that there are some significant risks involved. Our supplement campaign is about saying that it’s just not worth the risk. If you’ve accepted that you are willing to take that risk, then make sure that you minimise that risk by going to a source that is more reputable than others.

Nevertheless, the risk of taking that supplement comes with no guarantees that there isn’t something in there that shouldn’t be in there. I think that’s the reality, until somebody, somewhere, decides that this is  an industry that needs to be regulated. We can’t stop you, but beware if you do do it, particularly if you are at a competitive level of sport.

SII: I guess the danger is that once performance starts dropping off with age, then supplements become a more attractive option.

NS: We’re limited in our resources, but even if you’re seeing athletes doing this at the level at which you’re suggesting, those athletes are still bound by the rules of the sport. In being bound by the rules of the sport, they are also bound by the anti-doping rules of that sport. Therefore, if UKAD decides to focus its resources on that level of sport, then those individuals that are happily talking about getting ‘ripped’ and using these substances on social media are also eligible for testing, and therefore sanctions.

SII: What place do reformed dopers have in sport? If athletes serve their ban, should they be welcomed back with open arms?

NS: I do think that everybody deserves a second chance. I think there are different levels at which athletes dope. For example, somebody who uses steroids or EPO against somebody who has committed an inadvertent doping offence are two very different things, but I do think that both deserve a chance to return to sport. I think the Code is there to protect sport from those individuals who don’t learn from their first sanction and continue. The Code is very clear about lifetime bans, or incredibly long bans to basically exclude people from sport for the rest of their professional life. I also think that for us, athletes are a very powerful source of education material. If an athlete admits doing wrong and is happy to be a spokesperson for their sport or for UKAD, so that other athletes don’t go down the same path, then we should welcome those individuals with open arms.

You also have to bear in mind that notwithstanding their return to the sport, their reputation will always be slightly tarnished. No matter what happens, they will always be remembered for that offence. It doesn’t go away, but if they can show that they’ve learnt and they can do good things on returning to the sport, then why wouldn’t we say, OK, come back? However, do it again, and you will suffer the consequences. It’s like an employment situation. If somebody’s done something, unless it’s seriously wrong, there is a process for reforming them. It’s only when they continue that you show them the door.

Nicole will be attending Tackling Doping in Sport, which takes place at Arsenal’s Emirates Stadium next week.