SII Focus 28th May 2020

Testing programmes catching few intentional dopers

Analysis of the Annual Reports of three national anti-doping organisations (NADOs) show that anti-doping tests make up a large proportion of NADO budgets, and catch few intentional dopers. Discounting recreational drugs and sample evasion, in 2019 just four anti-doping rule violations (ADRVs) resulted from prohibited substances that could be used to cheat in sport being detected in athlete samples provided to the three NADOs.

Sport Ireland reported two ADRVs for cannabis during 2019 – a substance that is considered recreational rather than performance enhancing. Anti-Doping Denmark reported three ADRVs duding 2019, one of which involved evasion of doping control. The two ADRVs involved methylhexanamine, clomifen and tamoxifen, all substances that have turned up in contamination and unintentional doping cases, but nevertheless could be used to cheat. 

The Doping Authority Netherlands reported five concluded ADRV cases during 2019, however only two of those involved a positive test for substances that could be used to enhance performance. Two athletes accepted sanctions during 2019, and 11 proceedings were initiated by the Doping Autoriteit, not all of which were concluded.

The above highlights that providing accurate numbers is complicated, as doping cases can take years to progress from sample collection to an ADRV. The numbers also do not take into account that reporting AAFs and ADRVs is not the only purpose of the testing system. Knowing that doping control personnel could demand a test from you at any time is a powerful deterrent to any athlete. If the testing system was not in place, such a deterrent would not exist and it is reasonable to predict that ADRVs would rise. This is an often underestimated virtue of the testing system.

All three NADOs reported increases in out of competition (OOC) testing, based on the theory that ‘smart’ dopers would not use prohibited substances in competition. However despite this, Sport Ireland’s two cannabis ADRVs were reported in competition, as were two of three ADRVs reported by Anti-Doping Denmark during 2019. The Doping Autoriteit’s Annual Report doesn’t classify ADRVs as in-competition or out of competition, but does mention that 51% of tests were performed outside of competition.

Also, whilst testing is a vital component in anti-doping, so is intelligence, education and research. An interesting quirk of anti-doping in the Netherlands is that it is the mission of the Doping Autoriteit to keep the percentage of doping controls resulting in ADRVs to below 1% of doping controls. This leads to a focus on intelligence and education in reducing the incidence of doping in Dutch society, rather than how many ADRVs a NADO has managed to secure during a year being used as a benchmark for ‘success’.

Sport Ireland

Sport Ireland spend €966,842 on collecting 1,303 samples during 2019, an average cost of €742 per sample. Of these, 381 involved out of competition blood samples, which are understood to be more expensive to process than the 922 urine samples collected, 642 of which were collected out of competition. Of these, four samples collected in competition and one collected out of competition resulted in adverse analytical findings (AAFs). Two in competition samples resulted in an anti-doping rule violation (ADRV) for a prohibited substance, both of which involved cannabis.

A third ADRV involved a football player evading an in-competition attempt to collect a sample. Sport Ireland also has four pending cases, one of which involves evading an attempt to collect a sample and tampering with doping control. The other three cases, one of which involves an out of competition sample, involve AAFs for prohibited substances.

In April this year, Sport Ireland announced that Gaelic footballer Raymond Walker had been sanctioned with a four year ban for an ADRV involving meldonium. Also in April, Munster ruby union player James Cronin was sanctioned with a one month ban, after a pharmacy mistake led to an AAF for prednisone and prednisolone. Sport Ireland has since indicated that it will not be appealing that decision, which was issued by European Professional Club Rugby (EPCR).

Anti-Doping Denmark

Anti-Doping Denmark spent DK11.738 million (€1.57 million) on collecting 2,028 blood and urine samples during 2019, an average cost of €776 per sample. It reported 12 cases, twice as many as in 2018. Three of those were based on intelligence and are not yet settled due to ongoing appeals. Three cases reached their conclusion in 2019, one of which involved evasion of doping control. Five cases were concluded in 2020.

Doping Authority Netherlands

The Doping Autoriteit spent €1.54 million on collecting 2,427 samples as part of the national anti-doping programme, an average cost of €635.5 per sample. A total of 39 adverse findings were reported, 1.2% of the total 3,140 doping controls performed by the Doping Autoriteit in 2019 (the 3,140 figure includes tests it was commissioned to perform).

Three cases were non-analytical, leaving 36 AAFs involving 58 substances (see table on right). Cases involving 18 AAFs were closed due to athletes holding a valid therapeutic use exemption (TUE); and proceedings were initiated by the Doping Autoriteit in eleven cases during 2019. 

The Doping Autoriteit met its target in keeping the incidence of doping in Dutch sport to below 1% of doping controls. ‘The percentage of violations noted on Dutch territory pursuant to controls conducted as part of the national programme was 0.6% (15 cases under national anti-doping regulations resulting from 2,427 doping controls conducted as part of the national programme)’, reads the Annual Report (PDF below). ‘This percentage complies with the stated target for 2019 of a maximum of 1% positive cases in Dutch athletes’.

A total of 28 disciplinary sanctions were issued during the year, detailed in the table on the right. This figure is higher than the 11 cases initiated by the Doping Autoriteit for 2019 because many of these proceedings began prior to 2019.

Dopey dopers

In 2013 David Howman, the former Director General of the World Anti-Doping Agency (WADA) who now heads the Athletics Integrity Unit (AIU) of World Athletics, warned that sport was only catching the “dopey dopers”. Lance Armstrong was tested numerous times during his 19 year professional career and never reported an AAF, yet recently admitted doping since the age of 21.

Testing is expensive. A single test costs €635 to €776 per sample, based on the three Annual Reports analysed. The testing system isn’t catching determined doping cheats. It is continuing to catch the ‘dopey dopers’; i.e. recreational drug users and those who unintentionally dope through using products they were unaware contain prohibited substances. 

Detail from the Doping Autoriteit’s Annual Report…

Increasing testing numbers will only result in the sanctioning of more recreational and unintentional dopers. In 2017, scientists pointed out that throwing more money at the testing system doesn’t improve results – it only creates more anti-doping. 

It appears that real doping cheats are caught via investigations. The Russian doping scandal? The result of investigations. Lance Armstrong? Confessed after determined journalists and mounting evidence left him with no option. Operation Aderlass? The result of cooperation between law enforcement and anti-doping organisations.

This puts NADOs in a difficult position. It would be a brave NADO that decided to reduce the number of tests, which perhaps explains a relatively recent shift towards out of competition making up the majority of tests, rather than the minority. In competition tests remain essential, as it would appear that they have largely stopped intentional dopers turning up to events while boosted by prohibited substances.

It appears that we are now shifting towards an era where blanket increases in testing is no longer considered an acceptable way to conduct a national anti-doping programme. Under Article 5.8.3 of the World Anti-Doping Code, anti-doping organisations (ADOs) are now required to investigate any intelligence that may indicate an ADRV. Many NADOs are doing this.

There are also signs of a long-awaited drop in the cost of testing. Dried Blood Spot (DBS) testing was trialled by the Ultimate Fighting Championships in 2018; and has now been trialled with seven ADOs. This will not replace urine and blood testing, but provides NADOs with greater flexibility to investigate potential ADRVs without blanket testing everyone – a concept often referred to as ‘smart testing’ within anti-doping circles.

The pressure is on. NADOs are largely government funded and are under pressure to produce results. Often, politicians can interpret this to mean how many ‘doping cheats’ have been caught by a NADO, pressuring them into securing ADRVs against minor athletes that they arguably should be helping. NADOs are also often tied into expensive legacy systems that WADA has invested in developing, despite cheaper alternatives being developed, but discounted. This adds to their costs.

In The Netherlands, questions are asked of the Doping Autoriteit if the percentage of ADRVs as compared to tests rises above 1%. Such a policy appears sensible – it incentivises the NADO to help athletes, removing pressure to secure ADRVs against minor athletes in order to prop up figures, leaving the NADO free to investigate the real cheats.

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