Drug Testing Deception and Detection

With so many body enhancing products and methods available today, the task of accurately and effectively conducting a large-scale drug testing operation can seem like an impossible challenge. Despite the difficulties, scientists are continually developing new ways to detect body enhancing drugs in athletes. The relatively modern inventions of gas chromatography, mass spectrometry, and immunoassays have given hope to sports officials who are charged with the task of cleaning up sports. But adherence to any drug testing policy is a double-edged sword. Drug testing, or doping control, as it is often termed within athletic circles, has always been a reaction-driven science. In other words, as new drugs are created, athletes find new methods to avoid detection, and so new tests must be created in turn. It is a cat-and-mouse chase where, at least in today's world, the testers always seem to be one step behind the dopers.

THE HISTORY OF DRUG TESTING

Although the use of drugs in sports dates back at least to the original Olympic games, testing athletes for drug use is a relatively new endeavor. The first significant steps toward implementing a modern anti-doping policy came in 1960 when the Council of

Europe—an organization of 44 European states established in 1949 as a forum to address human rights issues and other matters of European law—passed a resolution condemning the use of drugs in sports. Following this initial resolution, France became the first nation to adopt a nationwide antidoping code in 1963. Soon after, in 1965, Belgium and a host of other countries put their own anti-doping codes into effect. Many sports advocates and athletes welcomed the tougher stance against doping, while others were adamantly opposed, but everyone realized that these new codes were essentially, as the classic American proverb goes, "all talk and no action."

The fact that new legislation against doping had little or no impact on actual doping practices in athletics is not to say that the codes were created without good intention. The fundamental difficulty that nations faced in these initial efforts to curb doping in sports was the reality that the technology needed to detect the various doping agents simply did not exist. The situation, however, changed drastically in 1983.

When the first actual athletic drug tests were conducted during the 1968 Olympics in Mexico, the effectiveness and reliability of the testing was viewed with intense skepticism, due chiefly to the lack of sound testing equipment and practices. At this time, athletes were easily able to avoid detection and were therefore not threatened or worried about being caught. In addition, even when drug tests produced results positive for drug use, athletes could argue, with good reason, that the results had been tampered with or were simply wrong.

Much of the confusion surrounding the ability to accurately detect drugs in athletes was eliminated in 1983 when Manfred Donike, a West German professor, first used gas chromatography and mass spectrometry (GC/MS) to detect drug use in sports. The use of these techniques resulted in accurate and consistent testing procedures that dramatically changed the effectiveness of drug testing. Today, thousands of drug tests, conducted by hundreds of athletic organizations around the globe, are done in almost every sport. Problems, however, still remain, as new drugs and methods are created to beat the tests. In addition, many athletes have begun to decry and speak out against aggressive drug testing policies, claiming that drug testing has become a witch-hunt. As with many issues surrounding drug use in sports, there are many differing opinions about drug detection, as well as a host of ethical issues.

DETECTION METHODS

As the variety and complexity of body enhancing products has increased, the methods of detection have evolved in order to keep up. Today, there are highly accurate and scientific machines and techniques that are capable of detecting most enhancement drugs. These systems, however, can only be as accurate as the samples provided to them. Tampering with samples and the altering of results by technicians will always stand in the way of completely valid and reliable testing procedures.

Gas Chromatography

First used for drug testing in 1983, gas chromatography is one of the most common methods of drug detection. The machine on which this test is preformed—called a gas chromatograph (Figure 7.1)—is able to analyze both urine and blood samples. The sample is inserted into the machine and vaporized (turned into a gas). The sample then goes through a tube and is broken down into its component parts (metabolites): The different metabolites within the sample vaporize at different times, making it possible to identify them. The time it takes each metabolite to turn into vapor is called its retention time. The time differences are recorded and analyzed by the machine, which is pre-programmed to recognize the retention times of prohibited drugs.

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Figure 7.1 Above is a model of the gas chromatography system, which is capable of analyzing both urine and blood. The sample is loaded into the injector and combined with gas, which causes the sample to vaporize. In this gaseous form, the detector is able to identify the various metabolites that make up the sample and determine if any illegal drugs are present.

Figure 7.1 Above is a model of the gas chromatography system, which is capable of analyzing both urine and blood. The sample is loaded into the injector and combined with gas, which causes the sample to vaporize. In this gaseous form, the detector is able to identify the various metabolites that make up the sample and determine if any illegal drugs are present.

84 BODY ENHANCEMENT PRODUCTS Mass Spectrometry

Along with gas chromatography, mass spectrometry is one of the most common ways to detect the presence of prohibited drugs. Mass spectrometry is very similar to gas chromatography. The sample is transferred to a gaseous state and then analyzed. The difference is that a mass spectrometer uses an electron beam to separate the sample into its different ions according to their mass. The machine is able to separate all of the ions into groups and measure their concentrations. The metabolites for many enhancement drugs have their own unique structure. The machine is able to analyze the image created by the electron beam and identify specific drugs. Typically, a sample is first run through the gas chromatography phase and, if it is found to contain illicit drugs, it is then run through the mass spectrometer to confirm the initial results.

Immunoassays

Immunoassays are another way to detect foreign substances in urine samples. Immunoassays detect antibodies, which are proteins produced by the body as part of the immune response that can recognize and bind to a specific substance. To test for illegal body enhancing drugs, scientists find antibodies for the metabolite traces left by drugs in the urine. The urine and a solvent that contains the antibodies are mixed together. Scientists are then able to tell whether a drug is present by the reaction between the two substances. Immunochemical assays are very common in all kinds of scientific research. Generally, however, immunoassays are less desirable than GC/MS analyses. Although immunoassays are cheaper and quicker to perform, they sometimes result in false positives. For this reason, GC/MS is the preferred method of detection.

SUBSTANCES USED TO MASK DRUG USE

One of the problems facing drug testers is the fact that there are many drugs and methods athletes can use to avoid drug detection. Drug tests can utilize hair, saliva, and blood samples, but urine is the most common source through which drugs are detected. When a person takes a drug, it is broken down into various components. These components are then absorbed into different areas of the body. Some parts of all drugs are inevitably extracted by the liver and kidneys and released as urine. The components of the drug that end up in the urine are called metabolites. Both dopers and testers are concerned with these metabolites for very different reasons. Dopers use drugs or methods that hide, or "mask," metabolites, whereas testers examine the metabolites in urine to detect various drugs. The most common masking drugs as well as the most common detection methods will be discussed in this section.

Epitestosterone

Epitestosterone is a naturally occurring hormone in the body that is analogous to testosterone. When taken on its own, epitestosterone has no performance enhancing qualities. It also has no serious adverse side effects. Athletes take epitestosterone not for the intrinsic qualities of the hormone itself, but in order to hide the use of testosterone, which does have androgenic effects. Typically, the test for anabolic androgenic steroids and the detection of illegal testosterone use involves calculating the testosterone/epitestosterone ratio (T/E ratio). In the average human, the ratio of testosterone to epitestosterone is one to one. According to the IOC, if an athlete's T/E tests above 6:1, then he or she is considered to be using testosterone. By taking epitestosterone, an athlete is able to manipulate the T/E ratio, balancing out the amounts of testosterone and epitestosterone in the body and avoiding detection.

Secretion Inhibitors

Most foods contain substances called organic acids. Many of the drugs athletes use have properties that are similar in structure to these organic acids. The body, specifically the kidneys, has a protein whose function is to remove acids from substances that enter the body and transport them into the urine to be excreted. Secretion inhibitors act as protein blockers, essentially keeping the protein responsible for acid removal from doing its job. If the protein is disabled, the organic acids are not removed and will therefore not show up on a drug test. Clinically, secretion inhibitors are used to treat gout, a condition involving an overabundance of uric acid in the body. Secretion inhibitors, by blocking organic acids from getting into the urine, can disrupt drug tests. Side effects of secretion inhibitors include allergic reactions, kidney problems, vomiting, and nausea.

Diuretics

As previously discussed, drug tests work by measuring and identifying metabolites in urine. Some athletes, in order to avoid detection, use diuretics. Diuretics allow an athlete to reduce his or her weight because they extract water from cells throughout the body (see Chapter 5). The water that is extracted causes an increase in urine flow, which, in turn, dilutes the amount of drug metabolites in the urine and makes them harder to detect.

Plasma Expanders

Plasma expanders work by increasing the fluid component of blood. They are often used by emergency medical responders to stabilize victims who have experienced massive blood loss. When a person loses too much blood, he or she is susceptible to shock and, if blood loss continues, death can result. Plasma expanders act as artificial blood by increasing the total volume of blood in the body. Plasma expanders have no significant side effects, except the possibility of allergic reactions. They can also be used as masking drugs, because they dilute the concentration of illegal substances in the blood, making them harder to detect. Specifically, some athletes use plasma expanders to hide the use of erythropoietin (EPO).

Additional Methods of Avoiding Detection

While some athletes use drugs to mask other drugs, the most common methods used by athletes do not involve the use of any natural or artificial substances at all. One method athletes use to avoid detection involves urine switching. That is, before an athlete is tested, he or she gets a sample of someone else's urine and uses it to pass the drug test. This method, though effective, has become rare and more difficult as testing agencies now frequently require the athlete to produce the sample at the testing site.

Perhaps the most common method of avoiding detection as well as the biggest problem testers face is the use of time. All drugs have what is called a "period of detectability." This means that all drugs are broken down, used, and discarded by the body in a certain amount of time, called the drug clearance time. If an athlete knows how much time it takes for a certain drug to leave the body and knows when he or she will be tested, simple math will allow the athlete to avoid detection. The situation is complicated, however, by the fact that different drugs have different clearance times. Anabolic androgenic steroids, for example, have much longer clearance times than stimulants. The most effective way to deter this practice is the use of random testing, in which the athlete has no idea when a drug test might take place.

CURRENT PROBLEMS AND ETHICAL ISSUES

As drug detection technology continues to improve and scientists are better able to accurately test large groups of athletes, the ethical issues of drug testing increase as well. One major problem facing testers is the use of new enhancing drugs that cannot be detected. Today, there are no completely accurate tests for many drugs such as human growth hormone and

EPO. Illegal use of these substances cannot be detected because they are found naturally in the body. If a test to detect their presence were used, no human being could pass. Although there are tests being developed for these enhancement products, the creation of more undetectable drugs to take their place can be expected.

Another problem facing today's sporting organizations, if they wish to eradicate or control drug use, is the disparity between the resources for testers and the resources for dopers. Doping is a big business with millions of dollars at stake. Although many of the drugs can be obtained legally over the counter or from other countries without restrictions, there are many others that must be obtained by illegal means. Much like the drug dealer selling cocaine or heroin, the dealer selling doping products, often called a "guru," works in a high-risk, high-reward business. Even though gurus can expect serious legal consequences and jail time if caught selling illegal substances, the money athletes are willing to pay for their services seems to justify the risk for many gurus. As long as there is more money invested on the guru side of the doping game than on the tester side, the gurus will inevitably have the advantage.

While new drugs and a lack of funds will probably always haunt their work, drug testers are also continually stalked by the ethical implications of their work. One ethical dilemma related to drug testing is the occurrence of mistakes. Many athletes feel that because of the possibility of testing mistakes, which could result in unfair suspensions, testing should not be used. This argument, however, is increasingly hard to make as the drug testing process becomes more accurate. Another issue arises from the extreme complexity of doping control and the number of prohibited substances. Many of the substances prohibited by athletic organizations can be found in clinically useful and common medications. This means that many athletes will test positive for drugs that are being used to treat health problems and not to enhance performance. In addition, testers are often criticized for concentrating so heavily on the use of doping agents that they are ruining sports. Clean athletes will often complain that the attention given to the doper stains the sport and hurts the reputation of all participants. Whether you personally side with the arguments of the dopers or the testers, one thing is clear: Both will continue to jostle for victory in the doping game of the future.

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