Amid Progress, Drug-Testing Still Produces Mixed Results

Olympic drug-testing lab director Donald Catlin said he realized his staff had made a historic breakthrough when it uncovered three positive tests for a new endurance-enhancing drug at the 2002 Winter Games.

But Catlin said his satisfaction at catching three athletes using darbepoetin, a drug introduced to the market just last fall, was countered by disappointment that an estimated 100 suspicious samples sent to the lab during the Games did not produce positive tests despite indications that banned blood-boosting drugs such as erythropoietin (EPO) had been used.

"We found lots of blood parameters that were certainly consistent with the recent use of EPO . . . but I have no proof they took EPO," Catlin said from his lab in Los Angeles. "My guess is that we were looking at people who had used, but their urine [sample] turned up negative because EPO goes away very fast."

The fact that Catlin had information that raised his suspicions -- yet failed to yield positive test results -- may be demoralizing news for drug-free athletes who competed at the Winter Games, but it can also be considered progress of sorts. In 18 months, testing for blood-boosting drugs in Olympic sports has gone from almost nonexistent to increasingly routine and occasionally effective. In fact, an unprecedented amount of testing for endurance-enhancing drugs will take place this summer.

The world track and field governing body (IAAF) announced last week that it would begin unannounced EPO and darbepoetin testing of its elite athletes, starting at this week's world cross-country championships in Dublin. The world soccer governing body (FIFA) also announced plans to conduct such tests at the World Cup, which takes place this summer in Japan and South Korea. Meanwhile, the U.S. Anti-Doping Agency may soon implement a program of endurance-aiding drug testing; officials will discuss the issue during meetings this week, USADA chief Terry Madden said.

Some athletes applaud the skyrocketing testing efforts for stamina-building drugs, which were completely undetectable as recently as two years ago. Yet, some question the efficacy of the testing. In the two Olympics -- the 2002 Winter Games in Salt Lake City and the 2000 Summer Games in Sydney -- in which EPO testing has been applied, the International Olympic Committee found no positive results. (About 300 EPO tests were conducted in Sydney; about 1,000 in Salt Lake City.) Though the combined blood-urine test for EPO was validated by an independent and respected team of scientists in the summer of 2000, it has not been proven reliable in detecting EPO unless the drug is used within about three days of the administration of the test.

IAAF Medical Director Arne Ljungqvist called the EPO test a "reasonably good" test that did not give false positives but couldn't be counted on to catch all cheaters. Still, the test appears to have had a deterrent effect. Days after it was announced that EPO testing would occur at the 2000 Summer Games, a handful of athletes mysteriously pulled out of the event.

"If it scares off one person from using drugs, then it's made a difference," said Deena Drossin, the top qualifier at the 2000 U.S. Olympic trials in the 10,000 meters. "I don't have as much faith that it will catch a lot of people as it will scare people into not doing it. . . . I would suspect there are probably three distance runners in the United States, and about half the field when you go to an event overseas, that are using drugs. That's just an assumption, not a fact by any means."

No one knows how many athletes use endurance-aiding drugs, but the EPO scandal at the 1998 Tour de France, coupled with the fact that the IOC didn't test for such drugs before the 2000 Summer Games, fueled the belief that EPO and similar drugs were used rampantly in distance sports such as cross-country skiing and marathon running.

The three cross-country skiers -- Spaniard Johann Muehlegg and Russians Larissa Lazutina and Olga Danilova -- caught using darbepoetin at the Winter Games represented three more athletes than ever before nabbed using blood-boosting enhancers at the Olympics. Previous Olympic drug-test positives have arisen only for strength-building drugs like steroids or energy-boosting drugs such as amphetamines.

Catlin's lab was able to catch the darbepoetin users for a couple of reasons: Because the drug was so new, athletes had reason to assume it would be undetectable and likely did little to cover up their use. Catlin's lab worked quietly and furiously from the time of the drug's release last fall seeking to alter slightly the standard EPO test so it could also detect darbepoetin, which stays in the body significantly longer than the fast-dissipating EPO.

Never before had any sports drug-testing body managed to blindside athletes by catching them with such a hot new drug. World Anti-Doping Agency Chairman Dick Pound said the darbepoetin positives had made "a huge statement."

"It proves that the IOC is not so behind as everybody thought," said Patrick Schamasch, the IOC's medical director.

Anti-doping expert John Hoberman of the University of Texas said this week that for the first time in more than 20 years he is hopeful that Olympic anti-doping efforts are making significant progress. He cites the political changes brought about by the 1999 inception of WADA under the direction of Pound, who has been brash and outspoken on the topic of anti-doping. (WADA, which spent $5 million on research into genetic doping last year, this week is leading an international genetic doping conference at the Banbury Center in New York.)

Hoberman also points to the ascendancy to the IOC presidency last year of former Olympic athlete and medical doctor Jacques Rogge, who calls drug-testing his No. 1 priority. Rogge last summer replaced Juan Antonio Samaranch, who had led the Olympic movement for 21 years. Hoberman has been extremely critical of Samaranch, saying his tenure represented "wasted years" in drug testing.

"Finally, you have what should have been underway 20-25 years ago," Hoberman said. "How efficiently it's going to work is still a question. . . . [but] this is the first time in human history there is reason for optimism in testing. In the '70s it was pitiful, and the '80s and '90s were under Samaranch."

Catlin, who has operated the IOC-accredited lab in Los Angeles for more than 20 years, agreed that times have changed since the 1984 Olympics in Los Angeles, which featured one of the greatest debacles in drug-testing history. Shortly after those Games, word leaked that a handful of drug-test positives had been inexplicably lost at the Games' conclusion. The missing positives were never found.

"It was very nice to have the support of the IOC, particularly Jacques Rogge," Catlin said about the testing program in Salt Lake City. "It's a different era working with him. He's really up front about all of these things, and out front. He's a no-nonsense person who understands the role of drugs and sports intimately, and he's not afraid of it."

Still, a willingness to deal with drugs doesn't ensure the competence needed to catch the majority of cheaters. Catlin's observations about the dozens of suspicious blood samples taken at the Winter Games aren't the only basis on which to assume that undetected drug use occurred there. After the Games, an assortment of blood transfusion equipment was found in a house that had been occupied by members of the Austrian cross-country ski team. The Austrian federation claimed the equipment was used for ultraviolet radiation treatment of the skiers' blood to prevent colds and the flu -- an explanation Pound called "errant nonsense."

Chuck Yesalis, a Olympic drug expert and epidemiologist at Penn State, said the discovery of the equipment suggests that athletes may have been attempting to circumvent the new blood-testing protocols by blood-doping the old fashioned way: injecting blood that matches theirs in type (or injecting blood of their own, removed months earlier and stored). Athletes who utilize this old-style form of doping get the benefits of EPO or darbepoetin without the risk of testing positive. (The practice, however, is banned.)

"People will just go back to good, old-fashioned blood-doping," Yesalis said. "It does the same thing [as EPO or darbepoetin]. It's not rocket science."

Though the combined blood-urine test used to detect EPO and darbepoetin by the IOC, WADA and a growing number of national and international federations cannot detect blood doping -- or, for that matter, any newfangled endurance-aiding drugs athletes may have discovered -- some federations are getting around that by using basic blood screens to try to prevent athletes from cheating. The catch? The tests don't actually label results as "positives" or punish athletes in any significant way.

The federations for cycling, biathlon, speedskating and skiing have experimented with blood screens to bar athletes from competing on a given day if the results seem abnormal (each has its own standard for what qualifies as an "abnormal"). The tests are labeled "health tests" and are administered ostensibly to protect athletes, who could die if their blood counts get too out of whack. The blood screens help filter out cheating athletes on days of competition without subjecting sports officials to the legal challenges that often follow when an athlete is accused of using drugs.

Savvy athletes, of course, can regulate their blood doping or use of endurance-enhancing drugs to ensure that they pass the "health tests," rendering them all but ineffective.

Catlin said the best way to catch athletes using drugs of any sort is through surprise, unannounced blood-urine tests -- exactly the sort of tests the IAAF says it will implement this summer, targeting the endurance-sport athletes among its 2,000 designated elite athletes. Unannounced testing requires substantial funding (it is more expensive than on-site testing because of the travel expenses of the testers and the cost of transporting samples). It also demands excellent execution by the labs that analyze the samples. Any procedural mistakes will be seized upon by the lawyers of athletes accused of using drugs.

One of the few EPO positives that has arisen in the short lifetime of EPO testing came shortly before the track and field world championships last year in Edmonton. That result, however, was thrown out because the particular testing method used (a urine-only test) had not been properly certified. The Russian runner who tested positive, Olga Yegorova, went on to win the world title in the 5,000 meters despite threatened boycotts from several outraged competitors.

Pound said WADA is pushing for more EPO testing, while studying ways of improving the test's reliability. Is the IOC's blood-urine test, in which the blood test is used as a screen, and the urine test is used as the confirmation, the best method? Is a urine-only or blood-only test a better option?

Will the testing done this summer catch or deter cheating athletes?

"The pressure is going to be heavy on sport to do EPO testing more and more at those types of events where EPO is likely to be used," Catlin said. "Whether sport will pull it off or not is very much a question."