They're Not Pros, but They Cheat Like Them

By Laura S. Jones
Special to The Washington Post
Tuesday, August 5, 2008

The International Olympic Committee will conduct 4,500 tests for performance-enhancing drugs at the Beijing Olympics this month. Good, you may think; they need to catch the drug cheats.

But what if that term applies to you and other weekend warriors?

Ridiculous? Maybe not, if performance-enhancing drugs include not only amphetamines, steroids and human growth hormone but also the common stimulants that experts and athletes say a growing number of people have begun using.

Endurance events have exploded in popularity, particularly among older athletes. Over the past four years, membership in USA Triathlon, the main sanctioning body for many triathlons and other multi-sport events, has doubled to 100,000; about seven times as many train for these events as take part in them. The number of Boston Marathon runners ages 40 to 59 has nearly tripled since 1997, to more than 10,000 this year, close to half the field.

And although the vast majority of participants compete for good health and fun, experts say a growing number are using painkillers, caffeine (in pill and standard liquid form), decongestants and asthma drugs to get an edge by increasing their energy and the flow of oxygen-carrying blood.

Because few amateur events test competitors for drugs, there are no hard data to back up these claims, but experts such as Charlottesville internist Martin Katz offer plenty of anecdotal evidence.

Katz says he gets requests for asthma inhalers from patients training for races who probably don't need the drugs. An athlete himself, Katz usually gives these patients the benefit of the doubt, but when "the symptoms don't sound typical," he suggests the patient get tested for exercise-induced asthma.

Olwen Huxley, a USA Triathlon-certified coach, a former rower for the U.S. national team and multi-time Ironman finisher, says she's seen an explosion in the number of inhaler devices left on the beach after the start of a triathlon's swim stage.

"When you start feeling your age ," says Huxley, "you are as subject to giving in to the allure of performance-enhancing drugs as an Olympic athlete."

Ethics aside, the practice is risky. When combined and used to boost performance, sports doctors say, these stimulants can endanger health, particularly for older athletes.

"People have come into my office with cardiac arrhythmias caused by combining a Red Bull habit with Sudafed," says New York internist Gary I. Wadler, who helps pick the drugs banned by the World Anti-Doping Agency, or WADA. "Drugs are for medical conditions. Being an athlete is not a medical condition."

Katz agrees. "The problem is that stimulants will elevate your heart rate, and combining them is a bad idea."

One reason drug abuse might be more prevalent at all levels of sport than it was 30 years ago, says former University of Virginia head strength and conditioning coach Derek Laing, is that there are simply more drugs. So "when people reach the limits of their God-given talent, and they don't want their dream to end there," he says, it's easy for them to explore what drugs can do for them.

An informal survey of four Internet sports forums (USMS.org, Slowtwitch.com, Letsrun.com and CuttingEdgeMuscle.com) showed a range of attitudes among amateur athletes.

Some posters freely offered advice on which drugs to take and when. Others spoke out vehemently against doping. But even among those who condemned the practice, many admitted to using caffeine and ibuprofen as performance boosters before and during races. (Caffeine, unregulated by WADA, is up for reconsideration as a banned substance, Wadler says.)

On the Letsrun.com forum, a poster asked, "Are there any performance-enhancing drugs that any recreational runner is able to pick up at a pharmacy w/out a prescription? Drugs that obviously aren't meant for performance enhancing but are?" Replies a fellow poster: "Creatine [an over-the-counter dietary supplement and muscle builder], caffeine and other stimulants found in cold medicine, allergy medicine or weight loss pills."

Those in search of a drug boost can get the ingredients from any convenience store. Or they can, as one poster on CuttingEdgeMuscle.com suggested: "Just tell a doc you tried Tramadol [a prescription opiate] for back pain and it worked great. Then take it with caffeine 30 minutes before a race for a big boost."

Jim Clemmons, 57, a masters swimmer from Dublin, Calif., described his tamer formula in an e-mail interview: "One ibuprofen, one Red Bull, a caffeinated energy drink, and wash em down with a cup of coffee about 30 minutes before high intensity demand. Ready to go."

Ed Hickey, 40, of Madison, Wis., says he and fellow cycling racers shrug off stimulant use. "I know lots of people who pop Sudafed to enhance their performance and pound Cokes and Red Bulls. " Hickey notes that most of the benefit is probably psychological.

Race organizers have done little to combat the practice, but that may change. "Sport," Wadler says, "should be a contest of character, not a contest of pharmacology."

Dean Jagusch, 30, a coach and a former triathlete from Baltimore, says one of the big problems in triathlons is that you have amateurs racing beside pros. "They see what the pros are doing -- No-Doz strapped to the bike, for example -- or something worse. And they'll follow their heroes." And the sport's headlines have been telling us lately that these heroes, at least some of them who competed last month in the Tour de France, definitely aren't clean.

USA Triathlon is considering testing all athletes, pros and amateurs, who compete in its events. Skip Gilbert, executive director of the organization, says, "Given what you hear, you just don't know. [Performance-enhancing drugs] are on our radar."

Gilbert is mostly concerned about steroids, EPO (erythropoietin, a substance that boosts red blood cells' oxygen-carrying capacity) and human growth hormone, drugs that have not only a reputation for improving athletic performance but also the potential for dangerous side effects. But he says stimulants might be included in testing as well.

Jagusch notes: "The whole amateur side of it, people take it too seriously. They think nothing of spending all their savings on equipment when all they need to do is train more and lose weight. Why wouldn't these same people, looking for an edge, turn to drugs? It's a Type A personality, where their goals are the be-all and end-all of their existence."

Wadler agrees. "Absolutely, a 45-year-old who spends $10,000 on a bike will find a doctor who will help with a friendly diagnosis" to get a drug with performance-enhancing abilities, whether it is a stimulant or a steroid.

So will you have to produce a urine sample after your next triathlon or masters swimming race? Maybe.

But Jim Miller, past president of US Masters Swimming, national team physician for USA Swimming and a doping control officer for FINA (the international governing body of swimming), is doubtful that's the answer.

"If you start drug testing in masters sports, you are as likely to catch a 75-year-old legitimately taking hormones for prostate cancer" as you are to find a steroid abuser, he says. He's pushing instead for more education about ethics and health risks.

Charlottesville triathlete Travis Mawyer, who says he refuses to take performance-enhancing drugs, wishes more people thought about the ethics. In an e-mail, he wrote: "I do have a sense of morality, integrity and honesty which seems to take precedence over my desire to be a better athlete. That is not to say the thought [of taking Sudafed or getting an inhaler] hasn't crossed my mind. I just let it slide on in, through and out of my mind."

Laura S. Jones, a freelance writer and recreational athlete who lives in Charlottesville, is an ACSM-certified health fitness instructor. Comments:health@washpost.com.


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