09 Jan, 2015

Side Effects - Cogs, Drugs and how we roll

The Anti Doping portion of the seminar caught my attention. When lawyers invite clients for a seminar with free coffee and pastries involving the anti-doping constabulary, you know things will be interesting. No-one left disappointed. SAIDS (The South African Institute for Drug-Free Sport) shone a beam into the grey cavern of anti-doping and the fight against performance enhancing drugs (PEDs). SAIDS is responsible for eradicating doping in South African sports.

It reminded me of an anaesthesiologist friend of mine. Some of her patients, before the anaesthetics kick in, think that the drugs won’t have any effect. They count down from ten and are out before they get to seven. “The drugs” she smiles “always work”. As I sat in the auditorium, those words resonated.

To understand the world of anti-doping, it helps to go back in time.

Three thousand years ago, the first reported examples of crude PEDs sprouted from the ancient Greeks and their alcoholic and hallucinogenic potions used as sporting accessories. The rampant progression of PED usage became noticeable after the first modern Olympic Games of 1896. First came the alcohol and amphetamines for the brain, followed by steroids for the muscles and later, particularly in cycling and other endurance sports, the holy grail of boosting oxygen in the blood.

The first Olympic Games doping case is from 1904. A marathon runner almost died from his own formula of brandy and rat poison. These were the early days of experimentation when few understood the hazards of doping. Athletes used an array of stimulants, cocaine and heroin to name but a few, to gain any advantage.

The first death of a cycling celebrity predates the 1904 Olympic Games and the inaugural 1903 Tour de France. In 1896, a Welshman died two months after winning the 560km Bordeaux to Paris cycle race. A concoction allegedly distributed from his manager’s little black bottle containing cocaine, caffeine and strychnine was the PED.

The great wars of the 20th Century which followed provided ideal testing grounds for countries to test PEDs on their citizen soldiers. The preferred drugs were usually amphetamines to create a stronger, more alert and aggressive warrior. Benzedrine, an amphetamine trade name, was issued in US field medic first aid kits. The German Panzer crews referred to their booster pills as tank-chocolates.

In 1953 my dad, a teenager at the time, remembers listening on the radio to Fausto Coppi racing Hugo Koblet up Italy’s Stelvio Pass. The war had been over for a few years with much of Europe still in the grip of the post-war depression. The radio and cycling became ideal means of escape. 1953 was the first year that the Stelvio, the second highest mountain pass in the Alps, was included in the Giro D’Italia.

Koblet’s amphetamine stare suggested he was overcooked. Coppi, no stranger to drugs, commented that he was just as dishevelled as Koblet. Today, people would be horrified at the frank openness of riders admitting amphetamine usage. At the time, drugs were standard issue in the cyclist’s fuelling regime as long as it did not significantly distort the playing field. Many thought it did not. Each rider, the peloton concurred, had access to the same pills as his adversary. No harm done. Coppi’s victory up the Stelvio and as overall Giro winner remains as one of cycling’s greatest ever victories.

Almost 60 years living in South Africa hasn’t erased the Italian origins from my dad’s accent.

“Everyone knew they were taking something. No-one thought it strange. Like students at the time who took drugs to help them study through the night. Cyclists used the same things in their races. Although drugs were discouraged, they were rarely frowned upon”.

What about today’s cyclists, I asked.

“Today the drugs are more sophisticated with many side effects. It’s getting dangerous and the people seem to be willing to do anything. Remember, in the early days, no-one knew that much. That’s all changed. Cycling’s changed.”

Some argue that the catalyst for the advent of concentrated doping efforts in sports was triggered by the descent of amateur sports into professionalism. Amateurs competed in their spare time for the rewards of fairness, honour and for the pure joy of taking part. Professionals were effectively full-time athletes competing for money and to win at all costs.

Critics lambasted professional sportsmen and their primary pursuits of money and victory. They feared that creating a sports profession brought out the worst in man and, more importantly, degraded the purity of the sports. Chasing money meant shortcuts and an entanglement with dishonesty and corruption.

Whether professionalism contributed to a slant towards cheating or not, history sheds light on how PEDs were at one time part of the ordinary arsenal of the professional cyclist. Like having access to high performance racing wheels or electronic gear shifters for today’s riders. And yet it shows how the tide shifted with cycling’s perception as a pariah - a breeding ground for swindling federations, dishonest teams, doped up athletes and fraudulent pharmacologists. It is a perception which cycling has struggled to overcome.

The first cyclist to die in the modern Olympics as a result of doping was Danish. The autopsy revealed traces of amphetamines in his system. It was the 1960 Summer Olympic Games in Rome. His death received little attention.

It was the death of an Englishman on Mont Ventoux that had any consequence. After washing down amphetamine pills with brandy, Tommy Simpson, his knuckles still clasped to the handle bars, rode up the mountain to his death. His televised death in 1967 was the preamble to an International Olympic Committee (IOC) medical commission in 1967 and drug testing in 1968.

Thirty years later the World Anti-Doping Agency (WADA) was established largely influenced by the doping incidents emanating from the Festina Affair, summarised below. Of the numerous drug incidents and scandals in cycling, below are some pearlers to share with your fellow wheelmen:

Eddy Merckx – one of all cycling’s all-time greats also known as ‘The Cannibal’. Merckx’s stained credentials include testing positive three times for doping in: the 1969 Giro d'Italia, the 1973 Giro di Lombardia and the 1977 Flèche Wallonne.

The Festina Affair
Willy Voet, the masseuse for the Festina cycling team, was arrested transporting large quantities of syringes, narcotics, growth hormones, testosterone, amphetamines and erythropoietin (EPO) into the 1998 Tour de France. Richard Virenque, regular King of the Mountain at the Tour wrote a book in 1999 asserting his innocence called My Truth (Ma Vérité). A year later, Richard together with his eight fellow Festina riders finally confessed to using EPO and other substances.

Operation Puerto – the Spanish police obtained a warrant to search the fridge of one Dr Eufemiano Fuentes. The police found 186 blood bags in his Madrid clinic, stored for purposes of blood doping, belonging to an array of professional cyclists, footballers and tennis players. Dr Fuentes was quoted as saying "If I would talk, the Spanish football team would be stripped of the 2010 World Cup".

Also known by the names Zumo (juice in Spanish) and Edgar Allen Poe, Dr Francesco Conconi is renowned for working on the idea of athletes transfusing their own blood in the 1980s and introducing EPO to the sport of cycling circa 1990. Dr Michele Ferrari, former doctor to Lance Armstrong, was a student of Dr Conconi and proponent for EPO usage. EPO improves oxygen delivery to muscles directly improving endurance capacity, however it is responsible for the death of several riders through sludging of the blood. To avoid dying in their sleep, cyclists would set an alarm each night to wake up and exercise for ten minutes to kick-start their circulation.

Betsy Andreu is the wife of former rider, Frankie Andreu. Frankie rode for the tainted US Postal Service cycling team under team captain, Lance Armstrong. In 1996, Betsy and Frankie were present in the doctor’s room when Lance allegedly revealed to his two cancer doctors that he had been taking an assortment of PEDs. Despite being vilified by the Armstrong-hate-machine and press, Betsy never capitulated and played a significant role in Armstrong’s downfall. She became a no-doping spokesperson for the US Anti-Doping Agency True Sport Campaign for student athletes.

Christophe Bassons
A former French professional rider who was outspoken about doping in the Tour which eventually culminated in his retiring from the sport. Bassons refused to take EPO despite being offered a 270,000 francs per month raise to do so. His team mates knew him as the guy who refused to “load the cannon.”

Alexander Vinokourov. Before being the general manager for the professional cycling team Astana, the Kazakhstani was a professional rider. He was found positive for blood doping during the 2007 Tour de France. Accusations were put to Vino that the blood may have originated from his father, to which Vino replied that if that were the case, he’d have tested positive for vodka.

Cycling’s love-hate relationship with drugs explains the current challenges faced by SAIDS with its enforcement obligations orbiting around three key terms:

1. The Prohibited List
2. The Code
3. The Rules

Reading The Prohibited List (also known as the Prohibited List of World Anti-Doping Code), it is simple to understand why you need a degree in pharmacology and access to a team of doctors to partake in the dark art of PEDs. Whereas the media relays elegant stories around EPO and blood boosting, it gets rather tricky explaining to the public that a rider was caught using substances like desoxymethyltestosterone (a synthetic anabolic steroid which the body cannot produce naturally) or methoxy polyethylene glycol-epoetin beta (aka CERA, a third generation EPO). The Prohibited List is updated on 1 January every year to remain aligned with advances in doping.

The anti-doping regulations flow down from WADA in the World Anti-Doping Code aka The Code.

The Code acts as a framework for the SAIDS Anti Doping Rules aka The Rules. Any athlete competing in a sport in South Africa is subject to The Rules. This includes everyone from an Olympic marathoner to a non-professional Saturday-afternoon soccer player. Enforcement is conducted through urine testing of athletes. Each drug test costs approximately R2 300.

Use of a substance or method appearing on the Prohibited List may be permitted under a Therapeutic Use Exemption (TUE). A TUE is granted by SAIDS if there is a doctor’s letter, no therapeutic alternative, and significant health problems would arise for the athlete without taking the prohibited substance or method.

SAIDS will confirm whether a registered medicine falls foul of the Prohibited List. However, this is not the case for supplements (including alternative or traditional medicines) which remain unregulated. SAIDS do not endorse supplements and, from the rising number of tainted supplement cases, should be steered through with absolute caution.

In 2015, new changes to The Code will be implemented. The bans for (i) testing positive; (ii) evasion or failure to submit to testing; and (iii) tampering with the doping control increase from 2 to 4 years. New bans of 2-4 years for complicity and 1-2 years for association are introduced.

And yet, some sporting event organisers do not think these rules are sufficiently severe. The Cape Epic organisers implement their own rules banning anyone found doping after 1 January 2013 from riding or being involved in the Cape Epic. Sighs of relief from the many pre-2013 doping violators echo.

In case it was unclear, all PEDs contain numerous medical side effects. You simply have to read the former East Germany’s state-sponsored drug program from the 1970s and 1980s to be confronted with the resultant deluge of medical problems. Serious liver and heart damage, growth defects, gynaecological issues (including female athletes taking on male characteristics such as facial hair, pronounced jaw bones and a deepening of the voice) and psychological damage were common for athletes under the program.

The list of side effects attributed to each PED is staggering:
• EPO? Thickening of the blood. Increased risks of blood clots, strokes and death.
• Blood Doping? Adds massive strain on the heart. Poorly stored blood leads to serious illness, blood clots, death.
• Amphetamines? Addiction, death.
• Diuretics? Headaches, nausea, kidney damage.

Side effects are measured by hospital visits and body count, however the side effects that should not be overlooked are those to the individual, their families, friends, competitors, team mates, sports fans and cycling.

Retired athletes who took drugs to rise to the top of their sport may be haunted by never knowing whether they could have achieved success without cheating. Some may not. However what bothers me is that cycling, once the purest of all endurance endeavours, may be reduced to just another theatrical sport without real performances or real athletes leaving the fans confused as whether to applaud for or sneer at the peloton.

Was it not the rider who was the most dedicated, the most willing to believe in themselves and take a risk and suffer that made our sport? When was the rider’s fortitude, dedication and natural greatness replaced by the rider with access to the best chemists and PEDs? What do we teach children about winning if we do so at any price?

I often think of the innocent rider: the kid who had a dream and fought against all the odds to be riding in the peloton. The rider who, between all the pain and torment, is clean and holding onto his dreams. Does he have a legitimate option to take part in sport? Or has he been left with no choice at all?

A black and white poster from the 1948 London summer Olympics sits above my work desk. It is a quote from Baron de Coubertin, father of the Modern Olympic Games and founder of the IOC, which says “The important thing in the Olympic Games is not winning but taking part. The essential thing in life is not conquering, but fighting well”.

Words to live by and to pass onto the next generation.
Roberto Riccardi

Roberto Riccardi

Journalist |