Who are the dopes?

On Saturday, Tour de France winner Floyd Landis will be told the results of the analysis of the second part of his controversial, apparently testosterone-full urine sample.

And on Monday, Justin Gatlin, the world’s fastest man, will have an opportunity to explain his own abnormally high testosterone readings to a disciplinary hearing in America.

It all means that doping stories will be all over the sports sections for another few days. American sportswriter Jim Ferstle reviews the coverage thus far, and offers some advice on how to cover such sensational stories better

“The sport’s been dragged through the mud again,” said Paula Radcliffe after the latest doping scandal began infiltrating the news last week.

While Radcliffe was referring to the talk of gloom and doom that enveloped athletics over Justin Gatlin’s adverse analytical findings for testosterone, Floyd Landis, the 2006 Tour de France champion, brought unwanted notoriety to the sport of cycling as he was being investigated for a similar finding made after the crucial 17th stage of this year’s race.

Because neither athlete has been formally charged with a doping offence and the test for determining whether or not an athlete has used testosterone, its precursors, or related banned substances is more difficult to interpret and adjudicate, there has been almost as much written about the science as anything else about these cases. A refreshing change from the usual scandalised reports.

The coverage from outside the United States has centered primarily on the impact these cases will have on sports that have still not recovered from past doping scandals. Overall the coverage has been accurate and comprehensive. The need to explain to the public what this test does, why it has generated controversy in the past, as well as what the accused athletes’ legal teams are preparing as defences, has increased the number of stories about the affair and provided science writers work in sport.

But the one glaring issue in the coverage has been the tendency by most media to declare that both Landis and Gatlin have “tested positive”. They have not.

The facts are that, as yet, both are being investigated because of “adverse analytical findings” in their respective dope tests. This may seem like splitting hairs, but it is a fact.

Landis’s B sample test results are not finished. While the probability is high that the B will confirm the A (an announcement is expected on Saturday), if it doesn’t then there is no charge to answer against Landis. So, it’s accurate to say that he’s being investigated for a possible doping violation.

The same goes for Gatlin, who is further along in the process, but still has not had the details of his test results vetted by a review panel, a necessary step similar to the Grand Jury process in the US where evidence is presented and the jury decides whether or not there is enough to warrant a trial based on that evidence.

First Landis, and then his lawyer, Howard Jacobs, have lashed out at the media and whoever was responsible for leaking allegations about the test results, noting that this was unfairly prejudicial.

Now this will be considered by many to be irrelevant if the athletes are ultimately convicted, but many media outlets, especially those in America, received angry letters or e-mails from readers claiming that the coverage was unfair, biased and inaccurate.

“As an engineer by trade, I know that on most issues there is more to the situation than meets the eye, and I get tired of the ‘sound-bite’ journalism because it provides little useful information,” wrote Jack Mulder of Oregon in response to an article run on the cycling website VeloNews. “Please let your editors know that there are people out here who are looking for real information, not just the latest tidbit of news/gossip. You’ll have an audience if the articles get written.”

This sort of “reader response” may be some form of “spin” on behalf of the athletes, but it cannot be denied that the complaint has merit.

It is accurate to say that the athletes are under investigation. It’s not to say they have tested positive. If the results of the subsequent inquests into these tests fail to result in any action against the athletes, then they will have been falsely accused of an offence, but not convicted. They could claim damage to their reputations, their ability to earn money. The financial and public relations consequences of such charges proved false would be considerable. The libel consequences for newspapers and broadcast outlets, and the journalists involved, could be disastrous.

How “clean” is clean?
The story began when the Chicago Tribune‘s Phil Hersh wrote a post-Tour column raising doubts about how “clean” the Tour was from drug use, about whether or not Landis should really be celebrated as a clean champion.

This was before the news broke of the adverse finding in the French lab. During the Tour there had also been articles speculating on whether or not this year’s event was any cleaner than the past, what the impact had been of the investigation into the doping scandal in Spain, and the expulsion of pre-race favorites Ivan Basso and Jan Ullrich before the start of the Tour.

The race had been the most unpredictable in years and ended with the seemingly “feel good” victory of Landis, who had revealed in an article written by Dan Coyle in the New York Times that he had a hip that would need replacement some time after the race. Everyone was celebrating. Greg Lemond, the first American to win the Tour, exulted in one interview that it was wonderful Landis won because Landis was “clean”.

Then came the announcement of the finding in the French lab and the feel good story turned into a search for facts, assessment of the impact this would have on the Tour and cycling, and an examination of Landis and the potential charges he faced. Landis attempted to regain control of the story by doing a teleconference, a sit down news conference and an interview on CNN’s Larry King Live. He proclaimed his innocence, urged others to wait until all the facts were in before reaching a conclusion about the charges and portrayed himself as the victim of an unexplained abnormal test.

The initial coverage ranged from “Say it isn’t so, Floyd” to “This will be the death knell for the Tour”. The French paper L’Equipe reported that Landis’s A sample was not only showing an abnormal ratio of testosterone to epitestosterone, but that the separate IRMS carbon isotope analysis indicated that Landis’s urine contained synthetic testosterone.

It was subsequently reported in the German media that Landis’s T:E ratio was 11:1 on the A sample.

All of this seemed to contradict what he had said in his press conferences that he had a natural “abnormal” testosterone level and that he would prove that the A test finding was the result of this and not doping.

The initial reporting on Landis centered on his news conferences, his family and the reaction in his hometown, and attempts to pry details of the A sample test and reactions from cycling officials. As evidence mounted against Landis, the coverage turned from mildly sympathetic to accusatory.

Then came the Gatlin statement. He, too, had an adverse analytical finding for testosterone, he said, and his case would soon go before a review panel. He said that he didn’t know the reason for the adverse finding but he and his legal team would attempt to explain it. He was innocent of doping, he said. His lawyer, Cameron Myler, acknowledged the facts of the case and noted that one option available to them was to petition under the adverse circumstances provision of the rules on a doping violation.

Prior to Gatlin’s announcement, The Guardian ran stories that examined the tests used for detecting testosterone. In August 2004, WADA, the World Anti-Doping Agency, had changed the threshold for reporting an adverse analytical finding from 6:1 – the level at which the test was established in the early 1980s – to 4:1. But Duncan Mackay reported that UK Sport had asked WADA to return to the old 6:1 threshold because of the 45 adverse findings for testosterone in the last five years, only 15 had resulted in sanctions.

Also in The Guardian, Michele Verroken wrote a column noting that the WADA yearly summary from accredited drug testing labs around the world showed that there had been 392 adverse analytical findings for testosterone in 2004, when the ratio was still 6:1, and 1,132 in 2005 after it had been lowered to 4:1.

These facts reinforced what UK Sports data indicated that there were more adverse analytical findings than athletes sanctioned for testosterone. Left unanswered is “Why”?

Testosterone testing: a brief history
The testosterone test had its genesis with the late Manfred Donike, who ran the Cologne drug testing lab in Germany and was the driving force within the Olympic and international athletics medical commissions during the developing years of the both those groups. Himself a former cyclist, Donike had been ambivalent about doping. Indeed, in an interview with British sportswriter Steven Downes, Donike admitted using amphetamines during his competitive career in the 1960s. “Things were different then,” Donike said in explanation.

In 1980, Donike the drug-tester took the leftover urine samples from the Moscow Olympics back to his lab to study them further. What he found was what he believed to be evidence of massive amounts of testosterone abuse. Donike had done some research into potential tests for detecting testosterone use and had discovered that a ratio between testosterone and its epimer, epitestosterone, was seemingly constant.

Donike determined that the “natural” ratio of testosterone to epitestosterone (the T:E ratio) was 1:1 or 2:1. In the Moscow samples he found a cluster of test results in the 4:1 to 6:1 range, and another cluster above 6:1.

He concluded that the athletes in Moscow, where they were testing for anabolic steroids, had been using testosterone in order to beat the tests for anabolics. He convinced the IOC to use the T:E ratio to test for testosterone. The test was introduced in time for the Games in Los Angeles in 1984. There, the first person to be sanctioned for testosterone use by the IOC, a Japanese volleyball player, had a ratio over 10:1.

The Japanese were so mortified by the positive test that they isolated the athlete, monitored his T:E ratio and discovered that he always had this same “abnormal ratio”. He was what is known as an “outlier”, somebody who falls outside the normal range of the test, but not through use of a banned substance.

So alterations have had to be made to the T:E test over the years. A Scandinavian study later found that tests on non-athletes also revealed a significant number of outliers, so longer term studies of individuals who returned adverse analytical findings for testosterone over the 6:1 threshold were ordered to determine whether or not they were outliers.

It was also found that other issues influenced the test. British 800 metres runner Diane Modahl was ultimately cleared of any doping violation when it was discovered that a bacterial growth in her urine sample had altered its T:E ratio. In other studies, alcohol was shown to influence the ratio.

All these issues caused the labs to look for another way to confirm that an adverse finding on the T:E ratio really had detected a doping violation. They needed to differentiate between synthetic and natural substances. Another ratio – that between the carbon 12 and carbon 13 molecules – was discovered to be proof of the use of synthetic testosterone.

Thus now the WADA protocol for T:E testing requires that any adverse finding that appears to indicate testosterone abuse be confirmed using the IRMS carbon isotope test.

Gatlin caught by a “trick”
Another interesting element of the Landis-Gatlin coverage has been the willingness of the WADA/IOC lab directors to speak out on the issue, attempting to explain the test and the issues. They have vouched for the test’s effectiveness and explained how it works. The director of the Swiss lab even put out a call for more research into testosterone testing, noting that it needed improvement to keep up with the tricks athletes were using in an attempt to beat the tests.

One “trick” that the US Anti-Doping Agency pulled was to analyse all the samples at the Kansas Relays, where Gatlin’s adverse finding came from, with the IRMS. They didn’t require an adverse finding on the four markers they use to detect potential testosterone abuse, they simply spent the extra money to test every sample collected for synthetic testosterone using the IRMS.

Gatlin is the first to acknowledge an adverse finding resulting from this practice. It is not known whether or not he was the only one discovered.

WADA had lowered the ratio from 6:1 to 4:1 because it was believed that athletes were still abusing testosterone, but were able to avoid detection by monitoring their usage so that they would not exceed the 6:1 detection trigger. Dropping to 4:1 gave the athletes less margin for error.

The cat and mouse game continues. The questions are already being asked whether these potentially high-profile busts indicate a closing of the gap between the testers and those attempting to beat the tests. The other question frequently asked is what will be the impact of these cases on their sports. The majority opinion is that the drug abusers are still ahead of the testers.

One thing is clear, however: it’s not about catching everyone who cheats, it’s about having a meaningful testing process that protects the reputation of those who don’t.

The often heard excuse of dopers, that they do it because “everybody is doing it”, has grown as it has been clear that athletes had found ways to dodge testing positive and continue to use drugs. Until an effective drug testing system is sufficiently funded armed, and deployed there will be more doping scandals, less belief that the top athletes are clean and more sports being “dragged through the mud.” Until athletes no longer believe that “everybody is doing it”, everybody will be tempted to do it and the cycle of doping scandals will be never ending.

Click here to read the considered opinion on the subject of Simon Barnes, of The Times

Some useful links:
UK Sport: anti-doping agency in Britain
Drugs in Sport News: daily digest of articles
Anabolic Steroids in Sport: does what it says on the tin, American-based site
White House doping policy: US government policies
World Anti-Doping Agency

Jim Ferstle is a freelance sportswriter based in Minnesota who has specialised in doping issues in sport for two decades