Re: Addict Limited

from the Fat Cyclist blog
--pws

Cycling and Doping: A Solution

July 27th, 2007

A Note from Fatty: Dr. BotchedExperiment and I ride together fairly frequently. When we do, I always try to get him to talk about doping in cycling. I do this for two reasons:

• He knows what he's talking about. Botched is an actual doctor and scientist. He understands the science and where it's going.
• It's entertaining. Botched gets really worked up. He doesn't just think about this kind of thing. He cares about it.

So I've asked Botched to write up his treatise on doping and what cycling should do about it. To my surprise and delight, he has complied. I think you'll find it as interesting as I do.

Some careless and unlucky cyclists are getting busted for doping, and they're really screwing up this year's TDF. What I really worry about is the future. I don't see the current anti-doping program working. Oh, I see it catching a few people, but there are enough data out there to suggest current anti-doping practices are only catching a small percent of the cheaters—and more importantly, I don't feel assured that those who are not getting caught aren't cheating.

Tearing cycling apart might be worth it if the sport was really going to be clean at the end. But it won't be.

The future of doping lies in two places. One is the development of new drugs/methods/masking agents. The other is manipulation of athletes' DNA such that they "naturally" produce more testosterone, human growth hormone, erythropoietin, etc. This is already technically possible and is done to mice all the time. In fact, it's already been done in humans too. "Gene therapy" is a highly active field of research to treat human diseases by altering the DNA of patients such that those patients produce more of some gene than they normally do.

Any way you slice it, the anti-doping folks will always be playing catch-up to the dopers and we'll never be assured of a peleton of clean cyclists or a "fair" winner of races. Instead what we're going to be assured of is more of the same of what we've experienced this year.

The Solution(s)
The solution is to get rid of WADA, UCI, ASO, etc. and re-organize cycling with privately owned teams and a league collectively owned by those teams (as in the NFL). This provides a single body with authority regulate the sport, and a group of people who are financially invested in the integrity AND popularity of the sport. Since that's never going to happen, an alternative is needed.

A paradigm shift is needed. I suggest cycling stop worrying about dopers and doping and start worrying about an even playing field and the popularity of the sport. I don't really care that some riders are using chemicals or transfusions to ride faster; I only care that maybe some are and maybe some aren't and that my favorite riders are being excluded from racing.

You can try to eliminate doping at all costs, or you can try to save cycling. I'm not sure you can do both. I suggest the following changes to current practices and thinking.

1. Switch the focus of doping tests from specific drugs to physiological parameters.
I suggested something similar in a previous post. The top juniors all over the world should have blood work and physiological testing performed a couple times a year. This gives a history hormone levels and performance values against which future deviations can be compared. Using this method, doping isn't only defined by finding exogenous chemicals in the athlete or extra copies of genes; it's defined by an improvement of performance values/hormone levels greater than two standard deviations above "normal" for that athlete.

Given that this is expensive and is too late for current riders (although CSC has recently started doing exactly this for its own riders) another version of this idea is to to use average values derived from the rest of the peleton, instead of individual values. For each hormone/physiological parameter set a cut-off value, and enforce that value.

This is already being done with hematocrit (percentage of red blood cells in blood). WADA and others established that a 'crit over 50 might be dangerous, therefore any cyclist with a 'crit above 50 is held out of competition for two weeks. The testers don't have to demonstrate that the 50 was produced artificially (for instance by detecting the presence of artificial EPO) it's an automatic bar.

There are several ways of increasing your hematocrit, some are considered doping, some are not. Most of the peleton rides major races with a hematocrit very near the 50 cutoff. Why then, does it matter if one rider gets to 49 hematocrit by using an altitude tent, another goes and lives at 12,000 feet of elevation, another uses EPO, and another uses a blood transfusion? The result is an equal playing field with all the riders at a crit value of about 50.

Similar cutoff values could be established for many hormones and physiological parameters, such as testosterone, human growth hormone, hemoglobin content in blood, and glucocorticoid hormones, to name a few off the top of my head. I suggest that the cut-off values to be considered doping be quite stringent. I'm not suggesting dropping all testing for exogenous chemicals, since some are very easily detected and obviously go beyond the bounds of an even playing field (such as anabolic steroids).

2. Eliminate medical exemptions for high physiological parameters.
Since the future of fighting doping lies in tracking the physiology of individual riders and/or establishing cutoff values for physiological parameters, this is an essential aspect of leveling the playing field. Right now you can race with a hematocrit over 50—if you have a note from a doctor stating that your 60 hematocrit is a naturally occurring value. Depending on the drug/parameter in question, getting an exemption can be as easy as having your hometown doctor fill out a form.

As new, undetectable drugs are developed and as gene doping becomes a reality, it will be impossible to sort out who has a naturally occurring "naturally high" value and who does not.

As for exemptions to use certain (potentially) performance enhancing drugs to treat medical conditions, I think some official agency (I can't believe I'm really about to suggest WADA be in charge of something) should be in charge of this, and riders should actually have to demonstrate the medical condition for which they seek treatment.

Racing bikes for a living is not an inherent right of human kind. If your natural hematocrit is 55, then if you want to race bikes, you'd better do something to keep it under 50 during competition.

3. Reduce the punishment for positive tests to a two week suspension.
This accomplishes 4 things.

•  It allows cycling to try to clean itself up and level the playing field, AND still have a sport people care about at the end of the process. Under the plan I suggest, more cyclists will test positive, so kicking them all out isn't a reasonable solution.
• It reduces the pressure on the anti-doping system. Riders will stop fighting for their lives when they are accused of doping; financially and emotionally, it won't be worth it any more. Currently guys (rightly so) try to tear down the system trying to save themselves, and frankly the system isn't robust enough to handle it.
• It reduces the focus on punishing dopers and dopers defending themselves, which are both very negative for the sport.
• It will allow cycling to more fairly implement new testing procedures and make the cut-off values for being considered "positive" more stringent. If someone is actually innocent, then you didn't ruin their lives.