A Sports Prescription

It is only partly in jest that some refer to the world’s premier bicycle race as the “Tour de Lance.” Lance Armstrong, who won an unprecedented sixth straight Tour de France last month, brought a sense of determination, hard work and grit back to the 21-day cycling race, which had been disgraced by a widespread drug scandal in 1998. One day, however, the 32-year-old Texan, who won his first tour two years after undergoing treatment for cancer, will retire from cycling and attention will return to the sport’s biggest problem – drugs.

It’s not only cycling but many sports. But since January 2003, eight elite cyclists have died. Seven, the youngest 16, died of heart ailments; the eighth of a cocaine overdose. There is no direct proof that these racers were using performance-enhancing drugs – autopsies only showed that a heart attack occurred, not what caused it. However, it would be an amazing coincidence that seven young people who were in top condition just happened to drop dead over 13 months. Fellow racers and sportswriters have laid the blame on erythropoietin or EPO, a banned synthetic hormone that boosts the production of oxygen-carrying red-blood cells.

The International Cycling Union has been criticized for not being aggressive enough in its drug testing. The same has been said of the World Anti-Doping Agency, the International Olympic Committee as well as national and sports governing bodies. The problem with this thinking is that drug users and makers are always a step ahead of the drug testers. It often takes years to develop a test to detect a banned drug; by then a different drug is being used. Just weeks before the Olympics begin in Athens, officials pledged to develop a test to detect human growth hormone, a substance that has illegally been used by athletes since the 1960s.

Instead of banning all performance-enhancing drugs, a good argument could be made for setting limits on their use. The International Olympic Committee, for example, has set a limit on the amount of testosterone that athletes can have in their body. The intent was to stop the illegal use of the male hormone without punishing those with naturally high levels, so the level was set fairly high. The result is that many athletes take the hormone, but not too much to surpass the IOC requirements.

The International Cycling Union took a similar approach with EPO. Since it mimics a naturally occurring hormone, the union set a limit on the total blood volume that can be made up of red blood cells. Again the limit was set high, but not dangerously so.

Efforts to stop drug use have failed. An alternative may be to set safe levels for their use. This approach, as unsavory as it sounds, has the advantage of ensuring that athletes safely use drugs that they are now often injecting on the sly and without medical supervision.