Medicine and science in the fight against doping in sport / D.H. Catlin, K.D. Fitch, A. Ljungqvist. – (Journal of Internal Medicine (2008) 264 (Aug) : p. 99-114)

• DOI: 10.1111/j.1365-2796.2008.01993.x.

Content:

- Introduction

• The IOC medical commission era
• The WADA era

- Detection of doping substances and methods

• Stimulants detection by gas chromatography Anabolic steroid detection by ummunoassay
• Gas chromatography-mass spectrometry and liquid chromatography-mass spectrometry
• Detection of testosterone and other endogenous steroids
• Isotope-ratio mass spectrometry
• Erythropoietins
• Flow cytometry to detect blood doping
• Human growth hormone
• Profiling of blood or urine: longitudinal testing, passports and volunteer programs
• Dietary supplements
• Designer anabolic androgenic steroids
• Rapidly deployed proactive methods

- Doping controls at Olympic games
- Therapeutic use of prohibited substances
- Conclusions

The fight against doping in sports commenced as a result of the death of a Danish cyclist during the Rome Olympic Games in 1960. The International Olympic Committee (IOC) established a Medical Commission (IOC-MC) which had the task of designing a strategy to combat the misuse of drugs in Olympic Sport. Some International Sport Federations (IF) and National Sports Federations followed suit, but progress was modest until the world's best male sprinter was found doped with anabolic steroids at the Olympic Games in Seoul in 1988. Further progress was made following the cessation of the cold war in 1989 and in 1999 public authorities around the world joined the Olympic Movement in a unique partnership by creating WADA, the 'World Anti-Doping Agency'. The troubled history of the anti-doping fight from the 1960s until today is reviewed. In particular, the development of detection methods for an ever increasing number of drugs that can be used to dope is described, as are the measures that have been taken to protect the health of the athletes, including those who may need banned substances for medical reasons.

Related cases:
AAA No. 77 190 00288 08 USADA vs Jessica Hardy
May 30, 2009
CAS 2009_A_1870 WADA vs Jessica Hardy & USADA
May 21, 2010
CAS 2011_O_2422 USOC vs IOC
October 4, 2011

In the matter of the Arbitration between claimant USADA and respondent Jessica Hardy, agree that testing of the supplements used by Respondent JESSICA HARDY in July 2008, has not yet been completed; and agree that the completion of the supplement testing is potentially relevant to issues in this case; limited evidence on the issue of whether respondent Jessica Hardy has violated La Fédération Internationale de Natation ("FINA") Doping Control Rules DC 2.1 and 2.2. for the presence of the substance clenbuterol in her sample.
The hearing has been bifurcated into two phases.The first phase of the arbitration hearing (hereinafter referred to as “PHASE ONE”) was limited to the issue of whether Respondent Jessica Hardy has violated FINA DC 2.1 and 2.2 for the presence of the substance clenbuterol in sample and the imposition of any presumptive period of ineligibility. The second phase of the arbitrational hearing (referred to as "PHASE TWO") will be limited to the issue of wether exceptional circumstances exist pursuant to FINA DC 10.5 that might reduce or eliminate the presumptive periode of ineligibility.

Klanttevredenheidsonderzoek Doping Infolijn : een enquête onder bellers en e-mailers plus trends van 2000-2007 / A. Palsma. - Capelle aan den IJssel : Dopingautoriteit, 2008

In 2000, a telephone information line for questions concerning doping was started: the Doping Informatielijn, abbreviated as DIL. In the first place this telephone service was intended for athletes in gyms, but in the course of the time other target groups within the sport were more and more reached. Since 2006 also the question and answers and context data of e-mailers have been registered. Because the DIL is ISO certified substantive appointments have been fixed about the quality of the settlement of guarantees for the information requests, the recording of the context data of the users of the telephone information line and mailers and intervision of question and answers by the DIL-operators. One of the quality requirements is that the information seekers appreciate the DIL with a report figure of at least seven (on a scale of ten). Until now it had never been examined if this quality requirement was obtained. Therefore a customer satisfaction investigation has been conducted in the period of 1 August 2007 up to and including 1 February 2008 under all information seekers (by phone and e-mail) who have approached the DIL during this period. The recent developments over the period of 2000 up to and including 2007 were also examined. It was also investigated if and which data are available of other doping information lines. The DIL is telephonically contactable on working days from 13.00 till 16.00 by phone 0900-200 1000 or by mail: dopingvragen@dopingautoriteit.nl.

For the customer satisfaction research under users of the telephone line and e-mailers, questionnaires have been placed on internet which could be filled in online. 222 of the 305 users of the telephone line were asked to participate and 65 have eventually filled in the questionnaire. Also 222 of 278 e-mailers have been asked to participate in the study and 68 persons have filled in the questionnaire. The recent developments have been examined using the statistic data of the previous years which have been stored in the access files of the automated recording system. Comparison of data of the participants to the customer satisfaction research with those of mailers and users of the telephone line over the year 2007 learns that the customer satisfactory research is representative for the information seekers which used the e-mail and the telephone service of the DIL.

The users of the telephone line are very satisfied and give an average report figure of 8.1 (spacing 6 - 10). However, 22% of the users of the telephone line noticed that extension of the visiting hours is needed. The users of the telephone line noticed that the mail service must be mentioned more prominent at the websites. The mailers are also very satisfied concerning the DIL and give to an average mark of 8.2 (spacing 7.5 - 10). However, 9% of them find the answer unclear.

From the recent developments it becomes clear that the number of female information seekers increases. The most questions are asked by people in the age categories of 21 up to 25 years, followed by 16 up to 20 years, 26 up to 30 years and 31 to 35 years. Parents do ask more often questions at the DIL, what can explain the increase of the number of information seekers in the age category of 41 up to 50 years. At other information lines it is also noticed that the number of mailers seems to increase.

The age of the users of the Anti-Doping Hotline in Sweden is lower than that of the information seekers of the DIL. As well as in the Netherlands the use of anabolic steroids here too is the most important conversation topic.

Information seekers of the DIL can also contact employees direct outside the opening hours of the DIL telephone and by mail. These question and answers generally are not registered. As a result of this research it is inventoried or and how the quality assurance of the questions which are settled outside the DIL can be realised. Extending opening hours of the DIL runs up against practical objections. For this reason the e-mail service is promoted more, so that information seekers know more about this possibility to get their question answered rapidly. Answering the e-mails will be improved by establishing a guide for this. Current quality is further maintained.

Narkar VA, Downes M, Yu RT, Embler E, Wang YX, Banayo E, Mihaylova MM, Nelson MC, Zou Y, Juguilon H, Kang H, Shaw RJ, Evans RM. AMPK and PPARdelta agonists are exercise mimetics. Cell. 2008 Aug 8;134(3):405-15. Epub 2008 Jul 31.

CAS 2008/A/1473 Joe Warren v. United States Anti-Doping Agency (USADA)

Related case:

AAA 2007 No. 30 190 00782 07 USADA vs Joe Warren
January 14, 2007

• Wrestling
• Doping (marijuana)
  Presence of a specified substance
• Condition of reduction of the ineligibility period based on exceptional circumstances
• Condition of reduction of the ineligibility period based on the principles of proportionality
• Determination of the applicable sanction for a second violation for the use of a specified substance

1. An anti-doping rule violation has been committed when the presence of a “specified substance” at a concentration greater than what is authorised in an athlete’s bodily specimen has been demonstrated.

2. To benefit from a reduced sanction, an athlete can establish the existence of exceptional circumstances. A pre-condition to obtaining a reduced period of ineligibility based on exceptional circumstances is that the appellant must establish how the prohibited substance entered his system. Under the circumstances of a particular case, it is not necessary to require the athlete to establish with precision when the prohibited substance use giving rise to the positive test occurred in order for him to meet his burden of establishing how the substance entered his system. Doubts about when and/or how often the athlete used the substance could, however, have a bearing on the athlete’s credibility generally. In any event, where the medical evidence demonstrates that the athlete was able to differentiate between right and wrong it cannot be accepted that his actions and decisions can be relegated to the category of “no significant fault or negligence” especially when the use of the prohibited substance was neither prescribed nor medically necessary. In this regard, the acute stress the athlete was under can be at best understandable, but not excusable.

3. To benefit from a reduced sanction, an athlete can also persuade the panel that the proportionality principle can and should be applied to reduce the otherwise applicable sanction. However, it is not appropriate to invoke principles of proportionality to vary a sanction which, even though it seems severe in all of the circumstances, is nevertheless in accordance with the rules in force at the time of the infraction, at the time of the hearing before the first instance authority and at the time of the hearing before the CAS panel.

4. If a doping violation involving a specified substance occurs for the second time for the same athlete and if the athlete concerned has not established that he bears No Significant Fault or Negligence, no reduced sanction based on exceptional circumstances can be granted. Moreover where there is no basis for departing from the sanctions provided for by the regulations based on the proper application to the principles of proportionality, the minimum penalty is a two year period of ineligibility.

On 14 January 2008 the American Court of Arbitration for Sport Panel (AAA) decided to impose a 2 year period of ineligibility on the wrestler Joe Warren for his second anti-doping rule violation after he tested positive for the prohibited substance Cannabis.

Hereafter in February 2008 the Athlete appealed the AAA Decision with the Court of Arbitration for Sport (CAS). The Athlete requested the Panel to set aside the Appealed Decision and to impose a reduced sanction.

The Athlete admitted that he had committing an anti-doping violation for which the minimum penalty is a two year period of ineligibility. He asserted that in first instance the Panel misapprehended the evidence and erred in failing to reduce the sanction based on exceptional circumstances and/or application of the principles of proportionality.

Following assessment of the evidence and the Athlete's conduct in this case the Panel determines:

• a.) The Athlee has committed an anti-doping rule violation, namely, the presence in his Bodily Specimen of Carboxy-THC at a concentration greater than 15 ng/mL;
• b.) Carboxy-THC is a cannabinoid and, as such, a “specified substance” for the purposes of Article 10.3 of the Regulations;
• c.) This violation is the Athlete’s second anti-doping rule violation, the first such violation having involved the same Prohibited Substance and having occurred in April 2006;
• d.) The violation arises from the Athlete’s use of marijuana prior to the test which gave rise to the positive finding noted above;
• e.) The Athlete has not established that he bears No Significant Fault or Negligence for this anti-doping rule violation and, as such, the Tribunal declines on that basis to set a reduced sanction based on exceptional circumstances under Article 10.5.2 of the Regulations;
• f.) There is no basis for departing from the sanctions provided for by the Regulations based on the proper application to the principles of proportionality;
• g.) The appeal is, accordingly, dismissed.

Therefore the Court of Arbitration for Sport decides on 24 July 2008:

1.) The appeal filed at the Court of Arbitration for Sport by Mr Joe Warren on 2 February 2008, against the United States Anti-Doping Agency, is dismissed.

2.) The period of ineligibility of 2 years from 23 July 2007, imposed by the Doping Tribunal on Mr Warren, is confirmed.

(…)

5.) All other prayers for relief are dismissed.

Facts
French Mountaineering and Climbing Federation (Fédération Française de la Montagne et de l'Escalade, FFME) charges M52 for a violation of the Anti-Doping Rules. During an event on January 19, 2008, the respondent provided a sample for doping test purposes. The sample showed the presence of prednisolone and prednisone which are prohibited substance on the World Anti-Doping Agency (WADA) prohibited list. They are regarded as specified substances.

History
The respondent thinks that the positive test derived from a pharmaceutical product he had used. He didn't mention the use on the doping control form.

Decision
1. The sanction is a period of ineligibility of six months in which respondent can't take part in competition and manifestations organized or authorized by the FFME.
2. The first decision (four months period of ineligibility and two months conditional) dated April 3, 2008, by the disciplinary committee of the FFME should be modified.
3. The period of ineligibility should be reduced with one month which as the time already served by the decision of April 3, 2008.
4. The decision will start on the date of notification.
5. The decision will be published and sent to the parties involved.

Facts
The French Ice Hockey Federation (Fédération Française de Hockey sur Glace, FFHG) charges respondent M51 for a violation of the Anti-Doping Rules. During a match on December 8, 2007, a sample was taken for doping test purposes. The analysis of the sample showed the presence of a metabolite of budesonide. Budesonide is a prohibited substance according the World Anti-Doping Agency (WADA) prohibited list and is regarded as a specified substance.

History
The respondent had used medication with budesonide to treat asthma. An error was made with the request for a therapeutic use exemption before the start of the season. However the amount mentioned for medical use is in accordance with the detected amount. The panel considers this case as a justified medical usage of the prohibited substance.

Decision
1. The respondent is acquitted.
2. The decision will start on the date of notification.
3. The decision will be published and sent to the parties involved.

Facts
The French Federation of Muaythai and Associated Disciplines (Fédération Française de Maythaï et Disciplines Associées, FFMDA) charges respondent M50 for a violation of the Anti-Doping Rules. During a match on December 9, 2007, a sample was taken for doping test purposes. The analysis of the sample showed the presence of a metabolite of cannabis. Cannabis is a prohibited substance according the World Anti-Doping Agency (WADA) prohibited list and is regarded as a specified substance.

History
The respondent had used cannabis three day before the match, it was used in a recreational setting, there was no intention to enhance sport performance.

Decision
1. The sanction is a period of ineligibility of three months in which participant can't take part in competition or manifestations organized or authorized by the FFMDA.
2. The decision starts on the date of notification.
3. The decision will be published and sent to the parties involved.

Facts
The French Cycling Federation (Fédération Française de Cyclisme, FFC) charges respondent M49 for a violation of the Anti-Doping Rules. During a cycling event on January 27, 2008, a sample was taken for doping test purposes. The analysis of the sample showed prednisone, prednisolone and a high testosterone on epitestosterone level. A complementary spectrometric analysis of the sample revealed an exogenous origin of testosterone. Exogenous testosterone is a prohibited substance according the World Anti-Doping Agency (WADA) prohibited list.

History
The respondent explained that he had used dietary supplements containing anabolic agents and medication containing glucocorticosteroids for ergogenic effects. He didn't provide any documents during the proceedings and didn't appear at the hearing.

Decision
1. The sanction is period of ineligibility of four years in which the respondent can't take part in competition or manifestations organized or authorized by French sport federations. This was the same sanction as pronounced by the disciplinary committee of the FFC on May 20, 2008.
2. The decision starts on the date of notification.
3. The decision will be published and sent to the parties involved.

Facts
The French Ice Hockey Federation (Fédération Française de Hockey sur Glace, FFHG) charges respondent M48 for a violation of the Anti-Doping Rules. During a match on November 24, 2007, a sample was taken for doping test purposes. The analysis of the sample showed the presence of a metabolite of cannabis. Cannabis is a prohibited substance according the World Anti-Doping Agency (WADA) prohibited list and is regarded as a specified substance.

History
The respondent had used cannabis together with a friend the eve before the match. He had no intention to enhance his sport performance. The amount measured was low.

Decision
1. The decision (a period of ineligibility of four months) dated March 27, 2008, by the disciplinary committee of the FFHG doesn't need to be modified.
2. The decision will start on the date of notification.
3. The decision will be published and sent to the parties involved.