Thursday, March 09, 2006

The drug cops are playing catch-up

The drug cops are playing catch-up
Wherein I meant to include this too, but forgot, but that's ok because that post was getting too long and no one's reading the damn thing anyway

There was another article in Outside I meant to reference in my performance enhancer post: The Awful Truth About Drugs in Sports, from July 2005.

It's a story about Dr. Don Catlin, who helped break the BALCO scandal and his lab conducts tests for the United States Anti-Doping Agency (USADA), the body that oversees drug testing for American athletes in all Olympic sports.

He thinks we're fighting a losing war against the dopers - the financial incentives favor the new drugs and evasion, not the testing - and proposes a new plan:
He calls his idea the Volunteer Program. It's driven by the concept of using science, testing, and free-will participation to prove that athletes who sign up are clean, based on thorough biological profiles of their bodies. Catlin would use these profiles to create a set of "biomarkers" that show what is and isn't normal for each athlete. Armed with these indicators, he would institute ongoing, voluntary checkups for any athlete who chooses to participate. In return for entering the Volunteer Program, athletes would receive recognition as members. The public, press, sponsors, and governing bodies would be assured that members of the program were not doping.

In this, the idea resembles one floated in the early nineties by Pat Connolly and Charles Yesalis, a Penn State health-policy professor and scathing critic of the current drug-testing system. They suggested creating a Team Clean. But Catlin would bolster the concept by deploying the latest research and technology to make clean a meaningful word.

First he wants to mount a research project using ordinary weekend athletes, such as college students. A number of biomarkers—blood pressure, cholesterol, total testosterone, hemoglobin, IGF levels, and many others—would be monitored and plotted over time to see how they vary between people and within each person's body. What happens, for example, during a long trip? How does having the flu affect biomarkers? Or doing a workout? The idea is to create a fixed portrait of each athlete so each can serve as his or her own standard.

Then, in a move sure to be controversial, the test subjects would be given safe doses of performance-enhancing drugs for a limited time. Their biomarkers would be monitored to see how the physiological portrait changed.

Using this data, Catlin wants to try the Volunteer Program with one sport, like weight lifting, which has the advantage of a small population that's tested frequently. If it works there, he wants to expand it. Athletes who volunteered would establish a pattern of historical data on their own physiology through frequent biomarker testing. Samples from that testing would be stored and used as reference materials.

For instance, if the monitoring shows a spike in a weight lifter's IGF-1, that probably means he's doping with growth hormone. At that point, Catlin says, a doctor would call the lifter in and say, " 'Joe, we've been following you for six months and suddenly your IGF is way up. I'm worried. Let's talk.'

"You'd approach it as a physician does a patient," Catlin continues. " 'Is something going on in your life? I am worried you are taking growth hormone, and you know we do not have a bulletproof HGH test, but we do have these blood markers, so I want you in here every week. We are going to track you, and I want to see that go down, and if it doesn't go down, a committee of your peers, other athletes, is goingto want to talk to you.' "

That's it. No punishment. If Joe doesn't agree, or his levels stay high, he would revert to the old system and take his chances. But he'd also lose the built-in absolution of the Volunteer Program.

Catlin's explanation reveals two critical ingredients of the program. First, he hopes to rejuvenate the role of the sports physician, to make doctors the system's eyes and ears. (Currently, some athletes avoid physicians for fear of being discovered; this endangers their health.) Second, Catlin believes the enforcement of the program's rules must be left to a panel of athletes. His plan makes athletes the judges, not USADA or WADA.

Under the program, there's no need to prove an athlete is shooting up HGH, so you don't need a complicated test for it. Because athletes booted out of the program won't be banned from competing, there will be no subsequent legal battles. Authorities will never again have to worry about unknown steroids floating around the sports netherworld, because Catlin isn't looking for specific causes—drugs—but instead for their effects. Yet another advantage, Catlin argues, is that fewer legal battles and complex drug tests should mean the Volunteer Program will be much cheaper to operate once the initial research is finished. And an athlete like Lance Armstrong—dogged by doping whispers throughout much of his career—would have the opportunity to trumpet a definitively clean bill of health.

Fascinating idea. Can't say I'm completely buying into it, but it sounds worth discussing. read the article, there's more bio on the doctor and criticism for his plan. Definately an expert worth listening to. On a month to month basis, Outside covers this topic much more than Sports Illustrated, who only swoops in for a big story.


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