International Cooperation Essential : Standardized Drug Tests Difficult to Administer

There may be a less enviable job in sports than being an international official who seeks to control the use of drugs, but it’s unlikely.

Consider the scope of the problem: Officials have to deal with international federations, all with different rules. There is the issue of international law--what is OK in one country is not in another. There is the East-West dynamic, the lack of trust among nations who come together on an athletic field but few other places. There are the athletes who, at this point, feel enormous pressure to take drugs in order to keep up with the competition. And there is a feeling of confusion over who to trust when it comes to testing.

It’s small wonder, then, that the problem of drugs in sports has reached the point that officials are putting aside their differences, as best they can, and trying to come up with an acceptable, standardized approach to beating the problem.

That was the aim of 85 sports officials from 27 nations when they assembled in Ottawa, Canada, June 26-29 for the First Permanent World Conference on Anti-Doping In Sport. Three days of lengthy meetings and intense debates yielded a draft document, an Anti-Doping Charter that is to be presented to the International Olympic Committee before the Seoul Olympics.

A primary concern for the delegates was the lack standardization about any aspect of the drug problem.

Prince Alexandre de Merode, chairman of the IOC Medical Commission, said at the conference that the lack of clear guidelines on a worldwide level was no longer acceptable.

“We need to harmonize the rules, the procedures and the lists (of banned substances),” Prince de Merode said. “(We) also (need to do this) between federations. In one sport, for example, the use of anabolic steroids would give the athlete a three-month suspension in the winter months (off-season) and another would give a two-year suspension. That is unacceptable.

“It is also unacceptable that in one country you can take one kind of drug and you can’t in another. We cannot accept that athletes are not being treated fairly.”

The proposed charter is filled with procedures and rules that represent the future of sports. In this case, the future means:

--A massive amount of testing.

--More IOC accredited laboratories.

--Tests for new kinds of drugs.

--Blood tests in addition to urine tests.

--Stiffer penalties for everyone involved in the drug chain, not just the athlete.

--More help from governments to stop drug sale and distribution.

--And, most important to the delegates, year-round, random, unannounced testing.

At Ottawa, it became clear that the U.S. position is often difficult for the rest of the world to understand. Many of the international rules and procedures are incompatible with the legal protection offered by the Constitution and its regard for due process, and the U.S. government’s structure.

Most officials worldwide are astounded to learn that unannounced drug tests probably will never be used in the United States. Prince de Merode and others have admitted that this appearance doesn’t help the United States’ image as a foot-dragger on drug testing.

What is difficult for others to understand is the U.S. legal system. U.S. officials do want to adhere to international drug-testing standards, but they can’t suspend the Constitution to do it. Currently, the most common type of drug testing--in the workplace of college and Olympic athletes--is facing legal challenges every day.

American sports officials work the way other American management personnel do: Run it past the lawyers to see if it’s OK.

Increasingly, officials say the only way that random year-round testing is possible is to require athletes to sign a waiver that would allow officials to test before the athletes can compete.

It was clear at Ottawa that the United States has not been a leader in anti-doping. One British medical official called the United States a stumbling block. What does not often get told is that most officials here are doing the best they can while operating within the law.

This is often not enough of an explanation for the rest of the world.

“Look, I know how it appears to others,” said Dr. Don Catlin, who runs the UCLA laboratory where the Olympic tests in 1984 were handled. “But we are going along at the usual American pace. We are slow, we talk things over a lot, we vote about everything. That’s our system.”

All of which brings up the second problem. The anti-doping models that were presented at the conference all work in a system where there is a centralized government ministry that oversees all sports. That is not the case here.

In East Germany, if the government would like to standardize the penalties for steroid use in all sports, the final decision is made by one person. Here, there is a maze-like bureaucracy. Each sport has its own officials. Not all of them agree. The U.S. Olympic Committee has limited power over Olympic -related events.

Another troubling proposal is the possibility of blood testing in the Olympics. Officials have been stymied with the blood doping problem, having banned the procedure but possessing no test for it. Blood doping is a procedure in which athletes reinject oxygen-enriched blood into their bodies, enhancing their aerobic capacity.

Prince de Merode of the IOC Medical Commission revealed that he was not opposed to taking blood samples in the Olympics if it were the only method for detecting blood doping. “Right now, we don’t have a test,” he said. “We believe it is possible to have a solution with blood samples. Why not? We would do a blood test if it is the only way to detect positive athletes, we will try to establish it.”

This announcement came as a surprise to other sports medicine experts. They point out several potential problems with blood tests.

To begin with, blood tests are invasive. “It’s one thing to ask an athlete to supply urine,” Catlin of UCLA said. “But it is quite another to ask them to give blood.”

Catlin and others say there are legal questions involved in such testing.

The handling of blood is much different than that of urine samples. In addition, much care needs to be taken because of the various blood-carried diseases.

There are cultural questions to drug testing as well, questions that will become more persistent in the future.

For example, some Muslim, African and Arab women have expressed religious and cultural protests over the current testing procedure, in which athletes must produce a sample in front of an official observer. This is to guard against tampering.

The same problem has been encountered in South America. Dr. Eduardo De Rose of Brazil, the medical chief of the Pan American Sports Organization, said he has had to devise a unique method to solve the problem. “For the men, instead of having the athlete face the observer, we put up a mirror and have the athlete face the mirror. That way the athlete is not embarrassed yet he is still being observed.”

De Rose also voiced some of the same concerns as the U.S. officials--the inability to apply universal rules.

“It is a completely different approach in developing countries,” De Rose said. “We will not use legislation to achieve this because we do not listen. It is no use to have a law against something--in Brazil we have laws and we do everything. It is not like Europe and developed countries where people respect the law. For us, education must be the way. We must tell people that it is not good to use drugs.”

The bottom line for South America and Africa is that whereas there are many problems faced by sports officials, they aren’t drug problems.

“We play with two realities here: The developed countries have one problem and they try to stop another,” De Rose said. “For developing countries, these are problems we won’t have until 10 years from now. We have children who do not eat enough. I must accept the priority of my government.”

The IOC is asking for more accredited laboratories. But who will pay the costs of establishing and maintaining a lab in Africa or South America? Dr. Robert Dugal estimates the cost of operating his IOC lab in Montreal as between $300,000 and $500,000 a year. Tests, which four years ago cost roughly $100 each, have increased to about $170, according to Catlin.

Though Prince de Merode would push for more laboratories in more countries, he also understands the financial realities faced by many countries.

“It is not only a question of money but also capacity and people,” he said. “We can have flying laboratories. It’s expensive, but it’s a solution. I’d prefer to have a flying laboratory than a bad permanent one.”

The battle against drugs has opened another front, the federal courts. Not only are some countries attempting to place the selling of steroids on the level of narcotics, as a criminal offense, but inroads are being made on lower levels.

Because of increased awareness of the abuse of performance-enhancing drugs among athletes, it is unlawful in California “to aid or abet in the unlawful sale, use or exchange of anabolic steroids, testosterone, and human growth hormone.”

Several other states have similar laws, as do several other countries, reflecting the scope of the problem of drugs in sports. In France last year there were two major drug busts, which also netted 20 doctors and 22 athletes.

“We know there is an active black market,” said Dr. Gabriel Dolle, the French Minister of State for Youth and Sport. “We had 420,00 steroid pills seized by customs two years ago. They came from the Eastern Bloc. We had 40,000 boxes of steroids in the Alsace (region).

“For the first time this year there was clear proof about the distribution channels. Narcotics agents at a six-day cycling event in Paris caught four dealers with the drugs in their cars. They sold the pills right from their cars.”

The case has not yet been brought to trial.

Dolle added: “If this exists in France, it must exist elsewhere. We must be honest enough to say so.”

The future holds new rules. For the first time a two-tiered system is in place for the Olympics, which differentiates between deliberate drug use, such as anabolic steroids and masking drugs, and a second category of inadvertent use, ephedrine and codeine, for example, that are commonly found in cold medications.

The proposed penalties are:

For deliberate drug use, three years on the first offense and a life ban for a second.

For inadvertent use, three months for the first offense, two years for the second and a life ban in the third.

Previously, the IOC had ousted athletes and stripped them of all medals, but left the penalties up to the individual sport federation.

New rules, new tests and even a worldwide education program may not be enough to stop the use of drugs in sport. If there is to be standardization of rules and cooperation between nations, then there must also be understanding and tolerance of cultural and philosophical differences.