Discussion about this post

User's avatar
Sarah Lavender Smith's avatar

For a deeper dive on this topic, I recommend Jason Koop’s multipart series on anti-doping on his Koopcast podcast. He and Corrine Malcolm deserve credit for advancing a lot of the dialogue and developments. I’m intrigued by your idea to get sponsors to require testing of their athletes, but it’s hard to see this catching on unless it became a widespread bragging & selling point. One thought on your proposals: I think you’re overlooking the desire and potential of midlife age-groupers to cut corners and dope. They’re at a time in life of generally greater financial security (i.e. willing to spend big on their sport) and wanting to fight aging and boost ego with doing well in their age group. I think this demographic, which flies below the radar, may be most susceptible to cheating and justifying it as another hack. It’s a slippery slope from supplements and super shoes and caffeine, exogenous ketones, and Adderall to thinking that some extra testosterone or HGH isn’t so bad or wrong to take. Also, FWIW, I briefly last year took testosterone off label on my doc’s advice for menopausal hormone therapy, which is increasingly common among women my age (over 50). It didn’t do much, and my level remains nearly nonexistent. But when I got into Hardrock this year, I stopped taking it and have remained off it since there’s no TUE for women taking testosterone, which is a banned substance. Although Hardrock doesn’t test, I wanted to be clean on principle. But hormone supplements are increasingly used and justified to get levels back to a normal range. Just goes to show how complicated this is, and although someone can be anti-doping in theory, they can justify using a banned substance if they feel they truly need it to make up for a deficiency.

Expand full comment
Buzz Burrell's avatar

Thank you for the review and suggestions on a very complicated topic. If illegal PED's in sport were as clear-cut as driving through a red light, we could simply say, "Let's enforce the law!" and quickly figure out how to do just that. Here's a few confounding factors for consideration:

1) We are a drug culture. Everyone takes drugs. Caffeine is by far the most efficacious PED in existence, and it of course is legal. The infamous EPO illegally improves the performance of a few people while also saving thousands of lives every year; alcohol is not only legal but is celebrated, and is responsible for at least a hundred thousand deaths every year. It would be great to draw simple and clear ethical lines, but these lines can be wavy.

2) Sport is supposed to be good for you. HRT can be very good if not vital for one's health, yet is quite illegal, and a TUE is very unlikely. OTOH, the supposed negative health consequences of using illegal PED's turns out to be surprisingly questionable - investigating these claims reveals them to be mostly negative marketing.

3) So the main reason to establish and enforce PED guidelines is to create a level playing field, especially for professionals with a paycheck at stake. This is definitely a valid reason which I support. However, the concept of "level playing field" itself is slippery - the average cost of a hyperbaric chamber is $8,000, which pro athletes use regularly, and which runners from poorer backgrounds can't possibly afford. But they can afford a pill given to them with a monthly dose costing maybe $100. Paying for a coach is now standard practice, which again many runners cannot afford, and the crew support at aid stations top runners have nowadays requires a major outlay of time and money. So have we created rules that favor our peer group while keeping others out?

4) The testing is problematic. A runner friend who does peer reviews for scientific studies marvels at the standard method of the "A and the B sample". Why would sample A ever test different than sample B? If it does just 5% of the time that means the test has a margin of error of 5%, which is too high for any scientifically valid test.

It's tricky, but we'll keep working at it! Again, let's keep in mind the real goal is for a level playing field.

Expand full comment
9 more comments...

No posts

Ready for more?