Dr. Doug Rollins presented the following lecture at our March meeting. Professor Rollins is a Professor of Pharmacology, Medical Director of the Poison Control Center, in charge of monitoring and detecting illegal drug usage among athletes at the 2002 Winter Olympics, and husband of Humanists of Utah chapter member Helen Rollins.

Think about these statements:

1. The real scandal concerning the Olympics is drug use among the athletes.
2. Wealth is woven into the fabric of daily life today in a way it never was in the past.
3. Since home-run king Mark McGwire admitted to using androstenedione last summer, andro use among kids has soared fivefold.
4. "Money is less tangible. It used to be property or gold. Now it's a blip on your computer screen. It becomes more a way to keep score, a game in its own right, the way athletes compete with each other to make the most millions, when each additional million can't possibly matter to the way they live." NY Times, Sunday February 28, 1999.
5. Carl Lewis, Newsweek, February 15th: "It can be an extraordinary distraction to settle into the starting blocks or prepare to launch oneself into the pool wondering if the person in the next lane might beat you because of something he or she ingested or injected."
6. Sepp Platter, President of FIFA, the World Soccer Federation: "Professional athletes are forced to take performance-enhancing drugs by the huge pressure to perform."
7. What if you were given a drug that would markedly improve your performance on the stock market? Would you take it if a doctor told you it was safe? What if it was an illegal substance, but it could not be tested for.

Now a little background. What are we talking about when we talk about doping.

The ancient classic the Iliad describes how Odysseus defeated Ajax in a footrace by enlisting the goddess Athena to trip his competitor. The notion of cheating seems to be as old as sport itself, though today the cheating "goddesses" come in different forms.

Well clearly it refers to the use of illegal substances such as narcotics and cocaine and amphetamines. But in the sport world it also refers to anabolic steroids, stimulants such as ephedrine, diuretics that can serve as masking agents, some heart drugs such as beta blockers, and some hormones such as human growth hormone and erythropoietin.

What do these drugs or hormones do that is so bad? Cocaine and amphetamines are pretty clear and most persons already know that they are general stimulants. Cocaine can produce an intense craving.

Anabolic steroids in large doses promote muscle growth and strength and may enhance performance particularly where strength is a major component.

Diuretics will cause the urine to become dilute and have known to be used to cause a false negative test. Thus, they can mask the presence of a prohibited substance.

Beta blockers are used medically to lower blood pressure and heart rate. This later use may be of benefit where steadiness and a low level of nervousness are required. For example, in the biathlon an athlete may take a beta blocker to lower his or her pulse thus allowing them to shoot between heart beats.

Erythropoietin (EPO) is used by athletes in which endurance is important. It increases the number of red blood cells and thus increases the blood's ability to carry oxygen.

Why do doping control? Doping control is the same as drug testing. So what if an athlete wants to increase their performances who are we to be concerned. Doping control is designed to benefit the health of the athlete and to provide a level playing field.

If an athlete takes anabolic steroids they are not only gaining an unfair performance enhancement, but they are also putting their health at risk. Perhaps the coach or trainer is making that decision.

An athlete that increases his or her red blood cell count with EPO is at risk for blood clots, high blood pressure, strokes and heart attack, particularly when they become dehydrated during a long event. There is concern that EPO use resulted in the death of several cyclists a few years ago. EPO use resulted in the elimination of several teams from the Tour de France last summer.

Anabolic steroids are allegedly in wide use by athletes not only at the elite level but also during the formative years of ages 10-18. Anabolic steroids cause adverse effects in virtually every organ. They can cause inflammation of the liver; tumors of the liver, decreased sperm count in men and loss of menstrual activity in women. They have also been associated with aggressive behavior "Zoid rage."

What is the history of doping? During the ancient Olympic games various brandy and wine concoctions or ingested mushrooms were taken to enhance performance.

The doping crisis arrived in the modern Olympics at the turn of the century when the American marathoner used a combination of strychnine in raw egg whites during his race. He required extreme medical measures to be revived at the end of the race.

After World War II amphetamines became popular. In 1968 a cyclist and a soccer player died in France due to amphetamine-related causes.

Most of us can remember Len Bias the Maryland basketball player who died of a single cocaine dose.

It has long been suspected that athletes from the former Soviet Union and Eastern European countries have used anabolic steroids. These feelings were reinforced during the 1976 Olympic games in Montreal. There, when the head of the East German swimming delegation was asked about the curiously deep voices his women swimmers had, he replied in a thick accent, "Ve have come to svim, not to sing."

In the mid-1980s four Canadian weight lifters were caught in the Montreal Airport with 22,515 capsules of anabolic steroids and 414 vials of testosterone, purchased for next to nothing behind the Iron Curtain.

North American athletes have not been immune from doping violations. Ben Johnson. Randy Barnes, shot-put champion. And what about Mark McGwire our national hero while taking a substance, androstendione, that was banned by baseball it is banned by almost every other sport including the NFL and the IOC.

IF THERE IS A MAGIC PILL THAT COULD MAKE YOU WIN, WHAT WOULD BE THE POINT OF SPORT?

It seems like a simple problem, test everyone on a random basis and let that be a deterrent to taking drugs. Let me give you an idea of the complexity of the problem:

Each sport in the U.S.--alpine skiing, bobsledding, and luge, ice skating, hockey, Nordic skiing, etc. have there own federation called a National Governing Body (NGB). There is an alpine skiing NGB, a Nordic skiing NGB, etc. Each nation also has an Olympic Committee a National Olympic Committee (NOC). In the United States it is the USOC. Each sport has its own International Federation (IF). So there is an alpine skiing IF, a Nordic skiing IF, etc.

The National Governing Bodies, the International Federations, and the National Olympic Committees may have different rules and guidelines for doping control. On top of this is the International Olympic Committee (IOC). Each of these groups is a player in the doping control process.

In between Olympics, the National Governing Bodies have a great say in doping for National Events such as the U.S. Figure Skating Championships held earlier this month or the bobsled event held this past weekend.

During international events the International Federations have a great say in doping control.

During the Olympics, the IOC has the final say in doping control (or so they think). To complicate things even further, the doping control rules and guidelines may vary from NGB to NGB, from NOC to NOC, from IF to IF and between all of these and the IOC.

The detection of marijuana in the urine of a snowboarder at the Nagano Olympics in 1997 is a case in point. Although he claimed to have been exposed to marijuana smoke from his friends at a party (an unlikely story) he also pointed out that although the IOC bans the use of marijuana at Games, the International Skiing Federation does not list it as a prohibited substance because they do not feel it is performance enhancing. In this confusion it was determined that he should get his gold medal back.

Where is the U.S. government in all of this? General Barry McCaffery was at the IOC Doping Control Conference in Lausanne and he made several negative comments about the IOC and drug use in sports. But he also TOOK several negative comments about the fact that Mark McGwire was using anabolic steroids. Furthermore, The National Drug Control Strategy for 1998 does not contain a word about drugs in sports. So it appears that McCaffery wants to tell others how to do it, but he doesn't have a plan.

HOW WILL DOPING CONTROL WORK AT THE 2002 GAMES IN SLC?

At each venue there will be a doping control station which will be nothing more than a large room with bathroom facilities within. For each event there will be a doping control site coordinator, at least one, and perhaps two doping control officers. These will be physicians. As the event is finished the top four finishers will be identified for testing. In addition, in most cases a random athlete among the rest will be chosen for testing. Each of these athletes will be assigned an escort who must remain with the athlete until they reach the doping control station. They have 60 minutes to reach the doping control station.

Once inside the doping control station they can not leave, but they are allowed to have one person with them, a friend, trainer, coach etc. Inside the doping control station there are sealed drinks that they may have. When they are ready to produce a urine specimen they go into the bathroom with a validator who observes the urine collection. They must collect 100 mL of urine. When this is done, they sit down with the doping control officer who instructs the athlete to how to put the urine into tamper-proof containers A and B. These are sealed and then the doping control officer talks to the athlete about drugs they have taken including vitamins and supplements. The samples are then placed in a courier container which is also tamper-proof and sent or taken to lab. The form the athlete fills out serves as a chain of custody.

For the 2002 Games we have selected one of the best labs in the world. It is an IOC Certified Lab at Indiana University in Indianapolis. The lab director Dr. Larry Bowers will come to Utah and set up a temporary lab. In the lab the samples are screened for drugs using nonspecific methods.

The positive specimens are then confirmed for the presence of specific drugs using highly sophisticated and extremely specific and sensitive methods. In the laboratory, none of the personnel would be able to identify a particular specimen with a particular athlete so that if they wanted to contaminate a specific sample they would not know which one it was.

Once a specimen has been identified as positive, the athlete is notified and they then have the right to have the B sample tested in their presence to assure that no contamination has occurred.

WHAT ARE THE PROBLEMS; WHAT ARE THE ISSUES?

We are a society that thrives on competition in all aspects of our lives. We are a society that wants all of our problems to be taken care of with a pill. Is it any surprise, therefore, that competition and drug abuse are linked together? I think not.

1. To me the biggest issue is that between events the athletes are not tested. Thus, they and their trainers and coaches know when they need to stop taking drugs, such as the anabolic steroids, so that they do not get caught at an event. It really becomes an IQ test as to whether they test positive. Furthermore, the National Governing Bodies pretty much control the athletes between the Olympics and the IOC has virtually no control. So if an athlete is tested positive the NGB can decide how to act on that positive test. And they have a major conflict of interest that they do not want to harm their sport or affect their sponsors by having a drug scandal. The IOC takes the blame for this but often it is out of their hands. The IOC is responsible for drug testing only every fourth year. And yet they are held responsible for all of the problems. At the IOC Doping Control Congress held in Lausanne last month it was the athlete delegates that repeated called for out of competition testing to catch the clever users of drugs.
2. The next most important issue is the substances that can not be detected: EPO and Human Growth Hormone. These are peptide compounds that are not excreted in urine. It is likely that tests for their presence will require blood testing and this is considered too invasive at this time. Indirect blood tests that will detect surrogate markers are also possible.
3. The third issue is a harmonization of rules, guidelines, and sanctions among the National Olympic Committees, the National Governing Boards, the International Federations, and the justice system of the participating countries.
4. Fourth, it would be ideal if there could be an independent agency that would oversee doping control in all of sport.

Finally, let's talk about the issue of competition and drug abuse. Why would an athlete risk his or her career by using drugs to win? The answer seems obvious: greed. As long as our athletes are paid tremendous sums of money for their performance by sponsors there will be cheating and substance abuse.

This is not localized to athletes and sports. What if a stock broker performed consistently better and picked winning stocks while under the influence of a new enzyme. And what if this became known either via word of mouth or by public information. Do you think others would try it--of course they would. And what if the Federal Trade Commission outlawed the use of this particular enzyme because it was jeopardizing the health of brokers who use it. Would brokers continue to abuse it--of course. Particularly, if there were no way of detecting its use.

The use of abused substances throughout society is rooted in our competitive nature. The person living in a large urban ghetto competes daily to get on with life. In far too many cases drugs facilitate that competition.

Competition occurs with high pressure jobs and drugs and alcohol facilitate the handling of these jobs. When someone can not compete on the level playing field they may rely on drugs to get them through.

We encourage our children to be competitive and when they can not do it on their own they are likely to explore chemical means of increasing their advantage. This is happening in far too many elementary and middle school sport programs particularly football and basketball. It is sad to know that parents are often encouraging drug use by their children to make them more competitive on the playing field.

Now I am not implying that competition is the cause for all drug abuse. But in many cases the need to compete in society, or to compete in business, or to compete in education, or to compete in daily life, or to compete in sport is the seed for the development of a desire to do anything that will allow us to get ahead.