United States Anti-Doping Agency Research Articles

Proliferation Of Orthobiologics Within A Professional Sport

The popularity of regenerative medicine has recently increased, with many athletes turning to orthobiologic therapies that utilize complex milieus of biological substances, such as stem cells and natural growth factors, to heal sports injuries faster. Commonly derived from donor and non-donor harvested tissues, these include umbilical cord blood, amniotic fluid, placental allografts, connective and adipose tissue. Many of these products are not well characterized and their safety and efficacy has not been proven. Orthobiologics, generally are not prohibited in sport if no exogenous growth factors or other prohibited substances are added after harvesting or during the administration process, and as long as they only return normal functioning of the affected area and do not enhance it. Use of these treatments by professional athletes, presents an ethical dilemma for anti-doping governance due to the unproven efficacy, possible health risks and potential to contravene the Spirit of Sport. The US Anti-doping Agency (USADA) adopted an orthobiologics Declaration of Use (DOU) policy in 2020 for the Ultimate Fighting Championship (UFC). PURPOSE: Document the use of orthobiologics within the UFC in order to assist in evaluating such products and provide an anti-doping status to athletes. METHODS: DOU were submitted to USADA in advance of treatment, including: Date of procedure, Product, Injury, and Course of treatment and reviewed by USADA. RESULTS: Over 50 stem cell DOU were submitted in 1y including over 15 individual products. Treatment was requested primarily for joint injuries sustained during competition or arising from overuse. The most common orthobiologic was umbilical cord derived Wharton’s Jelly following or in conjunction with surgical intervention. Despite the high amounts of growth factors and cytokines present, all but one DOU was approved since growth factors were not added post-harvesting. No adverse analytical findings were associated with orthobiologic use. CONCLUSIONS: The use of orthobiologics has exploded in UFC athletes. USADA continues to monitor the evolving field through a DOU process. More detailed studies are needed to characterize these products, ensure that the constituents lack the potential for performance enhancement, evaluate treatment efficacy and monitor their safety.

Thyroid Therapy or Dysfunction in Athletes: Is it Time to Revisit the Clinical Practice Guidelines?

Recent media have highlighted the controversy surrounding treatment of elite athletes for hypothyroidism. The World Anti-Doping Agency denied a request by the United States Anti-Doping Agency to ban the use of thyroid medication. At present, there is no scientific evidence that thyroid medication has the potential to enhance performance. Clinical practice guidelines are not definitive in regard to what classifies a patient as having hypothyroidism. Thyroid-stimulating hormone and free T4 are recommended to screen for thyroid disease; however, the thyrotropin-releasing hormone stimulation test is still advocated by some for detecting the earliest stages of hypothyroidism. Hypothyroidism has been demonstrated to reduce cardiopulmonary function and result in musculoskeletal symptoms, such as fatigue and muscle stiffness. Symptoms of hypothyroidism, including depression, fatigue, and impaired sleep, are similar to those reported in overtraining. These patients may have hypothalamic-pituitary dysfunction that may complicate interpretation of basal thyroid-stimulating hormone and free T4. To date, no association has been identified between training state and hypothyroidism. Research to more clearly define hypothyroidism using provocative testing, evaluate the potential for thyroid medication to enhance performance, and examine whether training may induce hypothyroidism in athletes is desirable.

On Apology

On Apology Gregg Murray (bio) Every man initiates a slanderous trial against himself.1 * When I cheated on my wife, it felt like I had broken into my own house and kidnapped myself. From then, a vast trial began to inhabit me, one in which I was found guilty. What I needed was apology. * Lance Armstrong is known for riding his bicycle in the streets of France. With a special kind of blood coursing through his body. In October of 2012, the United States Anti-Doping Agency released its bulletproof report of his guilt. Armstrong maintained his innocence. * Plato's Apologia Sokratous. This sense of the Greek word "apologia" means defense. In this text, Socrates is accused of corrupting the youth and not believing in the gods. He is on trial for his life. * Among some ancient communities, the worst punishment for murder was not execution. The guilty lived alongside their kinsmen but were banished from communication with them. They were still alive, but their tribal identity had been removed. * Twelve Atlanta Public Schools teachers stood trial in 2014-5 for altering test scores. In the face of convincing evidence, Judge Jerry Baxter gave the teachers an option: either admit guilt and apologize or face the consequences. Those who apologized were given light sentences with only one or two years of jail time. Those who didn't were given 20 years. * The Latin plagiarus, which arrives via the Greek plagion, means "kidnapper." [End Page 175] * She told me not to contact her. * During the 17 years Lance Armstrong rode bikes, his blood was different from yours and mine. It could hold more oxygen. Through narcotic doping, Armstrong was also able to manipulate the amount of pain he felt when fatigue set in on arduous mountain climbs. * In The Stranger of Albert Camus, Meursault kills an Arab man in cold blood. At his trial, he says he did it because it was too hot outside. Meursault is sentenced to execution. But, the narrator makes it clear that Meursault is not being executed for the murder. No, the real crime is that he didn't cry at his mother's funeral. This kept the jury from seeing him as a human being. * A juridical trial involves an examination of facts, which presupposes an objective reality to which we all have access. We call this "what happened." But trials in which we act as defendant and prosecutor and judge and jury… those are subjective to the bitter end. We produce narratives that deliberately incriminate or deliberately exonerate. The presence of the trial itself is a conviction. All that matters in such a trial is the sentencing. The sentences we write. The time we serve. Put another way, all that matters is a set of conclusions that reveals whether we have truly let ourselves go free, or whether in our masochism we lock the cell, turn the screws, up the voltage. * 20 years. * I had conversations with myself. Call her. No, that will make it worse for her. No, it won't. But it's what she wants. Maybe she doesn't know what's best. That's her decision to make, not yours. But I'm hurting so much. So is she, and it's your fault she's hurting. [End Page 176] * In cycling, a simple revolutionary movement is repeated billions of times. * Actor and Filmmaker Shia LaBeouf plagiarized his apology to the person whose film script he had plagiarized. * When she found out I had cheated, she refused to see me. I had been banished or, perhaps, kidnapped? * "I apologize" is one of the few examples of what linguistic philosopher J.L. Austin calls a performative utterance. To say "I apologize" is to do so. Another is saying "I do" when getting married. Sorry to tell you this, but saying you're sorry involves more than just contrition. It involves a performance of contrition. * I cry as I write this. * She wouldn't let me apologize, so I had to learn to forgive myself. How many times did I have her phone number completed on my screen? How many times the same dialogue in my head? * "Thank you for accepting responsibility...

A script analysis of the role of athletes’ support networks as social facilitators in doping in sport

The objective of this study was to examine the role of athletes’ support networks in doping in sport from a crime prevention perspective. To achieve this objective, the researchers conducted an in-depth script analysis of documents related to investigations in 2012 by the United States Anti-Doping Agency and in 2015 by the Cycling Independent Reform Commission of the doping programme carried out by the US Postal Service cycling team between 1996 and 2012. The results suggest that athletes’ support networks—such as team doctors, sports scientists, team directors and family members—play a critical role as social facilitators in doping in sport by encouraging, supporting and protecting both the doping programmes and the athletes who participate in them. This paper argues that a greater proportion of prevention measures must focus beyond the athlete themselves and on the activities of individuals within an athlete’s support network. The paper proposes several situational prevention strategies specifically targeting the activities of social facilitators.

Adulterated dietary supplements threaten the health and sporting career of up-and-coming young athletes.

The authors provide the perspective of the United States Anti-Doping Agency on the actions youth sport organizations should take to protect the health of developing young athletes.

Using the Rhetoric of Atonement to Analyze Lance Armstrong’s Failed Attempt at Redeeming His Public Image

In October 2012 former seven-time Tour de France champion Lance Armstrong was stripped of his victories and banned from professional cycling after the United States Anti-Doping Agency ( usada ) reported that he had lied about secretly using performance-enhancing drugs throughout his career. This essay analyzes the apologetic and atonement strategies employed by Armstrong during a two-part television interview with Oprah Winfrey in January 2013. Our analysis uses the framework of Benoit’s (1995) theory of image restoration discourse, Koesten and Rowland’s (2004) discussion on atonement rhetoric, and Shepard’s (2009) theory of simulated atonement. In this essay, we argue that Armstrong’s attempts at offering a public apology were undermined by his continued evasion of responsibility and his failure to outline a corrective course of action. Throughout the interview, Armstrong refused to describe his behavior as cheating and repeated past claims that he was merely a victim of the doping culture in professional cycling. We conclude that this failure to provide an authentic rhetorical atonement prevented him from redeeming himself among media and fans, as indicated by an examination of postinterview responses from the media and the public.

Why Lance Armstrong? Historical Context and Key Turning Points in the ‘Cleaning Up’ of Professional Cycling

The US Anti-Doping Agency published its evidence against Lance Armstrong in October 2012 after a lengthy investigation and a series of testimonies from his former US Postal Service teammates. This article aims to understand the development processes – local and global – that led eventually to his ‘confession’ in January 2013 on the Oprah Winfrey show. By taking a chronological approach from the 1980s onwards, the following key themes will be addressed: the doping state of play when Armstrong began his career; the incremental confessions of other cyclists that helped break down cycling's secret doping culture; the broader organisational changes in anti-doping; the reasons why Armstrong became the focal point of anti-doping efforts; and the implications for professional cycling and anti-doping in the near future. Thus, the aim is to synthesise macro- and micro-level developments to explain the outcomes, and to further understand the consequences of this ‘scandal’.

Social Agents’ Influence on Self-Perceived Good and Bad Behavior of American Youth Involved in Sport: Developmental Level, Gender, and Competitive Level Effects

Significant social agents are thought to play a vital role in youth development (Brustad, Babkes, & Smith, 2001). The United States Anti-Doping Agency (USADA) commissioned a nationwide survey to examine the effect significant social agents had on youth sport behavior. In Phase I, initial data were collected and results were published in the Journal of Coaching Education (2011). The results of the previous analyses were largely descriptive, and further analyses were desired. Therefore, the current study (Phase II) is a secondary but more in-depth data analysis of the initial data collected by the USADA. Phase II analyses (n = 3379, Mage = 12.23, SD = 2.78) revealed that youth sport coaches have the greatest positive influence on youth followed closely by parents, but all of the significant social agents, to different extents, were seen as more positive than negative by youth. Results varied by developmental level, gender, and competitive level. Results, limitations, and practical implications are discussed.

Detecting in the Dark

Many of the assays produced in the diagnostics field today take advantage of molecular labeling. Are you a coach who wants to know if your player is taking a performance-enhancing drug? A doctor interested in the disease status of your patient? Or, a TSA official wondering if there are explosives in a bag? Label it! But as diseases, drugs, and other threats evade our detection systems, researchers are not consigning themselves to label-based techniques. Labeling a molecule can interfere with its reactivity. “When you get into proteins and glycoproteins, it becomes more difficult to make label material,” says Dr. Larry Bowers, Chief Science Officer for the US Anti-Doping Agency (USADA).3 “Label-free biosensing is clearly very important.” The community is listening and has put its energy into the field of label-free diagnostic methods to improve the sensitivity and quality of detection. We discuss a recent advance in optical transduction that capitalizes on plasmons and man-made nanomaterials, which can come together to create a sensitivity so improved that “we can potentially see the binding of a single molecule,” says Andrei Kabashin, CNRS Research Director at Aix-Marseille University and lead researcher on the work. Kabashin and his colleagues reported recently in Nature Materials that label-free optical transduction technology has “at its core” surface plasmon resonance (SPR) (1). In SPR, scientists monitor the refractive index to observe the binding of a ligand to its receptor in real time. A newer offspring of SPR, localized plasmon resonance (LPR), in which SPR occurs in nanostructures, is full of potential—from detecting low molecular weight …

Update on Banned Substances 2013

Context:Doping has been pervasive throughout the history of athletic competitions and has only recently been regulated by organizations such as the World Anti-Doping Agency (WADA), US Anti-Doping Agency (USADA), and the National Collegiate Athletic Association (NCAA). These regulatory bodies were created to preserve fair play and maintain the safety of the participants. Their updated 2013 lists of banned substances and practices include a variety of drugs and practices that could cause harm to an athlete or give one an unfair competitive advantage.Evidence Acquisition:Published websites for the WADA, USADA, and NCAA were investigated. These governing bodies update and publish their lists annually.Results:The WADA, USADA, and NCAA monitor anabolic steroids, hormones, growth factors, β-agonists, hormone and metabolic modulators, masking agents, street drugs, manipulation of blood and blood components, chemical and physical manipulation, gene doping, stimulants, narcotics, glucocorticosteroids, and β-blockers. Some substances may be used by athletes but require formal exemption. The WADA has also recently created a category of nonapproved substances that have yet to be identified to curb athletes from experimenting with new doping agents.Conclusion:The lists of banned substances and practices per the WADA, USADA, and NCAA are in place to ensure the integrity of sports and maintain safe competition. Health care providers who work with athletes under the jurisdiction of these organizations should review updated lists of banned substances when prescribing medications.

The Lance Armstrong Saga

For cycling enthusiasts and LIVESTRONG supporters, October 2012 will forever be imprinted in our memories as the month of damning revelations and the demise of a hero. Literally millions of people worldwide believed in Lance Armstrong. For more than a decade, he inspired us with his phenomenal comeback and unrivaled good works in the fight against cancer. Sadly, he duped us. On January 17, after three more months of denial and increased seclusion, Armstrong came clean with Oprah Winfrey as a vast audience watched. The Armstrong question now has been answered. For the sake of his children, he finally admitted to using performance-enhancing drugs and is now seeking amends. Like no other story about drugs in sport, this one should rally us to action. It is no longer about Armstrong; it is about the charade of drugfree sport with all its nuances and complexities. We can only imagine the immense pressures in professional and world class sport. We understand why top athletes have networks of coaches and advisors to support training and maximize competitive effort. Their livelihood and prominence depend on it. Fans, the media, and corporate sponsors want to see splendid athletes competing at the highest level, so every potential aid is explored. Science and technology have spawned performanceenhancing advances, each with its own controversy. For example, cyclists benefit from improved bicycle materials and design, swimmers from bodysuits, and endurance athletes from altitude tents. All manner of dietary strategies and mental training techniques are used to gain an advantage. We see how doping could be viewed as just another tool. The World Anti-Doping Agency updates its extensive list of prohibited substances and methods annually. Notable on the list are anabolic steroids, erythropoietin, growth hormone, stimulants, narcotics, and blood doping. Banned drugs either impart an unfair advantage or are used to mask those that do. Many also pose significant health risks. National and international sports federations follow this antidoping code or a slight variation of it. Recent reports confirm doping is widespread in professional cycling, and most ‘‘dirty’’ cyclists are never caught. Doping is entrenched in other sports too; baseball, football, track and field, and weight lifting are obvious ones. Insiders are savvy and know how to beat the system. They live with the deception, while the public believe doping is limited and controlled by drug testing. Athletics like politics has its cover-ups, detections, and apologies. Following the United States Anti-Doping Agency report in October, many hoped Armstrong would see the light, admit his misdeeds, and show remorse. With his admission in January, he has an oddly unique opportunity to make a real difference, again. He could be a powerful force in dismantling the charade surrounding drugs in sport. Time will tell what role he takes. From youth leagues and pick-up games to national tournaments and the Olympics, we love sports. They are an outlet for our innate drive to play and compete, and cherished entertainment for young and old. Many pleasant memories are related to sport. We have all played a sport, ran a race, or competed on a team. Indeed, many learned about hard work, cooperation, and fair play through a sport. At the top levels though, the power of money reigns and ideals take a backseat. Questionable short cuts and secret strategies become necessary for getting ahead. Or so it seems. If doping in sport is to be eliminated, professionals need to stand up and admit the scope of the problem. Let us not shield the public from the hard truth. We all have been complacent. Fans overlook misdeeds and shady dealings as long as no one gets caught or is hurt. Then when a scandal breaks, we are outraged V for a few weeks. Like the Romans who filled the Coliseum 2,000 years ago, spectators still revel in the display of fierce competition but are not concerned with the details of preparation. Sport is a joy and a dilemma. It can be simple and pure but also complicated and corrupt. Armstrong’s saga is a stark reminder that doping in sport is insidious. Despite decades of well-intentioned and serious efforts, the current antidoping system is falling short. The recent stripping of Address for correspondence: Phillip B. Sparling, EdD, FACSM, Georgia Institute of Technology, School of Applied Physiology, Atlanta, GA 30332; E-mail: phil.sparling@gatech.edu.

Anti‐Dope Testing in Sport: The History and the Science

This summer, as the XXX modern Olympic Games and the XIV Summer Paralympic Games were held in London, millions watched magnificent efforts from the best athletes in the world. The ability of the athletes to produce their best personal performances in the spotlight and the pressure of the Olympic Games was a testament to the human spirit. But, because the margin between winning and losing is so small, one imprecisely placed foot or hand, one moment of indecision, one gust of wind at the wrong moment, and the gold medal is gone. Behind the scenes at these Olympics—properly so— was a scientific team performing under great pressure to ensure safe and fair competition by testing urine and blood for traces of performance-enhancing prohibited substances and methods. Their efforts were crucial, because, in partnership with the clean athletes, they support the integrity and the spirit of sport. More than 1000 samples were analyzed within a few days after each event for stimulants, steroids, masking agents, recombinant proteins like erythropoietin and growth hormone (GH), and other substances on the World AntiDoping Agency (WADA) Prohibited List (1). The List of Prohibited Substances and Methods is maintained by a committee of internationally recognized scientists and sport administrators. A revised list is released annually by the WADA. In deciding whether to add a compound or method to the list, the committee considers whether there is potential to enhance performance; a potential health risk for the athlete; or if use of the substance or method violates the spirit of sport. If two of the three criteria are met, the substance is added to the Prohibited List. The inclusion of the word “potential” recognizes that a substance may emerge for which there are no toxicological data. For example, the identification of the “designer” steroid tetrahydrogestrinone (THG) in a drop of fluid in a syringe turned in to the U.S. Anti-Doping Agency (USADA) in 2003 illustrates the problem. THG had been developed by Wyeth in the 1960s and taken to clinical trials as a potential anabolic agent, but never brought to market. It was impossible to locate any records from the clinical trials 40 years after the fact. THG had been shown to have anabolic activity (2). There were no publications about toxicological studies, but as a 17 -methyl steroid, comparison to similar structures strongly suggested the potential for some degree of hepatotoxicity. Based on this information, THG was added to the Prohibited List in 2006.

External calibration in Gas Chromatography–Combustion–Isotope Ratio Mass Spectrometry measurements of endogenous androgenic anabolic steroids in sports doping control

An alternative calibration procedure for the Gas Chromatography–Combustion–Isotope Ratio Mass Spectrometry (GC–C–IRMS) measurements of the World Antidoping Agency (WADA) Accredited Laboratories is presented. To alleviate the need for externally calibrated CO 2 gas for GC–C–IRMS analysis of urinary steroid metabolites, calibration using an external standard mixture solution of steroids with certified isotopic composition was investigated. The reference steroids of the calibration mixture and routine samples underwent identical instrumental processes. The calibration standards bracketed the entire range of the relevant δ 13C values for the endogenous and exogenous steroids as well as their chromatographic retention times. The certified δ 13C values of the reference calibrators were plotted in relation to measured m/ z 13CO 2/ 12CO 2 (i.e. R(45/44)) mass spectrometric signals of each calibrator. δ 13C values of the sample steroids were calculated from the least squares fit through the calibration curve. The effect of the external calibration on δ 13C values, using the same calibration standards and set of urine samples but different brands of GC–C–IRMS instruments, was assessed by an interlaboratory study in the WADA Accredited Laboratories of Sydney, Australia and Athens, Greece. Relative correspondence between the laboratories for determination of androsterone, etiocholanolone, 5β-androstane-3α,17β-diacetate, and pregnanediacetate means were SD( δ 13C) = 0.12‰, 0.58‰, −0.34‰, and −0.40‰, respectively. These data demonstrate that accurate intralaboratory external calibration with certified steroids provided by United States Antidoping Agency (USADA) and without external CO 2 calibration is feasible and directly applicable to the WADA Accredited Laboratories for the harmonization of the GC–C–IRMS measurements.

Debunking the Myth of Pregnancy Doping

The notion that pregnancy and abortion are forms of doping has persisted for 20 years. Popular and scientific literature on pregnancy/abortion doping was critically analyzed to compare pregnancy/abortion doping with definitions of doping and blood doping and to compare pregnancy/abortion doping themes to current scientific knowledge. Main themes included oxygenation advantage and hormonal advantage. During pregnancy, maximal oxygen uptake may improve but not exercise performance. Human chorionic gonadotropin, the only pregnancy hormone on National Collegiate Athletic Association and United States Anti-Doping Agency banned substances lists, increases during pregnancy but there is no evidence that hCG enhances athletic performance in women. Recommendations include revising USADA and NNCAA policies into congruence with World Anti-Doping Agency policies which ban hCG for men only. During the past seven years of advocating for college student-athlete athletic department pregnancy and parenting policies, popula...

Unfair advantage: the importance to clean athletes of preventing HGH abuse in sport

Drug Testing and AnalysisVolume 1, Issue 9-10 p. 410-410 EditorialFree Access Unfair advantage: the importance to clean athletes of preventing HGH abuse in sport Travis T. Tygart, Corresponding Author Travis T. Tygart [email protected] CEO US Anti-Doping Agency (USADA) USACEO US Anti-Doping Agency (USADA) USASearch for more papers by this author Travis T. Tygart, Corresponding Author Travis T. Tygart [email protected] CEO US Anti-Doping Agency (USADA) USACEO US Anti-Doping Agency (USADA) USASearch for more papers by this author First published: 22 December 2009 https://doi.org/10.1002/dta.78AboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL No abstract is available for this article. Volume1, Issue9-10Special Issue: Growth Hormone: barriers to the implementation of human growth hormone testing in sportSeptember ‐ October 2009Pages 410-410 RelatedInformation

The International Antidoping System and Why It Works

In the days leading up to the 2008 Olympic Games in Beijing, a number of scientific journals published special issues (1)(2) or critical commentaries and opinion pieces regarding the antidoping movement. For example, an analysis of antidoping policy by Kayser and Smith (3) presented criticisms based on ethical arguments (4). On the other hand, equally persuasive ethical arguments supporting antidoping policies were reported by Murray (5). In addition, the public statements released by the defense team before each of the 2 arbitration hearings for Tour De France winner Floyd Landis, at which he was convicted of committing a doping violation, vehemently attacked the laboratory and the staff that performed the test. These public attacks were by advocates for the defendant, and the antidoping rules prevented a response to these charges. My purpose here is to provide an overview of how the current antidoping rules came into effect, to review some of the science underlying the antidoping rules, and to discuss a few of the cases decided by the Court of Arbitration in Sport (CAS).1 The fight against performance-enhancing substances began in the 1920s, long before there were testing methods for the prohibited substances. For years, the leaders of sport went it alone in this fight. Some critics argued, and continue to argue, that sport leaders have an issue similar to the “fox guarding the henhouse” when it comes to overseeing drug-testing programs. A major shift occurred in 1999, when the World Anti-Doping Agency (WADA) was formed as an independent body to harmonize antidoping practices, and independent national antidoping organizations such as the Australian Sport Drug Agency, the Canadian Center for Ethics in Sport, and the United States Anti-Doping Agency (USADA) began to emerge. WADA was established as a Swiss foundation with the support of intergovernmental bodies, governments, …

Testing for Homologous Blood Transfusion in Elite Athletes - RPAH AT ATHENS 2004.

Following the 2000 Sydney Olympics and the introduction of testing for erythropoietin in elite athletes, it became apparent that many athletes had reverted to blood doping using homologous and autologous transfusions. The Science and Industry Against Blood doping research consortium approached Dr Nelson at RPAH to determine if a test could be developed to detect recent blood transfusions. A grant was provided by the US Anti-Doping Agency to develop a flow cytometric assay which detects the expression of a panel of minor blood group antigens. Most blood bank reagents are IgM and are not satisfactory as they cause aggregation. A series of IgG polyclonal antibodies were sourced and the optimal titre of each antibody to detect minor negative and positive red cell populations in in vitro mixtures was determined. The test was validated by four Sydney flow cytometry laboratories who tested unknown samples in a proficiency exercise. In April 2004, IOC, WADA and ATHOC agreed to introduce the test into the Athens laboratory in time for the 2004 Olympics with assistance from RPAH. From May till August, RPAH sourced suitable antibodies, performed antibody titrations, provided a standard operating procedure, consulted daily with both the Athens lab and the Anti-doping lab in Lausanne and conducted a series of 3 Proficiency Testing exercises for both labs. No false positives were found in 254 antibody/sample test combinations. The Athens lab used a panel which included antibodies to C, c, E, Jka, Jkb, Fyb, Fyb, M, N and S. Reagents for anti s, K and e were also provided by RPAH. Two weeks before the Games, the lab personnel moved into the IOC Athens Testing lab. A total of 350 endurance athletes were tested. This included placegetters plus randomly selected competitors.

Drug Use in Sports and Exercise

Drug Use in Sports and Exercise

Be Prepared

Be Prepared

Drospirenone

Drospirenone (DRSP) is a compound with mingled identities having been viewed as a diuretic,1 a progestational agent,2 and/or an antimineralocorticoid agent with an ability to reduce blood pressure (BP).3–6 The multiple personalities of this compound can be seen by examining the position adopted by the United States Anti-Doping Agency on its use as a diuretic in athletes. Until January 2005, athletes were prohibited from using the fixed-dose combination contraceptive product (3-mg DRSP/0.03-mg ethinylestradiol [EE]) in or out of competition specifically because it contained the diuretic DRSP, albeit a compound with very weak diuretic properties.1 This restriction on DRSP use in athletes has been lifted, although the use of spironolactone is still outlawed. More recently, DRSP has gained some momentum as an antihypertensive agent.3–6 All along, DRSP has been a progestational agent used in combination with estrogen for birth control or treatment of vasomotor symptoms relating to menopause.2 DRSP, formerly called dihydrospirorenone, is chemically related to 17α- spironolactone. It is a synthetic progestogen, which more closely resembles natural progesterone than conventional synthetic progestogens. As such, it possesses clinically recognizable antimineralocorticoid activity and is estimated to be 8 times more potent than spironolactone (3 mg of DRSP=25 mg of spironolactone).7 DRSP pharmacokinetics are such that it has an oral bioavailability of &80%, a half-life of 30 to 35 hours, and is without active metabolites, a characteristic that distinguishes it from spironolactone.7 In early studies, administration of 2 mg of DRSP daily for 6 days …