tainted gold?

analysis, bbc radio 4, 4 january 2004

KENAN MALIK   From Manchester United's Rio Ferdinand missing a drugs test to leading sprinter Dwain Chambers failing one: sports and drugs seem forever in the headlines these days. And it's not just their reputations that sportsmen and women appear to be putting on the line.

VIVIENNE NATHANSON   There are some very frightening bits of research which show that if you talk to people aspiring to be elite athletes and you say to them 'If we could give you a drug which would guarantee that you'd win a gold medal at the Olympics but you'd be dead within five years, would you do it?', the majority would say yes.

KENAN MALIK   Dr. Vivienne Nathanson, Head of Ethics at the British Medical Association. There are, of course, no drugs that can turn ordinary athletes into world-beaters. But the willingness of so many to contemplate such a Faustian pact seems shocking. How do former Olympic medallists Mark Richardson and Tessa Sanderson feel about this?

MARK RICHARDSON   What kind of moral standard, what kind of example are we setting you know when these sportsmen and sportswomen are meant to be, and are perceived as role models, but they're going out there and they're contravening the laws set by our sport in order to get a better performance? We want them out of the sport. It's the worst form of cynical cheating. It cannot be condoned in any shape or form.

TESSA SANDERSON   Many advice I give my athletes because if the question comes up about drugs - and it does because I have athletes from the age of you know seventeen right through to now thirty - and I say to them, look, don't even think about it. They've seen me compete for twenty-six years and I've never once been done for drugs. You know I have a clean image about me.

KENAN MALIK   So, what are the drugs that so worry Richardson and Sanderson, and how do they work? Dr Richard Nicholson is editor of the Bulletin of Medical Ethics, a former international rifle shooter, and the author of an official review of drug use in sport.

RICHARD NICHOLSON   It appears that the commonly used groups are anabolic steroids, which boost the proportion of muscle mass in the body and which certainly do enhance the power of muscles. There is a lot of suggestive evidence that erythropoietin an artificially produced exact model of a hormone that appears in the body, is used by distance runners, those who need to be able to transport a lot of oxygen, because what it does is enhance the production of red blood cells so that you have more red blood cells that can carry more oxygen around the body to the muscles. Its end effect is actually the same as that of training at altitude. Beta-blockers are of potential value in a few sports where one does not want to have the sort of nervous tension that most athletes rely on. So in rifle shooting, pistol shooting, archery, billiards, snooker, sports like that, beta-blockers may well give some advantage.

KENAN MALIK   Drug testing was first introduced into the Olympic Games in 1968. Over the past four decades a fully-fledged drug detection industry has developed, with the establishment of the World Anti-Doping Agency, the creation of specialist pharmaceutical labs, and an ever-expanding list of banned substances. But has the anti-doping industry become as much of a monster as drug-taking itself? Not satisfied with testing sprinters and weight-lifters, the World Anti-Doping Agency now wants urine samples from - wait for it - chess and bridge players. And among the drugs that they will have to avoid are coffee and Nurofen. At the Sydney Games four years ago, the 16-year old Romanian gymnast Andrea Raducan was stripped of her gold medal for taking two Nurofen tablets that everyone agreed had done nothing to improve her performance.So what does the sprinter and 1996 Olympic silver medallist Mark Richardson do when he gets the sniffles?

MARK RICHARDSON   I don't take anything. It's best. As an athlete, you can't afford, I just can't afford to take the chance of failing a drugs test, so I just sweat it out. I take good old-fashioned paracetemol or an aspirin simply because it is a minefield out there. As it stands, as the laws of the sport stand, you have to be very careful. And, yes, some people may legitimately be taking something which has pseudoephedrine to help them recover from a cold and it's perfectly legitimate for everyday people on the street, but you get other people who are trying to push the system and it is a legal minefield, to be honest.

KENAN MALIK   Four years ago Mark Richardson himself fell victim to the drugs police. He tested positive for the anabolic steroid nandralone, which he says he unwittingly ingested from a legal dietary supplement. As a result, he had to sit out the Sydney Olympics.

MARK RICHARDSON   I did miss the Sydney Olympics, yes, but I voluntarily withdrew because I was kind of forced into a corner. The IAAF wanted me to have an arbitration hearing just prior to the Olympics and I knew the science hadn't worked quick enough. Unfortunately the laboratory hadn't got the conclusive evidence and proof that I needed. I made the decision to withdraw from the games.

KENAN MALIK   You were later cleared totally of the charges, but how did you feel at the time at having to miss the Olympics?

MARK RICHARDSON  I can't even begin to describe it. Obviously it was a very low point. I was deprived of a medal, to be honest. I was in great, great shape. There was only one person who was regularly beating me and that was Michael Johnson. Everyone knows what he went on to achieve at the Olympics. But I can't turn the clock back. For me, at that time, the most important thing was to clear my name. You know my name is something that's going to be with me for the rest of my life and I did not want anyone thinking I was a drugs cheat, that I knowingly took an illegal product. I just couldn't live with that and so I had to do everything in my power to prove my innocence.

KENAN MALIK   All this might suggest that current drugs policies are both overly intrusive and deeply unfair, arbitrarily depriving both individuals and nations of medals and glory. Many, however, like Mark Richardson and Tessa Sanderson, defend the draconian powers of the drugs police - including the rule that athletes are guilty even if they've unknowingly taken a banned substance. They think too many athletes are both cheating their fellow competitors and harming their own bodies, while the anti-doping industry is forever lagging behind, as athletes move from one supposed wonder drug to the next. Richard Callicott is Chief Executive of UK Sport, the government body that runs elite sport in this country and is responsible for drugs testing. Does he agree with those who say he's always playing catch-up?

RICHARD CALLICOTT   I would reluctantly have to concede that they have a point. That said, however, the discovery recently of a previously non-detectable steroid is an indication the extent to which some cheats will go and, frankly, some unscrupulous people will go in laboratories, chemists, whoever they may be in order to try and con the public and con athletes and cheats by taking these sorts of undetectable substances. But the good news is that the formation of the World Anti-Doping Agency means that for the first time we've actually got governments of the world working together with sports federations, international federations. And we've never had that before. It's always been operating very much in isolation and there's been no coordination. But now we have a coordinated approach and as more countries come into that process and that programme, then the information that's passed between us will increase. The important part is we've got to get to youngsters to recognise that winning at all costs isn't necessarily the answer, but winning is okay but winning clear and winning fair. That's the important part.

KENAN MALIK   But it's never been clean and fair. For as long as sports have existed, sportsmen have taken drugs. Ancient Greek athletes used magic mushrooms to fortify themselves. In the 1904 Olympic Marathon, Thomas Hicks ran to victory thanks to injections of strychnine and doses of brandy administered to him during the race. It was the Cold War which turned sport - and drugs - into an ideological weapon. There was outrage in the West about the way that Eastern bloc coaches encouraged their athletes to pop a pill as easily as they slipped on a pair of spikes. Not that all Western athletes were squeaky clean. Tessa Sanderson, who became Olympic javelin champion in 1984, was well aware that many of her rivals from East and West were doped up. It's strengthened her conviction that drugs have no place on the sports field.

TESSA SANDERSON   When you're putting something in your body that is not natural, then you know there's got to be some harm that it is doing. So I can say, yes, that I really do feel that some athletes who take drugs probably feel that it is going to enhance their performance. But then you get the other side of it because you do get some sportsmen or athletes who probably have been taking drugs for a long time and it hasn't done a thing for them.

KENAN MALIK  When you were a competitor, was there any pressure on you to take drugs?

TESSA SANDERSON   Very much so. Not as much as I suppose there is nowadays, but there was a lot of pressure in the sense that I was asked to and also you know by people who even people who you knew. You know it was like, 'Here, girl, why don't you try this?'. And I thought you know you must be crazy. There were times that I was offered you know drugs to take, but I totally refused because, for one, I was frightened to death and thought well you know I'm sure this is going to harm your body somewhat, and also because you know I had a lot of confidence in my coach, I had a lot of confidence in my natural ability and I had good parentage behind me.

KENAN MALIK   Athletes, the argument runs, should not do anything that is either unnatural or gives them an unfair advantage. But athletes commonly do many things - from high altitude training to high protein diets - that are neither natural nor maintain a level playing field.

ELLIS CASHMORE   If you look at the history of sport, you'll see that cheating has been really a function of how we define what's fair play, of course, and that's manifestly obvious.

KENAN MALIK   Ellis Cashmore, Professor of Sports, Media and Culture at Staffordshire University.

ELLIS CASHMORE   If, for example, we turn the clock back and look at the time where spikes were introduced, for example, there was a hue and cry over it. People said hang on, you can't run in spikes, that's giving you an unfair advantage over the competitors who run in flats. And when world records were set on synthetic tracks as opposed to cinders, again people were saying is this fair, or isn't it fair? And we adjusted the rules. We adapted to the changes in technology. In other words, they are making the most of what technologies are available. It just so happens that some of those technologies are subject to bans and of course pharmaceuticals are one of them.

KENAN MALIK   So are you saying that there's nothing natural about sport?

ELLIS CASHMORE   I think that this is a fallacy that there's any kind of natural state of the human body. I mean we can trace it back to the 18th century and the days when gentlemen and players competed. And of course the players got wise to the idea that if you trained it would benefit your performance. The gentlemen said hang on, you can't go away and train because that isn't in the spirit of fair play. But they did train, of course, and they did enhance their performance through training. So training in itself changes the characteristics of the human body. It confers on us new qualities - we can run faster, jump higher, have more stamina.

KENAN MALIK   But what evidence is there that performance-enhancing drugs really enhance performance? Dr Richard Nicholson.

RICHARD NICHOLSON   There has been very little research about how any of these drugs enhance performance. There have been some studies, but remarkably few overall - only about two or three that are scientifically credible - which show that giving steroids to fit, young people will enhance their performance in certain athletic events, but the amount of evidence is quite small. One of the commonly found drugs for which sportsmen are disqualified or banned are stimulants. There is absolutely no evidence that any stimulant has ever enhanced anybody's performance in any sport. The research hasn't been done. It's all supposition. And in that field, it's quite interesting how the supposition was fuelled by the sporting authorities because for years in the 50s and 60s as soon as - and more recently - as soon as any sports authority heard that some sportsman was trying out some sort of stimulant, then they would ban it and that would give the message to everybody else in the sport that it must be effective. Why else would they bother to ban it? But the scientific evidence simply isn't there.

KENAN MALIK   You seem to be suggesting that despite the panic about drugs and sport, there is actually very little we know about how they're used, what drugs are used and what effects they have on enhancing performance. Is that right?

RICHARD NICHOLSON   It is right that we know very little because the problem is that the sports authorities have put a certain amount of money into this field but only into trying to improve detection rates. They're only now, through the World Anti-Doping Agency, beginning to do some of their own research and that research is still into how to detect drugs better.

KENAN MALIK   This year Britain alone will spend more than £3m on drug tests. Worldwide, the figure is estimated at over £100m. Why bother, if most drugs have no effect? For Dr Vivienne Nathanson, such spending is necessary, not to stop athletes cheating, but to prevent them harming their health.

VIVIENNE NATHANSON   We have considerable evidence of the harms, but some of the harms are less well documented than others. It's very interesting that young people take anabolics because they think it'll make them more attractive, but for women it's likely to give you quite severe acne, it may stop your periods, it may make your breasts get smaller; in men the exact opposite happens - they're likely to get breast enlargement and testicular atrophy. In both, you can get problems with fertility both short term and permanent. So those are just short-term effects. And long term of course, because it's having an effect on muscle, the heart is a muscle, it can damage the heart and it can cause permanent heart damage; that we'll see people with potentially lethal cardiac muscle, heart muscle abnormalities, in younger and younger age groups.

JIM PARRY   People say that you shouldn't take drugs in sport because your testicles will shrivel and then you'll die. Well actually this doesn't appear to be the case.

KENAN MALIK  Jim Parry, once a striker with Derby County, now a lecturer in Philosophy at Leeds University.

JIM PARRY   There've been very few doping related deaths in elite sport. There doesn't seem to be any documented evidence that performance enhancing drugs are anywhere near as harmful as tobacco smoking or alcohol, both of which are legal. Also sports itself is very harmful. There aren't really any figures for how many people are rendered paraplegic through participation in gymnastics and rugby, but you bet your life that the harms caused by sport itself are at least as high as the harms caused by the drugs that are taken.

KENAN MALIK   There is considerable anecdotal and personal evidence - much of it from East European athletes - that long-term use of performance enhancing drugs does create all manner of health problems. The East German shot putter Heidi Krieger, for instance, was forced into a sex change, the result she says of years of steroid abuse. Yet the scientific evidence for such harm remains thin. The British Medical Association has launched a campaign against the use of drugs, in particular anabolic steroids. Yet its own report, Drugs in Sport, acknowledges that 'Systematic life-threatening side-effects of anabolic steroids have not been substantiated' and that 'only speculative evidence links anabolic steroids and coronary heart disease'.

In any case, as Jim Parry observes, sports by their very nature can be dangerous. Around 100 people die each year in Britain from sports-related injuries. While there are no figures for deaths from the use of performance enhancing drugs, most people accept that it's considerably less. But we allow people to hanglide, go rock climbing, box and play American football because they are making informed decisions about the risks they are willing to take. Why can’t we treat drugs in the same way? Professor Ellis Cashmore.

ELLIS CASHMORE   Any policy that is based on the idea of banning the use of performance enhancers in sport is doomed to failure. I propose that we abolish the regime of this surveillance in drug testing in sport and perhaps replace it with some kind of mechanism for monitoring. I would ask athletes for disclosure so that we knew what products they were taking at what intervals and for what parts of the year. And then I think we could advise accordingly. It'd be transparent. And I think that that would create an environment which is far healthier for the athletes.

RICHARD CALLICOTT   I couldn't reject that proposition more violently. That is a totally unacceptable way of going. That suggests that we want to end up with chemical games.

KENAN MALIK  Richard Callicott of UK Sport.

RICHARD CALLICOTT   That suggests that we want to try and somehow see which drug is better at running a hundred metres than another drug and that's unacceptable. That's not the ethos of sport. That's not what sport is about. I reject that totally. All that means is that the strongest scientists will win medals and actually that's not what those of us that work in sport, and have worked in sport all our lives, stand for. I think that there is a new mood. I think there's a cultural swing and I sense that that swing wants more than ever for the United Kingdom, amongst others, to set a new standard in the ethics of world sport by standing up for principle.

KENAN MALIK   But scientists already help athletes win. Cyclist Chris Boardman won his Olympic Gold in Barcelona in 1992 sitting on a specially-engineered machine. In the Rugby World Cup, England players wore body-hugging shirts specifically designed to help evade tackles. In neither case did the scientific work in the labs devalue the sporting triumph in the stadium. Why view drug use differently?

It's difficult, in any case, for proponents of the current drugs policy to assume the moral high ground. Not only are the arguments for a draconian drugs regime flawed, but the policies often lead to dubious consequences. Is depriving a 16-year Romanian gymnast of her life's dream because she took a couple of Nurofen tablets really to stand on principle? One can't help wondering whether the cultural swing in sport is largely the consequence of financial and political pressures to present a cleaner image. Tessa Sanderson manages about a hundred up-and-coming athletes around the world. One of her jobs is to negotiate with sponsors.

TESSA SANDERSON   The first thing they'll probably say, 'None of you’re athletes is caught up in drugs, are they, or anything like that?'. Because a lot of them or the majority of them are very, very much aware that you know this goes on but they don't want it with their product. They do not want it with their product because they don't see it as you know a good thing. They care about the young people who are coming through. And because, especially with track and field, a lot of sponsors wants to keep that image of it's family entertainment, you know, and they don't want it tarnished. So they are more likely to stay away from you if they know that you have been tarnished with drugs than you know come with you and just think oh well it will be pushed under the cover and because you're a star. It'll happen. No, I do think that mud sticks, you see, and a lot of them are concerned about this.

KENAN MALIK   So that's the direction we're heading: football or rugby or athletics as family entertainment; sportsmen and women as clean-cut role models. But being clean-cut is not why fans worship Diego Maradonna or Eric Cantona, or why John McEnroe stirs the soul in the way Pete Sampras never could. What we want is passion and rebelliousness as well as sporting prowess. For Ellis Cashmore, the problem is not that money has corrupted the soul of sport but more that it has corrupted the soul of sportsmen.

ELLIS CASHMORE   What I think we've witnessed in recent months and perhaps years is the formation of an elite group of celebrity footballers who have more money really than they ever imagined they'd have and they have it by the time they're twenty-five. And they somehow have got into the frame of mind where they believe they're above the law, you know they occupy the same status as rock stars and movie stars and you know they expect the red carpet treatment wherever they go. Someone gives them a sample bottle and says we need a sample for a drug test and they say 'Don't bother me with such trivialities. You know I've got to do some shopping at Harvey Nicks. Get out of my way.' You know you suddenly get a young person and you start funneling several millions pounds into their bank accounts and then watch them go out of control.

KENAN MALIK   But perhaps we should be less pious about loadsamoney footballers. Yes, many behave badly. But why are we surprised at that? Why do we insist that rich young men and women, whose main concern is to score goals and win medals, should become moral standard bearers? Yet, many argue that sportsmen and women already are role models, and that their behaviour influences millions.

VIVIENNE NATHANSON   Certainly young people when questioned don't seem to see drugs used in sport as a problem. They don't see it as an issue, something they should avoid doing. Because they hear of elite athletes using drugs, they think well if it's good enough for somebody and might make them a world champion potentially, then it might help me.

KENAN MALIK   The BMA's Vivienne Nathanson. There is particular concern among doctors about the extent of the misuse of anabolic steroids by non-athletes.

VIVIENNE NATHANSON   The consequences that we see are not just immediate, the short term consequences, but we're going to see long term effects of people who have done permanent harm to their bodies from using these drugs. We have no real idea of numbers. We just know that in some gyms the percentage is maybe as high as sixty or seventy percent of people using their gyms have said they've used them. People feel you know before they go away on their holidays in the summer, they want some muscle definition and that this will make them look good on the beach and so on, so that's why they take anabolics. As with all other casual drug use that becomes apparently almost socially acceptable, you start to see increasing numbers of people and therefore almost an epidemic spread. And it's a public health problem because this is the health of large numbers of people being affected. And, as doctors, we can't just deal with the individuals; we have to deal with the root cause, which means the availability of these drugs, people's attitude to them and their understanding of toxicity.

KENAN MALIK   There is certainly evidence that steroids are freely available, in gyms and through the internet, and that they are increasingly widely used. But have they become socially acceptable merely because top athletes use them? Surely it's too easy to blame complex social ills on the behaviour of a handful of people we first put on pedestals, and then knock down. Perhaps the real difficulty is that we use the same word - drugs - to describe both an issue in sport and a problem in society. Jim Parry of Leeds University.

JIM PARRY   I think the moral panic about social drugs - and I think we're right to be very worried about social drugs - transfers to the worries about drugs in sport. I don't think that doping substances can be made equivalent to heroine and cocaine and shouldn't be. They're separate problems and should be treated differently. We shouldn't have a moral panic on about doping in sport in the same way that we have a moral panic about heroine and cocaine. Heroine and cocaine are social problems: they're problems for society and they require political and police activity. Doping in sport is a problem for sport, not for politics. It's not a social problem in a way. It's an internal problem for sport which affects the internal ethics of sport and that's the big problem.

KENAN MALIK   The very language of the drugs debate often precludes a rational discussion. Drugs baron and innocent victim, dirty needles and crack dens - the imagery of drugs is highly potent and morally charged. Transferring this debate from society to sport does little to help us address the issue in either sphere. For Jim Parry the pressures to take drugs are rooted in the competitive nature of sport itself.

JIM PARRY   If you take the Olympic motto 'citius, altius, fortius' - faster, higher, stronger - you can see that within it is a logic of the everlasting progress of sport through record-breaking and through higher and higher achievement, so that increasing demands are being put on athletes to become better and better all the time. And so the idea is that the internal logic of sport pushes the equipment that the athlete has to use and the athlete himself further and further towards the limits of human capability. The athlete comes to see his own body as an instrument for the production of a new record and this can produce abuses. Think about cyclists. What do you want to find out - which is the best cyclist, or which is the best bicycle? I have a prejudice that I'd like to think that we were watching the best cyclists, not the people who were riding the best bikes that had been produced by an advanced economy. It's the same with sprinters. Wouldn't it be nice if all the sprinters were as they were in ancient times - almost naked, running on the earth, not on a specially prepared track; running in bare feet, not in specially prepared shoes? Then you know who's the best sprinter.

KENAN MALIK   Oh, what a wonderful image that conjures up! But, I fear, we won’t be seeing many naked men running across Hackney Marshes, even if the 2012 Olympics comes to London. We certainly need a more rational drugs policy but one that’s rooted in 21st century Britain not in Ancient Greece. To create such a policy, we could start by scrapping the whole multi-million pound anti-doping industry and putting the money instead into some basic research into the impact of drugs on both performance and health. And once we have the facts, then we can start making decisions on which drugs are useful, which harmful and which we might wish to ban. It’s time the sports authorities started taking pragmatic decisions that will benefit both sport and those who take part in it.