The Tour de France is in a shambles and the I.O.C. is red-faced. What can be done to stop substance abuse?

By TIM BLAIR AND ROD USHER

o enhance something means to raise its value or beauty, or increase its strength. But such a boost is not necessarily of benefit to humanity; the technical name for a neutron bomb is an "enhanced radiation weapon." And when it comes to sport, to enhance is becoming synonymous with another, simpler, expression: to cheat. The Tour de France, which limped into the Champs Elysees on Sunday, showed just how deeply modern sport has been corrupted by performance-enhancing substances. The world's leading bicycle race was revealed to be more of a Tour de Pharmacy than a competition which lets the best man win. The top team, Festina, had its nine riders expelled after police found a masseur with hundreds of doses of substances designed to make cyclists ride faster for longer. And as the race went on, it became clearer--with more searches, arrests and protests by riders--that substance abuse is rife in cycling, as it is in elite running, swimming, weightlifting and a host of other sports.

The continuing Tour investigation into several teams is run by police and headed by a French magistrate rather than the sport's own officials, raising hopes it might reveal the extent of drug abuse in cycling, leading to action to stop it. But those hopes were already fading even before the Tour ended. The extent to which a degree of enhancement might be accepted at the highest levels of world sport was underscored by no less than Juan Antonio Samaranch, the president of the International Olympic Committee. Asked about the Tour, Samaranch said in an interview with the Spanish newspaper El Mundo that the Festina case was "a heavy blow for cycling and for all sport." But the 78-year-old Catalan, who has held the highest office in international sport for the past 18 years, went on to make clear his own view on what athletes should and shouldn't be allowed to consume to make them go, as they say in the Olympics, swifter, higher, stronger. "Doping," said Samaranch, "is all that which, first, damages the health of the sportsperson, and, second, artificially increases his performance. If it produces only this second condition, for me that's not doping. If it produces the first, yes."

Samaranch argues that what is needed is an exact definition of doping, something he has been seeking for years, to go beyond the simple list of prohibited substances. But he added: "The actual list of [prohibited] products should be drastically reduced. Everything that doesn't act against the athlete's health, for me that's not doping."

This idea shocked many. In Britain, Amateur Athletic Association president Sir Arthur Gold said, "These are very unwise remarks by the I.O.C. president, and I disagree entirely with them. No one knows for certain which drugs are dangerous to the health, but if they enhance a person's performance, it is blatant cheating." His dismay was echoed by 1980 Olympic 800-m champion Steve Ovett, who said Samaranch's remarks indicated he wanted to "throw in the towel" in the fight against drugs. Making matters worse for Samaranch was the news the day after his interview that two big names in U.S. athletics, 1996 Olympic shot put champion Randy Barnes and sprinter Dennis Mitchell, a bronze winner in the 100 m at Barcelona in 1992, have been provisionally suspended by the International Amateur Athletic Association (I.A.A.F.) for failing out-of-competition doping tests in April. A urine sample from Barnes--who was earlier banned for two years after testing positive for steroids--indicated a prohibited nutritional supplement, androstenedione. Mitchell's test indicated testosterone, and he faces a two-year ban if a case is proved. He is president of the U.S.A. Track & Field Athletes' Advisory Committee, the athletes' representative on the national governing body for the sport, which has taken a firm anti-doping line. Internal disagreement was shown again last week when the U.S. national body said it will not enforce the I.A.A.F.'s provisional ban on Barnes and Mitchell, arguing that positive initial urine tests don't prove they have committed any offense. The I.A.A.F. replied: "We are the governing body."

Simultaneously, the world governing body for swimming, FINA, was debating in Lausanne, Switzerland--where the I.O.C. is based and where Samaranch gave his interview--whether to act against Michelle de Bruin, who as Michelle Smith won three gold medals swimming for Ireland at Atlanta. She is accused of manipulating a urine sample, which laboratory testers claim was rendered useless by the addition of alcohol, possibly whiskey. The swimmer denies taking drugs or tampering with a urine sample. The same FINA committee last week had less difficulty in imposing a two-year ban on four Chinese swimmers who tested positive in the world titles in Perth this year for the banned substance triamterene, a diuretic which can mask the use of steroids. In the face of so much controversy, and with officials claiming Samaranch had been misinterpreted, the I.O.C. announced a world conference next January to agree on a definition of doping.

Meanwhile, at a conference in Sydney last month the former head physician to the U.S. Olympic team, Dr. James Puffer, observed that "The only athletes who get caught using drugs these days are those who are pharmaceutically unsophisticated." As fast as scientists learn new ways of drug detection, athletes and their coteries find new drugs and new ways of masking them, or of beating checks. Athletes have been found at control centers hiding bags of untainted urine received from someone else; others have even undergone "urine transplants," meaning someone else's "clean" urine is inserted into their bladder via a catheter, an often painful procedure.

"Always, athletes who cheat try to shift to new drugs," says Dr. Jordi Segura, head of drug testing at the 1992 Barcelona Games and secretary of the doping subcommission of the I.O.C. "It takes the laboratories time to catch up."

Before the Atlanta Olympics in 1996, it seemed they had. A sensitive testing machine, the high-resolution mass spectrometer (H.R.M.S.), was to be used at a Games for the first time; many predicted a record number of drug busts. But detecting drugs can be easier than prosecuting their users. Months after the Games, it emerged that four athletes had tested positive for anabolic steroids. They were not disqualified for fear that the technology, being so new, might be successfully challenged in court. Concedes Australia's Kevan Gosper, I.O.C. executive board member and vice president of the Sydney Organising Committee: "It was not a perfect outcome."

Lawyers have been playing an increasing role in sport since German sprinter Katrin Krabbe was suspended for four years for taking the banned drug clenbuterol in 1992. In 1995 she successfully sued the International Amateur Athletic Federation in a Munich civil court. It ruled that a four-year penalty was too long a restriction, given an athlete's short career. This effectively restricted the German Athletics Federation to two-year bans for drug use, a limit that national courts in other countries--such as France, Spain and Russia--uphold. This inconsistency has forced the I.A.A.F. to wind back its policy from four-year to two-year bans. British sprinter Linford Christie said of the change, "The deterrent is not strong enough."

Part of the problem is that many of the substances being used occur naturally in the body. These include human-growth hormone (HGH) and one of the substances police seized during this year's Tour, EPO, or erythropoietin, which is used properly to treat anemia, but which athletes and those managing them have learned increases the production of red blood cells and allows the blood to take up more oxygen. "With today's technology," says Dr. Ken Ho, head of the Clinical Investigation Unit at Sydney's Garvan Institute of Medical Research, "it is impossible to discover if EPO comes from the body or the bottle." HGH is used in medicine to treat retarded growth, but athletes found it can aid recovery after strenuous training.

However, a side effect of EPO is that it thickens the blood, meaning that in large doses it can cause heart attacks or strokes. Says John Hawley, of the Sports Science Institute of South Africa, "We don't know the long-term effects of EPO." The side-effects of taking HGH can be grotesque: excessive bone growth in the face, hands and feet. Athletes can develop what's known as HGH jaw. Again, long-term effects are unclear.

It is partly because such substances occur naturally that Samaranch wants doping defined. For example, is the once-common practice of blood packing legal? Sometimes called blood doping, it involves the removal of about a liter of an athlete's blood, which is frozen and stored while the athlete trains. Before competition, it is pumped back in, giving bonus oxygen-carrying red corpuscles, similar to those gained in high-altitude training. No drug is involved, so is it merely altitude training without the air fare? Ever since the Finn Lasse Viren was accused of blood packing in the early '70s--he denied it, insisting his success was based on drinking reindeer milk--it has remained a grey area.

One of the biggest obstacles to controlling drug use has been that, while the I.O.C. is able to test athletes during the Olympics, outside the Games drug testing is the job of national athletics bodies. Says John Whetton, principal lecturer in life sciences at England's Nottingham Trent University: "Either some countries didn't want to know about drugs or they couldn't afford to know, but you could see the records falling by huge amounts. [By the late '80s] it was fairly clear that we'd passed through a decade of increasing drug abuse."

One initially successful I.A.A.F. response was to form in 1991 a "flying squad" of drug testers, headed by Whetton, to arrive unannounced in countries such as India and Greece, and throughout Africa. Whetton says that in some countries, "we could forecast the percentage of drugs we would find just by looking at the athletes. We knew 25% would test positive to something"--usually steroids or amphetamines.

Whetton and the many examiners his group trained in different countries are now frustrated because they lack the means to detect the newer drugs. These include testosterone, which, like EPO or HGH, is a naturally occuring hormone. One test for its synthetic use is to compare the ratio of testosterone to that of epitestosterone--another hormone, but one that doesn't help performance--found in athletes' urine. A wildly disproportionate testosterone level is a signal that synthetic testosterone has been taken. In most men the testosterone-epitestosterone ratio is 1 to 1. But to allow for the fact that some have higher natural ratios, the maximum acceptable for Olympic competition is set at 6 to 1. That, however, means anyone with a low natural ratio can boost his testosterone levels to 6 to 1 and stay inside the legal limit. Says Whetton: "With certain ethnic groups the ratio is inverted. There is more epitestosterone than testosterone; you get a ratio of .2 to 1. These guys could take huge amounts of testosterone and stay within the rules."

Frustration over drug testing extends, naturally, to the competitors. Carl Lewis, who collected a gold medal in Seoul when Canada's Ben Johnson was disqualified for using steroids, last year accused U.S. athletics authorities of hiding the extent of drug use after four positive tests among U.S. athletes. "The structure has broken down and the doping problem is being ignored and sometimes supported," said Lewis.

Another indication of athletes' attitudes is an informal survey conducted every two years since 1982 by Bob Goldman, president of the National Academy of Sports Medicine in Chicago. He asks Olympic-level U.S. athletes: If you were offered an illegal substance that guaranteed you would win and not be caught, would you take it? In 1995, 195 of 198 athletes said yes. Asked if they would take a banned substance that would enable them to win every competition for five years but then kill them, more than half the athletes said yes. "With the money athletes can make, the kids don't really care about taking drugs," says Goldman.

John Konrads, Australia's 1,500-m freestyle gold medalist at the 1960 Rome Games, says today's elite athlete is so obsessed with victory that a positive drug test is more likely to make him indignant than ashamed: "He's lived every minute of his life to win a medal. The view would be that he had to take drugs to keep up with the rest of the competitors."

In the Olympics, neither athletes nor host cities want glory ruined by big drug discoveries. Says Dr. Don Catlin, director of the I.O.C.-accredited drug-testing laboratory at the University of California Los Angeles: "The last thing the Olympic people want is a slaughter. They don't want to catch a whole bunch of people in the middle of a nice Games. They tend to avoid those things by announcing in advance that they have a new test, and that if you're using a particular drug, to stop or you're going to get caught."

By 2000, any legal bugs should be removed from the H.R.M.S., making the $500,000 device a potent weapon against steroids and other, older drugs. "With the old mass spectrometers, we could detect a level of drugs equal to one drop of water in a swimming pool," says Australian Sports Drug Testing Laboratory director Ray Kazlauskas, who will use three H.R.M.S. units at the 2000 Games. "With the H.R.M.S., we can detect a drop in Sydney Harbour."

At the Lillehammer Winter Olympics in 1994, tests on blood, rather than urine, were used in Olympic competition for the first time. They have been used to detect EPO during the Tour de France since 1996, but after this year's substance scandal questions are being asked about how many are given, how often, and to whom. For instance, members of the Festina team were not blood-tested in last year's Tour.

Experts are divided on the advantages blood-testing has over urine-testing. Says Dr. Peter Sonkson, professor of endocrinology at London's St. Thomas' Hospital: "At Atlanta I did a little survey among athletes being urine-tested and the large majority would prefer blood-testing. It's cleaner, it's done and it's over with." But Whetton is less convinced: "Apart from being invasive, it can be against an athlete's religion. It can cause all kinds of upsets. It can cause you to faint." And again, while blood testing will reveal abnormally high EPO levels, it can't show whether these were produced by the body or introduced.

Even if EPO and HGH are brought under control, a new wave of drugs is sure to arise, their use driven by the wealth a gold medal brings. Says Dr. Mel Cusi, of the Australian College of Sports Physicians: "We know that the commitment of athletes to cheat is very high. Unless the I.O.C. is prepared to meet that commitment, it is always going to lose."

Another undetectable synthesized hormone, IGF-1, normally used to treat aids and cancer, recently became the drug of choice among power athletes. If it becomes as popular as EPO and HGH are believed to be, the work of designing tests and validating them in court will begin again. Says UCLA's Catlin: "You must get the right answer, you must be able to prove it's foreign, and you have to show that without any margin for error." While that process continues, the research that goes into drug taking keeps three or four years ahead of research into drug detection.

After the Tour de France scandal broke, James Waddington, author of Bad to the Bone, a novel about drugs and the Tour, came up with a tempting solution. In the London Times, he wrote: "Suppose bike racing was divided into two classes, Pure and Open. In the Pure class would ride those with a certificate of metabolic virginity. In the Open, anything would go." He assumes the best riders would go to doctors who could ensure them a healthy retirement, while the fools would turn to high-octane substances. But then he asks if "the money, the research, the intellectual excitement, the art, and, yes, the sport" would go to the virgins. He has to admit they wouldn't. So he opts for just an Open class, saying, "The energy now devoted to maintaining the hypocritical imperative could be directed to open research and debate, to discovering what is best for the riders, and educating them so that they can make informed choices about risk and benefit."

The trouble with that scenario, as Chicago's Goldman has found, is that many athletes would risk trading health for wealth. And whoever is the next president of the I.O.C. would have to change that famous phrase heard at the start of every Olympics to: "Let the Chemistry Begin."

[SIDEBAR]

DRUGS IN SPORT: A HISTORY OF DISHONOR

A spate of deaths in international cycling in the 1960s led to the first calls for drugs to be banned from sport, and for athletes to be urine-tested. In 1967, British cyclist Tommy Simpson--a user of various stimulants--died during a televised stage of the Tour de France. The first Olympic drug tests were introduced at the Mexico City Games the following year. By the early '70s, state-run drug laboratories in East Germany and the Soviet Union were working hand in hand with coaches and trainers to breed a generation of superathletes, and devise a range of doping methods that would defy detection. "After every workout I got a 'cocktail' with vitamins," East German swimmer Kornelia Ender, a quadruple gold medalist at the 1976 Montreal Olympics, told SPORTS ILLUSTRATED in 1992. Petra Schneider won gold for East Germany at the 1980 Moscow Games, but now suffers severe heart and liver problems she believes are linked to the "vitamins"--actually steroids--she was given. East German shot-putter Heidi Krieger claims that steroids effectively turned her into a man; now known as Andreas, Krieger has had a sex-change operation to complete what she describes as an irreversible process. Western sport has been characterized more by individual drug users than drug regimes. Canadian sprinter Ben Johnson's 100-m time at the Seoul Olympics may never be beaten, but he is better known for the positive test to the steroid stanozolol, which denied him a gold medal. Serial doper Johnson returned to sprinting after a two-year suspension, but was banned for life in 1993 after tests revealed a testosterone count 10 times above normal. Australian cyclist Martin Vinnicombe won silver at Seoul but tested positive for steroids in 1991. His former manager, Phill Bates, told the Sydney Morning Herald in 1996: "He knew the only way to win was to cheat." Earlier this year, after four years of stunning improvements in Chinese women's swimming, five team members were sent home from the Perth World Championships after evidence of drug taking. The courts have been as much a part of recent drug charges as have vials and chemical analysis. Two years ago, a Munich court ruled that former East German sprinter Katrin Krabbe could sue the I.A.A.F. over a four-year suspension for taking steroids, a move that prompted authorities to reconsider the severity of the penalties they could impose. Future drug penalties may be shaped by any legal action resulting from the case of Irish swimmer Michelle de Bruin, who, as Michelle Smith, won three gold medals at Atlanta, but who now faces a charge that she altered a urine sample obtained in January. De Bruin has denied this and has vowed to fight any sanctions against her in the civil courts--potentially adding yet another twist of complexity to an already labyrinthine problem.

--Reported by Susan Horsburgh

--Reported by Susan Horsburgh