Update
Drenched in drugs
Beyond biking
Blood doping
Steroids 'n kids
'roid rage
Right: Richard Virenque faces cameras and allegations of rampant drug abuse during the 1998 Tour de France, after police nabbed his team's handlers with a rolling pharmacy.
Photos by Kai Uwe Bohn and courtesy of Bill Mitchell.
Below: Virenque pedals toward an uncertain future.
Red blood cells as seen in a scanning electron microscope.
© James A. Sullivan.
Another drug war
One way to look at the problem is to gripe about "tainted athletes." On the positive side, the rise of doping is a sign of progress. As medicine identifies the molecular basis for health and disease, it presents athletes with new ways to improve their performance -- some legal, some not.
The quest for better athletics through chemicals goes back a long time. In 1972, before steroids were banned, 68 percent of Olympic athletes admitted using them. During the 1970s and '80s, East Germany's huge doping program produced legions of highly successful, but oddly mannish female swimmers and track stars. In 1976, the year the Olympics started drug testing, East Germany bagged 11 of 13 women's swimming medals.
After the Berlin Wall fell, some East German sports doctors moved to China. In the 1994 Rome world swimming championships, Chinese women swimmers accepted 12 gold medals at ceremonies while onlookers protested by waving syringes. Twenty seven Chinese women have flunked drug tests since 1990, more than the total from all other nations.
The tip of the hypodermic?
EPO is a genetically-engineered version of a natural hormone made by the kidney that stimulates bone marrow to make red blood cells. synthetic EPO is sold as a rescue medicine for treating anemia in end-stage kidney disease, when production of EPO declines.
In the past, bike racers tried to increase the number of red blood cells by removing their own blood, storing it, and transfusing it back just before a race. Nowadays, this gory process of "blood doping" has been replaced by genetic engineering. Athletes simply inject EPO, which causes the body to make the cells.
Since EPO is a naturally occurring hormone, testing for it would detect anyone, not very helpful for identifying doped athletes. Unable to measure EPO itself, the mandarins of international cycling at Union Cycliste Internationale (UCI) rely on a surrogate test that measures the density of cells in the blood. Blood, as you'll recall, is composed of cells -- mainly red, but also white -- and serum and other liquids that help the cells flow. A study from the 1980s, before synthetic EPO, showed that bike racers' blood averaged a cellular content of 43 percent, so the UCI decreed that anybody with a level above 50 percent would be disqualified for taking EPO.
Many of the most popular new compounds are identical to natural chemicals made by the body --- making sure detection difficult or impossible. It was one of those undetectable drugs, erythropoetin or EPO, that caused the latest stink in Europe. Biker Marco Pantani, AKA the Pirate, was close to winning the Giro d'Italia, a multi-day race in his native Italy, when he failed a test intended to catch users of EPO.
Because red blood cells carry oxygen to the muscles, and because bikers need a huge amount of oxygen during their arduous sport, raising the number of red blood cells can -- theoretically -- improve performance. Here's a description of the origin of synthetic EPO.
It wasn't me, babe
Whether Pantani, whose trademark is breaking away from the pack on a hill, is telling the truth or not, it's true that detecting EPO is tricky, since training at high altitude also increases the number of red blood cells.
EPO is not the only genetically engineered compound that could help cyclists and other endurance athletes on the market. Growth hormone, which stimulates the growth of bones and muscle, became so popular that some athletes took to calling the 1996 Atlanta Olympics the "Growth Hormone Games." Like EPO, growth hormone cannot be reliably detected in abusers. Growth hormone can cause carpal tunnel syndrome and swelling in adults who are normally deficient in the hormone; the effects of the hormone on people with normal natural levels are not known.
If EPO and growth hormone are the wave of the future, anabolic steroids are the wave of the present.
What happens when kids take steroids?
On June 5, 1999, Pantani, with a cellular content of 52 percent, was ejected from the Giro d'Italia. In a June 11 report in VeloNews, the great cyclist defended his record: "'I am a clean rider,' the 29-year-old Italian told a much-awaited press conference. 'My conscience is clear. I have nothing to do with doping. I am one of the few riders in the world who doesn't have a personal trainer. I don't need doping to win races, I need hill climbs.'"
