Doping to win

Can’t tell your peptides from your steroids? Not sure how EPO improves stamina? Catalyst investigates the substances at the forefront of the sports doping controversy and asks whether we are all potential candidates for life enhancing drugs.

Video credit: ABC's Catalyst / YouTube.

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COMMENTATOR: There’s 20 metres left to swim!

COMMENTATOR: She’s over the last! 

COMMENTATOR: He’s digging as deep as he can! 

NARRATOR: For those who dedicate their lives to sporting excellence, there’s no greater prize than winning. Seduced by fame and lucrative sports deals, many have been pressured into a dangerous drug culture. 

MARION JONES: And so it is with a great amount of shame, that I stand before you and tell you that I have betrayed your trust. 

NARRATOR: In February this year, the Australian Crime Commission unleashed the biggest doping investigation in our sporting history. 

JASON CLARE: The findings are shocking and they’ll disgust Australian sports fans. 

NARRATOR: The ACC exposed systemic drug cheating among our Aussie athletes. 

PROFESSOR JOHN RASKO: It’s always going to be a war of escalation between the cheats and the people who want to detect them. 

DR JASON MAZANOVO: If you get tougher, people will find other ways of getting these substances and ways of using them. 

NARRATOR: So, what are these drugs? What are they doing to our athletes and are they causing more harm than good? This time, peptides are in the headlines. 

DR MARYANNE DEMASI: Now, you’ve all heard of peptides, but what are they? Technically, it’s just a generic term to describe a small protein. Now, these proteins occur naturally in food, in our bodies. But they can also be man made as medical therapies. And it’s these peptides that the drug cheats are exploiting to get that winning edge. 

NARRATOR: If your sport is about power and strength, then one of the most commonly abused peptides is human growth hormone. Athletes use it to bolster their weightlifting capacity and to gain muscle strength. But world-renowned hormone expert Professor Ken Ho says that’s a big myth. 

PROFESSOR KEN HO: Giving more growth hormone than what the body needs does not make you stronger or more powerful. We looked at the quality of muscle function, the ability to jump, the ability to pull a dead weight and the ability to maximise one’s endurance. 

NARRATOR: Human growth hormone is actually a naturally occurring molecule released by the pituitary gland. It stimulates bone and tissue growth, particularly in children. Drug cheats inject a synthetic version of this peptide hormone, but more doesn’t mean better. 

DR MARYANNE DEMASI: Our hormonal system is under exquisite control. We make hormones as we need them and switch off their production when we don’t. So if an athlete supplements their system with more HGH than they need, they’re putting their health at significant risk. 

NARRATION: Excess growth hormone can lead to complications like an enlarged heart muscle, which can be fatal. Aesthetically, muscles look bigger, but it doesn’t mean the muscle is stronger. 

PROFESSOR KEN HO: Even though the muscle is increased, most of that is accounted for by fluid retention. So, what you’re looking at is muscle tissue having more water, rather than having more muscle fibre. 

NARRATOR: For decades, there hasn’t been a reliable test to distinguish between natural and synthetic HGH in the athlete. But the net is closing in. 

DR MARYANNE DEMASI: In the last few years, the World Anti-Doping Authority has launched a new sensitive test for HGH, but this has only seen the drug cheats get smarter. 

NARRATOR: The latest class of peptides to cause controversy work by stimulating the athlete’s own natural release of growth hormone. These are illegal peptides, like CJC-1295, listed in the ACC report. It’s been suggested that players use these peptides to help with soft tissue repair and shorten the time it takes to recover from injury. 

PROFESSOR KEN HO: Even though there is a lot of interest and appeal with regards to the use of these peptides, I know of no scientific evidence that they bring performance benefit. 

NARRATOR: Professor Ho is more concerned about the safety of these peptides. He says theoretically they could accelerate the growth of cancer—an issue recently raised since the death of Cronulla player Jon Mannah, who was given peptides just two years after he was diagnosed with Hodgkin’s lymphoma. Professor Ho fears many online product could be manufactured in backyards under substandard conditions. 

PROFESSOR KEN HO: There is no moral oversight to ensure the safety of these drugs. The standards of manufacture are not as strict as drugs or medications administered into the human body. 

NARRATOR: An alternative to peptides for enhancing power and strength are the anabolic steroids. These are synthetic drugs based on the natural form of testosterone in the body. 

DR MARYANNE DEMASI: And unlike human growth hormone, they’re proven to work. 

PROFESSOR ALISON HEATHER: Testosterone and dihydrotestosterone are our natural androgens, so these are the hormones that are responsible for developing the male reproductive system as well as muscle growth, bone growth. 

NARRATOR: In the body, testosterone or other androgens look for receptors on cells. It’s only once it engages with the receptor that it can exert its anabolic effects. Excess levels of testosterone carries inherent health risks. 

PROFESSOR ALISON HEATHER: A side effect of having androgens at a high dose for a long period of time can be coronary calcification, psychological disturbances, hormonal imbalances, and lead to some hormonal-based cancers. 

DR MARYANNE DEMASI: Now, detecting androgens has always been a little tricky because there are literally thousands of little tweaks you can make to a molecule to render it undetectable. But the researchers in this laboratory have found a way around it. 

NARRATOR: All androgens have the same core structure, but chemists have been able to manipulate these outer chemical groups to render the drug undetectable with standard testing. So Alison developed a more advanced test. Instead of looking at the chemical structure of the drug, she decided to test whether anything in the sample could elicit anabolic effect on the cell. Here’s how it works. A dish lined with cells is exposed to the sample in question. If the cells’ receptors bind to anything in the sample, the cell is activated and emits a light which can be detected. 

PROFESSOR ALISON HEATHER: Regardless of what the molecule looks like, as long as it’s biologically active and can interact with an androgen receptor, it will turn on the light in these cells. 

NARRATOR: Catching the drug cheats has a personal meaning for Alison. She’s a triathlete and believes in a fair competition. Many, including Alison, take supplements with the belief that it helps them train harder. The supplement industry is largely unregulated. But this hasn’t diminished its popularity. The consumption of protein supplements and powders has become the daily ritual with body-conscious school kids, gym junkies and amateur athletes. It’s reported that Australians spent $18 million on sports foods last year—that’s 28 per cent up on the previous year. Alison became curious about the safety of these supplements. So she decided to test a wide range of protein powders for illegal androgen, and found some shocking results. 

PROFESSOR ALISON HEATHER: We found that the nutritional supplement had an androgenic molecule in there, but it doesn’t actually declare an androgen on the label. 

DR MARYANNE DEMASI: These samples are available to school kids playing school sports at any age. 

PROFESSOR ALISON HEATHER: Yes. If they contain an androgen, that in itself can be a problem if it’s taken by a teenager, whereby their hormones are still being activated because they’re going through puberty, and we really don’t want that whole hormonal process being upset by taking in something through the diet. 

DR MARYANNE DEMASI: A lot of athletes claim that they weren’t aware of taking a banned substance. Do you think this could be a source?

PROFESSOR ALISON HEATHER: Absolutely 

NARRATOR: Sloppy manufacturing standards may be the reason for contaminated protein supplements. But Alison believes some manufacturers set out to intentionally deceive customers. 

PROFESSOR ALISON HEATHER: If an athlete takes that nutritional supplement and they perform better, they’re gonna keep taking it, they’re gonna go, ‘Wow, this is a great substance’, and they recommend it to their friends, the next thing you know, everyone is taking this nutritional supplement. 

DR MARYANNE DEMASI: For endurance sports like cycling or marathons, there’s a different drug of choice. By now, most of us would be familiar with EPO, short for erythropoietin. 

NARRATOR: Another way of achieving a similar result is to have a blood transfusion. 

DR MARYANNE DEMASI: What typically happens is that athletes are bled a few months before the race and their red cells are stored in packs like this one. Then, on race day, they’re reinfused, giving them an instant boost in red cells. 

PROFESSOR JOHN RASKO: A unit of blood like this, it’s concentrated so if you infuse that, there are risks of the blood sludging, it turns into pea soup, and so it can cause problems with stroke, with heart attack or clots in the vessels. 

NARRATOR: Between 1987 and 1990, 18 top European cyclists mysteriously died in their sleep after taking EPO. 

PROFESSOR JOHN RASKO: Well, of course this is all done behind closed doors, so there are always gonna be increased chances of infection or complications setting in. 

NARRATOR: Doping by blood transfusion is difficult to detect, but scientists are working on new ways to track reinfused blood. 

PROFESSOR JOHN RASKO: It’s possible to detect the minute amounts of plastic that’s in the bag, and that’s one way of doing it. But another way of doing it is to possibly try and detect the so-called ageing defect of blood. As soon as the blood’s taken out of the body, it starts to age in an accelerated way, and that could be detected in the athletic cheats. 

NARRATOR: Normally, the total volume of red cells in the blood is about 45 per cent. The cut off to pass a doping test is 49 per cent. 

PROFESSOR JOHN RASKO: If you administer EPO or give yourself a big series of blood transfusions, that packed cell volume can increase 50 per cent, even 60 per cent, and above. 

DR MARYANNE DEMASI: So, how do you avoid getting caught?

PROFESSOR JOHN RASKO: They can either dilute their blood by adding saline or they can simply take off enough blood to get it just below 50 per cent, and that’s exactly what happens. 

NARRATOR: Artificially boosting red cells in this way is obviously illegal. But athletes can expose themselves to certain environmental conditions to achieve similar results, yet stay within the rules of the game. This is Altitude House. It doesn’t look like much, but the reduced oxygen in the air is similar to that of the high-altitude mountains. Damien is a professional cyclist and will live here for the next two months. 

DAMIEN HOWSON: When you sleep, it can impact on the quality of sleep. And for the first two nights, it was a bit interrupted, waking up every hour or two, but now that the body’s acclimatised to the difference, I’m sleeping in full now. 

PROFESSOR CHRIS GORE: The level of oxygen is around about 15–16 per cent. Normally, it’s about 21 per cent that we breathe in. We usually run the Altitude House at around 2,500 to 3,000 metres of simulated altitude. 

NARRATOR: This control room maintains the air quality by pumping small amounts of nitrogen, which displaces the oxygen. 

DR MARYANNE DEMASI: It’s thought that living at high altitudes can mimic the effects of blood doping, but researchers here say it’s far more effective than just boosting the number of red blood cells. 

PROFESSOR CHRIS GORE: In low-oxygen environments, there’s a master regulator of the responses and it turns on …at least 200 genes have been identified. ’Cause obvisouly there’s the genes associated with red blood cell production, but there’s also genes associated with the buffering capacity of the body, with the mitochondrial efficiency and there’s multiple genes affecting those sort of pathways. 

COACH: Keep going. Yep, that’s perfect. 

DR MARYANNE DEMASI: So you think this’ll make a difference with your training?

DAMIEN HOWSON: I definitely believe, yeah, it affects me in a positive way. 

COACH: Three, two, one, and go. 

NARRATOR: Even though scientists can measure physiological changes after altitude training, it’s still unclear whether this actually translates into better performance. 

PROFESSOR CHRIS GORE: That is the $64,000 question. And there’s great controversy among the scientific literature. What you’re looking for are very small changes in performance at the elite level—about 1–2 per cent. Sally Pearson, 100 metres, probably one third of 1 per cent, which, in a 100-metre event is 30 centimetres, is the difference between first and second. 

NARRATOR: But all this technology to enhance performance has left Jason Mazanov thinking that it’s blurred the line between those who cheat and those who don’t. 

DR JASON MAZANOV:  In the end, this is the form of technology doping. To suggest that somehow sport is a level playing field, I think, is a misnomer. Sport is about discrimination, sport is about finding out who is better than whom. The 2000 Olympics, we had a guy from Equatorial Guinea, the first Olympic swimming pool he’d ever seen was at the Sydney Games. So this is hardly a level playing field, it’s hardly fair. 

NARRATOR: In fact, many have criticised the way Lance Armstrong was vilified and stripped of his titles. 

DR JASON MAZANOV: Lance Armstrong was the first among equals. We don’t know how many people were doping in the peloton when he was cycling, but if the rumours are true, it was pretty much all of them. If they were all doping, it was a fair competition and it was first among equals. So was he really cheating? Should the winner of the Tour de France in 2007 be the first clean winner, even if that person came 87th?

DR MARYANNE DEMASI: But surely there are boundaries?

DR JASON MAZANOV: Well, one of the things that I’ve suggested that we might do to control drugs in sports is to say to people, ‘Sure, you can use drugs, but if you breach any of these health parameters, you can’t compete’. So should we be monitoring athletes’ health rather than monitoring athletes’ performance enhancement?

PROFESSOR KEN HO: To condone the use of drugs in any sport at any age will be a poison to society. 

SPECTATOR: Go the Aussies!

SPECTATOR 2: Go Aussie! Whoo! 

SPECTATOR 3: Hockeyroos!

NARRATOR: But some say spectators are to blame because they’re placing unrealistic demands on athletes purely for their own entertainment. 

SPECTATORS 4 AND 5: Oi, Oi, Oi! 

DR JASON MAZANOV: So long as we demand so much of our athletes and get them to play such long seasons, such intense seasons, at such high speed, they’re going to need drugs to help them recover. 

KIDS: Go demons!

DR JASON MAZANOV: We think it’s okay for an athlete to get a painkilling injection. The pain is supposed to tell you to stop doing something. And yet we’re quite okay with an athlete receiving a powerful analgesic, and then going back out on the field and doing it more so, potentially damaging their body in the process. So, when we start looking at where the drive for performance edge, performance advantage comes from, we might need to look a little bit further afield than just demonising and vilifying the athlete and the physician.  

 

Drugs in sport

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