The serious health dangers of performance-enhancing drugs fail to deter athletes. Johnny Watterson reports
Since 2004, the World Anti-Doping Agency (Wada) has been responsible for the preparation and publication of the athlete's bible. That bible is known as the International Standard, identifying substances and methods prohibited in competition and out of competition in particular sports.
In short, it tells you the chemicals you cannot put into your body and the methods you may not use to prepare your body for competition. It is, in essence, the organisation that nannies world sport. It prevents athletes from killing themselves.
In the bible, you will find lists of anabolic agents, hormones and related substances, beta-2 agonists, agents with anti-estrogenic activity, diuretics and masking agents. You will find illegal ways to enhance oxygen, chemical ways to enhance the blood's performance and scary ways to modulate gene expression. You have the stimulants, the narcotics, the cannaboids and substances you cannot even pronounce - the glucocorticosteroids.
But this doesn't stop the coaches and the athletes.
Anabolic steroids can shrink a man's testicles and give a woman facial hair and a square jaw; erythropoietin (EPO) can turn the blood to treacle and cause the heart to stop; and ephedrine sends the heartbeat into a shocking sprint.
If you want to come down a little and chill out, then there are always the beta-blockers, which decrease the output of blood from the heart.
Athletes have exhausted the medicine cabinet in trying to find ways to cheat and if it's not in the cabinet, they have been known to go off and invent their own bespoke drugs, like the designer steroid tetrahydrogestrinone (THG). This exogenous soup is stuff that the body never could, never should and never will produce naturally.
"The damage these substances can do to an individual is enormous," says Dr Una May of the Irish Sports Council's anti-doping unit.
"It is also enormously damaging to the sport and, if someone like a coach is pressurising an athlete, it is highly dangerous and high-risk to the person involved."
Most recently, cyclist Floyd Landis, tennis player Mariano Puerta and track and field sprinter Justin Gatlin have been in the headlines for a variety of drug offences.
Landis, who won this year's Tour de France after an astounding comeback during one of the stages, stepped up on the podium with elevated levels of testosterone.
Puerta had taken the anabolic agent clenbuterol in 2003 and after last year's French Open final against Spain's Rafael Nadal, he tested positive for a second time for the stimulant etilefrine.
The Olympic 100m champion and world-record holder Gatlin, who had cynically positioned himself as a leader who was trying to prove track and field was clean, admitted he'd had an adverse finding for "testosterone or other prohibited steroids".
Like Puerta, it was also Gatlin's second time being busted, as he tested positive in college for a banned substance called adderall, which he claims he took to calm attention deficit disorder. His infraction cost him a two-year ban.
Used in a nefarious way, steroids are known to cause a myriad of problems. When bodybuilders "stack" them to up to 40 times the recommended dose, severe liver problems, reproductive irregularities and the tendency to grow breasts in males (gynecomastia) are recurring issues.
In women it is more dramatic and includes among other things acne, hair loss, lowering of the voice, facial hair growth and breast atrophy. And that's not to mention the mood swings and paranoia.
And where do athletes get them? Try logging on to www.anaboliczStore.com, where you can buy cheap steroids online once you click the mouse on an icon that says "I am over 18". It claims to be "a professional, discreet customer service". It's that easy.
Diuretics, meanwhile, increase the amount of urine in the body. In boxing, horse racing or rowing, where the differences between weight categories are marginal, athletes use them to lose weight quickly. Diuretics are also used to dilute urine to avoid detection of anabolic agents. Dehydration, kidney and heart failure are a few of the less palatable side effects.
Other more morbid concoctions such as human growth hormone (HGH), harvested from the pituitary glands of cadavers and injected into healthy people, is perfect for muscle growth and strength, while EPO stimulates the production of red blood cells. Great, you would think, for transporting all that oxygen during a long run or cycle race. And it is, until the blood thickens and clots and the healthy athlete suffers a stroke.
Numerous professional cyclists have mysteriously died over the years from heart attacks in their sleep, while the 1998 Tour de France winner Marco Pantani was found dead in a Rimini hotel in 2004. Not EPO this time, but "cocaine intoxication".
Cocaine is regarded as a stimulant and is one of the most commonly abused drugs.
"There are definitely people out there with scientific and medical support," says May.
"They know what they are doing. But there is also the back-gym knowledge going around where people take on hearsay. That is where it can become very dangerous, when people who don't know what they are doing listen to others who have been given information second-hand.
"The amount of detections we have been getting has basically stayed level. Overall though, the positive findings appear to be at a higher level now.
"It is not just athletes at the lower end of the sports that are being caught, but those at the higher level."
Often athletes inadvertently buy cold remedies over the counter that contain pseudoephedrine and then test positive, but the governing commandment in the Wada bible is that athletes are "strictly liable" for what goes into their bodies.
Stimulants act on an athlete's central nervous system to speed up the brain and body, adrenaline being the body's naturally occurring stimulant. Again, side effects can be dire, with the added risk of dependence and addiction.
There are 10 pages of proscribed agents and methods on the Wada website listing hundreds of ill effects, with one of the most recently added to the list being gene doping.
Since studies showed that injecting a virus carrying the gene for insulin-like growth factor number one into lab rats caused their muscles to grow in size and strength by 15-30 per cent, cheats have become extremely interested. Why not? When the rats were put through an exercise programme, their muscle strength had doubled.
"The things we are developing with diseases in mind could one day be used for genetic enhancement of athletic performance," said Lee Sweeney of the University of Pennsylvania two years ago. With this imind, a new generation of genetically shaped cheats may be about to emerge.
