Cheats are miles ahead, not just one step

The drugs crisis: It might be convenient to think THG is the only new product on the blocks, but a doctor warns...

When the THG designer-steroid affair first exploded in the United States 10 days ago, one leading official - John Chaplin, chairman of USA Track and Field's men's track committee - described the battle against drugs in sport as "like an arms race". Amid the fallout from the sudden discovery of tetrahydrogestinone, with Britain's Dwain Chambers and several leading American athletes getting caught by the retrospective testing net, there have been those who have proclaimed that the drug-testers are finally catching up with the drug-takers. Rob Dawson can't help laughing at the mere suggestion.

"Of course they're not," he said, taking a swig of hot chocolate from his Superman mug. "Insulin and human growth hormone are still being used, and they're still undetectable. And, in terms of catching up, let's be realistic about how THG was picked up. This drug was not detected by some super-scientist finding it in a sample. This drug was picked up because someone who was disgruntled sent the substance to the authorities in the States so that it could be checked out in their laboratories.

"So is this a victory or is it a sign of something far greater that is going on? Are we just actually seeing the tip of an iceberg? Now, it would be lovely for us to believe that this was the only new thing being used. But I'm afraid, with the near- 600 patients that I've seen, I am not that naïve to believe that it is."

Dawson - Dr Dawson - has seen those patients at the clinic he runs for sportsmen and women who choose to take drugs. His object in opening his doors at Chester-le-Street Health Centre every Thursday night is to minimise the harm being done by competitors who turn to the syringe and the tablet for pharmaceutical aid. The Discus Clinic (Drugs in Sport Clinic and Users' Support), funded by the Durham and Darlington NHS Priority Health Care Trust, was set up after research found that 60 per cent of people accessing needle exchanges in the North-east of England were anabolic- steroid users.

"In the late 1990s I picked up on the use of insulin and wrote an article about it," Dr Dawson continued. "I had it published in the British Journal of Sports Medicine. I thought I was being very clever, but I was brought back down to earth very quickly when one of my patients informed me that, really, this was nothing new and that they'd been using it for at least 10 years. So what was a cause célèbre in the late 1990s had actually been around since the 1980s.

"We would be very naïve as doctors, clinicians, scientists to believe that there aren't an equal number of clinicians and scientists potentially helping athletes to push the boundaries. Some people are making out that this is a big breakthrough, the biggest thing since the Ben Johnson affair. But what about the insulin affair, the growth-hormone affair, the nandrolone affair, the blood-doping affair, the EPO affair? In reality, it's just the biggest scandal until the next big drug scandal.

"Until we get to the point where we can use genetic modification, which I'm sure some people will then go on to do, science will always be pushing the boundaries. But maybe it's time for us to go with what the authorities think. Maybe it's time for us to massage the image that we have caught up with all the cheats. Or maybe it's time to get down to the real hard work, which is looking after the patients and trying to ascertain exactly what's going on."

For eight years now, Dr Dawson, a genial 40-year-old Scotsman, has been dealing with the reality of what has been going on at the sharp end - the needle-point, if you like - of sport in Britain. "I've been involved at a reasonable level of sport myself, so I've seen the dilemma that many athletes have been put into," he said, reflecting on his time as a flying wing with Portobello in the third division of the Scottish rugby union leagues.

"I was offered drugs. I was offered testosterone, as part of the World Health Organisation trial of the male contraceptive, by a doctor who was obviously unaware of the rules surrounding sport. I refused, because to me it was wrong. I wanted to see how good I could be, rather than how good I could be with the help of drugs.

"As a physician, I see my role as two-fold. It's a head-and-heart argument. My heart tells me it's totally wrong and it's morally bankrupt to take these drugs. My head tells me that it goes on, and that my role then as a physician is to protect the athlete's health, not to support them in cheating. As a physician, one's duty of care is to the patient and society. It is not my place - or our place, I would argue - to put a moral judgement on a person's behaviour. These people are as entitled to adequate care and treatment as anybody else."

As to the care and treatment of track and field's tarnished image, in the light of the five positive tests thus far confirmed for THG, there has been talk of a "zero-tolerance" policy being implemented by USA Track and Field, of implementing $100,000 fines and life bans, and of the prospect of athletes being stripped of medals won at the World Championships in August, after their urine samples have been re-examined.

"If you're going to be stripped of a medal through a retrospective test, then when do you award the medals?" Dr Dawson pondered. "Should the medals be awarded at the championships? Or should we wait six months, a year, two years, and say, 'Well, we now know you were clean, as you said you were, so you can have your medal'?

"Or do you have a situation where you don't show any of the major events live on television, wait six months before you screen them, and digitally remove any athlete who was found to have been taking any performance-enhancing aid? Obviously that's farcical. One couldn't do that. But it seems to me that the drug-testing programme, the way we're treating our athletes, is fast descending into farce anyway. It is, as I said, morally reprehensible to use drugs in sport. But it's time to see the emperor as he is. And there are no clothes on this emperor.

"You will always have people who desire to cheat. Bob Goldman in the States asked 198 world-class athletes, 'If I could give you a drug that would win you every competition for the next five years but had had one minor drawback, that it killed you at the end of those five years, would you take it?' And 52 per cent of these world-class athletes said yes, they would.

"Now you cannot fight against that in any rational way. Prohibition is not going to stop these people."