He gives drugs to athletes and keeps walking the blurred line

The Dr Rob Dawson interview: With the doping issue high on the agenda in Edmonton, Simon Turnbull speaks to a doctor committed to damage limitation

It is early Thursday evening in Chester-le-Street, mid-Thursday morning in Edmonton. In the Canadian city all the talk is of drugs: of erythropoetin, more commonly known as EPO, and whether the Russian runner Olga Yegorova will be allowed to contest the 5,000m in the World Athletics Championships, despite testing positive for the blood-boosting drug; of the male hormone testosterone, for which Fabiane dos Santos, the emerging Brazilian 800m runner, has registered a positive test; and of stanozolol, the anabolic steroid for which the Canadian sprinter Venolyn Clarke has fallen foul of the drug- testing net.

In the County Durham town all the talk is of drugs too. At Chester-le-Street Health Centre, a two-storey brown-brick building set back from Newcastle Road behind the town's police station and magistrates' court, Rob Dawson is getting ready for the weekly clinic he runs for the benefit of sportsmen and women who choose to take drugs. The Discus clinic – Drugs in Sport Clinic and Users' Support – is funded by the Durham and Darlington NHS Priority Health Care Trust. It 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 its six years in operation, some 450 patients have passed through Dr Dawson's door.

"The bulk of them are bodybuilders," he says, "but there are other sports people involved. Some of them are high-level or ex-high-level competitors, but I don't want to go down the track of which sports they come from because that could make them identifiable."

The irony could hardly be more profound. Out there in Edmonton the athletics authorities are busy attempting to identify the drug takers, while here in England the medical authorities are helping the sporting drug takers to beat the system – and next door to a police station, too, for goodness' sake.

Morally, how on earth can Rob Dawson justify helping those who blatantly want to break the sporting rules? "Morally, how can I justify it?" he says, momentarily raising the tone of his voice and his posture in his chair as he prepares to deliver his answer. "Because at the end of the day my responsibility is to the patient. In the United Kingdom, people taking anabolic steroids and other drugs – such as insulin and growth hormone – are not committing any illegal act. The only illegality of that act is within the sporting rules. It's not an offence in this country.

"Therefore to not be involved in a clinic such as this would be going against my Hippocratic oath. And to me that is every bit as valuable as anything else.

"It's not my place to put my moral viewpoint on my treatment for the patient. My place is to treat the patient. If we lose sight of that as doctors then we've lost sight of our vocation and it's no longer a vocation and a profession. It's simply a job. And even then I wouldn't be doing my job properly if I wasn't trying to help people.

"To me, if I can get someone to use a lower dose of steroids than they're already using then that's a win. If I can get somebody to inject safely rather than using an unsafe technique then that's a win. My ideal, of course, is to get them to stop using drugs at all. That's the best outcome that I could hope for. But it's got to be done through a harm-minimisation strategy.

"If I simply say to people, 'Don't do it', they'll walk away – and potentially harm themselves. And that is worse to me than going down the path I'm taking. I can see that some people would say that it's maybe debatable. But they can't really say what we do is offensive, because basically it's part of the drugs-management protocol of the United Kingdom. And, like I say, these people are not doing anything illegal in the eyes of the law. It's certainly no more illegal than smoking a cigarette. And we would give treatment for that.

"In terms of the male athlete using anabolic steroids, the irony for me is the great problem that may be coming in the future while we develop the male contraceptive based on nandrolone. Now, are we going to deny our male athletes the right to use these forms of contraception when the female athletes are allowed to use a female hormone for their contraception?

"A female competitor coming up to a big event who doesn't want to have a period simply takes two packets of the pill back to back. That means she is hormonally manipulating her body to give her a perceived advantage. If that's the case, then what's the difference with a male manipulating his body with a male hormone? Where do you draw the line?

"Creatine monohydrate is another case. When an athlete makes a decision to move down the supplementation track have they not already morally accepted the need for performance-enhancing aids? Then you're really just discussing a distinction between which aids are allowable and which ones are not – from drugs through to supplementation. And if you look at the Oxford Dictionary, the definition of a drug is a chemical with a pharamacological benefit and additional use. Do we say such-and-such-a-person is an athlete taking supplementation or an athlete taking drugs? The line is getting very, very blurred." It is indeed.

Rob Dawson is a genial, ginger-haired 38-year-old Scotsman. He was a sprinter in his youth, clocking a more-than-useful 11.2sec for 100m. He was a more-than-useful rugby player too, a first-team winger with Portobello in the third division of the Scottish leagues. He loves his sport as passionately as anyone. He is simply playing doctor's advocate.

He points out, for instance, that the caffeine in the tea his guest is drinking happens to be a performance-enhancing aid. The same applies to the caffeine in the hot chocolate he is sipping from his Superman mug. Dr Dawson is, he would argue, merely painting the big picture of this sporting life as it really is.

"There is no place for drugs in sport," he says. "The use of drugs in sport is wrong. Nobody can dispute that. It's terrible that any athlete should feel driven to take drugs. However, one has to live in the real world. And drugs have been around in sport since before Christ.

"The Egyptians used to grind Abyssinian asses' hooves to make them run faster. The gladiators used to use hallucinogenic mushrooms and potions in the arena. Horses were fed goodness knows what to try to make them go faster. For ourselves, there was cocaine, strychnine... the whole kit and caboodle of them were used. It was only in the late 1940s that anabolic steroids came into the lexicon of the drug taker, and that's when things really moved on apace.

"We should always keep reiterating that there's no place for drugs in sport, but the other thing we should be saying is, 'What are we actually going to do about it? How are we going to tackle the problem of drugs in sport in a consistent and even-handed way?' And if anything has become apparent in terms of consistency it is that athletes will consistently deny they have been on anything, people will consistently go on about drugs in sport, and athletes will consistently take them to gain an edge."

Edmonton, indeed, has been just another Groundhog Day drugs saga for the sport of track and field. The sight of Yegorova running in the 5,000m was no different to seeing Merlene Ottey and Javier Sotomayor compete in the Sydney Olympics. They, too, had tested positive for drugs but escaped punishment on what were broadly described as "technicalities". They did not draw the kind of public protest Paula Radcliffe and Hayley Tullett staged in the Commonwealth Stadium, though British women feeling aggrieved at having to compete against drug takers is nothing new – as Christina Boxer, Kirsty Wade and others who were denied medals by eastern Europeans on state-run steroid regimes would readily testify.

Venolyn Clarke's failed test was a throwback to the dark days of 1988, when another Canadian sprinter was caught taking stanozolol. His name? Ben Johnson. And the sad story of Fabiane dos Santos was just another tale – like Johnson's – of the apparent hero turning out to be a villain.

It seemed the Brazilian had come from nowhere when she finished within a whisker of Maria Mutola, the Olympic 800m champion, in Monaco last month and then powered past Stephanie Graf, the Olympic silver medallist, at Crystal Palace two days later. "I'm actually from the Amazon rainforest," she said. "I'm a native Amazonian Indian. I don't know my real parents. I was adopted when I was young and taken to Sao Paulo to live." What Dos Santos did not say – and what no one on the European circuit knew – was that she had taken nandrolone and been suspended for using it when she was an unknown Brazilian 800m runner back in 1995. She did not say that she had taken testosterone too – until the results of tests administered at the Grand Prix meeting in Rio in May were belatedly revealed last Tuesday night.

The reality is that precious few of the drug takers are ever caught out by the testing net. The vast majority are well ahead of the game. "I'll give you an example," Rob Dawson says. "In 1997 I got quite concerned about the increasing number of people coming to the clinic asking me for information about insulin. I did a lot of research into it and found it was a safe anabolic agent. I thought I'd been very clever and found something new, but when I mentioned it to one of my patients he said, 'Look Rob, we've been using it for 10 years now'.

"It became apparent to me then that there's nothing new and that many of these things had been tried and tested by these people long before we've heard about them. It's the same with growth hormone. These people have had access to these products all along. It's very naïve of us to think that doctors know best and that we know what's going on, because many of the people involved are sports scientists – they're chemists; they're medics; they're well read. They read the same literature as we do. They have access to the same research papers that we do. And they're pushing boundaries."

They are pushing the boundaries from a secure position too. There is no test for insulin use, and those developed to detect growth hormone have yet to be implemented. "The thing is," Dawson says, "the drug testing programme is doomed to fail anyway. I mean, it cannot succeed – because of the resources that are available to the drug testers, and the international scope of it. You would have to have all the top athletes tested all of the time to ensure that they were clean. You could potentially say, 'Right, the top 30 athletes in every country will be tested every month and only those top 30 will be allowed to compete.' And that would still cost a fortune.

"The whole total of spend in the UK on drug testing is only about £2m, of which approximately £170,000 goes to athletics. That's five weeks of a Premiership footballer's salary. A testimonial match for a football player will generate more money for that player than we're prepared to spend on all our drug testing in athletics. Now what does it really say about sport when we're doing that?

"Also, the programme is not sensitive enough to catch the cheats, as the case of Yegorova has shown. To me, the kind of procedure we have in place simply does not work. It can't work."

If the Chester-le-Street clinic can work, then it is simply in terms of harm-minimisation, which has been its primary objective all along. "In the six years it's been running there hasn't really been any let-up in the number of people attending," Dr Dawson confides. "It's certainly a problem that doesn't seem to be going away."

Biography: Dr Rob Dawson

Born: 13 March 1963, Peterhead

Education: Glenwood High School, Glenrothes. Trained in medicine at Edinburgh University 1981-86.

Sporting career: Runner-up in 100m at Fife schools' championships, 11.2sec. Played on wing for Portobello RFC.

Professional career: Has worked as a general practitioner at Rowlands Gill on Tyneside since 1997. Helped to set up Discus (Drugs in Sport Clinic and Users' Support) at Chester-le-Street, County Durham, in 1995. Has lectured on drugs in sport toInternational Endocrinology Society, Third World Congress on Stress in Dublin and Lister Institute in Edinburgh.