Cheating at Athens – is it worth it?

Dr Martin Brookes

August 2004

The drugs don't work, so the song says. But do they? There is so much secrecy surrounding the use of drugs in sport that it has been difficult for scientists to uncover the truth about the real effects of illegal, performance enhancing drugs like anabolic steroids. While there is no shortage of anecdotal accounts suggesting significant improvements in individual performance, these kinds of reports lack statistical and scientific credibility. They also say little about the physical and mental cost of drug-increased performance. On the eve of the Athens Olympics, Channel 4's groundbreaking documentary, Cheating at Athens – is it worth it? finally puts the drugs on trial. Using volunteers from across the world, an illegal anabolic steroid is subjected to rigorous scientific scrutiny. The results are both surprising and sinister.

If it meant winning, would you be prepared to take steroids? Yes No

Do you think there should be a separate Steroid Olympic Games? Yes No

Drug use in sport isn't a new phenomenon. Anabolic steroids first began circulating through the veins of Olympic competitors back in the 1950s. But pessimistic predictions suggest that the use of performance enhancing drugs has now reached epidemic proportions. The recent scandal in the US involving the Bay Area Laboratory Co-operative and its alleged supply of the illegal anabolic steroid THG to some of the world's top athletes, illustrates the depth to which the insidious roots of this problem now penetrate.

With drug use apparently so widespread, it might seem absurd to ask how effective these chemicals really are. Common sense suggests that anabolic steroids do exaggerate an individual's ability to run, lift and throw; otherwise why else would athletes bother to take them? But prohibition means that few scientific studies of their efficacy really exist, in the public domain at least. 'Much of the work that had been reported up until the 1990s was really anecdotal material,' says sports scientist Dr Robert Weatherby, from Southern Cross University, Lismore in Australia. 'There have been lots of papers published by people saying "I took a steroid. And look, I got better performance". But we didn't have the ability to say yes, we're quite sure, scientifically, that that is in fact the truth.'

Anabolic background

The first anabolic steroid was manufactured in the 1930s. Hitler recognised their potential, and it's believed that he ordered German soldiers to use them during the Second World War. In the 1950s, Soviet weightlifters brought them into the sporting arena. Not to be outdone, the Americans soon followed suit, with drugged-up weightlifters of their own. By the late 1960s, steroid use had expanded into other areas of athletics, prompting the International Olympic Committee (IOC) to institute an outright ban. The ban had little impact and in 1976 at the Montreal Olympics, the IOC was forced to introduce random drug testing.

Punitive measures have claimed their fair share of victims: Ben Johnson, Dietar Baumann, Dwain Chambers, Jason Livingstone, Paul Edwards. These are just some of the more famous names to see their careers ruined by a random drugs test. Many more, no doubt, have slipped through the net. But if drug-taking athletes are prepared to risk their livelihood, and possibly their health, then it suggests that the impact of the drugs must be enormous. That's what renowned expert on steroids and their use in sport Robert Weatherby wants to find out.

Steroid effects

All anabolic steroids are synthetic derivatives of the male sex hormone testosterone, which occurs naturally in the body. When an athlete pumps themself full of steroids, they are, in effect, mimicking the changes that take place in a male adolescent at puberty. So they get the desirable anabolic effects – the rapid development of the muscles and skeletal tissue. But they also get the less desirable androgenic effects – acne, facial hair, mood swings, aggression and a deepening of the voice. While an emphasis on the anabolic properties is obviously desirable in the synthesis of any new steroid, some degree of androgenic effect is unavoidable.

For women, anabolic steroid abuse can cause progressive masculinisation, which may be irreversible. At the height of the Cold War, it was impossible not to notice some notoriously masculine women among the communist competitors at the Olympic Games. It was only much later that the extent of systematic steroid abuse came to light. In 1997, the East German shot-putter Heidi Krieger underwent a sex change as result of what she claimed was enforced steroid use years earlier in her career.

Paradoxically, excessive steroid use in men can cause the development of feminine characteristics. Too much testosterone triggers compensation reactions in the body that convert the male hormone into oestrogen – the female equivalent. The result is enlarged breasts, shrinking testes and low sperm counts. Perhaps it's no surprise that testosterone enanthate, the steroid used in this test, has been touted as a possible male contraceptive. While this news was probably not welcomed by the volunteers in the trial, they could rest easy. Their doses of the drug were about 50 times lower than those used by competitive athletes, and administered over a much shorter period.

The muscle building properties of anabolic steroids have been put to good medical use in the treatment of injuries involving serious tissue damage and, more recently, in promoting weight gain in HIV patients. But it's outside the medical world where the drugs have achieved notoriety.

Setting up the test

Robert Weatherby was the man in charge of Channel 4's unique televised experiment. He and his team are among the few to address the performance enhancing effects of anabolic steroids from any kind of scientific perspective. Do illegal steroids really improve performance, and by how much? Are there any negative side effects associated with their use? And how do they compare with some of the legal performance enhancing drugs and training aids currently on the market? These are the questions that Weatherby, together with Channel 4 and New Scientist, wanted to address in this trial.

Once the legal and ethical issues of the experiment had been ironed out, Weatherby got together a team of psychologists, immunologists and physiologists at Casuarina Beach, near Byron Bay in New South Wales, Australia. Joining them was a group of 24 volunteer amateur athletes from across the globe who were willing to put the drugs on trial. Six of the 24 volunteers acted as guinea pigs for testing legal performance aids. These included the stimulants caffeine and pseudoephidrine; colostrum, the breast milk produced by new mothers; creatine, an energy source that occurs naturally in the muscles; tribulus, a tropical root extract; and the hypoxicator, a breathing device used to simulate altitude training. But the majority of the group, 18 of the 24 volunteers, would put the illegal anabolic steroid, testosterone enanthate, to the test, and this was where the real interest lay for experimenters and athletes alike.

Rigorous scientific scrutiny

To a scientific audience, the results of an experiment will mean nothing if adequate measures are not taken to remove any sources of error or bias that could confuse the outcome. It is well known, for instance, that you can change a person's behaviour simply by giving them something that they believe is a medicine, even when it's not. So while all 18 of the Channel 4 volunteers in the anabolic steroid test received weekly injections, only half of them were actually given the steroid. The remainder, the so-called control or placebo group, were injected with a harmless liquid. In addition, the experiment was designed as a double blind trial. In other words, neither the volunteers, nor those who administered the injections, knew who was getting what.

Over a six week period, changes to physique and physiology were closely monitored, as the volunteers, blind to their drug regime, underwent strict regimens of diet and training. A triathlon consisting of a 100-metre sprint, 5000-metre long distance race and the shot put, contested at the beginning and end of the study, provided the ideal visual spectacle.

But this mini-Olympics offered only a crude assessment of any changes that had taken place. The more rigorous tests went on inside the laboratory. Biochemical analyses of blood samples, measurements of muscle mass and fat distribution, tests of upper and lower body strength, and detailed assessments of energy combustion and power creation gave Weatherby and his team a much more vivid picture of the changes taking place, as the drugs got to work on the bodies of the volunteers.

The results

At press time, many of the results still await legitimisation by statistical scrutiny and peer review. But a preliminary reading already contains some intriguing finds. It comes as no great shock, perhaps, to hear that testosterone enanthate did improve performance. What was surprising, however, was the speed with which the steroids took effect. After only three weeks, there were striking differences between the steroid and control groups. According to Weatherby, such rapid changes have not been seen before.

So is it all good news for the drug cheats? Not quite. It seems that increased performance does not come for free. Even at the relatively low doses given to the Channel 4 volunteers, the drug had some serious, and potentially harmful, side effects. Analysis of the blood samples taken throughout the trial showed that the drug suppressed the activity of the natural killer cells, which form part of the body's armoury against viruses and tumours. 'For the first time, we've been able to show that androgenic anabolic steroids have a seriously detrimental effect on a specific part of the human body's immune system,' says Weatherby.

And while the body was losing its ability to fight infection, the mind was being remoulded in some alarming ways. According to Roseanne Coutts, the team's exercise psychologist, individuals within the steroid group began to show less empathy for those around them. This was not increased aggression, but a decrease in their consideration for other people's feelings.

Testosterone enanthate is just one drug among many. Each anabolic steroid will have some properties peculiar to itself. But Robert Weatherby seems in no doubt about the conclusions to be drawn from this particular experiment. 'If a person as part of their training programme is tempted to use an anabolic type steroid I think it will certainly improve their chances of winning a gold medal.' But his message comes with an important qualifier. This drug could seriously damage your health.

Find out more

Channel 4 is not responsible for the content of third party sites

Websites

BBC – Drugs in Sport
http://news.bbc.co.uk/sport1/hi/in_depth/
2000/drugs_in_sport/default.stm
Takes an in-depth look at the history of nandrolone, the reliability of drugs testing, and Ron Clarke's defence of drug use in sport.

BBC – Man, Beast and Machine
http://news.bbc.co.uk/1/hi/sport/195432.stm
Article on the Canadian sprinter Ben Johnson, the most notorious drug cheat of all time.

Channel 4 Sport Uncovered
No longer available through the main Channel 4 site, but this archive of sports articles is well worth a look. Written by Chris Nawrat, former Sunday Times sports editor, there are several good articles on drugs in sport.

Drugs in Sport
www.drugsinsport.net
Massive resource on all the issues, with articles, a news archive and online reports such as the UK sport drug database and anti-doping reports.

Football Culture.net
www.footballculture.net/players/
feat_doping.html
Article on doping in football that looks at the results of the 2003 Doping in Sport conference. Argues that immense pressure is placed upon sportsmen and women to achieve; many footballers are expected to play over 80 games per season. This may be, at least in part, to blame for this drug culture.

Olympic Movement
www.olympic.org/uk/organisation/
ioc/index_uk.asp
Official site of the Olympic Movement, with information on the IOC (International Olympic Committee), athletes' profiles plus articles and press releases on drugs.

'I'm a Scapegoat,' says Rusedski
www.channelnewsasia.com/stories/afp_sports/
view/65650/1/.html
News article on the banning of British tennis star Greg Rusedski for taking the drug nandrolone. Links to other related articles available.

Substance Misuse Net
www.substancemisuse.net
Portal site that aims to raise awareness and understanding of substance misuse, the problems it creates and the ways to deal with these problems. Provides articles on key issues, personal stories, project profiles, recommended books, and more.

US Holds back on Doping Funds
http://sport.guardian.co.uk/athletics/
story/0,10082,966910,00.html
Guardian article from May 2003. For the second year running, the US, which screamed louder than any other country four years ago that the International Olympic Committee was not taking the problem of drugs seriously, has failed to honour its obligation to pay the Montreal-based WADA (World Anti-Doping Agency) its £2.4m on time. It has left the organisation charged with stamping out drug abuse with a serious cash shortfall, threatening its effectiveness in the fight against doping.

Books

	Anabolic Steroids by Patrick Lenehan (Taylor and Francis, 2003) Brings together the key issues surrounding contentious drugs like nandrolone and EPO and looks at their mode of action, side effects, and the physiological and psychological risks and effects of overdosing. Outlining the history and social context of these compounds, this book provides a comprehensive profile of the most commonly used steroids. Get this book
	Anabolic Steroids and the Athlete by William N Taylor (McFarland, 2002) The athlete's use of, the physician's knowledge of, and the continuing controversy over anabolic steroids in competitive sports are addressed in this volume. Get this book
	Sport, Health and Drugs by Ivan Waddington (Spon Press, 2000) Examines sport, health and public policy; child abuse and sex abuse in sport; doping in sport; sports medicine; and the development of performance enhancing drugs. With interview transcripts, case studies and press cuttings. Get this book
	Doping in Elite Sport: The politics of drugs and the Olympic Movement by Wayne Wilson (Human Kinetics Europe, 2000) This historical and political overview of drug use in elite sport explains the procedures and protocols of drug testing, examines ethical dimensions of doping and the political and economic factors that influence the attempts to control doping. Get this book
	Drugs and Doping in Sports by John O'Leary (Cavendish Publishing, 2001) Excellent collection of essays from academics, practitioners and administrators, analyses contemporary socio-legal and political themes related to doping in sport. It provides a challenging and often controversial view of doping issues and confronts political and legal orthodoxy, supplying the reader with an insight into this area of academic study. Get this book

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