Every year over 100,000 drug tests are conducted worldwide at a cost of $30 million. The drug tests are designed to detect and deter abuse of performance-enhancing drugs by competitors. The testing procedures for drug abuse in sports are strict and at times deemed unfair by athletes. They are deemed unfair because athletes are responsible for knowing what is banned despite the fact that additions are made almost daily to the list of banned substances. The best possible solution is to avoid all drugs unless listed on the allowed substance list.
There are some athletes who will try and beat the testing. When athletes know when a drug test will occur, they can prepare for it and thereby neutralize the effects of drug testing on the use of performance enhancing drugs and/or masking agents. Year-round short-notice and no-notice testing are the most effective means to curtail the use of training drugs because they make athletes always at risk to be tested.
DRUG TESTING PROCEDURE
The drug testing procedure begins with taking a urine sample. While this sounds simple, it initiates a formal and highly regulated procedure to ensure that the urine sample that arrives at the laboratory actually comes from the athlete in question, with no opportunity to tamper with the sample. Once selected for drug testing, the athlete is notified by an official and asked to sign a form acknowledging this notification. The athlete may or may not be accompanied by an official and must attend the testing station within the designated period. The testing station is supposed to be a private, comfortable place where plenty of drinks are available. Many times it is set up inside a specially designed mobile testing unit. Independent sampling officers, whom are trained and appointed by the respective governing body, carry out the collection of urine samples. Each officer carries a time-limited identity card and a letter of authority for the event to which they are allocated.
Before giving a urine sample, the athlete is told to select two numbered bottles. After providing the sample (about 100 ml), the athlete must voluntarily complete a form. The athlete declares any drug treatment taken in the previous seven days and must check and sign that the sample has been taken and placed in the bottles correctly. The urine sample is then sent for analysis to a laboratory currently accredited by the IOC. In the event of a positive test result, the laboratory will notify the governing body of the sport, who will then notify the athlete. The rules of the governing body of the particular sport determine what happens next. The rules vary across governing bodies, sports and countries. An athlete is usually suspended while a positive result is investigated, but has the right to have a second analysis of the urine sample. This analysis may be observed directly by the athlete or by the athlete's representative. There is then a hearing, at which time the athlete's case is presented. An appeal can be made, and there have been successful appeals both in the United States and other countries.
COLLECTING A URINE SAMPLE
The testing procedure must be strictly adhered to so that all athletes receive the same treatment. Collection of the urine sample has to be observed because drug abusers may attempt to falsify the results by tampering with the samples. Volume, pH, and in some cases specific gravity and temperature of the sample are tested immediately. These simple tests check for some of the known methods of cheating the drug tests at this early stage. The urine pH is tested to detect attempts at changing the nature of the sample, which can affect the analysis of certain drugs, as well as their metabolism and clearance. Sodium bicarbonate, for example, can be taken by mouth in order to change urine pH. The pH is also tested to verify that the level of degradation, which a sample may have experienced by the time it is tested, is within acceptable limits. The specific gravity is checked for attempts to dilute the concentration of drugs, as is the case by deliberate diuretic use.
To ensure that the sample actually comes from the athlete, the testing officer must be able to see the urine flow from the athlete into the bottle. Male athletes are asked to strip to their waist and lower their shorts to their knees. Female athletes must also be observed very closely while they void a sample. This procedure can be very awkward, embarrassing, and humiliating. For a young athlete, giving a urine sample under these circumstances can be very traumatizing. Many people, regardless of age, are uncomfortable with the idea of being observed while giving a urine sample. The situation is further complicated if an athlete has been competing in an endurance sport and is dehydrated or competing at a weight category where they are reluctant to drink excess fluid.
At least 75 mL must be given under close scrutiny and the urine is split into 2 portions as "A" and "B" bottles. The athlete chooses the two coded bottles and the samples are sealed by the athlete. In most cases, only the athlete handles the urine and collection containers until sealed. The containers are sealed with tamper-proof strips, placed inside other sealed containers, wrapped in tamper-evident seals and coded. The independent official observing the sample procedure records all of the information on a document. This initiates a chain-of-custody record to be continued by anyone who handles the specimen until the urine is used up or discarded in the laboratory. The laboratory staff never knows the athlete's name, only the bottle identification number. Everyone who handles the sample must understand the importance of the chain of custody and the essential role of maintaining it. The chain of custody guarantees that the sample content is protected and that the sample tested is from the correct athlete.
The possibility of sabotage of a urine sample has been raised many times by athletes. It is for this reason that that athletes should ensure that the testing procedure is observed rigorously for their own protection. Samples should be dispatched in the appropriate containers and all paperwork completed without any errors. After this the athlete is no longer part of the process and must rely on the integrity and accuracy of the system. The sample is then taken and sent by courier, along with a chain-of-custody document, to an accredited laboratory.
IS THIS VIOLATION?
While the test protocol may seem excessive and violate certain rights of privacy and decency, there are important reasons for this protocol. There are many reports of athletes using elaborate arrangements of catheters to provide an alternative sample, bringing condoms filled with drug free urine to the testing station, and even catheterizing themselves and instilling drug free urine. If athletes go to these lengths to avoid detection, the testing protocol must be strict.
At the elite level, athletes are subject to year-round random testing. At any time, an independent sampling officer may call unannounced and request a urine sample. While this comes across straightforward on paper, in practice there are many difficulties. Frequently, athletes travel the world and finding the athlete can be difficult. After the independent sampling officer asks around to find the athlete in question, it is unlikely that the testing remains a surprise.
The proper storage of samples is important to the reliability of the tests. Once collected, the sample must be protected so that the fluid, when tested in the laboratory, reflects the composition of the sample as it left the body of the person being tested. As part of sports doping policy, urine is not refrigerated or frozen until it reaches the laboratory. In a clinical setting, great care is taken to ensure that the sample tested is as near as possible to the condition in which it left the body. This is accomplished by adding a preservative or more often by refrigerating or freezing the sample. With worldwide testing in sports, samples are sent all over the world and there can be delays in delivering them to labs.
While refrigeration or freezing of the sample is the usual practice in the clinical setting, note that this is definitely not the case in sports. The addition of chemicals to prevent bacterial growth in the urine could preserve the specimen and may be a more practical alternative. Athletes, however, regard this method with some suspicion and think that this may introduce the possibility of tampering with the sample. Current scientific evidence indicates that their fears are misplaced. Urine contains thousands of bacteria from many different species.
This is even more the case for a sexually active female. Urine collected from a female athlete will contain skin cells and microorganisms from the intestine flushed to the vaginal area by sweat. Many bacteria are ubiquitous and survive even in tap-water plumbing; if the water were used to wash any of the sample containers, other microorganisms could be added to the sample. Bacteria, in a container to which urine is added, will flourish in such a medium that is infinitely richer in nutrients than the water in which they have survived. Many constituents of urine support the growth of such bacteria, and metabolism presents a serious problem in drug testing because of the risk of falsifying doping test results. In this regard, urine contains several steroids that are utilized by bacterial enzymes that can interconvert endogenous steroids to the extent of producing testosterone (T) in the urine. Because of the steroid concentrations in the urine, even a low conversion rate of steroids to T will produce a level of T sufficient to distort the test result. So athletes should be more concerned if officials don't add something to the urine sample and not the other way around.Banned Drug List