“Doping in Cycling” _Doping in Radsport_

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					“Doping in Cycling” (Doping in Radsport) by Ralf Meutgens
Prologue The sport of bicycling and doping: two terms which, as it seems, are inseparably connected with each other, and this not only since the death of the British cyclist Arthur Lynton in the year 1886 at the tour between Bordeaux and Paris, probably caused by an intoxication through chemically pure alcohol with which he had hoped to increase his energy and strength. He is regarded as the first victim of doping in athletics in the modern world. Strychnine and arsenic have been used illegally since the early 20th century as drugs to increase bodily performance. Former professional participants in six-day races recounted, with pride in their voice, that they had been able to take a dose of these poisons, which would have killed any untrained person. Since the early 1930s, the first amphetamines were produced. They quickly entered the world of cycling. Still in 1983 during the Classical German cycling event “Around the Henninger Turm” in Frankfurt a Dutch professional cyclist was convicted of having used strychnine for doping. Earlier, in 1960, during the Olympic cycling race of the four-men team in Rome two Danish cyclists fell of their bikes after having taking amphetamine. One of them, Knut Jensen, died in the hospital, the other bicyclist of the team, Jörgen Jörgensen, survived. Seven years later a participant of the Tour de France died after doping. Again, it was a British, Tom Simpson, whose death in front of the TV cameras brought about intensified doping controls, also at the Tour. But the series of death cases continued. Between the end of the 1980s and the middle of the 1990s, more than 20 young and active professional cyclists died a sudden and very early death. In 1988 the kidney medicine Erythropoietin, short EPO, reached the market. People with kidney problems can no longer produce this important, naturally grown hormone in sufficient quantity. What proved to be a blessing for patients, however, turned out to be a curse for endurance sport. Dr. Martin Glover, Neuss, specialist for internal medicine and nephrology, describes this development very illustratively in this book. EPO considerably increases the endurance capacity, so it was quickly adapted by athletes in various sport disciplines as an illegal drug. Cycling was one of the first sport branches where this medicine was taken by the athletes. Side effects are, among others, an increased blood pressure, and an increase of blood viscosity. When these phenomena are accompanied by high physical stress and an increase of a loss of fluids, the risk factor of deadly thrombosis rises considerably. This was probably the reason for the series of deaths. The heart of those affected simply stopped because blood could no longer be pumped. This danger was particularly high during rest periods after intensive training. No one knew how to deal with this problem, not even the medical experts. At that time, a precautionary measure was the use of high frequency measuring instruments, which the professional cyclists used when they went to sleep. If the frequency of the heart rate sank below a certain value, they were awakened by an alarm, got up, drank a lot of fluids, and exercised on the bicycle ergometer. Adolf Müller, who had witnessed those practices and had participated in them himself, testifies here in this book.

Certainly, EPO was banned, but it took more than ten years until doping analysis could identify whether someone had actually broken the ban. Insofar as EPO is a medical drug produced through gene technology, it hardly differs from EPO produced by the own body. Curiously, the death cases connected with the use of EPO mostly occurred in the Benelux countries. At that time in Italy Professor Francesco Conconi had advanced his dubious EPO research so much that the handling of this medicine worked better there. The Italian doping investigator, Alessandro Donati, also addresses the case of Prof. Conconi. The leading EPO-analyst, Dr. Andreas Breidbach, head of the anti-doping laboratory in Los Angeles, describes, for instance, the helplessness of the World Cycling Federation (UCI) in fighting EPO-doping. But this is not the full extent of the problem with EPO. Professional cyclists in the meantime use such small dosages that they stay below the level where they can be detected. There is evidence for this from several anonymized e-mails exchanged among cycling professionals. Professor Horst Pagel from the University of Lübeck outlines in great detail what problems will ensue when the patent-protection for EPO will expire. Until today, we know of numerous sudden death cases of former cycling professionals who passed away at the age between 50 and 60. During their active time the use of anabolic steroids, an advanced variation of amphetamines, was widespread. The causes of death were frightfully often the same as the side effects of anabolic steroids. So far, of course, direct causal connections cannot be proven, but many researchers of sport medicine are fully aware of the dangerous implications. The medical coach for the cycling alliance of North Rhine-Westphalia, Dr. Gustav Raken, provides an extensive report about his experiences in the 1970s. There is a dramatic analogy between death cases in cycling sport and the misuse of doping medicine taken at specific times. This is so evident that, according to the opinion of the medical researcher of sport, Professor Dirk Clasing in Münster, this should have been the basis for a large-scale research project. But the early death of the Cologne doping analyst, Professor Manfred Donike, who himself had been a cycling professional, prevented this. Already ten years ago, medical researchers warned about a similar series of death cases as a late result of the misuse of so-called peptide hormones, such as EPO and growth hormones (hGH), IGF 1, and others. Especially the development of tumors, the uncontrolled growth of internal organs, and structural changes of the heart are dreaded long-term consequences. In 2003, for instance, a series of new death cases of young and active cycling professionals occurred, which cannot be exactly explained in medical terms. Within three years, thirteen cycling professionals, on the average below the age of thirty, suddenly died from heart failure. Early in 2007 the fourteenth death occurred, after a one-year break. Especially dramatic for medical sport researchers is the circumstance that these death cases happen almost exclusively during rest phases or during sleep. The cardiologist Professor Hans-Willi Breuer from Görlitz comments on this, drawing from his intensive discussions with international experts at the cardiologist congress in Barcelona in 2006. Dr. Wolfgang Stockhausen (Freiburg), who has been active for many years as the medical coach for the German Federation of Cycling, critically views the role of the researchers of sport medicine and demands that they have to adopt the same ethical rules as embraced by all other medical doctors. He also describes the dramatic consequences of doping in the sport of cycling.

The number of deaths that can be explained indirectly by previous doping is probably much larger, and no one can fully estimate the irreversible bodily damages suffered by cycling professionals. Many experience extensive problems with addictions once they have ended their career. “Once they have taken some drugs, they have to continue to take them, or they turn to alcoholism,” as another expert has stated. Apart from these medical aspects, the true extent of doping in cycling is now documented by roughly 30 reports about doping by former cycling professionals. The first was by Jörg Paffrath (Cologne), who is also quoted in this book. Countless legal cases in the European countries outside of German that were brought to the courts after the discovery of doping medicine during police raids verify and support these doping biographies. Monika Mischke, a sociologist and writer for the internet site `´ investigated more cases of cycling athletes who had tested positively than anyone else before her and she summarizes the most important legal cases. Does the sport of cycling suffer from a particular problem with doping? The former cycling professional Rolf Wolfshohl (Cologne) comments, “if other types of sport had developed as cycling has, the problem with doping would have developed similarly there as well.” The sport of cycling was one of the first that turned into a professional enterprise. It guaranteed a good income for the participants and their families. Considering the extreme conditions under which the sport of cycling was carried out at the beginning, it was probably necessary to resort to medicine and drugs in order to complete a cycling event in the first place. Six-Day Races lasted, as the name says, for six days and six nights during which one of the members of a professional two-men teams always had to be on the course. At that time, the Tour de France extended for 1000 kilometers more than today, and individual stages could cover more than 400 kilometers. Moreover, roads and the material were much worse in comparison with today. Nowadays, however, it seems to be necessary to do doping in order to have any chance during a race. This, at least, is the opinion of the vast majority of cycling professionals. However, this should not be this way, as Dr. Jean-Pierre de Mondenard and Paul Köchli illustrate in their contribution. But reality looks differently. At one point each cycling professional has to decide whether s/he wants to continue to earn his/her money in the sport of cycling and to accept doping, or whether s/he should stop working in this athletic profession. Even doping among nonprofessionals, among young adult cyclists, seniors in cycling races and leisure bicyclists can be observed. This often happens with the full awareness of the trainers (even on the level of the sport federations), the club managers, team captains, the medical doctors, and journalists. Doping is an existential problem. Doping is part of the system and intimately linked with success. The closed system of cycling sport, which is determined by family-like dynamics, which finds no parallels in any other type of sport, strongly supports the heavy use of doping. Apparently, there are much fewer critics against the philosophy of doping among cycling circles than in other kinds of sports. The researcher of sport sciences, Dr. Sascha Severin, a former member of the German national team, received his Ph.D. with a dissertation on doping. He describes how such a mentality favoring doping develops. But this does not even seem to be the biggest problem. The real concern seems to be that the way most of those involved handle doping, or rather that they do not know how to handle it. Controls of doping were

introduced at the Tour de France only after one of the participants had died as a consequence of doping. Systematic denial and downgrading of the problem despite many accidents, the availability of concrete statistical facts, and reports about doping do not lead to a solution. Even today, many embrace the opinion: S/he who is not tested positively is clean. This, however, proves to be nothing but wishful thinking. One can, of course, sympathize with such statements by professional cyclists. But when high-ranking officials in the sport of cycling argue like this, the limit of tolerance has been reached. Sadly enough, the various measures to suppress doping have not led to a true form of abstinence. To ban an athlete because of doping has happened much too rarely. The financial consequences are much too miniscule. In the early 1990s, the German Federation of Cycling established to impose a ban on an athlete only for three months in the case of a doping conviction, and in the case of a repetition only a ban for six months. The case of the German cyclist Danilo Hondo brings to light additional problems. Postfactum his ban of two years was confirmed only after a lengthy legal process. But during the time of the trial, he was actually banned only for one year and could actually pursue his career without any real interruption. Will the ban now be extended for this amount of time? Does he have to pay back his income, which he earned during this time through his participation in cycling events? The problematic of doping constantly raise new questions, which are very hard to answer. Jens Fiedler was tested positively early in 2005 during an invitational race without any athletic significance in Manchester, having taken amphetamine. The British Cycling Federation was in charge. But for entirely unclear reasons they never brought a court case against him. Neither the Federation of German Cyclists (BDR) nor the World Sport Federation (UCI) ever reacted. If punitive measures do not work, we should focus on prevention, above all. The BDR did not want to support a successful doping prevention conc ept developed by the cycling federation in Schleswig-Holstein when they were asked, already years ago, for a financial contribution for the printing of a flyer. The concept as developed by the cycling team of Lübeck itself was never considered. Gert Hillringhaus, who was responsible for this concept, writes about his negative experiences. Regarding the doping problem, almost everyone reacts, but no one does anything proactively. Decisions are mostly motivated by political reasons insofar one only reacts when no actions would have had even more unpleasant consequences. Often all that is done remains blind activism. The BDR developed, in cooperation with sponsors, team managers, and organizers, after a series of round-table discussions, a nine-point concept that consists only of punitive measures (procycling 9/2006). The concept does not mention prevention with one word. However, on September 19, 2006, when the official media outlet of the BDR, Radsport, was published, one could read on page 30 that prevention was suddenly of top priority. The text also referred to the above-mentioned conferences. It is hardly imaginable that journalists make such grave mistakes. But in the meantime, the missing prevention had been critically discussed in other media. Suddenly, the Lübeck concept was to be part of the trainer education program. But apparently, no one has so far thought about the form in which anyone is supposed to carry it out in pragmatic terms. Currently the topics of doping and doping prevention have not played any role in the education of trainers. It will also not be of any help if in the future former cycling

professions read some passages out of a brochure to the future trainers. A new philosophy has to be practiced and demonstrated. But this might not be possible with those who have for years internalized a special value system basically tolerating doping. Otherwise, it will happen as it did at a continued education seminar for A-Trainers in Leipzig in November 2005. One of the speakers said, for instance: “It is advisable to abstain from doping with EPO, growth hormones, and the growth factor IGF 1 because they can be detected.” I was one of the ca. 40 trainers present and first thought that this was a rhetorical joke for the warm-up. But soon I had to realize the opposite. The man thought that he was among colleagues who espoused the same concepts. In this value system, doping is present, but not doping prevention. But no one wants to admit it openly. Until today the active athletes, others involved in the wider field, spectators, and representatives of the media do not indicate any willingness to recognize the seriousness of the matter. Until today, personalized scandal cases are described as exceptions. However, in the meantime the entire field of sport is affected. Our task is to change the structures that have been responsible for the sport of cycling to turn into what it really is: a parallel world with organized and comprehensive doping that has life-threatening and life-shortening consequences, something outsiders cannot even imagine. Rolf Järmann, at his time of active athleticism the most successful Swiss cycling professional, describes how he, as an opponent of doping, could not resist the misuse of EPO and how he imagines approaches to solve the problematic of doping. But many were not even willing to speak about the topic of doping when asked for a contribution to this book. Perhaps they were not allowed to do so after they had checked with their respective authorities. Among them were well-known cycling professionals and representatives of the media. Names will not be mentioned here, as throughout the entire book. The purpose is to deal with structures, not with individual people. Those who have actively shaped the sport of cycling have not achieved, despite many assurances, any reform. The sport of cycling cannot reinvigorate itself from within, just as it is impossible to pull oneself out of a swamp. The sport of cycling needs help from outside. It deserves to receive this help. But it also must want to receive this help. This is so far not the case at all because far-reaching and painful measures are necessary. But how will the sport of cycling develop from here? It is undoubtedly a fascinating kind of sport that can be pursued for the rest of one’s life in order to maintain one’s health. But as soon as this sport turns professional, there does not seem to be an escape from the “doping trap” (Bette/Schimank, 2006). Andreas Singler (Master of Athletic Sciences) and Professor Gerhard Treutlein illustrate in their contribution how difficult it would be if one really aimed for such a reform. In his prospective Treutlein illustrates how complex doping prevention would have to be in order to achieve the desired goal. There are serious doubts that this can be realized without help from outside. The most important leverage could be applied by the TV stations. By refusing to offer life reports, they would pull the rug from under the sponsoring system. This might have the consequence that the professional teams would disappear. But the media are also existentially connected with this sport. Professor Karl-Heinrich Bette elucidates the connections with merciless frankness. The programming chair of the Saarländische

Rundfunk, Gabriele Bohr, who had granted us an interview, stated that she expects from the sport of cycling to provide the basis for further life reporting. According to her opinion, words must now be followed by actions. In fact, what else must have to happen in order to achieve fundamental changes in the world of professional and other cycling? Translation from German to English: Dr. Albrecht Classen University Distinguished Professor University of Arizona