The frustration of drug-testers might be reduced with one bold move: The IOC could require the testing of athletes' blood. Blood testing can detect signs of illicit usage of both hGH and EPO. Since March the UCI, cycling's worldwide governing body, responding to riders' requests, has been testing the blood of professional road racers for signs of EPO. Four cyclists found to have thickened blood have been forced to sit out races as a "health precaution."
Catlin maintains that blood testing is not yet reliable enough to be used at the Olympics. Other testing experts disagree but see it as impractical. "Blood testing is invasive," says Goldman, whose book, Death in the Locker Room, last updated in 1995, details the dangers of steroid use and abuse. "Blood's too much of a pain. Blood spoils. Tubes break. It can clot if you don't keep it cool when shipping. You're sticking holes in athletes, and some people have religious problems with that. People pass out. But blood testing would be more accurate. There's no doubt about that."
So why no official push for blood testing? Says Voy, "It's very difficult for sport organizations that depend on sponsorship money" to have their athletes caught taking performance enhancers. "The IOC fears exposing the high levels of drug use. It turns off the public. The IOC is very nervous about testing."
Voy quit his Olympic position in 1989 because, he says, neither the IOC nor the USOC was committed to eliminating the use of illicit performance enhancers. Exposing star athletes would create enough publicity to send sponsors packing, and it might also disillusion a sports-watching public that assumes that the overwhelming majority of Olympic athletes are clean.
Once scientists determine that the drug test of an Olympic athlete is positive, two separate IOC committees must accept the results. The committees meet in private and have been accused of putting the interests of a particular sport or a particular country ahead of the drug-testing rules. Ontario Supreme Court judge Charles Dubin, who as head of the 1989 Canadian government inquiry into drug use in sports heard months of testimony, concluded that the IOC had by omission covered up more drug use than it had uncovered. "The general public has long been led to assume that if only one athlete tested positive, the others were not also using drugs," wrote Dubin in his report. "We know now, as the IOC...has known for many years, that this assumption is false."
Nor is the testing itself as stringent as Olympic testers would have the public believe. The IOC tolerates startlingly high levels of testosterone in both male and female athletes. Olympic testing guidelines established 15 years ago by the late German biochemist Manfred Donike, who was the head of the IOC's doping subcommittee from 1980 until his death in 1995, measure an athlete's testosterone level as a ratio between the testosterone and the epitestosterone (a natural hormone with no known physiological benefit) found in his or her urine. Virtually all men have a testosterone/epitestosterone (t/e) ratio of 1.3 to 1 or lower. A small fraction of men, far fewer than 10 in 1,000, have a t/e ratio of more than 5 to 1. To cover these people and to avoid lawsuits, Donike pegged the maximum acceptable ratio in Olympic athletes at 6 to 1. Thus, a male athlete with a natural t/e ratio of 1 to 1 can artificially increase his ratio to 6 to 1 and still have legal readings. A man with a natural 1-to-1 ratio could take 200 milligrams of testosterone three times a week and remain below 6 to 1. Sports scientists say that a run-of-the-mill male athlete with a 1-to-1 t/e ratio who raised his ratio to 6 to 1 by injecting testosterone, in conjunction with hGH, could improve his athletic performance by as much as 10% to 20%. That's a huge advantage in, say, a 100-meter sprint, in which a few hundredths of a second can separate first place from fourth, or in a throwing event, in which six feet can separate a gold medalist from an also-ran.
Donike also established 6 to 1 as the legal ratio for women, even though it is almost unheard of for a woman to have a ratio greater than 2.5 to 1.
A woman who boosted her ratio to 6 to 1 would see even more dramatic improvements in performance than a man who did so. "Women require a lot less anabolic stimulation than men do in order to build up their strength and endurance," says Voy. "It's sometimes pretty hard to stimulate a lot of males with anabolic steroids because a lot of their androgen receptor sites [male-hormone receptors found in almost every muscle in the body] for the anabolic steroids have been closed down because of maturity. But in a woman those receptor sites are always open, so just a little tweak here and you can get great gains."
Donike's guidelines have had the unintended effect of encouraging female athletes to take more powerful muscle-building substances. Before Donike established the 6-to-1 t/e ratio, says Mooney, "women preferred synthetically produced steroids over straight testosterone because the synthetics had fewer male side effects. Since then, it's been easier to get by the tests with pure testosterone, so that's what they're using." He adds, "You start feeding a woman testosterone, essentially you're turning her physiology into a man."
That and other risks from banned performance-enhancing substances are well-documented. Steroids can cause heart disease, liver cancer and impotence. The hormone of the moment, hGH, can cause disfigurement by encouraging growth not only of muscles but also of bones, especially in the feet, hands and face. Some hGH users develop jutting foreheads, prominent cheekbones and an elongated jaw. (In Olympic circles an athlete with a pronounced chin is sometimes said to have GH jaw.) According to Walter Jekot, a Los Angeles pediatrician doing five years in North Las Vegas Federal Prison following his 1992 conviction for trafficking in steroids, a track athlete had to undergo a skin graft in the late 1980s because doses of hGH had caused the bones to practically push through the skin, and the athlete could no longer fully open his hands.