The Olympics are always a highly-politicized event, with athletes attempting to demonstrate physical superiority over each other through feats of physical prowess. Their performances are recognised not just as individual or team successes, but more-so as representatives of their respective nations.
Inevitably, the desire for a podium place – perhaps even a gold medal – will tempt some to seek to improve their performance by way of unsanctioned methods.
The idea behind doping controls is obvious: cheating athletes potentially gain a significant advantage over their peers, leaving “clean” athletes disadvantaged by those taking potentially harmful substances. But are the rules clear? Are they useful? Are they evenly enforced? The Total Flex Blog decided to take a critical look at the history and current state of doping in sports, focusing particularly on the Olympics.
“Anyone who fails [a doping test] faces a stigma at home. You have to carry that with you, that cloud on your head, that stigma against your name, for the rest of your life. You become an outcast. And the consequences, I’ve got to say, I think are diabolical.” – WADA president John Fahey (2012) 
London 2012 promises to be the most heavily-tested Olympics in history, with around 6,250 samples expected to be tested.  The extensive WADA list of prohibited substances encompasses anabolic steroids, growth factors, stimulants, narcotics, diuretics, and beta-blockers. 
The BALCO scandal uncovered in 2003 the use of hitherto-undetectable designer steroids, including the previously-unknown tetrahydrogestrinone (THG), by athletes from a wide variety of sports.
Former BALCO-doped athlete Dwain Chambers was penalized with a lifetime ban in 2004 by the British Olympic Association after his drug-use was discovered. The ban was subsequently overturned (very recently) by the Court of Arbitration for Sport, resulting in Chambers being selected for Team GB in the mens 4x100m relay and 100m sprint  something several people, including British Olympic ambassador Seb Coe, have spoken out against. 
In order for a drug to be included by WADA as a banned substance, it must fulfil at least two of the three following criteria:
1) It must be proven to be performance-enhancing.
2) It must be harmful to the health of athletes.
3) Its use must go against the spirit of sport.
Despite being vaguely structurally similar to anabolic steroids, these naturally-occurring compounds possess no anabolic qualities, and are not specifically performance-enhancing. Far from being harmful to an athlete’s health, they have been shown in several studies to improve cholesterol levels and immune function. Given that they clearly fail to meet the first of the two criteria for inclusion, it’s difficult to see how they conceivably fulfil the third. Their inclusion appears to defy the inclusion criteria, nebulous and ill-defined though they are.
The journal World Psychiatry suggests that there is a risk of drug use in sport spreading to wider society; that people may decide to emulate their athletic idols and try drugs such as “boldenose” and “closterbol” [sic] for themselves. 
With this risk to society in mind, the ACMD (the panel of scientists that advises the UK government on drug misuse), tasked with monitoring the WADA list with a view to staying abreast of the latest developments in potentially dangerous drugs, took the inclusion of 7-keto as an “anabolic agent” to indicate that it should be scheduled under the Misuse of Drugs Act as a Class C controlled drug in the UK, since they felt that the “potential physical and social harms of 7-hydroxy DHEA and 7-keto DHEA… are commensurate with other Class C drugs”. 
Following intervention by this blog, Patrick Arnold, and a US pharmaceutical company to point out that 7-keto DHEA is neither anabolic nor dangerous, the proposal was dropped, and the draft legislation was ditched.  Although on this occasion common sense won out, there remains the worrying possibility that in the future rules that are applied arbitrarily and capriciously to competitive athletes could be blithely copy/pasted into law for application to all citizens.
The use of erythropoietin (EPO, a drug employed to increase red blood cell count) reached epidemic proportions among cyclists in the 1990s, and when EPO-specific testing was finally applied to the sport in the 2000s, the number of positive results – and the subsequent revelations and accusations from Floyd Landis –  rocked the sport.
“In my opinion, 99 percent of riders at elite level take EPO or a similar drug, not particularly to dope themselves but to be at the same level as the others. And I find that rather sad.” – Graeme Obree (1996) 
Prior to the Beijing Olympics in 2008 doubts were expressed over the quality of the EPO testing, with several experts of the opinion that widespread use was still being ignored, suggesting that the problem was so prevalent that it was too big to challenge.  It’s unclear if this problem, which appears to be the systematic clearing of what should be doping-positive test results, has since been rectified, or if athletes continue to use EPO with apparent impunity.
Diuretics are commonly employed by doping athletes either to reduce weight rapidly or to speed up the process of the elimination of metabolites of performance-enhancing substances; they are so-called “masking agents”, administered to try and prevent a positive result from use of banned substances like steroids,  and as such are banned as a class. 
Prescription diuretics aren’t the only agents capable of concealing a positive result though: painkillers such as ibuprofen and diclofenac have been found to reduce the elimination of testosterone by the body  (by suppressing the glucoronidation of testosterone through inhibition of the UGT2B17 enzyme); recently green tea has been found to have the same effect.  Some concern has been expressed that these could be used as “masking agents” to temporarily reduce the amount of (exogenous) testosterone excreted during a urinary doping test, resulting in a “false negative” for a cheating athlete – particularly since it results in a lower T/E ratio.
Ironically enough, it was BALCO chemist Patrick Arnold who just this week pointed out the inconsistencies in application of sanctions against athletes who test positive,  with USA’s goalkeeper and poster-girl Hope Solo effectively let off after testing positive for a banned diuretic while other athletes face exclusion from the games. 
In addition to the steroids, diuretics and other obvious candidates, a range of synthetic peptides, GHRH secretagogues, and SARMs are available to athletes on the grey market, and although testing appears to be keeping pace with this technology relatively well,  it’s likely a number of compounds (like CK-2017357 and novel analogues of EPO and AICAR) can still evade existing doping controls.
“Given that the London 2012 urine samples can be stored and reanalysed for 8 years after the Olympics, perhaps we should wait until 2020 to hand out the medals?” – Chris Cooper (2012) 
The distinction between food, supplements, and drugs is an artificial one that is becoming increasing blurred as scientific advances are rapidly identifying naturally-occurring compounds that, although they don’t appear on WADA’s list, would appear to be promising candidates for enhancing the athletic performance of athletes. For example, grape-derived polyphenol resveratrol increases muscle strength and cardiac function in rats,  while ursolic acid increases strength, muscle mass, and induces fat loss in mice.  Both compounds are widely available as dietary supplements.
Doping policy is also riddled with inconsistencies; while drugs that raise oxygen content in the blood (such as EPO) are banned, and blood transfusions that raise oxygen content in the blood are banned, devices like hypoxic chambers (altitude tents) that achieve the same result are allowed – despite WADA’s own ethics panel declaring that they are “a violation of the spirit of Olympic sport”. 
Due to the appearance of inadequate testing,  positive test results being systematically ignored in the selection of athletes,  and the regulatory authorities reporting positive results as negative results;  drug testing seems to be more about providing the appearance of a level playing field than the reality of one.
- Doping regulations are arbitrary and inconsistent.
- Doping tests are sometimes unreliable and inadequate.
- Doping violations are inconsistently punished.
- The widespread dissemination of advances in sport science has a homogenizing effect on the athletic population leading to inherent genetic factors deciding podium places.
“Once you get to podium level, those people have that [tenacity and desire to win] and the only thing that sets you apart is what you’re born with naturally. So you can get to the top just on desire and aptitude, then the difference becomes genetic.” – Chris Boardman 
- Doping advances typically outpace detection methods.
“It’s simple, science always moves faster than the testers.” – Dwain Chambers (2007) 
- Doping is probably far more prevalent than most imagine.
“Do I think it’s relatively easy to circumvent the testing? I do. …If it was 80 percent (using drugs) before, I still think it is 60 percent now. I’m talking about the top tier — the top 20 in an event, not the top 50. But I still think it’s the majority of that top tier.” – Victor Conte 
Maybe it’s time to reconsider the doping paradigm?