Cycling in the South Bay

To recap: Salbutamol, when injected or taken orally, allows you to retain muscle and lose weight. It is banned by WADA for this reason, but allowed up to certain levels when taken through an inhaler for asthmatics, because inhaled Salbutamol does not enhance performance.

Chris Froome’s urine after Stage 18 in the Vuelta had double the allowed amount of Salbutamol, 2,000 ng/mL. This indicates cheating, i.e. oral or injected use for doping, not for use as an inhalant for asthma.

What is Froome’s defense? Well, he’s already telegraphed it pretty clearly, and it’s the only move he really has if he’s to avoid a doping ban. The idea is that it was his doctor’s fault. According to Team Sky, Froome upped his dose of asthma medication during the Vuelta on the advice of one of the team’s medical staff. Froome explained that his symptoms worsened during the Vuelta, and that he sought medical advice from the team doctor in order to increase his Salbutamol dosage. So the defense is, “The doctor doped me.”

Team Sky is already building on this defense, claiming that Froome also used Salbutamol after the stage to reduce his coughing so that he could conduct television interviews. Obviously, the implication is that even if he went over the limit, it wasn’t for a performance advantage but rather simply so that he could talk to the press. This is a move I’ll discuss more below, prepping the inquisitors for the idea that even if he doped, it wasn’t intentional performance-enhancement. The difference between negligent and intentional doping is irrelevant for purposes of guilt, but huge for purposes of determining the length of the sanction.

Strangely enough, this developing defense contradicts Froome’s initial statement to the press when his positive test was sniffed out by the media and he said “You have to remember I’ve been racing with asthma for 10 years now. I know what those limits are. I’ve never gone over those limits.” So on one hand he has never gone over the limits, and on the other hand he went over the limits, but it wasn’t his fault.

Before dealing with the difficulties of proving his case, let’s review WADA’s rules for riders who exceed the 1000 ng/mL dosage. The rule is that in order to not be considered doping, a/k/a an Adverse Analytical Finding, the athlete has to prove through a controlled pharmacokinetic study that the abnormal result was the consequence of the use of the therapeutic dose (by inhalation) up to the maximum allowable dose. In other words, the rider has to show that he inhaled the allowable dose but that something in his physiology caused the false positive. No jokes about Floyd Landis’s book, “Positively False,” please.

What exactly is a pharmacokinetic study? It’s pretty simple, actually. The athlete inhales the amount that he claims he inhaled, and then, in laboratory conditions with full monitoring, his urine gets re-tested. If his urine shows that he took more of the drug than he actually did, the rider is off the hook because he’s proved that he followed all the rules but that something about his body produced a false positive. But ominously, if his urine reflects the actual amount inhaled, then he is presumed to have taken the amount shown in the positive test on race day, which in Froome’s case was twice the allowed limit. Talk about going all in.

In a nutshell, here’s why Chris Froome can most likely look forward to a doping ban:

1. He will fail the pharmacokinetic test, which will show that there is nothing weird or freakish about his physiology that causes Salbutamol to register abnormally. He probably knows this, because he’s been taking Salbutamol for years and this has never happened before. Why would he suddenly be returning false positives in massive amounts for a drug he admits to taking all the time?
2. “The doctor doped me” is not a valid excuse for having excessive levels of Salbutamol in your urine. The relevant rule is Article 15 (1.1) of the UCI and WADA’s Anti-Doping Regulations, which reads in part: “It is each Rider’s personal duty to ensure that no Prohibited Substance enters his body. Riders are responsible for any Prohibited Substance or its Metabolites or Markers found to be present in their bodily Specimens. Accordingly, it is not necessary that intent, fault, negligence or knowing Use on the Rider’s part be demonstrated in order to establish an anti-doping violation under Article 15.1.” Also, no doctor has stepped forward to take responsibility for doping up Chris. If this were a horrible case of mistaken dosage, the first person to come forward would have been the doctor, and if he hesitated, Froome would have named him immediately. There can’t have been more than one or two people at Team Sky on Stage 18 with authority to administer drugs to the team’s star rider and four-time winner of the TdF. Why hasn’t the doctor come forward? Because everyone knows he didn’t dope anyone, Froome and Team Sky most of all.
3. The nutty defense that the positive test resulted from a post-race inhalation to talk to the press, if true, makes it certain that he will be sanctioned because taking excessive amounts of the drug is precisely what the rules forbid. Whether you take them before, during, or after the race is irrelevant if the amount exceeds the allowed limit. Moreover, no amount of puffing would result in such high levels; a standard puff is 100 mcg, and various estimates rate a 2,000 ng/mL reading to require 19+ inhalations.

The record for successful defenses of Salbutamol positives isn’t going to be a source of much encouragement for Chris Froome. Most recently, Diego Ulissi of Lampre-Merida was banned for nine months after testing positive for 1,900 ng/mL of Salbutamol after the 11th Stage of the Giro in 2014. Like Froome, he tested positive for this massive amount after exceptional performances, in this case winning stages 5 and 8. Like Froome, he claimed that there was no way he could have gotten such a high reading from mere inhalations. I would argue that he was right; he returned the high levels due to oral or injected use of the drug.

Worryingly for Froome, Ulissi went through the WADA protocol for a pharmacokinetic study in Switzerland only to find out that the readings were accurate, that he didn’t have freaky physiology, and that the elevated levels were sanctionable. Also like Froome, Ulissi was a long-time user/abuser of Salbutamol, and was in fact using it under a TUE. One silver lining for Froome in the Ulissi case is that Ulissi was only banned for nine months instead of two years, as the disciplinary committee bought the argument championed by his team that his violation was negligent, not intentional. This fits perfectly with the story being developed by Team Sky and Froome, that even if he did dope, it was a) because of someone else and/or b) done negligently to allow him to conduct interviews. What’s also fun to note is that Ulissi’s apologists took some of the same ridiculous tacts that Team Sky is now attempting, and of course it was written up in 2014 … here.

Another 2014 Salbutamol doping case involves Moldovan rider Alexandr Pliuschin, who tested positive at a stage race in Dubai where he won two stages. Don’t worry if you couldn’t find Moldova on a map after being spotted the Ukraine and Romania. Like Froome and Ulissi, the use of Salbutamol doping positives correlates with great results during the race in which they are positive. Distinct from Froome and Ulissi, Pliuschin’s team completely abandoned him when the tests came out, pointing out that it happened when he was with another team. This underscores the difference in treatment between World Tour stage and grand tour winners, and low-level pros trying to make it in the big time. Also distinct from Froome, and not in a good way, is Pliuschin’s reading: He tested for 1,600 ng/mL, far less than Froome or Ulissi, and received a nine-month ban for his efforts, marking the end of his career.

Most worrying of all for Chris Froome, the cycling world has plenty of examples of riders busted for Salbutamol who were sanctioned, as well as those who got the wink-wink-nod-nod. Given the drug’s proven effective used in combination with steroids, its users read like a who’s who of cycling greats. Alex Zülle  tested positive in 1993 as did Bo Hamburger; no sanction was imposed.  Laurent Madouas tested positive in 1994, was disqualified and suspended for a month. Two-time Paris-Roubaix winner Franco Ballerini tested positive and wasn’t sanctioned even though the result came in the ’94 edition of Roubaix where he placed third. Hour record holder Tony Rominger also tested positive in the same year and was excused for therapeutic use; his test result came after the prologue of the Tour.

The same thing happened to five-time Tour winner Miguel Indurain, popped in 1994 at the Tour de L’Oise for Salbutamol that was in a nasal inhaler. The drug was banned by the IOC and UCI at the time, except for athletes with asthma. In France, where he tested positive, it was banned outright, but he was still exonerated, with the IOC/UCI accepting his excuse that his use was legitimate. The bigger the star, apparently, the lighter the touch.

Matt White crossed the line in 1998 and was suspended for two months. Igor Gonzalez de Galdeano tested positive in 2002 and skated under the therapeutic use exception. Eric Berthou, busted in 2002, got off with a warning and a disqualification. Mederic Clain was busted and exempted in 2006, as was Tour runner-up Óscar Pereiro, later known as Tour Winner After Floyd Was Stripped. Continuing in a long line of obfuscation and outright lies about Salbutamol and its effects, UCI deposed president and Lance Armstrong flunky Pat McQuaid defended Pereiro with this bold-faced lie: “He was not positive. He uses Ventolin to treat asthma, as many people do. It is not a doping product or anything like that.” To suggest that Salbutamol isn’t a doping product is to ignore science in general and the WADA code of banned substances in particular.

David Garbelli was warned and DQ’d, also in 2006, as was Christoph Girschweller in 2007. Then a big fish wound up in the net, when Alessandro Petacchi, one of the greatest sprinters of all time, was nailed in 2007, excused by his federation, but later sanctioned by the UCI. His level of Salubotamol was 1,320 ng/mL, and came in an edition of the Giro where he had won five stages. This is a bad precedent for Froome, who has tested positive with far bigger numbers. What was most interesting about the Petacchi case is that the Barcelona lab which retested his sample concluded that the Salbutamol had not been inhaled. This comports exactly with my contention, that inhaling the drug is a cover for oral or injected use to lose weight and retain muscle mass. Nonetheless, CAS ignored the Barcelona lab’s finding, and although it sanctioned Petacchi, it bought his utterly unfounded claim that the Salbutamol had been inhaled. I doubt that this kind of chicanery would pass scrutiny today, and Froome should be worried. A kind of silverish-lining for Froome is the fact that although CAS did in fact sanction Petacchi, and they accepted the argument that Froome now advances, i.e. his levels were caused by a “post race” inhalation, he was therefore banned for a year rather than two. Yet unlike Petacchi, who was at the end of his spectacular career (and racking up five stage wins in the Giro, uh, okay), a one-year doping ban for Froome would be catastrophic for him and for Team Sky.

Leonardo Piepoli  got by after testing positive in 2007 in the same Giro as Petacchi, with therapeutic use, whereas Gerg Soeperberg was disqualified and warned in the same year. Matteo Trentin got a two-month sanction in 2007, as did Mariusz Olesek. Eric Berthou tested positive but was exempted in 2008. If none of these names mean anything to you, the name of Salbutamol should: It is an incredibly effective and popular doping agent and has been recognized as such since at least 1992, and probably before.

Whatever you want to say about Salbutamol, Froome has got to be considering the reality that if he can’t reproduce a massive 2,000 ng/mL test result with a few measly puffs from an inhaler, he’s looking at a minimum suspension of nine months, the loss of his Vuelta title, and the potential destruction of Team Sky, a cycling team already stinking of dope to high heaven. Worst case scenario is two years sitting on the bench, wondering where it all went wrong.

END

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