The New Doping Crisis Is not a Sports Issue, it's a Public Health Issue

Imagine you're standing high in a pass in Italy's Dolomite mountains. Around you, huge, snow-capped limestone spires stretch into the sky. A one-lane road snakes through the pastures in the green valley below, leading up to where you're standing. The road is packed with thousands and thousands of cyclists. A lean, 25-year old is out ahead of the pack, but just behind, closing slowly, is a man who looks twice his age.

You're at the Maratona dles Dolomites, one of cycling's most famous and popular Gran Fondos—a kind of open-entry, pro-am cycling race. Gran Fondos are both a fun weekend ride for amateurs and hobbyists; a proving ground for riders looking to turn pro; and entertaining, prestigious side challenges for pro riders, but the scene at some Gran Fondos is starting to change. Amateur riders—weekend warriors—are giving the pros a run for their money, literally.

Last month, the Union Cycliste Internationale, the world governing body of cycling, published a report on "the state of doping in cycling today, and the main factors that led to a doping culture," inside the sport. Some of the most interesting details have to do with doping at the amateur levels, which the report calls "endemic." Here's one of the report's juiciest bits:

"[The endemic nature of doping] was confirmed by amateur riders, as well as professionals, managers and anti-doping personnel who had exposure to it. It has been caused by a combination of ease of access to drugs via gyms and the internet, the reduction in costs for substances, a spread of knowledge in means and methods of administration, and a lack of funding for regular testing at the amateur level.

Masters races were also said to have middle-aged businessmen winning on EPO, with some of them training as hard as professional riders and putting in comparable performances. Some professional riders explained that they no longer ride in the Gran Fondos because they were so competitive due to the number of riders doping."

Along with match fixing, the proliferation of performance-enhancing drugs is the most troubling example of how organized crime has come to influence sports. Last October, at a conference in London, David Howman, the director-general of the World Anti-Doping Agency said "organized crime controls at least 25 percent of world sport in one way or another."

In 2009, WADA and Interpol, the International Criminal Police Organization, signed a cooperative agreement to counteract the criminal presence inside the international doping market. And, interestingly, it's not professional sports they're concerned about.

"It's not necessarily in the area of professional sports, but the sports for amateurs and semi-professional sports, we know that there is more performance-enhancing drug consumption," says Clément de Maillard, a criminal intelligence officer at Interpol. A former member of France's National Gendarmerie, de Maillard is a project manager in charge of all kinds of doping. "This kind of trafficking is in the end, organized crime."

What to do about it is an interesting question. As the UCI report makes clear, sporting government bodies don't have the financial muscle to test deep into the amateur ranks, and even if they did, the testing laboratories don't have the capacity to process all those tests. On the law enforcement side, there are also issues. You see "drug trafficking" and you think of the billions of dollars that fund the international War on Drugs, but the kind of drug trafficking at work in doping is far different from the kilos of coke moving between South America and the United States. The sale and distribution of doping drugs is considered a pharmaceutical crime, and is handled by a different branch of law enforcement, one that doesn't have the same deep pockets.

For the most part, these drugs aren't illegal to possess or consume. But that doesn't mean they're safe. Often, the drugs are classified as medicine—the most famous example being testosterone—designed to be given out to treat specific illnesses and diseases in a highly-regulated setting. When it comes to doping, doctors usually aren't filling out prescription slips—or at least not doing so in good faith—to then be filled by trained pharmacists who look for potentially dangerous drug combinations. Rather, most doped athletes simply order their drugs from the internet.

As you might imagine, not all of the drugs shipped on the internet are what the labels say they are, and the counterfeit drug market has grown with the ease of access the internet provides. The exact size of the market is difficult to estimate, according to de Maillard, but, "we know that the raw materials are generally from Asia and Eastern Europe and then [they're] sent to underground laboratories all over the world. All the countries in the world are impacted by production."

"[The criminals] know it's not always a priority of the country of law enforcement to fight against this kind of trafficking of medicine," continues de Maillard, "So for them it's a question of costs and benefits and risks. And the risk is lower if you produce steroids than if you produce designer drugs or cocaine, you know? So this is just a question of risk for organized crime groups and a question of priorities for countries."

Until countries devote more resources to fighting the counterfeit drug market, and the illegal shipment of drugs, things aren't likely to change. And while cycling's Gran Fondos might be the easiest place to witness the effects of doping, the issue stretches way beyond cycling, to Cross Fit gyms, to ultra marathons, and even high school track meets. Reducing the prevalence of doping in cycling might not happen until it's seen as a much larger issue.

"Actually this is a big health issue," says de Maillard. "We can consider the doping of professional athletes a kind of fraud, but regarding the mass consumption [of performance-enhancing drugs], it must be seen as a public health issue."