Lance Armstrong and the Prisoners' Dilemma of Doping in Professional Sports
Doping in professional sports is back in the news, as the overwhelming evidence against Lance Armstrong led to his being stripped of his seven Tour de France titles and more. But instead of focusing on the issues of performance-enhancing drugs and whether professional athletes be allowed to take them, I’d like to talk about the security and economic aspects of the issue.
Because drug testing is a security issue. Various sports federations around the world do their best to detect illegal doping, and players do their best to evade the tests. It’s a classic security arms race: Improvements in detection technologies lead to improvements in drug detection evasion, which in turn spur the development of better detection capabilities. Right now, it seems drugs are winning; in some places, these drug tests are described as “intelligence tests”—if you can’t get around them, you don’t deserve to play.
But unlike other security arms races, the detectors have the ability to look into the past . A laboratory tested Lance Armstrong’s urine in 2005 and found traces of the banned substance erythropoietin (EPO). What’s interesting is that the urine sample tested wasn’t from 2005…. It was from 1999. Back then, there weren’t any good tests for EPO in urine. Today there are, and the lab took a frozen urine sample—who knew that labs save urine samples from athletes?—and tested it. Armstrong was later cleared (the lab procedures were sloppy), but I don’t think people understood the real ramifications of the episode: Testing can go back in time.
The ability to test backward has two major effects:
- While those who develop new performance-enhancing drugs know exactly what sorts of tests anti-doping laboratories are going to run, and can test their drugs’ ability to evade detection beforehand—they don’t know what sorts of tests will be developed in the future. Athletes can’t assume that just because a drug is undetectable today it will remain so years later.
- Athletes accused of doping based on years-old urine samples have no way of defending themselves. They can’t resubmit to testing; it’s too late. (Though if I were an athlete worried about this I would regularly deposit urine “in escrow” to gain some ability to contest accusations.)
The Doping Arms Race as Prisoners’ Dilemma
The doping arms race will continue because of the incentives: It’s a classic Prisoner’s Dilemma. Consider for example competing athletes Alice and Bob, who are individually deciding whether to take drugs or not. Alice thinks:
If Bob doesn’t take any drugs, then it will be in my best interest to take them. They will give me a performance edge against Bob. I have a better chance of winning.
Similarly, if Bob takes drugs, it’s also in my interest to agree to take them. At least that way Bob won’t have an advantage over me.
So even though I have no control over what Bob chooses to do, taking drugs gives me the better outcome, regardless of his action.
Unfortunately, Bob goes through exactly the same analysis. As a result, they both take performance-enhancing drugs and neither has the advantage over the other. If they could just trust each other, they could refrain from taking the drugs and maintain the same non-advantage status, without any legal or physical danger.
But competing athletes can’t trust each other, and everyone feels he or she has to dope—continuing to search out newer and increasingly undetectable drugs so they can compete. And the arms race continues.
The Ever-Evolving Problem
It’s been this way in bicycle racing for decades. In the 1970s, cyclists used corticosteroids and psychostimulants such as Ritalin, and newly developed norepinephrine-dopamine re-uptake inhibitors such as Pemoline. They were banned, and by the end of the decade assays were developed to detect those substances. In the 1980s, athletes turned to newly developed analogs of endogenous substances made possible through recombinant DNA technology, including human growth hormone, testosterone, anabolic steroids, and synthetic human EPO.
Because EPO is a glycoprotein hormone that controls red blood cell production, it acts to increase oxygenation—an effect valued as highly by endurance athletes as it was by people suffering from anemia. EPO use became rampant in cycling and other sports, and continues to be rampant in spite of bans since the early 1990s and the development in the late 1990s of carbon-isotope ratio tests. Such tests are capable of determining whether substances are made naturally by the body, or come from performance-enhancing drugs.
Next came analogs of analogs, such as darbepoetin alfa (Aranesp), a variation on EPO that became commercially available in 2001. It swiftly gained a following among bike racers and other endurance athletes, and a test to detect it soon followed in 2003. Yet another EPO replacement, Mircera, found its way to both the medical and sports markets in 2007, and assays to detect it were developed by 2008.
Norbolethone, first developed in 1966, was resurrected in the late 1990s and marketed as the first designer steroid by an entrepreneurial bodybuilder-turned-chemist intent on evading detection by the doping police. Its fingerprint was traceable by 2002. This scenario was replayed with tetrahydrogestrinone and madol, with assays developed within two years of their introduction into sports. The mid-to-late 2000s have seen an increase in blood doping through blood transfusions used to increase blood oxygen concentrations. This was soon followed by the development of flow cytometry tests to detect it.
The as-yet-unrealized prospect of gene doping has led some regulatory bodies to preemptively ban any non-therapeutic uses of genetic technology in sports. Presumably tests to detect athletes using them will follow.
Testing and Enforcing
Some sports are more vigilant about drug detection than others. European bicycle racing is particularly vigilant; so are the Olympics. This can lead to some perverse outcomes. In at least two instances, positive tests for norandrosterone, a steroid of which traces are found naturally in human urine, have been traced to adulterated supplements consumed by unsuspecting bicycle racers. Another athlete tested positive for benzodiazepine after consuming a Chinese herbal product. The most widely used urine test for EPO has been found to result in false positives in urine collected after strenuous physical exercise, though this conclusion has been hotly contested by the test’s developer and others.
The most widely used tests—rapid-screen immunoassays—all too frequently yield false positives in individuals taking routine over-the-counter and prescription pain relievers, and allergy and acid reflux medications. Two days after winning the first British medal in Alpine skiing at the 2002 Winter Games in Salt Lake City, Alain Baxter was forced to return the bronze medal due to a positive test for methamphetamine… resulting from a Vicks Vapor Inhaler.
American professional sports are far more lenient, often trying to give the appearance of vigilance while still allowing athletes to use performance-enhancing drugs. They know that fans want to see beefy linebackers, powerful sluggers, and lightning-fast sprinters. So, with a wink and a nod, American enforcers only test for the easy stuff.
In the end, doping is all about economics. Athletes will continue to dope because the Prisoner’s Dilemma forces them to do so. Sports authorities will either improve their detection capabilities or continue to pretend to do so, because they depend on fans and associated revenues. And as technology continues to improve, professional athletes will become more like deliberately designed racing cars.
Categories: Theory of Security