ACE-ing the test: New frontiers in drug testing

Dr. Paul Strauss, MD

Dr. Paul Strauss, MD (Image credit: Paul Strauss)

News Feature, February 25, 2008

A new frontier in the fight against doping has come out of cycling's woes. It's not a new test; it's not a new punishment; rather, it's a unique idea designed to change the culture of sport and hopefully deter doping before it happens. With every new paradigm, there is a business opportunity, and as Cyclingnews' Laura Weislo discovered, the founders of the Agency for Cycling Ethics aren't trying to take advantage of cycling's situation just to make a buck, they are passionate about rescuing the sport they love from self-destruction.

Cycling has clearly reached a 'tipping point': a time when changes to the sport's way of dealing with the doping problem have taken on a life of their own. Years of doping scandals have scared off sponsors and fans alike, but now the sport is finally in the process of cleaning itself up. Still, the riders themselves are still in a credibility crisis. With Operación Puerto unresolved since its start in 2006, and four riders testing positive during the 2007 Tour de France alone, who is going to believe the riders who say they're competing clean? Just saying "I never tested positive" isn't good enough.

The situation disintegrated to the point where some teams have taken matters into their own hands, investing huge sums of money into anti-doping programs designed to more closely monitor their riders. The need for a way to gain credibility was met by men on two sides of the Atlantic during 2007.

On one side is the program commissioned by Team CSC's Bjarne Riis and designed by Dr. Rasmus Damsgaard, which was later adopted by the Astana team. On the other side, we have the Agency for Cycling Ethics (ACE), begun by entrepreneurs in California and adopted first by Team Slipstream, then by Team High Road and BMC this year.

The two are similar in concept, but very different in their business model. Both detect the physiological effects of doping rather than the drugs themselves, but while Damsgaard sees his program as a stop-gap measure to allow teams to monitor riders until the UCI can put a similar system (the 'biological passport') in place, ACE is a for-profit business conceived with the lofty goal of saving not just cycling, but many other sports, from the scourge of doping. Scott Fennell, the company's Vice President of Marketing and an amateur triathlete, and CEO Paul Strauss, an avid cyclist, described their business model to Cyclingnews with a passion and optimism characteristic of men who embrace the American dream.

"For years sports people have been rewarded based on success in the sport, and what you do off the field hadn't been punished or wasn't a problem. And people could get ahead by doing whatever," explained Fennell. "What we're trying to do is a cultural change. We're trying to show that you can do the right thing, you can not dope, and you can still get ahead."

"We're trying to say that teams, athletes and riders must be responsible. By holding them responsible, you're actually more endorsable, more sponsorable and more desirable to teams." It's not just cyclists, but athletes in many of the other Olympic sports, which the minds of ACE see as targets for this paradigm.

One of anti-doping's main problems has been keeping up with doping methods. The test for EPO was years behind the drug's use in sports, and steroids were developed specifically to cheat detection - and were only revealed by an insider in the BALCO scandal. Autologous blood doping and human growth hormone remain undetectable by conventional tests. But each doping method leaves a physical signature in the human body, and it is this fingerprint which forms the basis of both the Damsgaard and ACE testing program.

The strong potential of this paradigm in doping prevention was quickly recognized by the founders of ACE, who, under the umbrella corporation, the Agency for Sporting Ethics (ASE), want to expand the model into other sports. "We're seeing the money come out of cycling because of the doping scandals. We're actually making it more attractive for sponsors to stay in the sport, and to riders to stay clean in the sport." The same goes for any other sport which relies on endorsements or sponsorship, increasing the business potential for ASE.

"It allows the athletes to remain clean in the sport by holding them responsible out of competition. It allows money to stay in the sport so athletes can get better endorsements," Fennell continued. "It is the opposite of BALCO, who were helping athletes cheat to get ahead. We're saying, if you're doing the right thing, and we're holding you accountable to your team, your team-mates and the public, you're actually more marketable."

Branching out

For now, the group is focusing on expanding its testing from last year's North American operation to an international model fit for a ProTour squad like Team High Road and Professional Continental teams Slipstream and BMC.

"We'll have three teams so the logistics just expand. In order to scale that up you have to be smart," explained Strauss. "It changes the model: Slipstream was basically a domestic team that raced sometimes in Europe. This year they're a European team, so the challenge is bringing on resources to do collections in Europe, something we had to work on."

The ultimate goal of taking hundreds of data points and drawing conclusions from them is daunting enough, but Strauss emphasized that the real challenge lies in the collection process. "It's more than crunching data. Bringing the resources together to do the collection, then getting the data and crunching the data - that's the challenge, and that's where we've been successful.

"I cannot stress enough what that task is about," Strauss said, emphatically. Riders who are spread around the globe and constantly on the move create an even bigger challenge. "We have an online whereabouts system that combines the best of text messaging with highly trained logistics personnel." Unlike the UCI's system, the riders get feedback from ACE on their whereabouts. "We are actively communicating with riders, asking 'where are you?'. It's a two-way system, which is probably the key to our success."

Another key to their success was to get the riders to buy into the system from the beginning. "These athletes are busy, and it's important to develop a relationship with them so that they're participating in the system and they're not feeling imposed upon," said Strauss.

"At the beginning of training camp, we do a seminar with the guys, and we lay it all out for them," explained Fennell. "And it comes not from just us, but from the team management. It's in the riders contracts, saying this is part of what you're required to do, so it does help them buy into the idea.

"But they want to do this, they understand the value of it, and actually they're very cooperative. It's not an imposition - it's not like we're big brother looking down on them - they're involved in the process."

Testing the riders

Strauss described the procedure for testing, underscoring the fact that, while the team may be paying for the service, it doesn't mean they get inside knowledge on when the testing might occur. "The racers get night before notification to go to a specific location. At most they have eight hours notice. It's truly random."

The logistics are complex, since the collections have to be done in a controlled setting - something that's not always easy to come by when riders are in the remote locations that are suitable for training and racing. Riders must present a photo ID and their race license to the collectors, and precautions are taken to prevent athletes from swapping out samples or otherwise cheating the test.

"We only do the full WADA collection protocol sometimes - say, if we have a specific reason [if a rider is under suspicion]," Strauss said. "For routine urine collections we're doing the usual taping off sinks, blue stuff in the toilet... the current standard for employee drug testing.

"The reason we feel comfortable with that is our whole model is we use our analysis to look for bio markers in the urine. Our data shows trends, and it's a lot harder to cheat that. There are basic patterns in the urine for the steroids, so that if it's not yours we can pick it up. It's like a fingerprint.

"If you have any suspicions based on variation of trends, we'll go onto a full WADA protocol and look for specific things that we may suspect."

Overlap with WADA?

Not only will riders have to face their teams if the numbers should come up suspicious, but they will have to answer to the anti-doping authorities as well.

"We have developed a relationship with WADA where they have access to our data. We have a good working relationship with the UCI and WADA, and I have nothing but the utmost respect for both the organisations and the individuals in the organisations."

The data will be monitored by the UCI, and eventually incorporated with that organisation's own testing. But Fennell and Strauss are not afraid that the passports will eventually replace the need for their type of service. "The WADA passport program has, I think, 15 tests per year," said Fennell, "and our premium testing program is two tests per month per rider."

"Fundamentally we have different roles. The UCI and WADA are quasi-judicial. They define the sanctions, they enforce the sanctions. Our business will never be that way - we will never go into that space. On the day, while we're all working together, they're going to be the enforcing body."

Strauss agreed. "The fight against doping is constantly evolving, and that's why the cooperation between all the parties needs to occur so we evolve together and tackle the problem. The basic difference between us and WADA is their job is to catch cheaters. Ours is to give the resources to teams to deter the act before it even happens. Human behaviour is human behaviour. If somebody is not being watched, they're going to try to get away with whatever they can get away with.

"If the teams take the responsibility to monitor riders closely and effectively, hopefully the riders will know the consequences and they won't even think twice about trying to dope."

But what's to stop another Balco from stepping in to develop performance enhancing drugs that can cheat the tests? Strauss replied, "Instead of looking for bad stuff [banned substances], our bio-markers look at physiological parameters which respond to things people take. For instance, in blood, you can detect EPO and transfusions [without looking for the drug or transfused cells]. We'll see the effects in the blood."

The same goes for testosterone. The test for the synthetic version of this naturally occurring substance was highly contested by Floyd Landis' case. But Strauss thinks the same kind of profiling which can be applied to blood doping could detect exogenous testosterone use or any other drug which may affect the same biochemical pathway. "We're developing the same concept for steroids: we look at testosterone, it's precursors and it's metabolites. We can see if something is suppressing native testosterone - we may not know what [drug] it is, but we will know that something's going on.

According to the ACE web site, its longitudinal testosterone measure stands a better chance of catching illicit use of the drug than the standard testosterone:epitestosterone ratio which WADA has used to screen samples. Explaining that an athlete could go back under the 4:1 cutoff within a day of stopping testosterone use, but their profiling could detect use longer. "Using ACE's longitudinal analysis, oral testosterone use is easily detectable out to seven days and likely detectable out to 14 days, depending on the individual and dose. With ACE testing occurring randomly at a minimum of once every 14 days, the ability for athletes to escape detection is remote."

With this paradigm for testing making inroads through the peloton, Strauss and Fennell are confident that the sport is going in the right direction. "The people who we've met in cycling such as Bob Stapleton and Jonathan Vaughters, their basic belief is to clean up cycling. If you start like that from the top, that's where it's going to change," said Fennell. "I really think if the leaders of the sport are making a concerted effort to change the sport then it will happen. That's what really has to happen.

"The people at the UCI like Anne Gripper and Pat McQuaid really have a belief in cleaning up the sport. It's an expensive proposition, but people are changing their priorities in terms of where they are putting their money.

A few years ago if we had looked at what it would cost to run an effective anti-doping program, they would have said no, but things have changed now. They realise their priorities have to change in order for the sport as a business to survive."

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