Massimo Besnati, the hugely experienced Italian Katusha team doctor, has warned that the abuse of sleeping medication to fight fatigue is more widely used than doping in the professional peloton, claiming that riders often combine alcohol with drugs to create an 'explosive' effect. He also claimed some riders use tobacco powder 'snus', as a stimulant, with legal drugs replacing the now banned recovery drugs that athletes used in the past.
Besnati confirmed that he knew of Luca Paolini's sleeping medication addiction and claimed he tried to help the Italian rider and refused to prescribe him the medication due to the addictive nature of benzodiazepine.
Paolini's revealed his addiction to the drug in an interview with Gazzetta dello Sport, admitting he had taken it since 2004, failing to come off the drug several times. He claims his problems lead him to taking cocaine during a pre-Tour de France training camp and he then tested positive for the metabolites of the drug in a targeted test during the Tour de France.
"I'd be Pinocchio if I said that doping has been defeated but now the use of sleeping medication is worse and a more widely used. It affects the person rather than the athletes. What makes things worse is using it with alcohol: it has an explosive effect. It's terrible," Besnati warned in an interview with Gazzetta dello Sport.
"Riders take it because of the stress, for the progressive fatigue of stage races. Now that there are no longer pharmaceutical recovery products, riders, who refuse to use natural herbs, struggle to recover. When you're too tired, you struggle to get to sleep. Look at the last week (of a Grand Tour), they're all skin and bones."
Besnati raised the alarm about riders creating a dangerous cocktail of sleeping medication and alcohol.
"It's especially widespread amongst young riders. They drink a lot," he warned. "While we're talking about it, I'll add another thing: 'Snus' – putting tobacco in your mouth. It's has an exciting effect that shouldn't be overlooked. If you look carefully you can see riders with red, swollen gums."
"Of all the benzodiazepine drugs, lormetazepam creates the worst addiction. You start with 10 drops and then go to 15,20, 30… and up to 100. It's an endless escalation," he said. "If you try to stop, like with every drug, its creates abstinence problems."
Besnati revealed how Paolini tried to hide his addiction and the consequences of taking regular sleeping medication.
"He used coffee. He brought a little coffee machine to races and drank five or six cups before coming down to breakfast, 180-200mg of caffeine. That was needed to fight the effects left by the sleeping medication. But then you have to increase the dose and its like a dog chasing its tail."
"Minias is terrible. It's possible to scale back the dose of other drugs. For example Stilnox has heavier effects but it creates a lot less addiction. With Minias, you need a real detox programme."
In his longer interview Paolini revealed he spent two weeks at a clinic in October. On Monday Gazzetta dello Sport reported that the UCI had requested a two-year suspension for his cocaine positive case but the Italian is ready to fight his case during a UCI anti-doping tribunal hearing in the new year.