'Nowhere else would we accept that level of surveillance' – As 'clean anxiety' sweeps the pro peloton, is the anti-doping system in need of reform?

"Secrets are poison. They suck the life out of you." Tyler Hamilton.

"I viewed this situation as one big lie that I repeated a lot of times." Lance Armstrong.

"This place has been my home. They liked me here. Not anymore. Now they will look the other way. Now I don't belong." David Millar.

Is doping worth it? To live everyday looking over your shoulder? To enhance performance but diminish character? Cheating equals high anxiety and, of course, little sympathy. The stress-free solution? Don't dope. It's simple. Or is it?

These days, the advanced anti-doping and testing system means athletes face 'strict liability' for every single substance they consume, vigilance so high that they can't even buy vitamin C at a pharmacy, and surveillance that requires them to provide their location at a specific time every single day.

Is adhering to an anti-doping system that monitors you every day of the year, where you're guilty until proven innocent, in need of reform for athlete sanity? Cyclingnews investigated the system, the rules, and the mental impact they have on riders who are just trying to stay clean, and prove it.

The contamination issue

Michael Woods enjoyed a stellar 13-year professional career, primarily for Cannondale (now EF Education-EasyPost) and Israel-PremierTech (now NSN Cycling Team). He won four Grand Tour stages – one at the Tour de France, three at the Vuelta a España– and the prestigious one-day race, Milan-Torino. Woods retired from the WorldTour at the end of 2025 but, like many modern-day pros, he soon swapped road for gravel. When we caught up, he'd just 'won' the Canadian gravel national championships. Possibly. Extreme heat led to the event being cancelled while riders were still out on the course, meaning Woods' result was in doubt. Unlike his stance on cheats.

"I'll start off by saying that dopers ruin the sport for all of us," he says. "I'm all for clean sport and forged a career from clean sport. But the anti-doping system, while a necessary burden, is a massive burden. It's a huge stress. During my entire career, I guarantee that I never intentionally took a performance-enhancing substance. But I couldn't guarantee that I wouldn't have tested positive for one."

That's not an admission of guilt or Machiavellian Armstrong wordplay – "I've been tested 500 times and I've never failed a drug test" – but an honest appraisal of a system that can end careers if an athlete's urine or blood sample shows traces of one of more than 400 prohibited substances.

According to WADA's (World Anti-Doping Agency) Athletes' Anti-Doping Rights Act, 'strict liability' means that the athlete is solely responsible for any "any banned substance you use, attempt to use or is found in your system, regardless of how it got there or whether there was any intention to cheat". In anti-doping, not knowing isn't an excuse. You must live pure in an impure world.

"Unless you live on a farm, isolated from the rest of the world, growing your own food and ensuring no-one touches it, can you guarantee that something isn't contaminated?" says Woods. "Whenever I took a drugs test, that played on my mind. It's stressful and it's the same throughout the peloton.

"One of the biggest stressors is that you're guilty unless you can prove your innocence. And even if you prove how you ended up consuming contaminated food, by virtue of how the media handles the story and how the sport deals with you, you're tainted. I have friends who tested positive but discovered the source of contamination and were exonerated. But the damage to their finances and reputations was irreparable.

"They're especially damning in Canada. I'm proud of the fact that our country is vehemently for anti-doping, but it means any positive test results in you being crucified. Arguably, this goes back to Ben Johnson and what happened in South Korea. We were burnt and embarrassed on an international scale."

For our younger readers, the muscular Johnson won the 100m men's race at the 1988 Seoul Olympics in a new world record, before ignominiously leaving the Games and being stripped of gold after testing positive for the steroid stanozolol. It was arguably the biggest story in Olympic history. A piece of graffiti in the Olympic village encapsulated the drama: "Hero to zero in 9.79 secs."

Hormone-fuelled food system

Johnson confessed to doping. Many banned athletes don't, blaming their positive test on contamination. In the monochrome world of doping, it's seen as a convenient excuse. But the evidence suggests many grey areas.

Take the steroid trenbolone, used in the American food industry to boost efficiency and yield of meat production. It's legal in the USA. But trenbolone is on WADA's prohibited list. Maximum residue figures are set for how much trenbolone commonly remains in a slaughtered animal from farm to fork for anti-doping purposes. Several assumptions are made that impact these residue figures, including point of administration. Trenbolone is mixed into a compressed pellet and injected into the back of the cattle's ear. The steroid then dissolves into the bloodstream. After around 200 days, the animals are 'harvested', whereby the ears are removed to prevent potential contamination.

If the farmer follows standard practice and an athlete records an anti-doping violation, the contaminated meat excuse is flimsy. But not, many a defendant has argued, if the pellet was misplaced and entered muscles from which rib-eye and loin steaks are cut. Or oxtail. That was the defence of runner Erriyon Knighton, who tested positive for trenbolone in March 2024. An independent arbitrator initially cleared him after accepting that contaminated meat likely caused the result, allowing him to compete at the Paris Olympics where the American finished fourth in the 200m. However, the Court of Arbitration for Sport later ruled the contamination evidence was insufficient and imposed a four-year ban. Knighton continues to protest his innocence.

Clenbuterol is another WADA prohibited substance used to increase meat yields, albeit it's banned around the world because residues are high enough to cause health issues. Despite that, there's a huge black market in many Latin American and south-east Asian countries.

Alberto Contador was handed a two-year ban and stripped of his 2010 Tour de France victory after testing positive for clenbuterol. The Spaniard's contamination defence – that it was down to eating meat brought across the border from Spain to Pau on the rest day – didn't hold up because the illegal clenbuterol farming practices are rare in Spain, despite Contador passing a lie detector test.

(As an aside, for my new book Dope I interviewed Morten Hostrup, associate professor of physiology at the University of Copenhagen, who'd recently undertaken human studies on clenbuterol. Hostrup told me it's great for muscle building but actually impairs endurance performance because it 'suppresses mitochondrial function' in the muscle. "It's one reason why the current regulations would have accepted Contador's explanation," he told me. "He wouldn't have been suspended.")

In short, contamination is a very real stressor for professional athletes. "I raced the Vuelta a Mexico [which last took place in 2015 but is scheduled for a return in 2027] and the Tour of Qinghai Lake in China and basically you eat rice and eggs," says Woods. "You have to be hyper-vigilant and it's an extra stressor."

Supplementary pressures

It's the same with supplements. According to a 2025 survey by Sport Integrity Australia, one in three sport supplements – around 35 per cent of 200 samples – bought online contained at least one substance prohibited by WADA. Why is down to two reasons: accidental (the equipment wasn't cleaned thoroughly) and intentional (the manufacturer purposely added a prohibited performance-enhancer to crank up its effectiveness and have the athlete coming back for more).

WADA recommends athletes take supplements that are third-party tested. These products will feature the testing company's respective logos, and include NSF Certified for Sport, Informed Choice and Informed Sport.

"You couldn't take anything not approved by the team," says Woods. "It makes sense, but if you're feeling under the weather and want to buy vitamin C, you can't go to the pharmacy and be an adult. You have to report to mom and dad and ask if it's OK. It's for the right reasons, but it becomes crazy. You lose any autonomy and it's something you're constantly thinking about."

"When I first started competing, I was proud of making sure I was doing everything right," Woods adds. "Come the end of my road career, I'd been on some form of anti-doping programme for nearly 15 years. After all that time, you start to think, ‘Fuck this. I am so over it!'"

Or I'm not just over this, but I'm over life, in the case of former British cyclist Lizzy Banks, whose contamination case left her battling suicidal thoughts. In July 2023, Banks tested positive for traces of the banned diuretic chlortalidone. April 2024, UK Anti-Doping (UKAD) cleared Banks, accepting that contamination likely stemmed from a tablet she took for asthma. June 2024, WADA appealed her case to the Court of Arbitration for Sport, ruling that she'd failed to prove the source of the contamination despite overwhelming scientific and contextual evidence and so banned her for two years.

"This case demonstrates the high bar set by the application of the 'strict liability' principle," UKAD pronounced, "and the challenges in identifying and establishing unintentional violations."

The 'will they, won't they?' sanction left Banks in turmoil.

"I'm not sure yet whether I regret having carried on the fight," she wrote at the time. "I'm so empty right now that I barely know what I feel anymore. But this is what they do to people like me. They crush us. They expect that we will just walk away and they will never have any consequences. But there must be consequences."

Banks proposed a series of anti-doping changes to protect athlete welfare including easing the burden of proof – that athletes shouldn't be required to provide the exact source of contamination when strong scientific evidence shows the substance level is incompatible with intentional use. She sees the current system as creating prolonged uncertainty and psychological harm.

Whereabouts is the welfare?

As do a dozen professional tennis players, including Nick Kyrgios, who in January 2025 filed a legal case against tennis federations and the International Tennis Integrity Agency (ITIA) for a complete disregard of athlete wellbeing when enforcing anti-doping policing.

The case came off the back of doping allegations against the men's world number one, Jannik Sinner, who twice tested positive for the banned steroid clostebol. WADA accepted the Italian's story that he didn't cheat and exposure came via his fitness coach's massage cream. Both parties agreed to a three-month ban that some felt conveniently expired before the first second of the year, the French Open. The civil class-action cited his preferential treatment due to potential financial implications and access to superior legal representation.

A team of academics – including Alex Smith, senior researcher at Bern University in Switzerland – examined the complaint in a paper entitled, 'Coercive compliance? Anti-doping systems in tennis and athlete mental health.' It's a fascinating read and draws attention to the need for fairness when enforcing anti-doping policy.

"The focus of most anti-doping bodies remains firmly on detection and deterrence, which is understandable, but the inadvertent psychological implications of compliance sits largely outside that frame," co-author Smith tells us. "Research has documented what some call ‘clean anxiety' among athletes, which is a persistent fear of inadvertent rule violations and the reputational damage that would follow.

"For younger athletes who are still developing, that could be particularly problematic. They're trying to establish themselves in elite sport, managing uncertain incomes, unpredictable travel, sometimes young families, and on top of all that they carry this background fear of making an administrative error that carries the same punishment as failing a drugs test."

For administrative error, read the Whereabouts system. This is a requirement in any sport signed up to the WADA Code and allows anti-doping authorities to conduct unannounced drug tests on athletes between 6am and 11pm (and, in some cases like targeted testing, also between 11pm and 6am) on any day of the year. Athletes must update their ADAMS (Anti-Doping Administration Management System) to give a specific 60-minute time slot each day when they guarantee they'll be available for testing. You can update it any time before that 60-minute time slot begins. If you miss three tests within a 12-month period, you're banned.

"Athletes have described the constant need to remain organised, available and compliant, particularly during periods of travel, family commitments, illness or other major life stressors," says Smith. "The concern is often less about being monitored and more about the possibility of making an administrative mistake that could carry significant professional consequences. In that respect, the psychological burden may be less visible than other stressors in elite sport, but it does remain present in the background of athletes' lives."

Smith stresses that the integrity of anti-doping testing is vitally important and out-of-competition testing is an effective tool. "However, athletes are required to disclose their whereabouts around the clock, submit to surprise testing and provide highly sensitive health data, including biometric identifiers and medical information," he says. "Nowhere else in a democratic society would we accept that level of surveillance as a condition of employment."

That's the academic viewpoint. What about the athletic one? "Of course, out-of-competition testing and monitoring is important," says Woods. "Dick Pound [former president of WADA] had a great saying that if you fail in competition, you've failed two tests: the doping control test and the IQ test!

"So, things like the Whereabouts system are useful but I'd actually have preferred a tracking device, especially in the off-season when you're looking to switch off from cycling mode. That's when your plans tend to change. You might head to your mate's for a couple of drinks and the last thing you're thinking of is logging into your phone to change the address on ADAMS. You then awake the next morning and panic that if the doping officer visited, you've messed up.

"Thankfully, I was pretty diligent and only had one out-of-competition miss, which I contested because the tester made fundamental errors and it was removed. The area – Andorra, where I was living – was unfamiliar to them and they went to the wrong building. But it was stressful."

Woods says he has friends who missed three tests in the 12-month period but fought the last one and won. "And I know others who missed three and were banned."

Punished for neurology

Further pressure arises from the therapeutic usage exemption (TUE) system, which allows prohibited substances to be used for medical reasons. It's supposed to be performance-enabling rather than enhancing, though is perceived to be widely abused.

"The burden arises from the additional documentation and evidentiary requirements imposed by the anti-doping framework," says Smith. "For conditions such as attention-deficit hyperactivity disorder (ADHD), it's a challenge. Many cyclists take medication for ADHD, which is on the prohibited list, but the process of sorting a TUE is extremely involved. That's not great for a disorder associated with forgetfulness and disorganisation. You're almost punishing someone for having the disorder, which means many might not bother taking the medication to avoid form filling. If you're in the middle of a peloton and you've got a disorder that's linked to hyperactivity and impulsivity, that has clear implications for you and your fellow riders."

"That's me," says Woods. "I've never been officially diagnosed but I was almost held back a grade and repeatedly told I had 'attention issues'. If I was younger, I'm confident I'd have been diagnosed with ADHD at school. Keeping on top of these forms and apps is a real issue and can kill careers. Miss tests and teams won't sign you. Sponsors won't sponsor you. You can't race."

Smith says British Cycling has delivered TUE courses specifically aimed at riders with ADHD, but suggests all levels of elite athletes should be better supported, as they can face considerable costs simply to demonstrate eligibility for a treatment that's medically needed. More broadly, he says that greater focus must centre on the daily strain of adhering to anti-doping policy.

"The argument is always that athletes consent to it, but that consent is functionally coerced," he says. "An athlete who refuses compliance faces immediate exclusion from international competition. The balance shifts when you build genuine welfare support into the framework. Right now, the obligations are clearly defined and the consequences of failure are clearly defined, but the psychological support available to athletes navigating that system remains largely absent. We believe that you can uphold rigorous testing and provide mental health resources."

"We'd suggest introducing mandatory welfare assessments as part of the anti-doping relationship as standard practice for any athlete in a registered testing pool," Smith continues. "Right now, the system is entirely focused on compliance. There's no touchpoint where anyone asks how an athlete is actually doing. A welfare check-in, delivered through the existing infrastructure, would catch athletes who are struggling before they reach crisis point, and it would send a signal that anti-doping organisations view athletes as people with lives and health needs rather than just samples to be collected."

This humanising of the anti-doping system is picked up on by those dozen tennis players, who contested the ITIA policy of "requiring players selected for drug testing to shower under direct observation if they choose to wash before providing a sample".

Woods echoes the indignity. "I've had testers come straight after my morning coffee. Let's just say I'm regular after that first caffeine hit. The chaperone can't take their eyes off you once you've opened the door, so I've had times when I've taken a shit staring eyeball to eyeball with a tester. I get it because there are cases in the past of athletes passing off clean samples by using a prosthetic penis. But you don't want it, the tester certainly doesn't want it. I must admit, you do sit there thinking fuck the dopers."

Anti-doping remains essential. Few athletes and researchers would argue otherwise. Yet as sport pursues cheats with ever greater vigilance, it must also consider the cost borne by those playing by the rules. For every doper trying to evade detection, thousands of clean athletes are navigating surveillance, suspicion and the fear of inadvertent error. Protecting sport's integrity matters. Protecting the wellbeing of the people who uphold it matters, too.