It may seem peculiar to have a drug win an award in our Year in Review Series, but this is elite sport, and the only guarantee is that every year, doping will feature heavily in the sports science news.
This year, there were two "nominees" for the Drug of the year category: Clenbuterol was an option, courtesy Alberto Contador and the Tour de France. This is certainly a topic we will cover later on in this 2010 recap, but for this category, we go with a stimulant, methylhexanamie, a drug that kept making appearances in 2010, before eventually hitting the news here in South Africa when two SA rugby players tested positive for it.
It is an especially interesting case because it stimulates (pardon the pun) a discussion around liability, "accidental doping" and most pointedly, the supplement industry, and how narrow a tightrope elite athletes sometimes walk with regards to supplement use.
Methylhexanamine - meet the winner
Methylhexanamine (or 4-methylhexan-2-amine for those preferring its IUPAC name) is a stimulant that was only added to the WADA list in 2009. It was developed as an ingredient of nasal decongestants, and has since become a component of certain supplements (as we'll see later), and was also used as a recreational drug in New Zealand, until it was implicated in a few serious illnesses (strokes, severe headaches and nausea) and banned.
But for our context, it is the role of methylhexanamine in sport that leads to its controversy. Having been placed on the banned list in 2009, it did not take long to "claim" some fairly high profile athletes. A group of Jamaican sprinters tested positive, but were cleared after confusion over the status of the drug. They were later sanctioned because the drug resembles another which is on the banned list (this confusion around the banned status of the drug comes up often, as you'll see).
In 2010, there have been at least 30 cases since the middle of the year. They include the Commonwealth Games women's 100m champion, Damola Osayemi, who was stripped of her gold medal, as well as a dozen Indian athletes, nine Australian athletes, and most recently, and most high-profile for me in SA, the two Springbok rugby players, Bjorn Basson and Chilliboy Ralepele.
Sifting through the possibilities
The multiple uses of methylhexanamine confuse the issue when an athlete tests positive for it. Of course, there is the possibility that the athletes were deliberately taking it to gain some advantage, and this being sport, it would be naive not to recognize that this happens (too often). However, in this particular case, there is just too much to suggest that the positives tests are not a sign of "cheating", but rather of accidental ingestion, especially in the amounts the rugby players were reported to have. And quite frankly, if a professional athlete is looking for an advantage, there are better ways to do it. So we look at some other options for how a "non-negative" test might occur, but acknowledge upfront that deliberate doping is still possible.
When the two South African rugby players tested positive after a Test match in Wales in November, the first reaction by many in the media was that they had mistakenly used medicine for a cold.
However, this is unlikely in modern day professional sport, for the simple reason that everyone is so sensitive to the possibility of it happening - there are some very high profile, very damaging cases of this very mistake being made, and so most professional sports teams will be particularly careful about giving out cold and flu medicine to athletes. When an athlete presents to the doctor complaining of any symptoms, usually the very first check is to make sure that the athlete does not dope - teams now have lists of what they can and cannot take, and most travel with medicines that have already been cleared. Unless the athlete goes "rouge" and treats themselves, it's exceptionally rare. And certainly, the Springbok rugby team has a very experienced, very good doctor who would not make this error.
That's not to say that mistakes don't happen - perhaps you will remember the case of Andreea Raducan, a Romanian gymnast who won the all-round title in Sydney in 2000 at the age of 16. She then tested positive for pseudo-ephedrine, an ingredient of Nurofen, which was given to her by a team physician, and was stripped of her gold medal.
The case went all the way to the Court of Arbitration for Sport (CAS), where it was ruled that Raducan should be exonerated of any wrongdoing, but that the medal should still be taken away. The physician meanwhile, was banned for two Olympic cycles for what really was a catastrophic error for a young athlete.
So while errors to happen, my feeling is that it's not likely that a positive test for methylhexanamine would come from inadvertent use in cold and flu medication. The next option is that the players took it in a recreational drug. That's possible, but unlikely, bordering on impossible in the case of the rugby players, since they are tested immediately after a match. Tests done out of competition, perhaps, but not hours after playing.
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