First things first
7.24.07 by Dan Empfield

As we enter a movie theater we also enter into a pact with the movie's director. We're asked to suspend disbelief and, if we do, we're promised entertainment, and perhaps enlightenement.

I'm going to ask you to do the same. Let us suspend our disbelief, for now, and assume that everybody racing in the age-group ranks in mass participation endurance sports is honorable: each plays by the rules, and nobody engages in PEDs in order to gain a competitive advantage.

This may stretch the credulity of many readers, nevertheless let us just suppose. I ask in order that we may tackle the most vexing problem facing the greatest number of athletes.

As we leave the movie theater we re-enter the world of reality and, trust me, we'll return to the sad reality that there are those in age-group racing who'll dope in order to gain an illegal and unethical advantage over their peers. But I think we can agree that the great majority of those who participate in age-group racing seek to play by the rules. Let's consider for the moment the issues facing this large group.

What of those athletes, including ourselves and most of those we know, racing in their 40s, 50s, 60s and 70s? For some of these athletes -- for patients suffering from osteoporosis or anemia, for those HIV positive, or whom require dialysis -- testosterone supplementation is strongly indicated for health reasons. Must they choose between their health and their honor? Of course, the professional athlete might be granted a therapeutic use exemption (TUE), allowing him to take medications that might otherwise be banned. But the great majority of TUEs granted are for beta-2-agonists (asthma inhalers) and it is exceedingly rare for a TUE to be issued for testosterone or other anabolic agents. Ought the older amateur athlete be granted the right to apply for a TUE for classes of drugs elites cannot take? Ought the "panel" of drugs tested for be different for age-groupers than for elites?

These are among the questions that divide doping into roughly parallel but necessarily divergent tracks, depending on whether it's the amateur weekender you're talking about, or doping in the professional ranks. As for the latter, the elite athlete must always be vigilant. He cannot obtain and consume powders and supplements, or use patches and creams, without first ascertaining their purity. He cannot accept water bottles from a friend in anticipation of a Saturday ride. He must know with precision every substance that's on the banned list. He must inform USADA, through a rigorous and invasive process, of his whereabouts, all the time, 365 days a year, for the purposes of out-of-competition testing. He must fill out and submit forms in advance each and every time he deviates from his "whereabouts calendar" previously submitted to USADA. This is the professional athlete's life. Ought the amateur be expected to live his life this way as well?

These and many other questions give us pause. They should not cause us to abandon our pursuit of a clean age-group sport, but they should constrain us, as members of a vibrant sporting community, toward an introspection leading to wisdom and, in the end, toward getting right whatever posture we take on age-group doping.

Before we decide what to do with the cheaters, we must decide what to do with those who do not cheat, but who only wish to preserve both their health and their honor. What of the 53-, 58-, or 64-year-old male, or female, with osteoporosis? If he or she requires a regimen containing a drug found on the banned list, can he or she ethically take part in a bike race or triathlon? Perhaps there is little or no chance of getting drug tested, but for a lot of people this is not the point. Would they cut the course short if there were no chance of getting caught? Of course not; neither would they consider it okay to take a banned drug simply because no test exposing this fact is imminent.

So, then, what of the drug that is both health-preserving yet honor-debasing? When is a proposed course of therapy worthy of a TUE, versus those that simply bolster the physiology of someone in a low-normal range? Who grants the TUE for the age-grouper? Whose responsibility is it to make these decisions?

According to USADA's Science Director, Dr. Richard Hilderbrand, the TUE application an athlete fills out will be considered if the athlete is a reasonable hope for an international medal, and I understand this to include an age-graded athlete. Clearly, however, this leaves in limbo the questions asked by the rest of us who aren't a threat for the podium. The fact that we're not being tested isn't enough. Isn't there some more concrete way of knowing what is considered illicit versus allowed? Might USADA or a sport's national federation at least afford the masses a sort of "self test," allowing us to distinguish whether our specific condition meets the criteria for a TUE?

I know a man well past the age of elite competition. He's very competitive in his age category (that is, he's very fast). He suffers from a particular condition requiring supplementation with a substance that is banned absent a therapeutic use exemption. He does so under doctor's supervision, only after being apprised of his condition by his doctor, and only after his doctor plainly spelled out this man's limited therapeutic options. He supplements only to the level necessary to abate his symptoms. He does not race currently, as he feels it is dishonorable to race without a TUE, even though he's not at risk of getting tested. As of this date neither his federation nor USADA have acted on his TUE application. I know of a woman in another sport in roughly the same predicament.

Thorny isssues like these are not as readily evident to most 25-year-olds. But relevance increases with age. They are among the questions we'll investigate with this series. We'll start with the most basic questions, such as, "
What is healthy?" "What is honorable?" Only then can we ask, "What is verifiable?" And finally, "What is practical?"