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Recent observers of international sporting meetings may have been disheartened yet again by the ongoing battle against the use of banned drugs in sport. This is particularly so for sports medicine clinicians, who usually attend these athletic meetings voluntarily and may be inadvertently brought into these controversial matters.

Often a team doctor is asked to chaperone an athlete during a drug test or provide information to the testing authorities about recent prescribed medication. The media often fails to see a distinction in the roles of medical staff, and, if an athlete tests positive to a banned agent, then the team medical staff are often tarred with the same accusatory brush. As sports medicine clinicians, we follow the various rules and regulations that govern each sport from the drugs issue. If an agent is banned, then we should not administer it to an athlete. How then do we gain the understanding of the media in distinguishing the roles of the medical staff in this area?

Another problem that continues to crop up is when drug testing procedures are not followed, and an athlete has a “negative” test because of this breakdown in procedure. This was the situation recently at the International Association of Athletics Federations (IAAF) Athletic World Championships in Edmonton. Most sporting bodies have introduced anti-doping regulations which serve as a set of rules for testing and penalising athletes. In Edmonton, there was a breakdown in the drug testing procedure, which requires both urine and drug samples to be taken when testing for erythropoietin (EPO), resulting in a test being declared invalid.

Apart from the procedural difficulties, the off field arguments between athletes before the final were a blow to the credibility of the IAAF. Gabriella Szabo, the reigning World and Olympic Champion, made her criticism of the process very public, and, at one point, agonised about boycotting the race entirely. The English also threatened a boycott, and one athlete, Paula Radcliffe, held up a homemade sign during the semifinal saying: “EPO cheats out”.

In this case, the system designed to eradicate drug use and cheating in sport was flawed. The IAAF was in an impossible situation. If they had banned an athlete from competing on the basis of an inadmissible test result, presumably the athlete would have successfully appealed to the courts to be reinstated. A frightening prospect for any sports administrator.