Examination of Witness (Questions 80-99)
20 APRIL 2004
PROFESSOR DAVID
COWAN
Q80 Derek Wyatt: So in the elite athlete
programme, if we put into that programme a clause which covered
coaching and covered that, you would be happy?
Professor Cowan: I would be delighted.
Q81 Chris Bryant: We tend to focus on
the drugs in elite sport, but obviously there is a continuum between
the sport centre around the corner run by the local authority
where people are body-building or whatever through to elite sport.
Has there been any substantial work done on the role of drugs
in ordinary street-corner, if you like, sport?
Professor Cowan: There have been
surveys of drug use and typically they focus on gymnasia, the
places where they are likely to get hold of the drugs, so there
are some statistics published and I could make them available
to the Committee[1]if
you wished.
Q82 Chris Bryant: Do you think that is
a significant part of the problem or not?
Professor Cowan: Well, you get
the drugs from somewhere and they can be different sorts of substance.
It might be that what are often called "social drugs",
drugs like cannabis, cocaine and ecstasy, that they are sold illegally
around the country, so that will not necessarily be in gymnasia,
but it may be in nightclubs, maybe on street corners, and for
many of those substances they are adequately controlled in law.
There are other substances, like the anabolic steroids, which
are probably of less interest in society in general, although
in areas where people might want the behavioural effect which
appears to come from taking anabolic steroids, it puts you into
a more aggressive mode if you are a susceptible individual, so
it does not happen to everybody, but some people are affected
by taking anabolic steroids and if you are then using those substances,
at what age might you start doing it? A good study carried out
in the USA on youngsters actually showed that quite a high percentage
of them did use anabolic steroids, males mainly, with the intention
to impress their girlfriends.
Q83 Chris Bryant: So you are saying that
there is a significant number of young men for the most part going
to gyms, taking anabolic steroids as much for the social effects,
as it were, the personality changes, as for the body-building
aspects?
Professor Cowan: I suppose the
subtle difference of the macho image to change physique, not to
perform in sport, but to impress in society.
Q84 Chris Bryant: But then there is an
irony, is there not, about sport centres and health centres becoming
potentially centres for a whole series of different drug dependency
problems?
Professor Cowan: Yes, that is
exactly the concern, that they might then be the source where
these materials are distributed.
Q85 Chris Bryant: Most of the people
who run sport centres have been trained at colleges in PE or whatever,
so how good do you think the training is in those educational
establishments about all of these issues?
Professor Cowan: Well, it is illegal
to supply these materials, to sell these materials anyway under
the Medicines Act.
Q86 Chris Bryant: I understand that,
but that does not answer my question.
Professor Cowan: I do not know
about what training they receive.
Q87 Chris Bryant: Moving on to a different
area, when you see a big story in the newspaper about some famous
athlete being tested the wrong way, one of the first things people
question is the process about whether it was the right sample
for the right person. How secure do you think that process always
is?
Professor Cowan: I have been trying
to think of a case where the process has been successfully challenged,
which I think is part of the way I would answer that question
to you. If we talk about the UK Sport programme, they take a lot
of care when collecting the sample and the documentation that
goes along with that in getting the signature from the person
whose sample is given, the chain of custody of getting the sample
through to the laboratory and within the laboratory there is an
extremely cautious and very careful chain of custody. Because,
in our side of the work, we test the sample not just once, but
we screen it and if there is something present, we confirm by
going right back again to the sample, so should there be a challenge,
we also have a sealed B sample and we test that.
Q88 Chris Bryant: You dropped a comment
earlier about sometimes you do not know how, but these stories
get out before, I guess you suggested, they should do. How do
they get out then?
Professor Cowan: I think it is
sometimes that someone speaks a bit too loosely maybe in a public
meeting, out in the street, or we may have to change the person
whom we are selecting for competition, if I present the scenario
in that way, and then the press might hear and think, "Ah,
maybe someone has been caught in a drug test", and they then
will phone around to the different competitors whom they know
are in the selection process and the competitor may say, "Oh,
you've caught me. You found it", so it could come in that
way. In the majority of cases, it is felt that it has actually
come from the competitor or someone around the competitor rather
than from further down the line.
Q89 Chris Bryant: So not a deliberate
leak?
Professor Cowan: I could not say.
I do not know about many specific cases, but most that I am aware
of have come when the athlete has admitted it was them, and although
a scenario has been established, there was some suspicion.
Q90 Chris Bryant: Because these stories
are big news and they are, therefore, valuable information which
a newspaper would be only too happy to pay for, I am sure.
Professor Cowan: I understand
that and that is why we are extremely careful and all my staff
know that it is not quite under pain of death, but it is part
of their contract of employment that they have to be very careful
when speaking outside of the laboratory environment.
Q91 Chris Bryant: Another issue is the
relationship between medicinal drugs and doping. As ordinary members
of the public, we read these stories and hear that someone has
taken Night Nurse or something and suddenly they are bang to rights.
How sympathetic are you to coaches and athletes in this area?
Professor Cowan: I read the press
like everyone else and I often have privileged information relating
to a case and that makes me think, "Well, that's just what's
written in the press rather than the facts of the case",
so I think there is a bit of getting public sympathy and of course
cases are not generally detailed, not in the public domain.
Q92 Chris Bryant: So are you saying—
Professor Cowan: I do not have
a lot of sympathy in most cases where I have the details, is what
I am saying, but occasionally I do think, "Well, maybe they've
been a bit tough on that person in that case", but I am not
judging the case and I may not have been present throughout the
whole hearing, so really on a legal basis I should not say if
it was lenient or if it was not. One needs to know the detail
before one should make such a comment.
Q93 Chris Bryant: Do you think the medicinal
drugs industry, for want of a better term, could do more to make
these things clearer? I do not know about Night Nurse particularly,
but let's say you go and buy Night Nurse and then the next day
you read that it has got some element of it which is a performance-enhancing
drug. Most members of the public would be a little bewildered
that they had been taking a performance-enhancing drug for the
last two weeks.
Professor Cowan: I think it is
nice where some indices of medicinal formulations do actually
describe whether the substance is prohibited in sport. The British
National Formulary now has in part of the index how to get information
about substances prohibited in sport. I would like to see that
over-the-counter cold remedies could bear some symbol or some
label to make it clearer.
Q94 Chris Bryant: Like Fair Trade or
whatever, some kind of stamp which says, "This is safe"?
Professor Cowan: Exactly, yes.
I think that would be very helpful.
Q95 Chris Bryant: Because it might actually
be nice for ordinary members of the public to have that information,
let alone for elite athletes, when they are going to buy their
cold remedies.
Professor Cowan: I think then
if it is a member of the public, they are already licensed to
be over the counter because they are relatively safe, so it should
not affect the normal member of the public. I think this is something
very special to the sport competitor.
Q96 Chris Bryant: Just one final question
as to blood or urine?
Professor Cowan: The answer to
that is both. In some ways we are lucky because urine is non-invasive
and you can provide a urine sample without someone sticking a
needle into you and many drugs are actually present in larger
concentration in a urine sample than they would be in blood, so
we have done very well over the years by being able to manage
with urine samples. However, because of the control over several
protein hormones, erythropoietin was the first example, and blood
sample collection is also necessary now, so it is "and"
rather than "or", it is likely that we are going to
continue to need blood and urine in the future.
Q97 Chris Bryant: So, for instance, if
you were testing for cannabis which would provide a more reliable
sample, would one pass through the body faster through one system
than the other?
Professor Cowan: The body handles
drugs by trying to take them out of the body, trying to eliminate
them, and the body does that by making the drug more water-soluble.
Once it has made it more water-soluble, it will be in a greater
concentration in the urine and obviously it is the liver and then
the kidneys that actually deal with getting that material out
of the body. In most cases then urine is going to give us better
evidence of the identification. The problem is what has left the
body rather than what is in the body. If you wanted actually to
see what was the effect of that time on the individual, then blood
would be a much better medium than urine, so it depends what you
are trying to do with that.
Q98 Chris Bryant: The reason I am asking
this question is because I have read the stories in the newspapers,
which of course does not necessarily mean that they are true,
but which suggest that some high-performance athletes will take
cocaine instead of cannabis because cannabis will stay in their
body longer and, therefore, on a random testing will be more likely
to come up. Is that true or is it simply a myth?
Professor Cowan: They are two
different things. One is a stimulant and one tends to suppress
more, although suppressing, getting rid of inhibitions might be
quite helpful if you are fearful in a sport. I have had it said
to me that with surfing, for example, if you are on top of a big
wave, you might want to be on some cannabis to make you a bit
more relaxed than you would be if you were a bit more sober. Cannabis
does stay in the body longer because it tends to dissolve in fat
tissue in the body and that makes it more resistant to being made
water-soluble by metabolism, by conversion by the body and hence
going into urine, whereas cocaine is a lot more mobile and it
does change. It gets metabolised very rapidly and it is a short
half-life. I am not aware of that sort of combination, or the
thinking that, "I will take cocaine close to the competition",
but for other drugs, yes. Certainly people would not take an injectable
anabolic steroid which will stay in the body maybe for six months,
being detectable for six months if there is a competition coming
up, but they would take one by mouth, one which will clear from
the body more rapidly and some are clear in a matter of days.
Q99 Chris Bryant: But then recreational
drugs like ecstasy, cannabis and cocaine which high-performance
athletes might be taking, not for performance-enhancing reasons,
but for other reasons of their own, how long would most of those
be staying in their bodies and be detectable? I ask this question
because obviously if you are summonsed and have to appear for
a random testing in 48 hours or 72 hours, then the length of that
period is obviously very important.
Professor Cowan: We would normally
describe that as a possibility of manipulating the sample. Although,
legally, manipulation would be after it has left the body, we
talk about a biological or physiological manipulation, "Maybe
I could take something which will affect what gets into my urine",
and the sort of things one might do is if there is a concentration
threshold in urine, then drinking a lot of water might dilute
the amount in the urine sample and get it below a penalty threshold,
so that is one possibility. Although it is banned now, at one
time there was the possibility of taking a substance, like probenecid.
Probenecid is a medicinal treatment for gout, although not in
great favour now, but it actually will reduce the concentration
in a urine sample of certain drugs and it depends on exactly how
the drug has been changed. It seems that when this came up and
probenecid was prohibited by sport, the athletes were somehow
aware of that process. In the area of employment, work-place drug-testing,
where one is looking for a relatively few number of substances,
there is a lot of literature on the Internet which actually tells
you how to beat the test. That often depends on the type of method
of analysis being used by the laboratory. Sports drug-testing
laboratories use far more sophisticated methods, so generally
we will get an indication where there may have been manipulation.
In my mind, manipulation implies intent and of course we cannot
tell that just by looking at a urine sample, so all we can do
is to say, "Well, there was this present or that present",
and maybe it is allowed and maybe it is not. If it is banned,
it is easy for us and the moment it is actually a prohibited substance,
if we find this there and it should not have been there, therefore,
technically an offence has been committed.
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