By Russ Ebbets, Editor, Track Coach
Tammy Hanson currently serves as the Education Manager at the U.S. Anti-Doping Agency (USADA), where she oversees day-to-day operations of USADA’s education and engagement initiatives, driving strategic planning for the team, and developing effective education programs focused on athlete rights and responsibilities.
1. What exactly is USADA and how would you describe its mission?
The U.S. Anti-Doping Agency (USADA) manages the anti-doping program for U.S. Olympic, Paralympic, Pan American, and Parapan American Sport. To protect clean competition and the integrity of sport, USADA provides education, leads scientific initiatives, conducts testing, and oversees the results management process for all United States Olympic Committee (USOC) recognized sport national governing bodies, their athletes, and events.
2. What is the difference between USADA and WADA?
USADA is a signatory to the World Anti-Doping Code and fully complies with the World Anti-Doping Code’s International Standards. Our anti-doping program is often referred to as the gold standard in the global anti-doping movement and we are at the forefront of the fight for clean competition.
3. What is USADA’s TrueSport program? How is it set-up and who is the main focus of the program?
a. TrueSport supports athletes, parents and coaches by partnering with organizations throughout the country to promote a positive youth sport experience. An experience that gives young athletes the tools to be leaders in life.
b. TrueSport is founded on three cornerstones:
i. Sportsmanship
Winning the right way—with respect and gratitude for teammates, coaches, parents, and competitors.
ii. Character Building
Using the sport experience to develop positive whole-life attitudes and behaviors: perseverance, courage, honesty, and more.
iii. Healthy Performance
Wellness-centric lifestyles that fuel athletic and personal success—in sport and in everyday life.
4. What are some suggestions you would make so coaches could foster positive attitudes towards “anti-doping” to parents, coaches and athletes?
Stressing the importance of competing clean, sharing resources with those they coach, being an advocate when an athlete is selected for testing and complete the Coach Advantage tutorial through USADA.
5. Do you have any suggestions for program information that an athletic director could use? Am I correct in assuming that successful prevention programs are a team effort?
The pocket guide is a great resource for anyone looking to gain more information on the testing process. The pocket guide is a condensed resource providing an overview of the doping control process, athlete rights and responsibilities, and other crucial information for young athletes and their parents and coaches.
6. When a urine test is done—how many drugs are tested for? I know when we did a urine analysis in school, we got profiles on 12 substances and 31 on a blood chemistry. Who determines what is to be tested for?
There is no exact number of banned substances a urine sample is screened/analyzed for. It is dependent on a number of factors, including, for example, if the sample was collected out-of-competition or in-competition. In addition, the list of prohibited substances is constantly growing and changing, thus to get a better idea of what substances a urine sample may be screened for, please check the WADA Prohibited List.
7. When blood is drawn, how much is needed and how long is the blood sample good for?
The amount of blood drawn/needed and how long the sample lasts depends on the analyses that will be performed. The ISTI Blood Sample Collection Guidelines put forward by WADA outline how much blood may be collected and discusses the longevity of a sample. On average, the amount of blood needed is 15-16 mL.
8. Typically, how much does a blood or urine drug test cost? And who pays for this cost?
The costs associated with a blood or urine sample can vary depending on a number of factors, including but not limited to, shipping costs and analyses scheduled. Typically, USADA or another Anti-Doping Organization who has oversight over the test or athlete will cover the costs associated with a blood or urine test, to include the storage of the sample at a WADA-accredited lab, which could last years.
9. How long are the samples stored? And who pays for that storage?
USADA or other Anti-Doping Organizations will cover the costs associated with storing blood or urine samples. Samples are required to be stored a minimum of three months and a maximum of 10 years.
10. Why are there A and B samples taken? And what exactly is an A sample and a B sample?
An A and B sample are the result of dividing urine collected during one sample collection session into two separate and secure containers. In the event that the A sample is reported as an Adverse Analytical Finding (“positive”), then the B sample can be used to confirm the analysis of the A sample.
11. How come a urine test is more the standard than a blood test?
Urine is extremely effective for anti-doping analysis because it can be characterized as the biological “waste” from a person and includes the metabolic breakdown products (metabolites) of food, drugs and endogenous waste products. A urine test is also less expensive, less invasive, and does not require a licensed phlebotomist.
12. Do the drug monitors actually have to watch you urinate?
Doping Control Officers, or DCOs, must watch the urine come out of the body to eliminate the possibility of someone tampering with the sample.
13. I have heard of one technique to beat a urine test is to drain the bladder of urine and re-inject “clean” urine—is there any truth to this or is that a “sport myth?”
Under USADA’s testing program, athletes do not have advance notice prior to being tested, thus it would be difficult for an individual to conduct this process before providing a urine sample.
14. What are the challenges of drug testing in the Third World? I’m thinking of notification, access to testing and other logistics of administrating a drug test.
Some of the challenges include lack of resources and technology.
15. If I were notified this minute of an impending drug test can you walk me through what procedures I would need to follow?
The USADA pocket guide walks a person through this entire process step by step.
16. I heard one nightmare story where a woman was at her wedding and called for a drug test and had to comply. Is there no wiggle room when it comes to getting tested?
An athlete is subject to testing 24/7, although I have never heard of someone being asked to provide a sample at their wedding. An athlete does have the right to request a delay with a valid reason, as outlined in the WADA Code.
17. How long does it take for a sample to be processed? And then who gets notified of what?
It takes approximately 6-8 weeks for a sample to be analyzed. The athlete will be notified directly by USADA if USADA has results management over the test.
18. How often can an elite athlete expect to be tested during a 10-year career? And when is the first test given?
An elite athlete who is in the Registered Testing Pool (RTP) will be tested a minimum of three times per year.
19. Where does the NCAA stand with all this testing? Do you work “hand and glove” with them? Or are there different procedures and protocols?
USADA tests many collegiate athletes who compete under the Olympic and Paralympic umbrella, but we are not the testing authority for the NCAA.
20. What common over-the-counter (OTC) products will test positive that most people are not aware of?
USADA’s best resource is GlobalDro.com where athletes can check the status of any medication. In addition, USADA’s Wallet Card shows commonly searched for ingredients that are prohibited on one side, and commonly searched permitted substances on the other side.
21. With the widespread legalization of marijuana happening throughout the United States how will this complicate your job?
Marijuana & Cannabinoids—Why are they on the List?
The WADA Prohibited List is the international standard for identifying substances and methods prohibited in sport. The List is updated annually, and a substance will be considered for the List if it meets any two of the following three criteria:
1. It has the potential to enhance or enhances sport performance.
2. It represents an actual or potential health risk to the athlete.
3. It violates the spirit of sport.
The annual decision to include or not include a substance or method on the Prohibited List is the responsibility of the WADA Prohibited List Committee based on current scientific and medical knowledge and the input from all stakeholders during an annual consultation process. Since the inception of the Prohibited List in 2004, marijuana and cannabinoids have been prohibited in-competition.
Why might marijuana and cannabinoids meet this criteria?
• Performance-enhancement: A common perception of marijuana is that its use impairs physical activity, including exercise performance. While the effects of marijuana can decrease hand-eye coordination and distort spatial perception, there are other effects that can be performance-enhancing for some athletes and sport disciplines. Cannabis can cause muscle relaxation and reduce pain during post-workout recovery. It can also decrease anxiety and tension, resulting in better sport performance under pressure. In addition, cannabis can increase focus and risk-taking behaviors, allowing athletes to forget bad falls or previous trauma in sport, and push themselves past those fears in competition.[1]
• Actual or potential health risk: A number of studies show that marijuana use may cause a variety of health risks. These risks include negative effects on respiratory, cardiac, and mental health. Frequent marijuana smokers can experience respiratory problems including more frequent acute chest illness and a heightened risk of lung infections. Marijuana use raises the heart rate by 20-100 percent shortly after smoking which can increase the risk of heart attack. Chronic marijuana use has also been linked to mental illness including paranoia and psychosis.[2]
• Violation of the spirit of sport: Negative values and ethics included in sport, and beyond sport, are considered in this criteria. Due to the illegal nature of marijuana in most countries, the use or abuse of marijuana does not exhibit the ethics and moral judgment that upholds the spirit of sport.[1]
22. How much of a problem are PEDs in the master’s athlete (40+) community?
USADA posts all sanctions on our website and those announcements include the athlete’s age. This is a great place for people to see where the risk is. We do continue to see an increase in master’s level testing from some sports as more and more sports are investing in education and testing at all levels of competition.
23. I saw recently (January 2019) that a 90-year-old master cyclist failed a drug test after setting an age-group world record. Do masters athletes who test positive suffer the same consequences as the younger, elite athletes?
The rules are the same no matter the age.
24. What about the testing schedule for masters—are they only tested at competition sites? Do they have to undergo “out-of-competition” testing?
All members of USATF are subject to in- and out-of-competition testing. Athletes competing in USATF-sanctioned events may be subject to in-competition testing as well.
25. What about the youth athlete? Are there testing protocols that they are subjected to? Or does their first testing opportunity come when they are vying for a national championship or NCAA program? Aside from the ADHD drugs what are the problem drugs that are abused by youth athletes?
Youth athletes, just as masters athletes are subject to testing at any time if they are a member of an NGB.
26. Where do bans stand for coaches? I realize an athlete may get a two- or four-year ban but what about the coach that continually churns out banned athletes? What sanctions can they suffer? Who does that sanction come from?
Just like athletes, coaches and athlete support personnel can and do receive sanctions for anti-doping rule violations and can range from a public warning to a lifetime ban. WADA has a list of sanctioned athlete support personnel—https://www.wada-ama.org/en/media/news/2015-09/wada-publishes-global-list-of-suspended-athlete-support-personnel.
27. And also, the medical professionals. Oftentimes the banned drugs are given with prescriptions. Does USADA track where the illegal substances come from? Are the medical professionals immune due to their own licensing and prescription abilities?
USADA regularly works to investigate the source of doping or a positive test. Certain medical professionals are considered athlete support personnel and must comply with the anti-doping rules.
28. What is a “therapeutic use exemption” (TUE)? How does one get that?
In some situations, an athlete may have an illnesses or condition that requires the use of medication listed on the World Anti-Doping Agency’s Prohibited List. USADA can grant a Therapeutic Use Exemption (TUE) in these situations in compliance with the World Anti-Doping Agency International Standard for TUEs. The TUE application process is thorough and designed to balance the need to provide athletes access to critical medication while protecting the rights of clean athletes to complete on a level playing field. In order to apply or get more information about the TUE process, you can visit https://www.usada.org/substances/tue/.
29. What is the threshold for a TUE? I can remember a time when it seemed like every Olympic Gold Medalist was suffering from asthma.
Each TUE is evaluated on a case by case basis, as every athlete is different. In order to obtain a TUE, the athlete has to show that the medication is medically necessary, the use does not give a performance-enhancing effect, and the athlete has tried other medications (that are not prohibited) in the past that have not worked.
30. How long does the resolution of a case ending in conviction take? And does the ban that comes with a conviction include retroactive time from the date of the initial test? Or is that a negotiable issue?
Each anti-doping rule violation case is treated on a case by case basis in compliance with the rules and regulations, so resolutions may vary. Some cases can be resolved in a few months, while others can take longer.
31. Where does caffeine fit into all this? There is a ton of research on the enhancing effects of caffeine. I believe caffeine is the most widely used drug worldwide.
In 2016, WADA initiated the Code Compliance Monitoring Program. Caffeine is not prohibited, but it is on the 2019 Monitoring Program for in-competition only.
32. How would it be determined that a drug should come off the banned list? Caffeine did this or at least the standards were greatly relaxed.
Under the WADA Code, a substance or method may be added to the WADA Prohibited List if it meets at least two of the following three criteria: It has the potential to enhance or enhances sport performance, it violates the spirit of sport, or it represents an actual or potential health risk to the athlete. Also, ADOs can submit suggestions to WADA for items to be added to or removed from the Prohibited List.
33. All drugs have an effective range. How is this range determined? This has been a point of contention that some coaches and athletes have “gamed” the system by using micro dosages of a drug possibly getting some benefit without slipping into the banned range of the drug usage.
This is determined by WADA.
34. I have a strong feeling that 100 years from now history will show the United States as a drug culture. We might not be comfortable with that characterization, but the U.S. has fueled the drug trade from Mexico and Central America which has accounted for over 150,000 deaths in Mexico over the last 15 years (according to Frontline). And the opioid crisis in the U.S. kills 70,000 annually which translates to almost 8 people an hour for 365 days a year. Given these realities what goes through your mind when you wake up in the morning and set out for another day’s work?
At the end of the day we want to make sure we do everything we can to protect clean athletes and elevate their voices. When we set out for a day’s work, we are asking ourselves what can we do for clean athletes today.
35. Are there any weird stories or strange cases that you’ve dealt with that are just too weird to make up?
One of our athlete presenters always tells the story of how his cat was prescribed a steroid medication, and his mother used the kitchen cutting board to cut the cat’s medicine in half. He jokes about how he was worried that it might contaminate his food.
36. If someone had further questions what resources are available to them (hotline, website, email or phone)?
For further information, you can visit www.usada.org or you can call Athlete Express at 866.601.2632. If someone wants to report a tip to our anonymous Play Clean tip line, they can call 1-877-752-9253 or email playclean@usada.org.
37. I imagine since this is such a constantly evolving area there must be education programs to highlight the latest data and support systems. Do you present them to organizations, at clinics or conventions? How do you get your message out?
We publish an Annual Report and educate more than 12,000 athletes and athlete support personnel annually with updates about the WADA Code and anti-doping in general. The Olympic Education Team has presented research at the 2nd WADA Global Education Conference in Beijing, and we collaborate on an international scale to share ideas and resources. If you or someone you know would like to receive education, you can contact me at Thanson@usada.org.
Prior to any sample collection or testing, USADA provides extensive anti-doping education to thousands of athletes each year. USADA’s Education Presentation helps athletes and support personnel understand the goal of providing fair and honest competition, as well as their rights and responsibilities in regards to drug testing and what to expect from the drug testing process. Topics include prohibited substances, sample collection process details, including what to expect during a urine or blood test, how and if it is necessary to apply for permission to take a prohibited substance for medical treatment (therapeutic use exemption), dietary supplement education, whereabouts information (out-of-competition testing programs), and the results notification process.
