Anti-doping Solutions for Ultrarunning Part 1-USADA and Dr. Fedoruk (2021) #197

Trail and Ultra Runners. What is going on? What's happening? Welcome to another episode of the Coupecast. As always, I am your humble host, Coach Jason Koop, and I am back in action almost this week. For those of you who follow me on social media, you will know that over the course of the past couple of weeks I have been lamenting that all of my podcast equipment every single last stitch of it, except for one memory card, has been lost in my return from UTMB. It is somewhere in the Munich airport but I can't get ahold of a real person, nor an electronic person to figure out if or when I am ever going to see this equipment again. So I went out and I scrambled and I bought all new equipment and this is the very first week recording from that and I promise I will be back in action in full next week. But for this week we have a very special podcast lined up. It is a re-release of one of my favorite podcasts with Dr Matthew Fedorik, who is the chief science officer over at USADA, us Anti-Doping Agency. I initially employed Dr Fedorik to entertain us on how anti-doping works as a whole and then how we might actually apply it into the trail and ultra-running space, with all of the movements, with UTMB and some of Western States policies. I think that this was a great re-release at this particular point in time and I would encourage those of you to go and check out the other podcasts that I did in this series, all about anti-doping solutions within the sport of trail and ultra-running. Those are episodes 81, 82, 83, 84, and 85, recorded all the way back in 2000 and 2021, yet they are still applicable today. I hope everybody goes and checks that out. But for now, without any further ado, here is a re-release with my podcast with Dr Matthew Fedorik, and I'm going to leave the intro as well as the outro of this podcast intact in its entirety, because I think there's some great context in that as well. I hope you guys enjoy this podcast. Thank you guys for putting up with a little bit of the delay and we'll be back in action next week. All right, here we go. I'm going to get right out of the way. Here's my conversation with Dr Matthew Fedorik Trail and ultra-runners what is going on? What's happening? Welcome to a really special episode of the Coupecast, the first in a series of special episodes of the Coupecast that is all about anti-doping measures that we can take in the sport of trail and ultra-running. This has been in the works for a really long time over a year, in fact. In fact, this first conversation that I had with Dr Fedorik over at USADA was scheduled in March of 2020, right before the pandemic hit. In fact, the day that their offices closed was the day that I was supposed to go in for this particular interview. It has been over a year in the making and I'm actually very fortunate that I took over a year, because I was able to gather some of these other interviews that I always wanted to do and really compile them into a series. I'm really excited.

Over the course of the next five weeks, I'll be releasing five different podcasts, all from different people's perspectives who are influencers, policymakers, athletes, people who have had encounters within the current anti-doping systems that exist around the world all to gather their individual perspectives and use those perspectives and use that knowledge and expertise for the solutions that we can potentially create in trail and ultra-running. Make no mistake, you guys have heard me say this before. I've been tooting this horn for over a year now. Trail and ultra-running is on a parabolic rise. We are going to continue to see more athletes come into the sport. We're going to see better athletes come into the sport. We're going to see more professionalism come into the sport. We're going to see more money come into the sport. That is going to continue. We keep looking at the rise of ultra-runners over the last four years and there is no indication that that is stopping.

I wholeheartedly believe that, from a professionalism and from an anti-doping standpoint, we are truly at an inflection point where there is not a culture of doping within the sport. But that is not static. We can choose to do something now for the betterment of the athletes and the entire ecosystem in the future, or we can sit on our hands and wait another decade. When that decade goes by, we're going to look back and we're going to kick ourselves because the sport has gone awry, just like many of the other endurance sports that we've seen in even sports like weightlifting and other Olympic sports where they got caught behind the eight ball.

In fact, I have a podcast coming up in a couple of weeks talking about those exact scenarios, so you will have to stay tuned. Here's what is on tap for the next five weeks. Today I'm talking with Dr Fedorik, who's the Chief Science Officer over at USADA Next week released. On June 3, I will be talking with Paul Demio, who is the author of the Anti-Doping Crisis in Sport Causes, consequences, solutions, which is a fantastic book. You guys go ahead and check that out in advance of the podcast, it would actually be really insightful.

On June 10, I have a conversation with Lisa Roberts, who's a former professional triathlete and got entangled in Western States' anti-doping policy, and we talk a lot about the consequences of that. On June 17, I have one of the few people who have actually put some effort into this and the trail and ultra-running community and that is Charlie Ware. We talk about what he has done to date and how we can move forward. Then, finally, on June 24, I have a conversation with two of the people that I respect the most in the sport, and that's one of my athletes still in Bowman and fellow coach Mario Freoli. We basically have a brainstorming session on what anti-doping solutions can look like and how we can best serve the community. What I want to have happen at the end of all of these podcasts is for them to serve as an initial educational, galvanizing piece for the community to come together and ultimately create solutions

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Those solutions are not easy, don't get me wrong. We are not going to be able to copy and paste something from the IOC, copy and paste something from WADA. We are not going to be able to easily come up with a contract boilerplate draft of something and have everybody sign it. They are going to be hard and these solutions are going to be full of compromises. They are going to be imperfect but hopefully practical and pragmatic. It's going to take a lot of elbow grease, which, fortunately, ultra-runners are really renowned for the air level of effort that they can put into things. It's going to take a lot of elbow grease to put together. I hope, after listening to all of these, the community can come together as a whole to try to create some reasonable solutions.

The best way to get all these podcasts is just go and subscribe. For the life of me, whenever I throw something up on Apple Podcasts, the subscribers get it immediately and the people who don't subscribe they get it like I don't know, sometimes an hour later, sometimes a day later. If you don't want to be caught out in the cold with the conversation, go ahead and subscribe. You'll get it immediately on any of your podcasting platforms, starting with this one with Dr Ferdorke, before I get into that conversation, though, and before any of this can actually take off, I do have to go over some efforts of full disclosure. That is because anytime I have ever remotely walked anywhere close to talking about doping or anti-doping solutions, inevitably the twiddy-its come out of the woodworks and start throwing stones and hurling arrows. Do you hurl an arrow or shoot it?

Anyway, I'm subject to a lot of criticism, and that's fine. I've gotten used to it over the years. It's been something that I've been dealing with for 20-some odd years, and I'm okay with it. I'm comfortable with where I'm at right now. But, if I'm being honest, that criticism and that polarization has really kept me on the sidelines of this conversation and of this topic, and I'm not afraid anymore. I'm not afraid of the criticism. I've got thick skin. People want to come after me with whatever. I'm cool with that.

But I want to go over these efforts of full disclosure, kind of for the uninformed, the people that are just getting into this and have no awareness of it Because I don't want any of the nonsense that is inevitably going to ensue after I release these podcasts. I don't want any of that nonsense to stand in the way of the information and to stand in the way of the effort, because I'm not going out here on a limb for nothing. I'm going out here on a limb because I want to leave the sport better than I found it, and I do believe that we are well-served, as a community, to come up with solutions now, before the problems actually start to arise. So this whole controversy has to do with my very non-relationship with Lance Armstrong and my very good relationship with his former coach and my boss and somebody who got me into coaching, chris Carmichael. I'm going to take you through that whole storyline, just like I have with my family members, just like I have with my athletes, just like I have with my fellow coaching colleagues, just like I've had with anybody in the community who bothers to ask and wants to sit down for 10 minutes and discuss it. I'm going to take you through the whole thing. If you're rolling your eyes right now and you've heard me say this, or you just don't care, feel free to fast forward 10 minutes. I'm not going to hold that against you, but I have to say something because it's weird if I don't. I'm not going to ignore this and I'm not going to ignore that people are going to come out of the woodworks and say whatever, because it would just be weird and ultimately it would stand in the way of us coming together to find a solution. And, as I mentioned earlier, I'm off the sidelines with this. I'm getting up off the bench and put me in coach and part of me doing that is kind of releasing to the world this non-issue, as weird as that actually sounds. And so here it is.

My coaching career began 2000. Super Humbly, that's why I begin these podcasts with I Am your Humble Host. Super Humbly, as a very lowly intern with a company called CTS. Now how I found CTS was very serendipitous. I knew I wanted to be an endurance coach. There are really only two avenues I had to go down. The first avenue was within the collegiate coaching ranks and cross-country and track and, with all due respect to those fine individuals, that's a coaching carousel and I did not want to play ball in that arena. The second opportunity I had was an internship over at the Olympic Training Center and for a variety of reasons I just didn't want to take advantage of that opportunity.

So as I was trying to figure out how to get involved in coaching in the year 2000, I just happened to stumble upon an internship and stumble upon is very literal in every sense of the word An internship called CTS, whose founder and CEO and current CEO, chris Carmichael, was Lance's coach during his tour de France run and even when he was going back to a junior. Now me being an endurance aficionado and also a native Texan, that's absolutely a part of it. And Lance's prominence, not only in sport but as an iconic world figure, had an absolute impact in my attraction to come on board with CTS in the year 2000 as a very lowly I can't remember, for us unpaid, my money had paid like 500 bucks a month. It wasn't paid much. Intern that was sweeping the floors and packaging together soft goods and maybe coaching a little bit on the side. That aura of getting involved in elite sport on that level was absolutely attracted me. So I took the internship kind of on that and that alone.

What became very clear to me within months, a few very short months, of joining that organization is that it was far bigger than the relationship between one coach and one athlete. I literally had at my disposal coaches that had worked with Ironman World champions, with Olympic medalist, world championship medalists, athletes and coaches across all four of the major sports football, baseball, basketball and hockey coaches that worked with the motor sports athletes. This is IndyCar drivers, formula One drivers and NASCAR champions, you name it. We had a coaching staff and a coaching stable that at the time was unparalleled. And here I was, this 21 year old knucklehead that couldn't coach his way out of wet paper bag. I got to take, I got to take it all in and I was like a kid in a candy store and, very quickly, what started out as me starting with this company, simply for the reason that Lance Armstrong was somehow involved in it, to I really enjoy what I'm doing and this is the opportunity of a lifetime because all of these opportunities are directly in front of me to which I had no idea what I was stepping into. That became very apparent from the get go, and so I stuck with it. I became. I went from an intern who couldn't coach to a coach that could coach a little bit better, and then a coach that was okay, and then the coach that was pretty good, and then the coach that was better than pretty good, and then, all of a sudden, to the coaching director, which I had oversight and management responsibilities over the entire coaching staff and then I started to get involved in the operations of the company as a whole and now I manage the, the, the suite of uh ultra marathon coaches that we have here at at CTS.

And that storyline is important because it it raw. It runs a similar path as Lance's career, where I came on board and he was he was winning or riding or whatever we're calling it right now His second or two, third tour de France, and then he won his fourth and his fifth and his six and his seventh and his comeback and then the entire fall from grace that we all publicly uh, uh witnessed. I got to ride alongside with that on the sidelines. And during the course of that journey and even during Lance's rise from first tour de France, when to the seventh tour de France, when, or whatever we're calling them, people would ask me hey, do you think Lance is doping? And those, those whispers got louder and louder and louder. And every single time, no matter who asked me what or what format it was asked of me in, whether it was family member, friend, training partner, coaching colleague, whatever, I said the exact same thing every single time because it's the truth and that's. I don't know. No shit.

I have only met Lance a small handful of times for very brief handshakes. There's zero chance he would ever be able to pick me out at a bar or a restaurant or at a social event. I simply have had no relationship with him. Nor have I ever had any sort of relationship with him, nor did I really even care if he was doping or if he wasn't and I know that that sounds weird, I know that from the outside, looking in for somebody who came into a company, partially because of this relationship between Chris and Lance, for me to say, oh well, it doesn't care. I know that seems kind of a flippant attitude, but the fact of the matter is it's the honest truth.

I was more involved in coaching athletes and growing coaches and taking advantage of all of the other opportunities where I did have great relationships with and a lot of those individuals I've brought onto this podcast, which is JT Kearney you guys should go and check that out who's singularly had probably the biggest impact in my entire coaching career. But I was more. I was. I was more involved in those happenings with those athletes, with those coaches, with those individuals, and I could care less about the Lance Armstrong storyline at the time. We can all look back now, and now that the curtain has been peeled back, at all of the mistakes that cycling as a whole has made over the course of that time and really continues to make now for being honest and we're going to talk about that on a future podcast as well and those mistakes are tragic, and almost all of those individuals have owned up to those mistakes, and we can learn. We, as the ultra running community can learn a lot from those mistakes, but I simply wasn't involved in any way, shape or form, and not only was I not involved, I wasn't even close.

I've never been a subject or a person of interest for any of these dealings having to do with Lance Armstrong or the reason decision or any of the aftermath of that from usada or Wada or any of those interested parties. The great thing about this, though, is that you don't have to take my word for it, and we've all heard dopers and people that have been involved in doping deny, deny, deny over the years, and it's it's very unfortunately become cliche that it's deny first and deny until the death, and I know that this dialogue might actually sound like that, but the great thing is is you don't have to take my word for it. One of the fantastic things that you saw it did with the reason decision, which is kind of the whole demise of Lance Armstrong as we know it today, is they've made all those records public. They made all the testimony public. They made all that, the data of its public. They made the rationale public and you can go and find it right now. You can go right now, search for it easily, find it. You can control F, koop, k-o-o-p on any or all of those documents and there's several hundred of them to pour through and I'm not anywhere mentioned there. I quite simply was never or have never have ever been involved in any of those in any way, shape or form.

Now there are going to be some people out there when these podcasts that come out that are going to insinuate that I was involved, that somehow I knew something. I must have known something because I worked for CTS and I worked for Chris and this whole thing is a huge scandal and everything dealing with Lance or within a thousand miles of Lance must be dirty. Just go look it up, people. I'll put all the links up to that on the website or on the show notes to this. Go look it up, go find it, go do your own research. You don't have to take my word for it. You can take other people's word for it. There are going to be other people that just simply say bad things.

I have a character flaw, I have bad judgment. I should have done this. I should have done that. Those opinions are fine. I'm cool with that.

You guys want to have your own opinion about stuff Great, everybody's allowed to have an opinion, but you're not allowed to your own facts. And so if you come out with facts that are incorrect you're not allowed to have facts that are incorrect or you are somehow misstating my lack of involvement within this whole thing make no mistake that I will correct the record and that I will correct the record with the actual facts you want to come out. You want to come at me with your opinions. You don't like my hair, you don't like the way I run, you think I'm stupid, whatever, I don't care. You can say it Great, that's your opinion. You're not entitled to it, but you're not entitled to your own facts. And that will happen when this comes out and that will be unfortunate. But I hope that we can see through all of that for the nonsense that it actually is, and I really hope that none of that clutters the information that is to come for this podcast and the next several podcasts.

The final thing that I will say is that I have never turned down any interview, any conversation, any form of dialogue ever about any of this. I have always been transparent and I've always been an open book to the obnoxious nature of this 20 now 20 minute intro and that is going to remain the same. If anybody wants to contact me at any point about anything, about any four, in any format, I am game. All of my information is public. You guys know how to get ahold of me. I've never shied away from any of that because I, quite frankly, have absolutely zero to hide. My record is beyond reproach when it has to do with this.

So with that as an intro, I hope everybody can buckle down for the next five podcast and in advance I thank all the guests for coming on, because some of these topics are not the easiest to talk about and we'll get into that in a few weeks this podcast, but also over the course of the next few weeks. So thank you to Dr Fodoric, thank you to Paul Demio, thank you to Lisa Roberts, thank you to Charlie Ware and thank you to Dylan and Mario for recording these with me. I realize that some of these conversations are just hard, you know, but they're necessary. So we're going to get right into it with the first podcast of five, and this is with Dr Matt Fedork, who's the chief science officer over at USADA. Let's get right into it.

Oh, I don't know if I'm going to be able to get into it.

I want to know first off, before we get into anything because this is a super interesting curiosity point for me, having a chemistry background, is how have the dried blood spot tests been going? I know it's been a really big, a really big project and COVID kind of like accelerated it to a thousand two thousand miles an hour.

So I'm kind of curious as to how that's going. Yeah, I mean it's going fantastic. We started in 2017. Yeah, and you know, we are culminating now actually in just about rolling out a official technical document which allows us to start officially, under water code compliant rules, collecting and analyzing dried blood spots. So where it's been a pilot project up to date, it's really we've tried to advance the science and advance our experience so that, globally, this is hopefully going to be a brand new matrix that can be used in every country if they have the resources and they want to do the blood testing.

We're going to have to back up just a little bit because the listeners aren't even going to be familiar with it. But as a test, you literally take a pinprick of blood, you put it on what looks like a piece of paper and that gets tested.

Yeah.

So this concept of rather than doing blood draws through a vene puncture, so sticking a needle in an athlete's arm obviously very invasive and athletes don't love it.

So in 2017, we started investigating you know what are some alternatives to this, and one of the things that came about was you know, they've been doing finger sticks and heel sticks on babies and in other instances applications for decades, but there's a couple of companies in the US that have actually developed new collection devices that basically just you put them on your arm and you stick them down, similar to like a sticky 3M post-it note and then you press a button and it draws blood out of the top layer of your your skin, out of your capillaries. So we started working on this and, you know, ultimately it's it's culminated in um. There's two main ways to do it. So you can do finger sticks and you can do cards, or you can use these devices, which are essentially a biomedical device that it's all integrated into one. So you press the button, the blood gets drawn into a cartridge and that cartridge has the spots in it and then you send it off to the laboratory. Fascinating.

Did the athletes like that you're initially piloting that out on just go, come on, this can't work Like? Did you get a lot of skepticism from them?

Um, I think we got actually a lot of excitement because they just they don't want to get poked anymore.

And, um, you know there's obviously a lot of scientific validation work to do and and the blood that we collect now because of the volumes, it gives you the most flexibility to do the analyses that we're looking to do with a smaller volume of blood than you're essentially limited by that.

So really, you know, a lot of the work has been one coming up with new collection procedures and instructing our sample collection personnel.

And this is something great because you don't actually need a train phlebotomist out in the field anymore. You can just have a doping control officer instruct the athlete on how to operate the device. And then, of course, the transportation costs around blood are huge for us. And so if it's dried, it's very stable and just throw it in the career, the mail and it gets sent to the lab. And then you know you've got some limitations on the analysis side that you need to make sure that you work through and and you're limited and the number of things you can actually test for in a single spot. But I think it's going to, you know, continue to evolve. And we're actually looking at other complimentary techniques like, rather than a dried blood spot cartridge, you can actually get like a micro volume, a tube of whole blood and then doing things like the athlete biological passport analysis or some of the other analyses that we can just instead of having to ship a huge tube to the lab, we can ship a micro tube is really advantageous.

Yeah, we used to do like type samples, like that way back in the day.

Exactly Same type of concept, yeah.

Okay, thank you for satiating.

Yeah, that's not what we're going to talk about today. We're going to get down to brass tacks. I love talking about science.

No, that's cool Like I said, when I when I initially saw it, I was like, wow, that is going to be, that's going to revolutionize things if the, if the testing side of it can come around right, if you get a high, high, high, high enough quality test precise enough tasks to test for the right things, it's going to be revolutionary. Yeah, um, you're the chief science officer.

That's your official title, right? Yes, yes, okay.

We're going to back up a little bit and we're going to go into the science a little bit later, but I first want to go over all of the different like anti-doping tools that you saw to uses at their disposal, because a lot of times we get geeked out on the stuff's like oh, we're going to, you know, do a urine test, we're going to do a blood test and in in in many unfortunate ways you saw it kind of gets put put into this box and other anti-doping efforts kind of get put into this box of.

well, we're just making people piss in a cup and the piss turns hot, which is the colloquial way that everybody describes it. Right, the piss turns hot, then you know the athletes been been doing something wrong. But in reality there's this like whole, whole portfolio of things that you guys do without taking up the whole hour. Can we just kind of like run through that just to set? The table before we go into the science side.

Yeah, absolutely. And and you know we uh in in the year 2000, when we were founded, I think lots of people thought you know, we're just glorified P collectors. We've come a long way in 20 years, um, not only on the science but the, the reputation and um what the organization's known for. So I think it's you can break it down into kind of four main areas. The first is education. So any successful program we are looking to make sure we properly educate all of our stakeholders on what the rules are, how we go about the program. And that plays into deterrence as well, right, because we're not all about just catching athletes out.

It's really important that an effective anti-doping program, the number one goal, should be to deter athletes from doping in the first place. So we have a lot of tools in our toolbox to try to achieve as high a level of deterrence as possible. So education is one component, you know, investigation and intelligence gathering is another. Testing is another component of that. New sample collection matrices is another. So that that's always in the back of our minds is that we're not just out to, you know, get a positive test.

We are out to deter athletes from doping in the first place and that should be the goal of of any program and and I think it's also important to realize that, whereas many people think of doping as a positive test, that's only one definition of doping. There's actually 12 different anti-doping rule of violations that we're responsible for under our set of rules. So everything from sample manipulation to tampering, to refusal of a test, to aiding and abetting and doping if you're an athlete support personnel. So it gets very complicated very quickly and people I think they tend to like have this lens of okay, we're just trying to collect urine here and get and detect some kind of a steroid in it. That's actually a really small part of what we do.

Yeah, thank you for that background, because I do think and I've talked to people in the community, especially the ones that have it they haven't either had to participate in an athlete whereabouts program or anything like that. They just have this like really, really narrow lens and I think broadening it out is super important. Yeah, so when we describe what you saw, it does for our purposes, we're primarily going to use framework that you use for USA Track and Field, usa Cycling and USA Traffon, which are kind of the equivalent endurance applications.

Before we go too far, I just want the listeners to understand that nobody's proposing that. That is the structure that gets implemented into ultra running. There's no governing body, and that's part of the issue that we're working with. If an athlete that qualifies for the national championships in Track and Field or whatever they have this rule system incorporated into their lives by default, they have no choice in the matter. But we're going to use that as framework because it's the current framework that exists. So let's get into your wheelhouse. We're going to go back to the prototype now to explain it to the listeners. Athlete is underneath some umbrella USA Traffon's umbrella, usa Track and Field's umbrella, usa Cycling's umbrella and they have to submit a test, whether it's a race day test or somebody knocks on their door at 6am or whatever that happens.

Once that happens, Do you want to talk about first the context of the rules, or do you want to get down to the testing part

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of it. Start, the context of the rules, if you think that provides good background.

Just from the context of the rules, that USADA, and the United States in particular, is a signatory to a Doping Against Sport Convention, a United Nations Convention, and that makes us what's called a World Anti-Doping Code Signatory. So the United States is a signatory to the convention and then the World Anti-Doping Agency is the regulatory body that actually creates the set of rules in partnership with all their stakeholders. So right now, globally there's over 700 code signatories, and that could be national anti-doping organizations like USADA, it could be national sport federations, it could be international sport federations, it could be the IOC. So all those people agree that we needed a harmonized anti-doping system globally because an athlete in Italy or the UK or the US should be subject to the same set of rules. And before that existed, you had this totally chaotic system where essentially, countries were responsible for administering their own anti-doping and actually sports were responsible individually. So what did that encourage? A system that covered up tests, that was not independent and that's by and large.

The last two decades have been spent putting in this very extensive framework that protects athletes, but it also protects the independence of the anti-doping system and encourages harmonization. We're not there yet. You've got agencies like USADA in the world, and then you've got countries that maybe don't have the funding to fund anti-doping like they should. So there's still a lot of work to be done, but that's essentially the framework that's created that we operate under, and we could talk about professional sport as being slightly different than that. But essentially professional sport has, in a lot of instances, collectively bargained agreement. So they use the world anti-doping system as kind of a guide, but then they modify it based on their sport.

I'm glad we went down that part, because before all of this existed, it was a really weird time where the Brazilian national tennis team would say, okay, well, we're going to test for these things in this way and on this frequency. And then you had US tennis saying, okay, we're going to do something completely different. And I remember when you would look at those different policies it was like one was on Mars and one was on Venus and the incentivization structure. The incentive structure was completely asked backwards.

You need. Really the core of the global framework is specific documents that govern and make standards around certain things. So we've got a standardized prohibitive list. Everybody's agreed to the substances and the methods that are banned. You've got a standard for laboratories, so there's 30 accredited labs around the world that, no matter where your sample goes, it should be analyzed in the same way. You've got an international standard for therapeutic use exemptions, so an athlete in the US that has a medical condition can get a prescription and get it evaluated in the same way as an athlete in another country. You've got a results management standard, so when there is a positive test or a violation, it's managed similarly in all countries.

And so all these things. They just help to make sure that there's not inequity in the system. And, yeah, I think when you're looking at a sport like ultra running, I think you need to look at it like that lens and do you need to reinvent a system or do you use the system that's in place? And can we improve the system Absolutely and we advocate for that every day but we've got now a very robust system to in order to operate under, which is really valuable for athletes.

I promise the listeners we're going to come back to talking about TUEs, because that's a really hot topic, as well as results management or adverse findings management and how that whole process works. But for the uninformed, let's go back to the original question. I'm sitting at my home. 6am DCO knocks on my door. You know, Mr Cooper, you hear I don't know why they'd be looking for me and it's the last person they'd be looking for.

But somebody knocks on my door. We're here to drug test you. What athletes submit to sample, what happens from there. Take us through the scientific process of what gets done to that sample, with that sample.

So when an athlete is notified at home, that's what's called an out of no notice, out of competition test, so they don't know the testers going to show up, and that's a really important part of the work we do. If you gave advance notice, there would be ways that an athlete could maybe circumvent the test or not answer their door or those kinds of things. My doorbell doesn't work. We all heard that one. So once the athlete is notified, then the DCO instructs the athlete to go through this process and the process involves sample collection equipment that allows the athlete to essentially provide a sample and that sample gets split into an A and a B bottle. And that's really important because through the analysis process and if there is a positive test, then that B bottle becomes really important to validate the finding in the A sample and that's the athlete's right to have their B sample analyzed as part of the process. So they go through this process.

It typically takes athletes, you know, 15 minutes to 30 minutes to provide a sample. If they're ready to provide a sample, they're responsible for securing their own equipment. They can see the equipment is secured, they package it up and then the DCO sends it directly to the laboratory and that equipment doesn't have any markings of the athlete's name on it. All that's on the bottle is a sample code number. And that's very important because the laboratories operate independently from USADA. So when they see the sample, they don't know who sample it is. They know that it's a male or a female sample, they may know the sport that it comes from, but in order to have independence and make sure that a laboratory can't manipulate or, you know, lose a sample, then that's code number protects the athlete. So once it arrives at the laboratory, then that's when all the kind of magic starts happening. How?

does the lab know what they are testing for? Because you can test for anything and everything and the cost goes up depending upon what you're actually testing for. In the situation where we're looking at USA Cycling, usa Trathlin and Darnist applications right, is there a standard set of things that initially get run or does the lab know we're matching up XYZ test with athlete number one, two, three, four, five.

Yeah, no, so it gets a little complicated, but basically there's three areas of the prohibited list. There's substances that are prohibited at all times, there's substances that are prohibited only in competition and then there's substances that are prohibited only in particular sports. So when the lab gets the sample, they get the sample and it says in competition test or out of competition test. If it says out of competition, they're analyzing that sample for the menu of substances that is prohibited at all times. So you've got anabolic steroids, you've got peptide hormones, you've got hormone and metabolic modulators, you've got diuretics, and so those substances are the core of what they analyze for as an out of competition test. Where it gets a little more complicated is that that core menu can't analyze for some of the more sophisticated substances. So this is where, when you mentioned, you know, the cost goes up.

We have other ways to determine when we need to conduct what are known as special analyses. So there's a different menus that we can use. So analyzing for growth hormone releasing factors, analyzing for EPO, analyzing for testosterone, those are extra tests. But we have other tools in our toolbox to be able to look at that sample and say, well, should it be analyzed for those things. What are the characteristics of that sample that may suggest an athlete is using those substances? And that's where the passport comes into play, because that informs us of when we need to spend extra money to order those tests.

So is it fair to say that with when you're deploying one of the more advanced tests after you've done the first menu? It's a human looking at the whole situation they're looking at. Do we need to test for these things? They're looking at like the. I guess what I'm trying to say is how does that, how does that decision making process actually run? Like you've got the sample in, it's all. It's not hot. What's the opposite of it's turning hot Is there something negative?

We'll use the scientific words Something here with scientists.

Test are all negative. Who then looks at it and says, okay, you know what something's got to be going on here. Let's do run A, b and C. How does that work?

Yeah, so it's. Let's just use an example like EPO. So EPO is a substance obviously used by athletes as a blood booster. It's a hormone that appears in our bodies, naturally, produced by our kidneys, and so we need to be able to figure out whether the EPO that we see in the sample is supposed to be there or if it's synthetic EPO. So the way we do that is a number of different ways.

The highest level way is that we're required to do a sport specific risk assessment on a substance by substance basis. So if you're an endurance athlete, you would naturally have a higher risk because there's a history of EPO doping in your sport. So we assign a higher percentage of EPO tests to endurance based sport samples than we would, to, say, badminton samples. So that's the first level. The second level is using the athlete biological passport. So we collect blood samples on endurance athletes, we follow those indirect markers over time and by looking at those indirect markers in conjunction of specific points in time, we can determine whether we need to assign EPO testing to specific samples based on the variability that we see in individuals. So that's an easy way for us to use our resources as effectively as possible, because we can say, okay, that athlete has abnormal hemoglobin increase or abnormal immature red blood cell increase. Let's look a little more closely at that urine sample to see if the cause of that was EPO use.

And that's still blinded, absolutely. It's somebody looking at athlete number one, two, three, four, five, not I'm looking at Jason Koops. It's blinded by the lab.

It's blinded to the laboratory, it's not blinded to us. So we know we collected the sample, we know what the results are and we, as a, as you saw it, have our athletes in our registered testing pool that we can see their passport data and find out, okay, that sample is maybe a little abnormal, let's look at that a little more. But we don't tell the athlete who that is, we just say lab analyze this sample for EPO.

Okay, so the lab has independence in terms of they don't know who they're testing Correct, so the lab can pull these, these more stringent tools. Yeah, knowing who the individual is. I think that that's an important distinction. Once again, not to say that this is what we deploy in ultra running, because that's probably solution like 5.0. It's like 10 years from now, maybe 20 years from now, we get to things like that. But I've always found that an interesting concept that there's a human element looking at the ABP and the, and I'll also I'll just say the landscape Cause.

I know there's a lot of other things that go into it and say, okay, we need to do this with that particular athlete, not just with the sample, absolutely.

And so the other. The other thing that adds another level of independence is when the hematology expert is looking at that ABP or that passport pattern, that person is not identified. So I may, as a chief science officer, be able to identify that athlete, but our expert looking at that particular result in the context of that passport, that passport's identified by basically an ID number that's anonymous, so they don't know who they're looking at. And that adds like another level of okay, I can't bias my scientific opinion because I just happen to know who that is. So we act on their recommendation and then notify the laboratory based on that.

So yeah, okay, good, I appreciate that context. Okay, hot water to you Ease. Yeah, I know you deal with this a lot Sure, and there's definitely both sides of this in ultra running where we've got the camp that If you need a TUE you shouldn't be able to compete in the sport or you shouldn't need to use that TUE in the sport.

That's just inherent if you're trying to be an elite athlete, you know. Sorry, it causes too many problems.

Yeah and then you have what I would consider the more reasonable solution. We need to. We need to allow for TUE's in certain cases. I know you understand the criticism that it's an abused system. Yeah. But to start out with, why do we need TUE's in the first place? Why does sport need a place? Why do we need to carve out these things and say athletes should be able to take these under certain circumstances?

Yeah, so, yeah, great question. So I mean, I think the most basic answer is that the prohibited list is a very diverse set of substances and some of those categories of substances are used in medicine to treat common medical conditions that athletes may have.

Give me an example.

They may be chronic conditions or they may be like acute conditions, like musculoskeletal conditions, but an athlete may need, you know, for example, a Good one is like an ADHD medication. Okay, so they've been diagnosed with attention deficit. This order they're using a stimulant in order to operate their normal lives, so they can operate day to day. We don't want to put their health in jeopardy by saying you need to wean yourself off that medication before you compete.

Let's have a process in place that we have independent doctors that don't know the identity of that athlete looking at their medical records and evaluating it against the international standard of criteria that are specific to each substance and diagnosis, saying was this Condition diagnosed properly? Does it meet the ISTUE? And if so, we're going to grant this athlete a TUE to use this substance to protect their health. But, more importantly, it has to return the athlete to a normal state of health. They can't return them to a Supra physiological state of health. So all those checks and balances are part of that process and we have a TUE committee of 21 Physicians that are medical specialists in each category that they may be looking at, saying, listen, we've looked at this diagnosis. More than one of us has looked at this diagnosis and we agree that a TUE is Necessary in this situation.

So why? How does the criticism get formed that it's so rife with abuse?

I'm not sure.

A little bit. You know I'm responsible for the drug reference department and and we get we get about 800 TUE applications per year and we evaluate all those in the same fashion. They all get evaluated independently. They go to Physicians that are no specialists in those fields and they're they're evaluated according to the ISTUE. So there isn't some special, you know, criteria for one set of athletes versus another. They're all treated in the same fashion. So I think a little bit around the abuse may be not necessarily Understanding the robustness of the process and just seeing that an athlete, you know, has a TUE, this one has a TUE, this one doesn't. And you know, because they have a TUE, they must have got it just because they submitted a prescription and that's all they need. That couldn't be further from the truth.

Well, this is part of the issue with races Races that have drug testing policies, that have this vague Line or rule about TUE's, where they're gonna figure it out after the fact. Right, and look at that and there's. There are races in ultra running that have this, but there are races outside of ultra running that have seen that have this as well. I Look at that. I'm like you don't have the expertise to figure that out, right, it's hard to figure it out with all of the experts in the room, just as you're alluding to. So you're gonna tell me, like you're Non-expert, board of directors of this 5013C is gonna figure out this. Tue that somebody just got flagged for is actually really necessary. Like, I just look at that is right, bizarro town.

Yeah, yeah, it's, it's really. I think it's important to have the right people looking at it, doing it in independent fashion and then rendering a decision that is consistent across race to race, athlete to athlete, sport to sport and, at the end of the day, that that takes the responsibility and the reaction out of the hands of race directors or Individuals that don't have that expertise, and you, literally, you don't want that liability either.

to be honest, yeah, yeah, trust me, that's I.

Anyway, we're gonna we're gonna move on from there, because otherwise I'll go down a rabbit hole and I'll take up all your time. Okay, the next thing that I promise we would talk about is what happens after an adverse finding. Yeah, so somebody comes and knocks on. We're gonna use me as an example, because I'll throw myself under the Bus. Sure, somebody comes and knocks out on my door. I provide a sample and Something shows up in it that the lab determined was not right, some sort of add, a competition and competition, whatever it is. What happens at that point in time?

Yeah, so After an adverse finding, we get the result from the laboratory. That result is then matched up with an athlete's name, and so lab still doesn't know who it is.

I just showed it up. They should. They'd say athlete one, two, three, four, five has this? They shoot the results to us.

Yeah, exactly, and so the science department first reviews the laboratory testing data to make sure that you know everything has been done properly and that we agree that there's a positive, and then at that point we would. Sometimes we actually do a little bit of an internal investigation First of all, and what that means is we may collect another sample from the athlete before Notifying them in order to see if the same pattern appears or, you know, just to get a bit more information, because a single sample is just a snapshot in time and with many of these substances we want to make absolutely sure that you know maybe there's another explanation. Or we don't want to tip, necessarily tip the athlete off First before we maybe gather some more information. Scientific, so we may.

The most common thing is to conduct a follow-up test, but it once that process has been completed, essentially the athlete is notified of their adverse analytical finding or positive test and they have the option of Having their B sample analyzed, so that at that point the athlete says okay, you, I know what it is, it's my right to have you, sada, ask the laboratory, and and the athlete can actually go to the laboratory and confirm the B Samples, still closed and intact. Confirm the sample code number matches. They can actually themselves or a representative watch the analysis of that B sample to confirm the a sample.

Up until that point, yeah, everything's internal, yeah, lab is blinded to who the athlete is. Notifies you, sada. Yeah, you guys. Unmask who the athlete is you do a little bit of internal investigation. Yeah then inform the athlete of the adverse finding. Yes, is all the communication up until that point still in the room, like it hasn't been leaked out to the public? The only people that would know would be. You saw it in the athlete, yeah and we never Throughout the whole process.

It's important to know that. You saw it. The process is confidential. So at no point do we like announce that an athlete is tested positive Until we actually announce the sanction at the very end of the process. And that's really important because the athlete has rights during the process and they have the right to challenge the result as well, and that challenge, in fact, is confidential as well. So they have the right to an arbitration hearing, they have the right for to representation, they can argue their case, and we don't. We don't publicize that or that is all confidential until the point at which there is a conclusion, and that conclusion Maybe that that athlete is not charged. So then there's no announcement, or they're charged with an anti-doping rule of violation and a sanction, and then there's a sanction announcement. And those are the things you see, you know, every so often.

Press releases. Okay, how many times is there an actual false positive? I?

Don't like the word. You know in our, in our business, false positives and are very serious. And though the international standard for laboratories actually has, as part of its core framework, a Internal quality assessment scheme that basically ensures that the laboratories operate under this standard and their sense samples in order to show that they're proficient at detecting these substances. So if an, if a, if either a proficiency testing sample is Reported in the wrong way, the laboratory actually gets penalized for that and you can have a laboratory. You've seen labs around the world either get suspended or they can get their laboratory accreditation revoked, and and that's a that's a serious thing For a laboratory you never want to be reporting a false positive.

Well, the reason I the reason I posed it that way, is that in the scientific community, everybody realizes what a false positive is is. You run a sample, through whatever, however, you're running it and it shows Something is being read and it really is green. You're detecting, you're literally detecting, something that's not there. That's the scientific version, or that's a scientific way to describe a false positive. But when a lot of people say that what they really mean is Something showed up that they didn't intend to show up. They took a contaminated supplement, they didn't know that whatever, xyz was banned and things like that, I know that everybody in the anti-doping community is pulling their hair out over supplements.

Can you?

paint the picture of how big an issue that is.

Yeah. So it's a great topic and one that has been at our forefront for a number of years, and it's the issue of contamination, and it's not just supplement contamination, it's pharmaceutical contamination, it's environmental contamination, it's contamination due to intimate contact with somebody that may be using a prohibited substance. So, as we get better scientifically at detecting these substances, what the challenge is is that you wanna increase the detection window of these substances to get better at detecting the compounds, but what that also does is it leaves open the opportunity for detection of the presence of these compounds due to things that aren't intentional doping, and I think that's where the evolution in the thinking around anti-doping really is changing quite rapidly in the last couple of years and you saw it has been advocating for rule changes that make sure that this process remains fair around those things. So you don't want an athlete testing positive because they're using a permitted medication that just happens to contain a low level diuretic that is there because of the manufacturing process but the athlete did nothing wrong.

We've had 10 of those cases. We've had cases around meat contamination athletes testing positive because they had a dinner somewhere and there's residues of legal growth promoters in the meat that show up in their sample. So scientifically, we've actually been developing new solutions in order to solve some of these problems and basically what the solutions are is minimum reporting limits for the laboratory for certain substances. So for example, for diuretics, even though it's prohibited at all times and the labs have methods that are extremely sensitive, they're not gonna report when the concentration of those diuretics is at such a low level that there's a question that it could have come from contamination.

I promise that I won't ask you to find a pica gram, because I know some of the cases that you're referring to. But I mean, is that a case where the technology and the scientific technique to detect these substances are moving faster than the policy?

I think in some instances we wanna make sure that the science and the policy is connected and informing each other right. And it's no fault of the laboratories they're trying to do their best at detecting substances. The challenge then becomes we don't wanna be sanctioning athletes for unintentional doping and ruining their careers, because we know the impact it has when we see an announcement of a positive test. So that's where we wanna continually evaluate all the characteristics of these cases and we've gone so far as to, when we see a low level diuretic, we ask the athlete to provide their medication. We go to the same pharmacy and get another prescription of that same medication, send it off to the laboratory and have it analyzed, and we've found those diuretics in that prescription medication. So it's scientifically, it's a process to do that. But as you see more cases you realize that there's a prevalence of this that you weren't aware of before and so you need to adjust policy based on that to keep confidence in the system, because the detection levels are going down so quickly.

So what happens? When athlete knocks on my door? I provide a sample. You get a really low level diuretic. I say, ah, it's because I'm taking this heart medication. You guys go to the pharmacy, you get this heart. I'm not on heart medication, I'm just trying to come up with an example, you go and you get the heart medication and, oh voila, like it's in this, it's in there. What happens at that point? Does anybody know about that? Does that just stay in the room? What goes on?

It's basically it's between the athlete and you start a athletes. A lot of athletes at that point get assistance from some legal counsel to help them through the process. There's also an athlete ombudsman at the USOPC that can independently offer advice to athletes and help guide them If they're underneath one of the NGPs.

Exactly, yeah, yeah, yeah.

So that's a really useful resource for athletes. That okay, you saw this, telling me this, but can you kind of help me?

verify it and figure it out.

So, yeah, I mean at that point we work together with the athlete and it's our, it's the athletes burden to demonstrate how the substance got into their bodies. But, based on the science and what we've seen, it's part of my job to say listen, does this make sense? Like what's going on here? Let's try to like work with the athlete to find the source of their positive test.

So it's not piss turns hot, let's go sanction the athlete.

Absolutely not.

Whatever the scientific version, if you have an adverse finding, let's figure out what's going on. During the part of figuring out what's going on, there's all these different pathways that you can take. The athlete can have their B sample tested. They can be present when it's tested. You ask them for a list of all these other things that they've been taking. You can go to the pharmacies and piece the story together before determining what to do. I mean, it's a sound from what you're describing. It's a very methodical, planned process.

And at the end of it, it's either yeah, you ran foul the rules or no, you didn't. This was unintentional. Yeah, absolutely.

So through that process there's a point at which if we don't hear from the athlete or it's an egregious substance and the athlete doesn't provide any kind of explanation, we'll charge the athlete with an anti-doping rule of violation. At that point they're not being compliant.

Yeah essentially, they've got a violation, they've got a positive test and at that point we will offer a sanction to the athlete. So they can either agree to that sanction or they can challenge that sanction. So they can challenge it, they can go to arbitration, they can offer an alternative explanation, and that is all done with a panel of independent arbitrators from the American Arbitration Association. And then, if they don't like the result of that arbitration, so those arbitrators will render a decision like yes, this violation is valid. We're gonna sanction you for X amount of time. They have an appeal right as well, and at that point you can take your case to the Court of Arbitration for Sport, and that is the international sport body that hears appeal cases for anti-doping. So they're based in Switzerland and that's the final body that can make a ruling and many cases are re-idudicated at that level. So you have to start from scratch again and present your case, and Sotter-Prince presents its case, and then the arbitrators make a decision. So it's a multi-stage process, depending on what the situation is.

And under the umbrella of the three NGBs that we're kind of using as a model who pays for the legal bills.

So yeah, that's a little complicated. So many times the athlete pays for their legal bills and you saw it pays for its legal bills. There is certain circumstances where legal aid might be available to the athlete, depending on their situation. So yeah, and then at the end of the day, the arbitrators can decide. Maybe, depending on the outcome of the case, the athlete is responsible for a portion of you who saw it as legal bill, or you saw it as responsible for a portion of the athlete's legal bill. So, depending on the circumstances I mean it is different in every case- Somebody's gotta pay the legal bill, though I mean I think that's a realistic ramification of having this type of rule structure.

When you elevate the case to the court of arbitration for sport, you gotta be able to figure that out. That might be getting too far ahead for our group. So let's kind of go back to something a little bit more fundamental that you already touched on. This is this area of sanctions. Right, there are levels of sanctions, and they range from really benign, like what we would call a slap on the wrist colloquially, to a lifetime ban for sport. You cannot go back to the sport for forever. Why, fundamentally, is there this big range? Like, let's start with that and then we can kind of take it into the buckets that we typically see in the media play out.

Yeah, so a little bit of history.

When the World Anti-Doping Code, the first version of it, came out, the default sanction was two years.

Doesn't matter, everybody gets two years. Well, no.

So there's two years as the default sanction and then, based on mitigating circumstances and degree of fault, you can go from two years and that sanction can either go up or down depending on the circumstances of the case. So, for example, on the prohibited list there's substances that are specified substances and non-specified substances. Non-specified substances are like anabolic steroids. So if you test positive for an anabolic steroid, your default sanction is four years. If you can show that there's some reason to reduce your degree of fault, that four years can go down to as low as one year. But for specified substances, like stimulants, for example, they're less egregious. You could get a public warning, depending on the circumstances of the case. So the rules, the sanctions, are scalable depending on various mitigating factors that come to play in the case itself.

But the fundamental. I don't wanna put words in your mouth, so I'm gonna ask the question again the fundamental reason why there are different level. I guess I won't put words in your mouth. What is the fundamental reason why there are different levels of sanctions? Is it because of the egregiousness of the offense or this one calibration point? Because I want people to understand that, just like in any other sporting event, you have degrees of penalty. You go watch a football game. You have a five-yard penalty, a 10-yard penalty, a personal foul. People get ejected from the game. You don't eject everybody from the game for a holding penalty. What is the philosophical umbrella that the different rules fit under? Is it the egregiousness of the offense? Is it the potential to enhance performance? Is it the harm to the sport? How does that all?

get worked out. It gets a little complicated, but essentially you've got athletes demanding that four years for an egregious offense takes an athlete out of sport for long enough that it acts as an effective deterrent for doping. So if you only slap somebody on the wrist and say they can't compete for 30 days, that's not very effective at deterring somebody from doing a doping substance. So the reason the four years exists for egregious doping is that that removes those athletes from competing and participating in sport for an amount of time. That's been agreed to by 700 signatories that are out there. So that's changed over the years. It used to be two, now it's four.

So it's part deterrent, I guess is what I'm trying to give, Absolutely the philosophy behind this four-year benchmark. It has a lot to do on the deterrent side of it.

But, as we discussed, there's lots of reasons why a substance may be in an athlete's sample. So you wanna be able to adjust the sanction based on that so that you're not giving somebody who ingested a substance because they didn't intend to for years. That seems very, very unfair right. So it's not just apples to apples to apples. Every case is different and therefore the legal system allows for this adjustment process based on the situation, and you've got case law informing that. So you saw that when we propose a sanction, we may look at past cases for that substance or similar circumstances and say, well, in this situation one year seems appropriate, but in this situation we can't go below two years.

And who is at the table figuring that out?

The legal team.

The legal team. You're like, not me. I'm out of that decision. I could just tell you green or red.

Well, and it's important, it's not just you saw it making that decision. We make it in the context of cases that are adjudicated worldwide. So the sport itself has an appeal right and WADA also has an appeal right. So if they don't agree with our sanction length, they can appeal that to the court of arbitration for sport. So it prevents you saw it from saying, okay, we're gonna give all US athletes a really lenient sanction when all these other countries are penalizing their athletes more heavily. Like there's checks and balances in the system to prevent countries and anti-doping organizations from being wildly different with sanctioning of athletes to the rule.

So I'm gonna represent the people that are listening right now that are giving this a hard eye roll, and the hard eye rollers are the people that are going well, these people that get popped for EPO in the endurance world. Right, that's a heavy hitting drug. They need to be sanctioned for more than four years because that drug has an effect on their performance. Outside of that four years and I would actually put myself in that opinion category as a coach, I know that training that I apply to an athlete lasts for more than four years. If I'm doing my job right.

But in addition to that, the scenario that they have in their head is an athlete gets popped for something heavy hitting like EPO. They go into the arbitration that you just mentioned. They present some compelling reason. My meat was contaminated and I was taking this over the counter this that or the other, my supplements or whatever, and they get their sanction reduced, not raised, Like I want listeners to understand. Like, peel the curtain back a little bit on how you saw to either sticks to, we're gonna levy out this four year sanction or reduce it.

Yeah. Well, that's where, by and large, the legal process and arguments come into play, right? So when we're saying, okay, we think the athlete should get a four year sanction, we're, and the athlete challenges that. They may have their reasons for challenging it. We have our reasons, we have science that suggests that they got this performance benefit. It's an egregious substance. You know a whole host of explanations and then it's up to the arbitrators to say, okay, who had the better argument and who are we going to believe? You know it's not a beyond a reasonable doubt. It's to a comfortable satisfaction. That's the legal framework that we operate under. So you know, by and large, if an athlete is not able to argue effectively that this substance, you know, appeared for a non-doping reason, they're gonna get the full sanction.

Where does the benefit of the doubt line up?

What do you?

I mean, the athlete is always gonna say they're gonna come up with some reason and we see this play out in the media all the time. There's all these. You know I can say it. I know you probably can't, but there are all these bullshit reasons why athletes have tested positive for something and they're gonna come to the table with those reasons in a room with USADA, with the science officers and things like that.

And inherently there's going to be a disagreement. Yes, I did this, no, you didn't. When, in deciding what ultimately happens, like in the legal system, there's a burden of proof, right that lies on one side. Where does that lie within this system? Does it lie on the athlete or does it rely on USADA proving that something happened?

Yeah, so great question. So when we have a positive test, it's on the, it's the athlete's burden to demonstrate. That's what I wanted to get at, but in other violations, like use violations or a passport case it's you saw it as burden to demonstrate the athlete doped.

So it's different depending upon the situation. It's depending on the situation.

Yeah, absolutely Okay, and then you know it's my job. One of the things I love about my job is the legal department comes to me and says the athlete gave us this excuse. Tell me scientifically if it's a valid excuse or not. And that's my job is to write a scientific opinion and consult with outside experts. Look at the research that's being done, maybe even do additional research out there to demonstrate whether what we're seeing lines up with the athlete's explanation or it's due to doping. And that's what

I do every day. What's?

the craziest reason you ever heard. I know you probably can't tell me, but I'm gonna ask a question. Anyway, I wanna know the most ridiculous off the wall thing you've ever heard from someone. You could stylize it if you want to.

Yeah, I think the most challenging case is recently and recent mind, and you know I would have never believed this is the intimate contact cases that we've recently had and it takes a lot of scientific evaluation and work to piece together the pharmacology, the pharmacokinetics, how they ingested it, how they were exposed. All these cases, I mean they're analyzed to the nth degree to try to determine whether it's possible and some people would say it's not. I firmly believe, depending on the circumstances, that these were true contamination cases and no athlete should be penalized for that. So those are some of the craziest I mean there's been.

You know, it was in my toothpaste or you know I rubbed up against somebody or you know I think there was one excuse, like I ran by a hospital and EPO splashed on me from the street and you know just crazy stuff like that, but generally those are always.

I wanted to use that, though, as a little bit of an example that it's not like you're just taking the athlete's word for it.

Right.

It's not just like oh well, you know, someone's Koop said that you know he had a contaminated tic-tac or whatever, and you know, okay, well, we believe him. You're actually looking at the validity of the whole situation through a lot of different, very complicated mechanisms that we're not gonna go into. Okay, I appreciate that dialogue. Thank you for entertaining me.

You could tell me the real story out there.

Oh, okay, let's theorize for a little bit. You kind of know ultra running situation right, it's a sport that doesn't fall underneath any sort of governing body, either nationally or international, with very, very, very, very few exceptions, and the community as a whole is trying to figure this out.

The athletes are trying to figure it out. I'm doing my part as a coach to try to figure it out. Race directors are trying to figure it out. Sponsors and brain managers are trying to figure it out. We're not gonna get adopted by something and have a rule system all of a sudden placed over us. We've gotta kind of figure it out. What are the big broad brushstrokes that you would advise the community to look at, as we're trying to get our feet wet and just figure out a solution?

Yeah, yeah, and I think this goes back to you know, one of your very first questions. I think there's four things you need to think about. You know education, testing, science and results management. And so in breaking those things down, I think you know you need a harmonized program. You can't have different rules for every single event, or you know athlete. So having a harmonized set of rules and taking some cues from what's currently working, I think is the first step. And then you need to educate athletes around that. You can't put rules in place and athletes don't know what rules are subject to.

So you know, for example, in the UFC program we didn't even start testing athletes for six months. We spent six months educating those fighters on what the rules were because we knew that was important for them to understand. Once the program hit and we started testing, they were then responsible. So that's how I would outline how you would start. Then you've gotta have a testing program in place that not only has in competition testing but has a robust out of competition testing program. So, athletes, it's almost like an IQ test when you test them in comp Like you're gonna. You know, they know they're gonna be tested because they compete, so they can stop using whatever they're doing and they're using it during training.

So those most highest level athletes in your sport, I would suggest you know an out of competition program on those athletes where they file whereabouts and they are subject to testing anytime, anywhere, and that is a huge deterrent to doping in the sport.

And then, of course, you've got a science component and making sure that you know if the resources allow that you're adopting things like the passport and you're doing some of the scientific things to increase the analysis of samples. So you know, beyond just the basic analyses, having a framework in place to do EPO testing, testosterone testing, some of these things that are likely being used in the sport due to their risk. You know you wanna make sure that you're at least doing some testing of those in intelligent fashion. And then the results management of that is, of course. You know you don't wanna put that in the hands of you know your governing body or your race organizers. You wanna have an independent body like you saw to governing that and that protects the sport, it protects the athlete and it makes the process consistent from you know athlete to athlete if they test positive.

Those are the bare minimum. Would you recommend in your professional opinion and you're the expert here finding a solution that doesn't have one of those components or has a really shitty part of one of those components? And I'm trying to work down to the practical piece of it, so we can get together the education and the testing and the screening. But results management we don't know what we're gonna do with. Let's just throw the solution out there.

Well, I think those are the basic components, because without any one of those, what you're gonna open yourself up to is a lot of criticism. Right, you're gonna. People are gonna say, well, you're trying to do anti-doping, but you're missing a vital component of this which is either unfair to athletes or it's totally ineffective, or it's not financially, you know, viable, because you can't have a race director funding the results management of a case that, if an athlete wants to take it to the highest levels of adjudication, it might cost tens of thousands of dollars. I'm sure race organizers don't wanna be on the hook for that after the fact.

I'm gonna evoke a quote from I'm gonna keep this person anonymous because I probably wants to be anonymous at this conversation but when we were originally talking about this kind of within USADA, you would tell me that you're better off having those four components and having a solution that meets the minimum part of those four, then removing one entirely in a way to kind of get the program off the ground, like you're going to be stuck with initially having imperfect solutions, but if those imperfect solutions hit all those categories you have something to build off of.

And hopefully I've given you like a flavor, for you know, on the surface, anti-doping may seem like just collecting a sample and analyzing it, but there's a lot that goes on behind the scenes that you know. It's vital in order to have a fair and consistent and a confident you know athletes confident in the process. If we had laboratories knowing whose samples they analyzed, you know there's a hole there that could be exploited right. So it's really you know that framework is so important.

We're gonna leave it at that. First off, I really appreciate your time. This has been over a year in the making.

It's awesome that I've finally been able to talk to you.

Finally, I will have explained that backstory in the intro so everybody knows, but to leave the listeners, and this is particularly pointed at the athletes. If they want to get more educated on this whole suite of stuff, where can they go to either in USADA's website or anywhere else to get that education?

Yeah, so we've got a comprehensive website that you know. If you go to the athletes section, a lot of these aspects that we've talked about today are outlined and athletes can find about more about the collection process or results management or look at our education. So, yeah, I would encourage you to go directly there. And you know World Athletics as well as the International Sport Body. They do great work as their anti-doping team there is awesome. So if athletes are interested to see what's going on internationally, that's another resource.

Yeah, dr Matt, this is great man. I really appreciate your time and I appreciate what you do within your organization and what your entire organization does for sports. I think I could speak for the sporting community and I'm just greatly appreciative of it. And I was here. I moved to Colorado Springs in 2000. I saw the transition from NGB's run in the show to USADA running the show and I honestly think that, despite all the criticism that gets thrown around every once in a while, that's one of the most impactful transitions in all of Olympic sport, that singular transition right there, and it has made such a big impact. It's always going to have bumps in the road, but seeing it from the ground level and what it did, how it like transformed cultures within sports, has been absolutely amazing. You're a big part of that and we thank you for that.

Yeah thanks, Jason.

All right, folks, there you have it. There you go. Much thanks to Dr Fedorik for coming on the podcast today. I appreciate everybody that made it through the intro. That was normally a long one. I usually like to get through those a little bit quicker, but I feel that the caveats are necessary because otherwise, if I don't say anything, people are going to be like why don't you say anything? And I just want to get it out on the all on table because this information is super important. I do think that this aspect is super important for the community as a whole, so stick around.

Next week we've got Paul Demio. That's on June 3rd. That will be released. The next week we had Lisa Roberts, who got kind of entangled in this whole thing with Western States. That's on June 10th. And then June 17th, charlie Ware, who is my hero. He actually decided to do something about this. God bless his soul. We go through that whole arc of what he tried to do and what the pitfalls are and how people in the community can pick up on his work, which is super important. That is coming out June 17th.

And then, finally, a great conversation with Dylan Bowman and Mari Frioli about what they think is community members what they think antidoping solutions should

look like. So I hope everybody is looking forward to the next series of podcasts that I'm putting out. I really appreciate everybody who has come together for these. I did put these together kind of all in sequence so they're going to be released while I'm out on the Pacific Crest Trail with Timothy Olson, and what I really wanted to mention with that is I hope the community uses this as a galvanizing point and creates some sort of conversation around these issues because, as I have mentioned and as I will continue to mention over the course of the next several podcasts, is that it is going to be up to us. Nobody's going to save us but ourselves.

And the initial part in all of this before we start going down the rabbit hole of do we want to ban people for life or let everybody dope up to the gills or whatever solution kind of emerges, before we go down that part of determining the finer bullet points of antidoping solutions, let's first take pause, educate ourselves on all of the different complexities of this particular issue, of which there are many. Educate ourselves first and then come together as a community and hammer out the solutions. Let's take some time and get some education underneath our belts. I hope that this podcast and the next several podcasts serve as an initial point for all of those educational pieces. That is it for the podcast today. Let me know what you think on social media. I'm sure it'll all fly around, but I hope you guys are looking forward to next week and the week after that and the week after that. As always, we'll see you out on the trails.