Interesting takes from WTO and USADA as it seems to contradict the majority opinion in other doping threads on this forum.
I think that is because people with hot takes on forums don’t have a sense of how this works at the highest levels, and what the priorities of these agencies actually are. I promise you, it isn’t to catch age groupers abusing ADHD medication.
In a previous (non-cycling) life I was an international level athlete in the WADA/ADAMS testing pool, required to submit whereabouts information, regularly underwent in and out of competition testing, biological passport analysis, etc. In the twilight of my athletic career I also sat on numerous athletes’ council boards, and represented athletes to NSOs, WADA, the IOC, etc. In other words I’ve had extensive interactions with doping control programs both as an athlete, but also on the administrative side.
The number one thing people need to understand is that doping control is a massively resource constrained operation. I think everyone understands that testing is expensive, but the number of touch points involved for a basic out of competition test can be staggering. Just at a high-level:
International/national level athletes in the testing pool need to submit their whereabouts quarterly, describing where they are going to be every single day for the next 3 months. This includes training times, travels days, and competitions. You also need to submit a 1-hour mandatory period (not everyone is subject to this) where you absolutely will be available at the location described. Essentially what this means is that if doping control tries to get you at home today, but you are out for groceries, it’s not the end of the world. However, if you put your mandatory period between 6am and 7am (which many athletes do), and you am not available during that time, things get more serious.
Doping control officers are trained individuals, not randoms off the street. And depending on your national WADA affiliate’s policies, two or more officers/chaperones may be required during sample collection (in Canada, CCES always required two, USADA did not at the time, but this may have changed since I retired). If the doping control officer is not the same sex as the athlete being tested, then a chaperone of the same sex is required to observe sample collection (i.e., watch you pee). If you are in the biologic passport program, and you are getting blood + urine samples collected, then a trained phlebotomist/nurse also needs to tag along. More and more the doping control officers are getting trained in blood sample collection, and the newer testing kits have made this process somewhat less of a hassle, but it’s still a blood draw, and (at least when I retired) it was still very common for a specifically trained individual to be required for sample collection. Finally, as an athlete you are also entitled to have an elected representative present (coach, friend, etc.) to observe the entire procedure.
So just to recap at this point: It’s 6am and potentially 3 people show up at your door:
- The doping control officer.
- The chaperone, either because your WADA affiliate requires it, or because the doping control officer is not the same sex as you.
- The phlebotomist.
From your end there is also:
- Your elected representative if you so chose to have one.
- Yourself - the athlete being tested.
We’re 5 people deep, and we haven’t even begun the test yet!
Depending on where you live/train, doping control officers may not necessarily be available in your area 24/7 so they may need to travel in, and the time of the other required individuals such as the phlebotomist will need to be booked.
The testing procedure / sample collection itself is not an instantaneous process. Part of why many athletes choose the early morning for their mandatory period is because they are going to be woken up by the door-knocks (and man do they knock hard!) of doping control, and most people have some level of urinary urgency as soon as they get up in the morning. Sometimes you are not so lucky, and you have gone to the bathroom minutes before they show up, or they come at some other time of day, or show up during practice and you are dehydrated. Some people, understandably, have a near impossible time peeing while someone is staring at their genitals. This is actually more common in (for lack of a better term) lower-level athletes who aren’t regularly tested, and the whole testing process itself is a bit nerve wracking and overwhelming. However, there are absolutely world-class athletes who get tested dozens of times per year who have this problem every single time. For in competition tests, it’s extremely common for people to sometimes take hours to pee, especially for endurance sports.
In addition to the sample collection itself, there are several formalities around the procedure. ID verification, paperwork… lots of paperwork, even sample kit selection. What is sample kit selection? When a doping control officer shows up at your door they have a giant duffle bag filled with testing kits. You the athlete choose the kit you want to use, break the safety seals, etc. This is one of the many parts of the process designed the guarantee confidence, prevent tampering, etc.
Speaking of the kits, you aren’t peeing into mason jars from CVS. These are precision manufactured, tamper-proof, custom kits specifically designed for this process. Those of you who have seen the documentary Icarus might have a cynical view on the tamper-proof nature of these kits, but just know they are constantly being iterated upon, and it took a coordinated effort from the KGB + compromised lab directors to successfully open and re-close the bottles. Since then, the bottle locking mechanisms have been further improved.
Doping control officers also need to cary a few instruments with them to test the specific gravity and pH of your sample. If the specific gravity is too low, i.e., your sample is too dilute because you’ve been pounding waters in order to be able to pee, you need to start the entire process again from zero. This often involves selecting a new kit, new paperwork, and doing what’s called a “partial” sample collection form.
Once everything is done and dusted, forms signed, samples separated into A/B, and sealed into their containers, they need to sent to the lab. The mere transport of these samples is a non-trivial exercise, and two big things need to be controlled for: The first is security/chain of custody - there are myriad control points that go into this from the design of the kits themselves, to the shipping containers, to WADA procedures and policies. The second is just ensuring sample viability - these are biologic samples, so things like temperature and time-in-transit on their way to the lab are critical factors that need to be controlled in order to sustain their viability.
WADA accredited labs are not a dime a dozen. Most countries have no WADA accredited labs and need to utilize labs in other countries. The US has two WADA accredited labs: UCLA and Salt Lake. These labs operate at the absolute highest standards of practice, and have the most sensitive equipment and highly trained individuals (read: expensive) for detecting metabolites in urine and endocrine levels in blood.
Back when I was involved the average cost of all this was estimated to be around $500 per test. This is virtually guaranteed to be higher now, as it’s not a basic economies of scale problem where we get to continue performing the same exact tests every year at ever reducing marginal costs. Doping sophistication is constantly improving, meaning the science required to detect this is needs to evolve with it. This means more sensitive equipment, new analysis techniques, new test development, experts in more fields (endocrinology, pharmacology, chemistry, etc.)
Phew that was a lot! There is much more involved, but I really just want people to have a high-level sense of how many moving parts there are for a standard part of doping control programs. Roughly 10,000 to 15,000 out of competition tests are performed globally by WADA affiliates every month, the resources required to bring this to bear are astronomical. This doesn’t even include in-competition testing which, depending on the month, can sometimes double or triple these figures.
Bringing this all back to the TUE for an age grouper… The best (but still not very good) analogy I can make here is it’s a bit like emailing the Department of Justice to let them know that your vehicle registration has expired, but there are legitimate extenuating circumstances about why this happened, and you will be taking care of it immediately. Officially they care, and maybe they will say in accordance with the National Traffic and Motor Vehicle Safety Act you need to take care of this immediately. But in practice their position will be to do nothing, they aren’t going to redirect the FBI to pre-emptively deal with your case. If you happen to get pulled over - which is extremely unlikely in relative terms - you will probably need to explain yourself, etc., but otherwise we are relying on you to do the right thing here because our finite resources are otherwise consumed dealing with serious crime.
I am oversimplifying but TUEs broadly have two flavors: pre-emptive, and retrospective. The majority of cases, even for world-class athletes in testing pools, fall in the later category. There are a lot of things that are prohibited that people do not realize. Just getting an IV hooked up to you is a prohibited method in many contexts (let alone potentially prohibited substances contained in that IV), but is obviously acceptable given a legitimate medical need. Now if you go the hospital and one of the first things they to do you is hook an IV into your arm, they are not going to call USADA first to check if it’s okay. They’re not even going to check if it’s okay after the fact. But, if for whatever reason this comes up post-hoc, you can leverage the hospital records in your TUE. Just due to the standard of care in many medical scenarios, and the administrative overhead required for TUEs, it’s just not practical or even possible in most cases for these to be done pre-emptively. Where and when they need to be done pre-emptively is really a whole other discussion and goes into anti-doping code policy specifics, but even the majority of these are similar to the response @batwood14 received which is “okay, thanks for letting us know, if this comes up in a test we’ll pursue it at that time”.
Meanwhile in those other threads you have most people saying stay home, when you come in 708th place you ruined the event for the person in 709th.
There is a lot of virtue signalling, hand wringing, and armchair experting on forums across the internet by people who have never had to truly participate in an anti-doping program (either as an athlete, or on the doping control side) beyond competing in an event that had some lip-service level of doping control present or maybe being selected for a test once at such an event. The reality is that most age-groupers and weekend warriors will take something or do something in the course of a year that is either a prohibited substance or method, without realizing it, be none the wiser, then get online and start talking about how ridiculous it is that someone in their Cat-5 race is on Concerta.
Most people are not trying to cheat, and are taking medications to address a legitimate medical issue. They are probably being taken in a way that does not confer a performance benefit relative to whatever issue they are managing, i.e., a diabetic taking insulin. When it comes to people who are trying to cheat at the age group level, my (perhaps somewhat controversial) take on this is really just - whatever man, you do you. People should mentally reframe this and think about it the same way they would think about someone cheating in a local golf club tournament by lying about their score or moving their ball. Is it annoying? Yes. But more than anything it’s just sad and somewhat hilarious that a mediocre athletes who is paying (read: not being paid) to do a leisure activity is cheating at it. It’s a reflection on a deeper set of insecurities and problems that person is dealing with, and overthinking their issue, legitimate or not, for yourself is not worth it - control the variables you can control, ignore the rest.
I have been paid to do sport. It has been my livelihood. I know more than most what is to have something actually taken away by people not respecting the rules. At the level I was at, which I’ll describe as “working-class” athlete, meaning a few positions +/- made a big difference in race winnings, bonuses, potential sponsorships, team selection, and my general ability to sustain myself - the material impact was real. I never let this interfere with my passion for sport or pursuit of excellence - you shouldn’t either.
tl;dr - Do the right thing. Don’t cheat. It’s always better to ask and inform (like @batwood14 did) your relevant NSO / governing body / anti-doping institution. Unless you are in the testing pool or otherwise national/world-class you are probably not the target, but if get tested something does come up be prepared to explain yourself (with medical documentation and records).