The 2006 Winter Olympics in Turin have been hailed as one of the most successful Games in recent times, with excellent competition and the establishment of some Olympic firsts. The biathlon featured the first mass start in Olympic history, a dangerous undertaking given the number of skis vying for position. Some countries also won their first gold medals in particular events, including Japan (ice skating) and China (freestyle aerial skiing). The games were also remarkable for the low number of positive drugs tests from a total of more than 750 tests completed. In fact, the major controversy this time was the discovery of doping equipment at Austrian training camps, including blood transfusion kit, which led to 10 athletes being tested. The find illustrates the sophisticated advances made by drug cheats over the years. The use of anabolic steroids and stimulants has been supplemented by blood doping methods to increase the number of red blood cells and by the injection of "natural" substances like erythropoietin, that stimulate the body to produce more red blood cells. The use of biological compounds as dopants is especially difficult to detect. Unearthing drug cheats is set to become even more problematical with the dawn of gene doping, in which athletes undertake gene therapy to improve performance. Genetic breakthroughs in medicine can easily be twisted to provide an athlete with an unfair advantage. It is easy to see how unscrupulous sportspersons could manipulate a gene treatment that counters muscle degeneration to build up their own muscle. As Gary Wadler, renowned authority on performance-enhancing drugs and a committee member of WADA, lamented: "In the world of doping, milestones become millstones." Although it might seem to be a modern curse, taking performance-enhancing drugs dates back to the Roman era and beyond. Gladiators used stimulants to counter the effects of fatigue and injury. In the early 20th century, competitive athletes were also taking stimulants. The winner of the 1904 Olympic marathon took raw egg, strychnine and brandy, all legally, to help him through. Heroin and cocaine were widely used, along with caffeine, until they were redesignated prescription drugs in the 1930s. Strychnine was also popular until the introduction of amphetamines. It might seem remarkable that these were allowed, but human drug testing in sports did not become established until the latter part of the last century, even though horses had been tested since 1910. The use of strychnine as a stimulant may appear reckless, since incorrect dosages lead to poisoning and death, but it has long been used as a sports drug and even longer as a homeopathic medicine. Dried seeds of the tree Strychnos nux-vomica are one of the most popular preparations, used largely as a tonic and to treat digestive complaints. The main constituents are the alkaloids strychnine and brucine. Strychnine is still on the WADA prohibited list, even though it is rarely detected as a sports drug. However, athletes who take nux vomica might test positive for strychnine. As such, it is important that strychnine can be detected in urine after taking over-the-counter preparations to see whether it results in false positive doping cases. Scientists in Belgium had previously developed an LC/MS method for the detection of many doping agents in urine, including strychnine. Now they have adopted this method to measure strychnine concentrations in the urine of volunteers who had taken a single dose of a nux vomica liquid preparation, equivalent to 380 micrograms of strychnine. Peter Van Eenoo and colleagues from the Doping Control Laboratory at Ghent University tested urine samples collected 2-48 hours after administration. Following a simple extraction procedure with ethyl acetate, the urines were analysed by LC/MS/MS with atmospheric pressure chemical ionisation. One unique transition in the product-ion spectrum of strychnine (from m/z 335 to 264) was monitored and the area of the product-ion peak was measured and converted to concentration via a calibration graph. The characteristic peak tailing observed for basic compounds on silica-based reversed-phase columns was avoided by replacing with a cyanopropyl column. The linear range of the calibration graph covered 1-100 ng/ml and method accuracy was excellent at 1.3-4.4%. In the four volunteers, strychnine was detectable for more than 24 hours after ingestion. Their urinary strychnine excretion profiles had roughly the same shape but the maximum concentrations observed varied greatly from 23 to 176 ng/ml. These levels would not be detected by the methods routinely employed in toxicology. Clearly, the use of over-the-counter preparations of nux vomica by athletes would be picked up by doping control programmes and lead to false positive identifications and accusations of cheating.





A gray area exists between real drug cheats and those who inadvertently take banned substances via medicinal preparations A gray area exists between real drug cheats and those who inadvertently take banned substances via medicinal preparations