This article is part of a ParaSport News series of articles looking at doping in the Paralympic, Deaflympic and disability sports movement.
The history of doping and doping controls in disability sport dates back to the early 1980s. This lagged behind Olympic and professional sport by about 10 to 20 years, with the first reliable testing methods for testosterone and anabolic steroids being developed in 1974. The 1976 Olympics subsequently including bans for these substances and in competition testing for them.
The first doping controls reported in disability sport occurred in 1981 at the World Deaf Games in Cologne, Germany. For wheelchair sports, the first reported doping controls took place at an International Disabled Sports Association (ISOD) competition in Oslo in 1983, though the samples from the competition were never tested. There were doping controls the following year at the 1984 Stoke Mandeville Games, with 8 sportspeople getting their urine tested and all results coming back negative. Wheelchair powerlifting had also formally developed anti-doping policies by 1984. They were one of the first Paralympic specific sports to independently create and adopt their own anti-doping policies.
The next reports of doping control in disability sport took place at the 1986 World Championships for athletics, swimming, archery in Gothenburg, Sweden. This competition is where the first documented doping control offenses occurred in disability sport. Several hundred samples were taken with four positive results involving amphetamine-case and three offenses with stimulants.
The 1988 Summer Paralympics in Seoul were the first Games to have doping control, which was handled by International Coordinating Committee of World Sports Organizations for the Disabled. Around 50 sportspeople were tested at these Games, with 1 positive result.
Total doping sanctions in wheelchair powerlifting by year.
In 1989, the International Paralympic Committee (IPC) was founded. Its creation would aid in unifying different parts of the broader disability sports community by bringing together athletes with different types of disabilities with the general exception of deaf sport. The creation of the IPC also assisted in bringing more consistency policy wise in terms of doing.
Around the same time that the IPC was founded, a few countries were beginning to develop doping control policies encompassing disability sports on the national level. One of these countries was Australia. By 1990, sportspeople with disabilities were active stakeholders in the anti-doping process in the country. In 1992, they held a workshop for Barcelona bound Paralympians in Sydney about the doping process. The Australian Sports Drug Agency (ASDA) undertook a review to address special needs of sportspeople with disabilities as it pertained to doping issues. National testing took place in 1991 with around 25 athletes tested nationally with no positive results. In this early period, it covered both sportspeople with physical disabilities, vision impairments and intellectual disabilities.
Germany was another country developing national anti-doping policies in the late 1980s and early 1990s. They created their para-sports anti-doping program in 1992 when the German Paralympic Committee instituted doping controls in partnership with their national anti-doping agency.
Total doping sanctions in unidentified Paralympic sports by year.
International Stoke Mandeville Wheelchair Sports Federation, the precursor to the International Wheelchair & Amputee Sports Federation, formally created a doping policy for all sports under its purview in 1991. It was this policy would be in place for the 1992 Summer Paralympics in Barcelona, with doping control being managed by the International Coordinating Committee of World Sports Organizations for the Disabled. There are conflicts in reports in terms of how many people were tested and how many positive tests occurred. One report said 4 powerlifters and one wheelchair basketball player where caught doping, while another said 1 wheelchair basketball, 1 judo and 2 athletics competitors were caught. What is abundantly clear though is that the first positive doping tests occurred at the 1992 Games, and these games cost medals. David Kiely was an American wheelchair basketball player who tested positive in an in competition test right before the gold medal game against the Netherlands. His positive test result led to an automatic forfeiture later of the game by the United States who came away empty-handed despite winning the game.
Following Barcelona, some national anti-doping agencies continued to try to address issues related to doping controls in disability sport. This included Australia, where integration continued. In 1993, the Australian Confederation of Sport for the Disabled, Special Olympics Australia and Australian Deaf Sports Federation were all seeking assistance from ASDA on doping policies. One concern in 1993 was the issue of transplants, and the need for deaf athletes to be notified in advanced so they could be properly communicated with. Australian Confederation of Sport for the Disabled finalized their policy in 1993. The Agency Regulations were amended in July 1993 to address issues previously identified, including allowing a person associated with the athlete to be present to assist in sample collection. Issues around the need for therapeutic use exemptions were beginning to be addressed. Around 15,000 copies of the “Drugs in Sport Handbook” which included info on drug testing for people with disabilities were distributed in 1993/ 1994.
Doping milestones in the Deaflympics and Paralympics.
Doping control continued in the early and mid-1990s with the frequency of testing in and out of competition starting to increase and more drugs being tested for at international competitions. Doping control was in place for the 2nd Lawn Bowls Championships for the Disabled in Adelaide in April 1993 with testing being managed by ASDA. Doping control was also in place for the Melbourne, Australia hosted World Disabled Weightlifting Championship in April 1994.
Autonomic dysreflexia, more commonly known was “boosting,” had become part of Paralympic doping by 1993 with allegations wheelchair athletes were engaging in the practice to trigger elevated hormones from that fight-or-flight response to improve their performance. Reports suggest that engaging in the practices leads to a 9 to 10% increase in performance. It was first noted as potentially taking place at the Paralympics at the 1994 Winter Paralympics in Lillehammer, though it was not tested for and no one was banned for being suspected of using it.
The mismanaged 1996 Summer Paralympics had doping control, but amazing had zero positive test results despite over 300 athletes having been tested in competition and in pre-Games out of competition testing. Most of the pre-Games testing in the lead up to Atlanta was done in only a few sports including athletics, swimming, powerlifting and cycling. No clear explanation has ever been provided as to how the Atlanta Games managed to have zero positive tests given that positive tests occurred later in 1996 and there had been at least 2 positive tests the year before, and at least 4 positive cases in 1993 and 1994. The number of identified positive doping incidents by ParaSport News in 1997 and 1998 in disability sport is zero.
Amendments were made to global anti-doping policy in 1997 that impacted the disability sports community in the Commonwealth of Nations. The following year, the International Wheelchair Tennis Federation (IWTF) was fully integrated into the International Tennis Federation, and became subject to their doping controls.
In 1999, the World Anti-Doping Agency was created. That same year in the lead up to the 2000 home hosted Games, the government of Australia increased funding for out of competition testing of Paralympic sportspeople by 37%. Despite increased visibility of anti-doping efforts in Paralympic sport, doping internationally continued to be something that many experienced only in Games Years. From 2000 to 2009, peak years for in and out of competition on the national level occurred during Paralympic year. In the case of the French, this was a 3 to 4-fold increase compared to other years in the same period. From 2000 to 2012, the overall level of positive doping results based on total doping controls was less than 1%, with the highest rate occurring in powerlifting. There were at least 60 cases of doping in that period according to one report, with 37 of these being in powerlifting.
While not banned, boosting was reportedly tested for at the 2000 Summer Games in Sydney by choosing random wheelchair sportspeople. There are no reports on the results of these tests.
In 2001, Paralympic doping controls were formally put into place in the United States on a national level for the first time. That same year, the European Paralympic Committee (EPC) ran a campaign called “Doping Disables”.
In July 2001, WADA and the International Paralympic Committee have signed an agreement to formalize their collaboration in fighting doping in Paralympic sport. The cooperation program included WADA Independent Observation of the doping control processes for the 2002 Winter Paralympic Games in Salt Lake City, and the development of a testing service agreement for in and out-of-competition doping control.
Starting in 2001 and continuing to 2010, French rules began to change with sports federations initially handling positive national level doping tests inside their federation base on internal standards. These standards eventually became national and in compliance with international standards for doping that evolved with those international standards. National sports federations could no longer set their own doping standards that were not WADA compliant.
While the United States and France had finally gotten on board a year earlier with a national doping control program, not all countries had their national anti-doping agencies overseeing their NPCs in 2002. The IPC and WADA were lobbying to change this at the time to make doping control more frequent and ensure greater control in reliability of testing. This was being supported on the continental level. That year, the EPC organized a program in cooperation with the IPC and the Slovak Paralympic Committee where they discussed strategies for the harmonisation and effective delivery of anti-doping programmes in the European Union (EU) Member States and Candidate States.
Comparable level of sanctions by disability sport governing organization since 1986.
At the 2002 Winter Games, WADA had 5 independent observers monitoring all aspects of doping control. Athlete passports were also use at the 2002 Games for doping control purposes. The first positive doping test for the Winter Paralympics occurred at the 2002 Games, with German Nordic skier Thomas Oelsner.
In 2003, the IPC signed the World Anti‐Doping Code along with around 1,800 delegates from 80 countries. That year, the IPC also gained a seat on WADA’s Board.
The doping rules in 2003 as stated by the IPC Medical Committee reaffirmed that there does not need to be proof that the drug gives a competitive advantage when dealing with a positive doping sanction. Presence alone of banned substances is what matters. This had been an issue that had come up in disability sport related to Court of Arbitration of Sports (CAS) appeals, where people had tried to claim that lack of performance enhancing effect should negate penalties. Around this time, WADA would make clear that there were three reasons for drugs to be on the prohibited use list. These three reasons were performance enhancing effect, moral turpitude for use and drugs causing impairment that may result in an athlete coming to harm in competition.
Another change that took place in 2003 was a requirement by the IPC that in order to protect the athletes’ fundamental right to participate in doping-free sport, all NPCs and sports wishing to take part in the Paralympics must declare their acceptance and recognition of the WADA Code. After that, all new IPC members needed to join while being in compliance with WADA Code.
Doping controls nationally in the United States were also improving in 2003, with Paralympic sport in the country starting to use US Anti-Doping Agency (USADA)’s OOC program. As part of this, USADA tried to meet with as many Paralympic sportspeople as possible, to give a face to doping control in the country and as part of new outreach efforts. In 2003 in the United States, cycling was the most OOC sport checked, followed by athletics, and then powerlifting.
Deaf sports had not really changed much from the early period in the 1980s when they first appeared to have developed an anti-doping code. They were late to the game when it came to aligning with international standards, not becoming a WADA signatory until 2004. Prior to their signing, there was no official anti-doping regulation in place for the Deaflympic Games apart from agreements between host cities facilitating international Deaf sporting events and the ICSD.
The IPC Anti-Doping Code came into effect on February 1, 2004. The code is a unique code in the world of sports governance as it applies at all IPC sanctioned competitions, meaning at all 13 IPC organized sports’ competitions and at Paralympic Games. This is in contrast to the IAAF, which governs only one sport. In 2004, as an International Federation (IF), the IPC was only the second IF in the world to release a WADA compliant Code. That year, the IPC rules allowed retroactive application for TUE, but this was only generally for emergency situations. The IPC also utilized blood testing for the first time 2 in 2004. That year, cannabinoids (marijuana) were added to the list of prohibited items for the first time by WADA and other anti-doping authorities. In the following years, a lot of disability sportspeople would get 1 month to 1 year bands for marijuana use until the minimum amount was raised in 2013 and out of competition testing for marijuana was stopped. 2004 also saw the IPC formally ban the practice of boosting.
Doping cases were continuing to occasionally make their way to CAS. One case from 2004 showed issues with transition period between banned substances, with one athlete getting no sanctions because of the substance was not explicitly mentioned on the list of prohibited drugs. Another CAS case that year Andrew Brockman was a British equestrian in 2004 who also got free of sanctions because the IPC rejected a TUE request that WADA subsequently overturned. At CAS, Brockman and WADA were sided with over the IPC.
Doping controls were again in place for the 2004 Games in Athens. The Games were the first held under the new anti-doping rules that came into effect earlier in the year. WADA sent Independent Observers and an Athlete Outreach team to the Paralympics. WADA worked closely with the IPC on doping controls for these games. Slovak tandem cycling pilot Jurak Petrovic became the first victim of a positive doping result, his blind cyclist Vladislav Janovjak his silver medal. By the end of the Games, over 515 sportspeople who undergo some form of in competition doping control among the 4,000 sportspeople competing with 10 results coming back positive.
The 2006 Winter Paralympics were the first major competition to use the ADAMS system. ADAMS is a web based database management system developed by WADA to help stakeholders worldwide coordinate their anti-doping activities. This was a major test for how well the system worked, and came about because of the IPC’s close relationship with WADA. 242 doping control tests took place at these Games in Torino with zero positive results. Throughout the year, 620 doping control tests were administered by the IPC with two tests coming back positive.
Boosting was first tested for at the 2008 Games, with between 20 and 37 athletes tested and 0 positive results. The practice was covered by the anti-doping rules. Testing included looking at an athlete’s demographics (gender, country of origin), classification and blood pressure measurements. A 2009 report claimed boosting was most common in wheelchair rugby, followed by wheelchair marathon and then other long distance races. In 2012, IPC chief medical officer Peter Van de Vliet estimated that as many as 30% of Paralympians with spinal cord injuries may have done boosting at some point in their career. That same year, the French national anti-doping agency acknowledged boosting was an issue they too were looking at. The issue was that it is very difficult to test for.
From 2007 to 2012, there were 13 positive doping tests nationally in France for disability sports. 1% of all tests given came back positive. This number was in line with other figures from the period estimating positive results in the 1% and sub-1% range. In 2011, a review of doping compliance across all international federations by WADA found that the IPC and 6 of the 8 Paralympic Sports Federations were compliant. 2 were not.
The 2013 Summer Deaflympics had their doping control handled by SportAccord after the ICSD contracted this task out to them. There were 12 positive doping results at those Games, down from 13 at the 2009 Summer Deaflympics.
In 2013 and 2014, a review of doping rules took place in the IPC. Among the things on the table at the time were financial sanctions for NPCs with established doping problems. This was discussed because of concerns that some countries, specifically countries with powerlifting programs, were not doing enough to address doping problems. On January 1, 2015, WADA rules changed and doping offenses that resulted in 2 year bans now resulted in 4 year bans. This was to try to further discourage people from doping.
A WADA Report about the 2014 Sochi Paralympics suggested there might have been government interference with doping results in favor of Russian sportspeople. Craig Spence said they would investigate if they believed anything came from this. There was no follow up in the media regarding this. A year later, Russia had also hosted the 2015 Winter Deaflympics, where the Games were completely clean without a single doping sanction from in competition testing.
Going into Rio, the IPC was considering changing the way to detect boosting, lowering the 180 mm of mercury threshold to detect it.
The data collected by ParaSport News for this report is available here for the benefit of other journalists and the sports community.