How to Identify a Doper

“If you look at East German athletes who doped in the ‘70s and ‘80s, they showed up at swim meets and were visually larger than their counterparts, and people were like, ‘What’s going on here?’” says Dr. Matthew Fedoruk, the U.S. Anti-Doping Agency’s Science Director. He’s in charge of guiding the agency’s science, testing, results management, and supplement areas. I called him to ask how easy it is to visually spot a doper after spending most of July wondering if those super skinny Tour de France riders and superhuge CrossFit gamers were, um, all natural. “But that kind of thing I don’t think happens—I won’t say ever—but not so obviously as it did before,” he says. “Because people aren’t just using steroids anymore.” 

That’s because performance enhancement now goes way beyond increasing strength. Newer, more sophisticated substances can give athletes a mental edge, promote ridiculously fast recovery, and generally rewire the body from the inside, allowing it to transport oxygen more efficiently, for instance. “There’s no way you could tell by looking at somebody that they have more red blood cells,” Fedoruk says.

Still, when I press, he fesses up some of the visually undetectable things dopers are doing these days, careful to highlight the associated health risks. He should know. Last year, USADA handed out 34 sanctions and performed 9,497 tests, the majority of which were on cyclists (1,454 tests) and runners (2,205 tests). That’s 1,007 more total tests than in 2012. 

In particular, Fedoruk has seen an increased use of EPO, “a hormone that boosts oxygen levels in the blood by prompting the bone marrow to produce more red blood cells,” as one of our writers found out when he volunteered to inject the stuff more than a decade ago. Back then, experts blamed EPO for a rash of pro cycling deaths. Today, athletes are still using it, though the pros have switched to more refined intake formats like microdosing. But it’s not without side effects; EPO can thicken your blood, increasing your risk of cardiac arrhythmias and pulmonary embolism. 

Some athletes also use insulin to promote weight loss, Fedoruk says, as it changes the way the body metabolizes sugar. (If you’re not diabetic, using insulin puts you at risk of hypoglycemic coma and death.) There’s also been a rise in TUEs, or therapeutic use exception applications for stimulants traditionally used to treat ADD, like Adderall, Fedoruk says, which can increase focus. 

That’s not to say people don’t still use steroids. “Traditional anabolic steroid use is still surprisingly quite prevalent,” Fedoruk says. (Just peruse USADA’s sanction list for proof.) Like the drugs mentioned above, they’re relatively cheap and easy to come by, making them a favorite among cheating amateurs and pros alike. And because the right steroid regimen helps endurance athletes become more lean than bulky, it can still be difficult to tell at a glance if your newly-cut nemesis is doing something nefarious, or simply exercising more self-control in the face of cronuts.

There’s one more drug Fedoruk didn’t mention that’s become popular among pro cyclists. AICAR has been touted as exercise-in-a-pill, a compound that can increase endurance and power-to-weight ratio by making muscles burn fat rather than sugar for fuel. This could make a person appear skinnier as well. (So my suspicions about super thin Tour de France riders weren't unfounded.) But the drug costs close to six figures which means the likelihood that the guy you’re racing against is using it very small. Humans, Velo Nation estimates, would have to take 500 milligrams of AICAR per kilogram of bodyweight every day for four weeks just to match the amount mice took to improve endurance performance in a groundbreaking 2008 study (the drug was originally created to protect against cardiac ischemia). At an estimated $80 to $100 per gram, that would cost a 160-pound athlete $2,900 to $3,625 per day, or $81,000 to $101,500 for the month. And that’s just a wild estimation. There is “no research whatsoever to show how much and how long you need to take it to get an effect, so figures are hard to determine,” Velo Nation writes. 

Yet while visual cues may not be the most useful method for identifying dopers in today’s PED-savvy world, vision-plus-intuition can prove a reliable tool. “Peers are very good at determining, ‘Oh this performance doesn’t necessarily fit into the pattern of what we would expect from this person,’” Fedoruk says. 

And if you are suspicious enough, you can  always tip off the doping police with an email, call, or anonymous tip to USADA’s Play Tip Center. (The Tip Center is also useful if you’re concerned about someone’s potential drug use because the side effects of all of these drugs can be life threatening.) USADA can test any athlete who is member of a U.S. sport governing body including USA Cycling, USAT, USATF, etc., Fedoruk says. 

The takeaway? There is no such thing as a typical doper. Nowadays, they come in all shapes, sizes, colors, and ages. You can make up your mind about someone. But who you call about it—your buddies for a good gossip session, or USADA—is up to you.