The MPCC group has called on WADA to ban Tramadol and to impose stricter regulations of corticosteroids in an open letter. The idea is noble but the method of an open letter seems fruitless. What if cycling’s stakeholders could be “nudged” into adopting these measures? This week saw Richard Thaler win the Nobel Memorial prize for economics for his ideas on prompting behavioural changes and maybe there are lessons that can be applied to the pro peloton.
Tramadol is a potent painkiller with side effects from nausea to addiction. There’s no data on its use but speaking to cyclingnews.com, Slipstream medic Prentice Steffen said “We got a letter back from WADA saying that they were going to continue to watch for [Tramadol] and that they were getting a lot of positive tests for it, particularly in cyclists”. If you need a painkiller this strong then you have a chronic issue that suggests you ought to be taking time off work and probably shouldn’t be racing a bicycle but obviously this isn’t stopping use and abuse.
It is in the peloton’s collective interest to end Tramadol use. If a rider uses a banned substance they may cheat others from success but with Tramadol they put everyone’s health at risk. The medicine comes with advice not to operate heavy machinery and to be aware of effects like blurred or even double-vision, the last thing you want when trying to pilot your way down the Poggio. Bad enough on a solo ride but a risk for a peloton. The MPCC member teams have agreed to avoid it.
Similarly the MPCC has a code for cortisone use. Riders on member teams are not allowed to use it in competition. They test for cortisol and riders with low levels are advised to stop racing. Low cortisol levels are indicative of cortisone doping (and approved cortisone use by a Therapeutic Use Exemption) or a health problem, perhaps a disease or a concern with the adrenal glands so it’s good to stop them in any case. If the rider were to, say, crash then the body would respond by producing cortisol for the inflammation but a rider with low levels could not and therefore the body’s natural ability to recover is endangered. It all makes sense for rider health and helps prevent doping with corticosteroids too.
So why aren’t these things banned? Because not all drugs are banned, they have legitimate therapeutic uses and to ban a drug is to deny its legitimate medical use. There’s the W in WADA, the World and the body covers all sports around the world and so to ban Tramdol and corticosteroids is to stop people in events who may have a real need for it (quite what these are is a headscratcher). Similarly cortisone is difficult to control for, to detect between legitimate therapeutic use in and out of competition, and abuse.
The UCI itself is wary of going above and beyond the WADA Code because it means going out on a regulatory limb, denying medical treatment to athletes that WADA permits is a potential litigation minefield. Plus the UCI has sports politics to think of, stating to the world that the WADA rules are effectively so lax you need to go beyond them may sound virtuous to you and I but in the corridors of the IOC this is hardly going to be well-received.
So what to do?
The self-regulating MPCC is a great idea in theory and a good idea in practice. It gets mocked when teams quit but we ought to mock the teams who sign up to an agenda for the sake of appearances and bail the moment they have to hold themselves to it. But an open letter? This looks like an impotent gesture, as if saying you can’t achieve something but might as well signal your good intentions.
Which brings us to the “nudge theory” aspect. Here is a case where it’s in everyone’s interest to ban these substances but doing so is hard work and technically different. In short it’s difficult and risky to for the UCI to enforce this unilaterally. So make it voluntary but with a twist: teams applying for a World Tour or Pro Conti licence can opt out of cortisol and Tramadol testing conducted by UCI anti-doping at their will, but this decision will be made public. Perhaps when opting out they could publish a statement why too? Similarly test results for low cortisol or the presence of Tramadol will be made public but not bring a sanction. This turns the situation from teams subscribing to the MPCC Group to one where they have to opt out of a UCI policy, it is there right but it puts the onus on them to explain.
Cortisone and Tramadol can be better regulated and even banned but WADA seems reluctant to do this, perhaps it makes perfect sense to regulate their use more in pro cycling but not other sports? So the UCI is caught in a bind, these substances should be regulated more but WADA won’t play ball. The MPCC offers a path out of this but for various reasons teams don’t want to sign up. They may have legitimate reasons but they don’t state why and it leaves many drawing conclusions that they want to arbitrage the rules on cortisone for performance advantages. So how about asking teams to opt out of these tests? This “nudge” changes the status quo, putting the onus on teams to explain when substances like Tramadol are used rather than seeing a few teams adhere to voluntary self-regulation. Will this fix everything? Of course not but nor will an open letter and until WADA acts, softer measures could be explored.