Traces of Tizanidine

One of the unwelcome side effects of following pro cycling for a while is all the side lessons. Come for the roads, races, landscapes, stories and personalities, then spend lunch breaks informing yourself about things you hadn’t envisaged, like haematocrit, off-scores, and even unapproved experimental substances.

Today’s novelty is tizanidine, a muscle-relaxing medicine. According to a scientific paper traces of it have been discovered in samples from three cyclists competing in “international three week cyclist race in France”.

September’s Drug Testing and Analysis journal, which is about toxicological testing – think chemistry and forensics of all kinds rather than anti-doping – writes:

“During an international three week cyclist race in France, a special public health division of the police controlled a whole team. In addition to the control of the rooms and the medical devices and products by the police, a trained forensic pathologist was requested to collect head hair specimens from seven cyclists…

…Among other substances, tizanidine tests were specifically requested. This was a target request from the judge based on suspicion as numerous boxes of tizanidine were found in the room of the medical doctor of the team”

Now you’re probably wondering how many international three week bike races are there in France, let alone ones with teams, and sufficient to attract the attention of a judge and the police? But let’s pause before treading down the deduction path as the point of the journal article is science and the sample analysis here is a new chemistry technique. It is not about rousting riders and besides, my emphasis, there’s an ongoing police investigation and possibly a court case. So you might very well have ideas about which race this could be or the police agency involved but keep them to yourself.

As the journal is about chemistry rather than citing races or teams, so let’s explore the testing and toxicology angle. First what is tizanidine? The journal offers an explainer:

tizanidine is widely used for the treatment of muscle spasticity in case of multiple sclerosis, spinal cord injury, or acquired brain injury….
…In France, tizanidine can only be obtained via a nominative temporary use authorization. It is not available in street pharmacies and must be ordered via hospital services.

It was approved in 1996 and since then also seems to for other conditions like chronic headaches and more. Sold under brand names like Zanaflex and Sirdalud, it is not banned by WADA.

Why might athletes be using it? The journal strays at one point, suggesting “as it can cause drowsiness, it should not be used during the race but during the evening or bedtime to aid recovery. May be the drug can be used to avoid cramps since it has a relaxing effect on muscle”. Meanwhile Swiss newspaper La Tribune de Genève asks this too and, speaking to a “doping specialist”, is told it could help athletes fall asleep, to counter the muscle fatigue of a grand tour. This rings true as paradoxically the longer the race goes on and the more riders feel tired, it’s not uncommon to hear sleep becomes harder to find. But it could be used in competition, drowsiness might not be a barrier as we know the opiate Tramadol had been used in competition, and the drowsiness countered by copious caffeine consumption so it’s equally possible tizanidine could be used in this way too.

Another question is how was it obtained? While it seems more common in the US, it has a special status in France with a temporary authorisation for use (ATU): it’s not available by ordinary prescription in France: no athlete can buy it and no team doctor could walk into a pharmacy en route and pick up a box to go. But a doctor could have got it in another country and crossed the border into France with it. Either way this would imply intent and planning. As it happens “numerous boxes of tizanidine were found in the room of the medical doctor of the team” according to the journal which is of interest because even if “numerous” was to mean two boxes it’s notable they were being taken into the hotel rather than left in the back of a cupboard or at the bottom of a box on the team bus. Anyway, the substance was identified in samples from three cyclists after all.

The third question is whether its use is a good idea? If it was being used in an event subject to the WADA Code and the UCI then these bodies might want to review its use and if deemed useful, place it on the watch list or even the prohibited list. The UCI did just this with Tramadol and as tizanidine has similar known side effects like drowsiness and dizziness  in-competition use could be questioned.

Chances are you’d been blissfully unaware of tizanidine until now. The journal article is all about “the first contribution to the identification of tizanidine in hair”, a small advance for toxicology. But we also learn the police have been using forensic pathology and this appears to give us a peek behind-the-scenes during a long race. If professional athletes are using this substance it’s unusual but remember it’s not banned under the sports rules and some teams seem to use medicine right up to the limits; WADA might want to review whether it is being abused. However sourcing this product is not easy, it is no over-the-counter remedy and there could be questions for any doctors as to why they had “numerous boxes”, where they got it from and on what grounds were they prescribing it.

82 thoughts on “Traces of Tizanidine”

    • While I get you’d like to avoid the usual speculation sh*tstorm in de comments, what’s your reasoning for not mentioning the probable race and team? I mean, other media do and there are facts known that at a certain race there was a police raid and riders confirmed they had to give samples… You can hardly call it theory if you combine the research with those events.

      • I think readers here will all have a very good idea. You can probably guess the race, many will wonder how many public health divisions of the police there are in France. But remember OCLAESP – the public health division of the French police, has conducted several searches in recent years. We had one this summer and we had one in the 2020 Tour too. When the searches were done teams had seven riders still in the race. So the tests could be from this year’s Tour but that would be a fast turn-around for the testing and then the write-up, the peer-review, submission for publication.

        So since we don’t know the point of the blog post was to explore the substance, what it could be used for, whether it is legal in France or not and whether WADA or the UCI should think about a review. For all we know other teams might be using it as well.

        • Great post, as usual. Regarding the timeline, this year’s raid was on the night of July 14-15, and the article was submitted to the journal on Aug 13. Though I am not from the field, that seems like not a lot of time to do the work, analyze the data, and write up the results. On the other hand, some figures in the paper seem a bit rushed, as they are low resolution and some may in fact be screen shots (eg Fig 6 and 9). Again, I don’t know if that is standard for the field. My main question, though is: doesn’t this type of scientific experiment using human subjects require some consent? I don’t see it mentioned anywhere.

  1. Sadly it’s hardly a surprise that – yet again – a team or riders are prepared to seek an undetectable or legal marginal gain. The product may seem strange but the doctor would not be giving it unless he felt it provided some performance benefit. And from the product description: “Tizanidine is a short-acting muscle relaxer. It works by blocking nerve impulses (pain sensations) that are sent to your brain.”. As I read that it translates into a chemical version of Voigt’s famous ‘Shut up legs” exhortation.

    The team is named in Ouest France which has some detailed analysis from former TdF doctor Pierre de Mondenard.

  2. my concern here is that more recent revelations are showing an increased use in meds like tramadol and Tizanidine which are presumably recovery related treatments. so if we have riders, otherwise at the sharpest end of physical performance and conditioning, needing (or wanting, your choice) to be medicated to find sleep or rest, maybe it’s time to re-evaluate expectations of the entire sport.

    folks absolutely love to glorify the grueling stages and back to back to back mountains, then recoil in horror that an athletes body is literally rejecting the effort at a metabolic level.

    so i ask this question with all sincerity: can we continue to expect epic stages of spectacle while simultaneously expecting riders to not rely on pharmaceutical support?

    on top of that, is anyone aware of long term studies of the affects of these huge efforts on athletes health? similar, but not in severity, to long term affects of traumatic brain injuries and encephalopathy in contact sports?

    • Yes the sport is gruelling but rewards and incentives also play a big part, for example the 100m sprint in athletics has a very chequered past and to be blunt, it’s over in ten seconds and flat too. I’m not sure if cycling is showing an increased use, it would depend on which year we compare things to perhaps?

      As you suggest there should be oversight. Specifically here what kind of a team doctor prescribes substances like this, and on what grounds, there’s no literature to guide them on the longer term effects, on doses, is this really a medical need or has the team doctor crossed over and become part of the performance and coaching side? Riders can’t be expected to make an informed choice when presented with this.

      • absolutely.

        i try to take a modern approach to these issues and look for the obscured causation behind dangerous or illegal actions: what motivates an athlete or physician to seek these specific treatment (outright performance enhancers a le EPO or HGH aside)?

      • Whether doping with medical assistance a racing animal or a racing human, neither patient will fully comprehend all physiological effects of the substances ingested. IR is therefore correct to focus on the medical assistance aspect. Not that it is any mitigating factor, but aside from any potential rules violations, the health of the animal/human is a large issue.

        This of course in addition to the physical effects of contemporary crashes.

    • ” I ask this question with all sincerity: can we continue to expect epic stages of spectacle while simultaneously expecting riders to not rely on pharmaceutical support?”
      By “pharmaceutical support” do you mean that allowed by the rules or banned substances? Two very different things and that’s not just IMHO. When you take our a racing license you agree to play-by-the-rules, whatever they may be.

  3. Alleviates cramps, effect peaks after about an hour on an empty stomach, I’m guessing that as well as recovery, it could be useful to take during long mountain stages.

    • Certainly, it is allowed but presumably the intention would be for medical reasons rather than performance. Much like WADA didn’t/doesn’t think tramadol was a problem or look at cortisone and its abuse.

      • Medicine and performance will always be irreversibly intertwined.

        In a sport so rigidly defined by stipulations on what and how much of something you can put into your body it’s bizarre to come away with a “bust” for something that isn’t illegal….yet. I know bust isn’t the right word in regards to this particular piece of reporting, but it’s likely where it will wind up.

  4. What has been left out of this conversation is that Tizanidine is commonly used for muscle spasm such as back pain. Many reports have labelled it as only for MS which is misleading and adds to the ‘ooh’ factor. This is the first article I have seen that discusses the legalities of crossing the border with medications, which presumably multiple teams are doing throughout the season. It can be obtained from a pharmacy in the US, but I am unsure about other EU countries. I also think the phrase ‘expressly permitted’ is more accurate than ‘not banned’. This is not a team exploiting a gray area (this is not saying that further issues might not develop from other substances). Also, have charges been laid against the team doctor for possession of tizanidine? Personally, I think French police got all excited about a med they were not familiar with, and didn’t ask a WADA liaison what they thought.

    • Almost any drug can be obtained in the US due to it being run ‘for profit’. It’s why there’s an epidemic of opiate addiction basically created by big pharma. The moral of this story is… don’t use the US availability as a justification of any drug being ‘harmless’

      • Charles, I called tizanidine ‘commonly used’, not ‘harmless’. You are also using the French classification to guide your perception; because it requires authorization in France, it must be special and dangerous. It is likely has as much to do with the way the drug is funded in France as it does its safety profile. Different countries classify and control drugs in different ways. Just because France controls it in this way does not mean that other countries do, which is why I am curious about other EU countries. Your comment on opiate addiction is also highly ironic given the role that a medication like tizanidine plays in reducing opiate use for a condition such as back pain; availability is good thing.
        The only things we know here are that some riders have taken tizanidine in the past, and that the team doctor had a quantity in their possession. Only one of those things is illegal, in France. If the possession case is open and shut, why has the team doctor not yet been charged? It has been months after all.

        • “Only one of those things is illegal, in France.”

          May I ask which one that should be? AFAIK it’s not illegal if I bring a medication over a border, neither taking it, regardless how prescription policies in France are.

          • If you’re a patient from another country and you have a prescription, you can bring in a (certain limited amount of) medication for personal use. The illegal thing, therefore, is obviously the team doctor bringing in and prescribing the medicine.
            But is it illegal? Are doctors for visiting teams generally exempt from national rules and legislation (other than those in the sport)?
            PS There are, of course, exceptions, such as when the medicine in question is a banned drug in another country.

        • “Only one of those things is illegal, in France.”

          May I ask which one that should be? AFAIK it’s not illegal if I bring a medication over a border, neither taking it, regardless how prescription policies in France are.

          All I see for the moment is an annual raid by the antidoping branch of the French police, who need to proof they exist and “do something”. No smoking guns, no words about other teams may using it too, not on WADA list. Wake me up if there’s something substantial.

    • That’s the thing, it’s not commonly used in France at all. You can’t even get a doctor to prescribe it normally, it has to go via a special system that allows some to get medicines that have yet to be fully approved, see the AUT hyperlink in the text above. So using it during the middle of a bike race invites questions, it’s unusual.

      • My antidepressants that are prescribed by my GP in Australia (where there is no stigma about mental health) were not routinely used when I resided in Singapore (where mental health medication is not really seen as a legit treatment).
        I used to get my six months of doses when I’d be home for vacation twice a year. I wonder what a report would read like if French police raided my home in Singapore and found a stash of tightly controlled medication.
        Cycling is very much an international sport. While I don’t know the legalities around possession of this drug in France (and other countries), I guess they have to start spelling out very specifically what can be in your possession and what needs to be declared when in France if police are going to search, and then leak what teams have in their possession. If it’s not banned, or illegal, why mention it? If I’m reading about it, it’s because it’s being presented as cheating.

        • So at least 3 riders of one team would need this very rare and heavy medication ? I understand you are trying to be the devil’s lawyer, but there is a non less heavy presumption it was used for performance instead of health… Then I don’t know how the sports legislation works : is it possible to sentence someone if there is a clear use of heavy medication for performance, but not with banned substance ? Is it the name of the medicine or the alleged intentions that counts ? Is it more the English-American way of seeing the law, or the French one ?

        • I get you but we’re not talking about medicine for personal use and moving between countries, it’s more about a doctor having supplies of it and crossing borders, and this is subject to more regulations.

          One idea for team doctors would be to draw up a list of all the medicines they travel with and take to races. Then send a copy to the UCI, WADA and the race doctor, perhaps the public authorities too. If they did this, not sure they’d bring boxes of tizanidine with them?

          • No, I’m just using my personal medication as a first hand example. Is this drug legal in France, and is it banned by WADA? Those are the questions I’m interested in, as I think they’re the ones that matter. If it’s legal in the country, and not banned, what’s the story, really?
            My example is about a drug you can’t get all that easily in a country, but is not an issue if you have it.

          • Even as a EU-citizen you often need a medical form when you are taking certain medicines across the border. France in a Schengen country (which means that for a lot of riders/teams there’s no real border control when travelling over land) but even in Schengen you need papers for opiats and other drugs. However, I checked the Dutch lists of drugs that are restricted for travel by law, and I did not find tizanidine on it (which should mean that there are not restrictions travelwise); France could be different though.

  5. If its permitted and was being prescribed by a doctor for riders with muscle spasms or even soreness or trouble sleeping I don’t see the problem. If it was being used systematically, then I suppose it’s in the grey zone of permitted but against the spirit of fair sport. But then if aspirin was used systematically by a team after stages, would that be ethically questionable?
    Anyway, if grey zone scandals are all that come from team raids these days it’s actually kind of encouraging.

    • I suppose that’s how caffeine got briefly banned. WADA and UCI should have proactively have their own philosophy and approach behind some of these potentially controversial topics rather than responds to “scandals” passively. I also agree that it looks rather more encouraging if all we get are grey stuffs.

      • Yes it’s encouraging, but hopefully the sport won’t overshoot and descend into a purity spiral where use of everything & anything ending in ‘ol’ or ‘ine’ leads to Salem witch trials and mass denunciations on twitter.

  6. “Commonly used” is relative. There are plenty of users but it is not the first or the second muscle-relaxing medicine a doctor will prescribe if I walk or crawl into his office and complain of a severe back spasm.

    Sirdalud is a favourite among party people who are on the slippery slope and a step away from having a drug problem. First they use something to get high and to stay up all night, they they need something to come down and get some sleep.
    Sirdalud apparently does the trick, one wakes up fresh like after a good night’s sleep – unlike various sleeping pills that leave one feeling drowsy all day.

    In my opinion we are quite deep into the gray area when a team doctor administers a medicine that he, in his day job so to speak, wouldn’t give to a patient with the same medical condition as his rider.

    • Fair comment about my usage of ‘commonly used’, but I would argue that description is more accurate than the way almost every other article has described it, as some specialized med only used for MS. The original article authors even mention acute back pain in their introduction, but this has been ignored by almost all. The circumstances in which a doctor prescribes a medication are likely to be individualized. What is missing from all the articles is any comment from teams about whether this is common practice, on or off-the-record. What I find most frustrating is that almost all media have taken the original article at face value without any extra research.

      • In medical terms ‘acute’ means severe ie not just ‘an achey back’ but something that has crippled the patient to the point where they can’t function. You seem to be banging the ‘nothing to see here’ drum very loudly

        • It also seems to be used in the US for chronic back pain (as in the sort that lasts consistently over time, opposite to acute). Whether three cyclists on a team of seven need this is worth exploring. Plus we don’t know the dosages, it could be under or over the expected amount.

        • Charles, not to be a contrarian, but (at least in the US) we use “acute” to donate short duration not severity of symptoms (I’m an Emergency Physician). Acute (days to weeks)—> Subacute (weeks to months)—> Chronic (months).

          I personally don’t prescribe much tizanidine, but it is fairly common and doesn’t raise my eyebrows or set off any bells when I see patients with acute pain in the ED. As mentioned above, it’s a medication with a separate mechanism of action that may actually *reduce* opioid use/abuse so would generally be preferable if the patient notes benefit from it.

          From my perspective, if the drug is actually being used properly (that is to say, it’s used to treat muscle spasm *after* the race/stage is over) and it’s not banned, then it is conceivably appropriate. It’s a different modality than ibuprofen (non-steroidal anti-inflammatory) and used in conjunction could provide additional analgesic effects.

          Following on, if it’s used properly and not readily available, but also not illegal, why shouldn’t the physician bring it with? I suppose for me the headline here would be if the team doc is breaking the law by bringing the drug (or certain quantities of the drug) into the country…

  7. It’s a grey zone but hard to compare because nobody is coming into a doctors office and saying “I just rode 200km a day for two weeks and can’t sleep”. I suppose if they did, the doc would tell them to take a break and get some rest. But since they can’t do that, a drug that helped them rest and relax and then wake up fresh would be a fairly good treatment.

  8. Inner Ring, I can’t thank you enough for your website and intelligent commentary. Your race previews are eerily prescient. I’m an anesthesiologist and a pain doctor in the southern US. Tizanidine is an excellent, safe way to treat acute or chronic myofascial pain (e.g. back spasm or chronic cramps). It’s my first-line therapy for muscle pain. About 40% my patients use it. For the above mentioned multiple sclerosis (spasticity-predominant), cerebral palsy, or true spinal cord injury/transection, you wouldn’t waste your time with tizanidine. It’s too weak, same with cyclobenzaprine. You’d use baclofen and probably require pretty decent doses. Tizanidine’s not addictive, burns clean, and has no long-term side effects. It’s out of your body in 4-6 hours. It has no place in active cycling (all muscle relaxants make you weak), but I imagine cyclists may benefit from it while recovering after races from cramps/muscle aches/sleep adjuncts. It’s not a medication you can get over the counter, but if the UCI says tizanidine is doping, it’s pretty silly. The teams all have medical doctors. Plus, at least it’s actually indicated for myofascial pain. Tramadol’s a weak mu agonist (amongst some other mechanisms) – you’re not really treating what’s wrong, you’re just masking it. Plus tramadol’s technically a controlled substance and opioid (albeit a weak one). In my opinion, tramadol’s doping (and poorly indicated for myofascial pain), but tizanidine’s fine (and appropriate therapy). You can make a good argument that ibuprofen’s more dangerous than tizanidine.

    • Thanks for the informed viewpoint, lll makes sense and in 24 hours I’ve read also that it can be used for back pain, chronic headaches etc… but in the US. In France it’s not available on prescription which makes it highly regulated so for the team doctors this is a potentially a legal/liability issue.

      Also we don’t know the doses involved, the methods etc, it could be ordinary and within the guidelines but the sport has a history of finding medicines and then abusing them, eg team doctors handing out tramadol and stimulants to be used late in a race. Hopefully that’s not the case here.

      • Indeed. I don’t know the exact rules in France, or any country really, but ‘off-label use’ is something to be careful with. Both in a medical and a legal sense.

    • Thanks for this! Reminds of ketones – they’re being studied but as far as I know have yet to be declared PED’s so, just like this tizanidine stuff, the actual jury (WADA) is still out and teams can use ’em any way they like. Leaving the packaging behind seems to indicate the users weren’t too much worried about leaving evidence of cheating behind.
      The way this all is being framed makes me wonder if this is the “smoking gun” so many were hoping to find to explain why their guy was getting his a__ kicked by someone on Bahrain?

  9. The thing that always strikes me is how a cyclist can’t function without all these meds. Let’s say this drug is being used to treat someone with spasms or sleep issues then where is the responsibility to the rider? These conditions must have been known prior to the event, should they rider have been on the team? Why not help the rider deal with these issues outside of the race?

    Instead they are most pumped full of drugs and sent on their way. It’s wrong.

    • I think it’s not a matter of cyclists not being able to function without meds, but optimizing performance by aiding recovery.

      That said, to get rid of all grey areas in all sports, I kind of like the idea to get rid of the banned/controlled substance lists and only approve drug use for ilnesses an independent doctor has diagnosed, as well as to have the ability to withdraw a rider if his/her own health is at risk. Maybe add a white list of very generic medication like paracetamol and that’s it. Have WADA employ the independent doctors so no team doctor, the UCI or any general practitioner can be used for fraud.

    • We could perhaps imagine a scenario where the team doctor gave tizanidine only to those riders who’d been involved in a crash. We all know that the next few nights can be worse than the days.
      This is a policy I could accept – but I agree that it would be, well, nicer if there was a white list of medicines (or, indeed, a kind of mobile “UCI pharmacy” and team doctors would have to visit it to fill their bags.

      • I’d rather have an independant anti doping agency perform that service, so no one could even try to blame the UCI (a popular game these days), but the funding and organization would be very difficult.

        • We all know the limited resources of the UCI. As a governing body, every now & then they might benefit from third-party-applied “pressure” (e.g. a raid here, an investigation there), whether legal, political,or cultural in nature, as a sort of PSA to every team to not push the limits of currently permissible drugs. In short, the spirit of UCI/WADA tules is just as important as the rules themselves.

    • It’s an interesting thought game: what drugs are allowable for sporting purposes? What constitutes cheating? The answers are not clear cut.
      What I feel personally is that we are not seeing authentic performances. Not by the winners anyway. The original remit of the Tour de France was supposed to be deliberately attritional (Henri Desgranges wanted it to be so difficult only one winner would win it). Thankfully we’ve pulled back from that. But unfortunately, what we tend to see is that the winner is almost guaranteed from the start, the spectacle is just waiting to see when they will show their hand, barring a fall. The human aspect of the sport has fallen away. This is sort of a problem in many sports though. You can say to me that this is not your perception, but so often money makes the difference when it comes to winning and losing, and this is problematic.
      At the end of the day sport is just theatre. So perhaps even where doping happens we might look on it as entertainment, but for the potentially tragic consequences it has for people’s health. The medicated rider over seen by his team doctor may not suffer, but the amateur self-medicating can and does, and even those not medicating can in trying emulate those who do. To this extent I am reminded of a young cyclist that fell asleep in a pub and never woke up trying to train for his dream. So dream and want a clean sport.

      • “But unfortunately, what we tend to see is that the winner is almost guaranteed from the start, the spectacle is just waiting to see when they will show their hand, barring a fall. The human aspect of the sport has fallen away.”
        Wow, I thought I was cynical! I think the dangers you describe are out there though perhaps less in cycling than other sports but it’s up to all of us to keep pro cycling from ending up this way.

      • It’s not really a thought game: this is precisely what WADA does: decide which drugs are acceptable for competition purposes. So caffeine is ok, ephedrine is not. Paracetamol is OK, opioids are not. Cannabinoid metabolites re not ok, alcohol use outside of competition is.

        Not all of these are related to the specific impact on performance (clenbuterol probably has less effect than caffeine in most athletes) or risks to health, there is fairly convoluted selection of substances/techniques that are considered doping and sometimes you can argue it’s arbitrary.

        It certainly is problematic, and certainly defining what “clean” sport is not easy. But saying the winner is decided from the start is a bit much – tell that to Roglic on that fateful TT. What I would agree on is that for Grand Tours the selectivity is massive: you really only have a handful, maybe 10 guys that would win 75% of them. Over 20 stages the regression to the mean is very real and guys that can light up some stages and one day events simply can’t perform consistently every day. No MvDP. No WvA. You have the same guys that barring accident will be there: Contador was almost always there. Froome was almost always there. Evans. EPO/Blood doping has a massive effect, you say? Alright, let’s go earlier. Merckx, Hinault were always there. Gimondi. Heck, wasn’t Anquetil paid to NOT attend so the race would be more attractive? (I may have confused the rider, but certainly some racers have been requested not to attend to add interest).

        If you look at the 1o years in 1-day races, I’d say certainly the variety of winners is up. I don’t think anyone had the short odds on Matthew Hayman! Or Bettiol.

      • I don’t think professional cycling is quite as bad as you describe. Yes we often know the winner of the Tour in advance, but that and the Vuelta are pretty much the only races you can predict with a degree of certainty that compares to Football or Formula 1. We have a little crop of riders at the moment who are dominating but they have been well known and winning races pretty much since they were children in the cases of Pogacar, Van Aert and Van der Poel. It’s not like they are the same nationality, or ride for the same team, or even ride for teams from the same country. If anything that is a good sign. I don’t Adri was sticking all sorts in young Mathieu’s corn flakes.
        I think there have been times when the playing field was skewed, and money, access to certain drugs or doctors or just being from or living in a certain Southern European country have you a significant competitive advantage. I.e. the late 80s through the 90s.

  10. There is a world of difference between lower back spasm, and ‘an achey back’, both of which are ‘acute’ issues. The drum I am banging the loudest is that cycling media, in particular the English-language cycling media, are just doing press releases for the French Police when they should be doing their job. Sensationalist headlines, lack of context and zero analysis. Have you read the report? The abstract and discussion read more like a hatchet job than a scientific report. Some of the statements are blatantly incorrect:

    “May be the drug can be used to avoid cramps since it has a relaxing effect on muscle. There is nothing published in the scientific literature on this specific topic.”

    This statement would come as a surprise to anyone actually familiar with the medication.
    If the scientists wanted to report their new test for tizanidine in hair, they could have done so without alluding to any of the circumstances surrounding the test. If the French Police wanted to charge the team doctor for possession of a ‘specially authorized medication’ they could have done so. They could have held a press conference stating that the team doctor was holding large quantities of tizanidine and that this was unusual and illegal. If we are really so serious about cleaning up the sport, we should be asking these questions, and expecting the cycling media to ask them.

    • We’ll see with the police. These investigations can take a lot of time, the procedure is not to press charges on first sight. When OCLAESP and the judge searched Remy Di Grégorio at the 2012 Tour de France… it led to a court case that reached a verdict in 2018 (a suspended prison sentence). The wheels of justice are rusty and out of true sometimes.

  11. greatly appreciate the very grounded knowledge of “witlessprotectionprogram” above. sounds level with and no different, nor more nefarious, than an ibuprofen or acetaminophen. what’s to get so worked up about. I’m grateful for either after hard training to mitigate some ache and pain at night easing transition to sleep. that’s at a fraction of what these athletes experience. I’m 100% anti “doping” but come on this doesn’t seem to rise to that level.

    • Buying a gun and live ammunition is commonplace in the US and an anathema in Europe. Do Europeans need to realise that guns aren’t something to be concerned about?

  12. Recovery?
    Is cannabis (marijuana) still banned?
    Cannabis has been show to aid recovery.
    A pure plant material, which in over 5,000 years of documented use has not killed a single person.
    Here in Colorado, cannabis is totally legal, however the talons of prohibitionists still extend into sport, without a sane argument to continue the discredited ban.

    If cannabis were RE-Legalized for use by sportsmen & women, would there be less instances of this particular subject matter?

  13. Ok, tizanidine is not banned by WADA.It’s act as clonidine. On the 2022 prohibited list, clonidine is still on S6b (specified stimulants) exceptions. But it has nothing of a stimulant! It has been sold in France as a antihypertension medicine until 2016. It’s known as a GH secretagogue, brings moderate hyperglycemia and enhances lipids use. So does tizanidine. Very interesting side effects. We can wonder how the cyclists manage with others (anticholinergic one: sleepliness, orthostatic hypotension, drownsiness). May be with high doses of caffeine. The first one to blame is WADA. Clonidine and tizanidine will be fast put on the S4 paragraph (metabolic modulators);then the doctor of the team who don’t care with medical ethic, but who found the interpretation of the list.

  14. What surprises me most on this sorry tale is the team manager’s denial of knowledge and use of the product (Cycling News: “What’s that? We are not using this. Never heard about that.”) . That seems in direct contradiction with the police find of product packaging in the team doctor’s possession, and maybe to a slightly lesser degree in rider’s hair samples.

    Was the team manager attempting to mislead, ill-informed, confused…or simply lying?

    • It’s not certain to be his team though. See the comment I posted above dated Friday, 22 October 2021, 1:25 pm, because one year before OCLAESP raided another team with seven riders in the race too. We’ll see.

  15. I’m curious whether the police were looking for this substance specifically, or found it while seeking evidence of something that’s actually banned.

    If the latter, can we assume nothing was found, or might the wheels still be turning on that?

      • I read that as: the police found tizanidine in the doctor’s room so asked for specific tests on the riders’ hair samples. That doesn’t answer the question of whether the police *expected* to find tizanidine, a banned doping product or – perhaps unlikely – it was just a random sweep of a team hotel.

  16. The big thing I never understood: Why have a ‘prohibited list’? To do that you must first know about the substance. What we see is gaming of the non listed substances to gain an edge, which means teams are positively encouraged to get doctors who are willing to go off-piste with meds.
    Why not have a ‘permitted list’ from WADA and a Tour Dispensary in the Medical Service of a Tour. Any drug detected in any way outside of that gets a sanction.
    This still stops HGH,Tramadol, Tizanidine, but it does it before they become banned.

    • Good question! Why not a “permitted list”? Probably because a) it might work too well b) might be a nightmare for the testers. Where are the science/medical experts to weigh-in on this idea?

    • Because if someone forgot to print your genome on the permitted list you would be prohibited… far more bio chemicals out there than you think.

      • RQS – So that would be b) then?
        All this about tizanidine seems kind of silly after reading of the chicanery with British cycling in the run-up to the 2012 Olympic Games. Between violating the rules with secret pre-testing or ditching the testers when they come for urine samples, a drug not even on a banned list seems rather unimportant.

        • “a drug not even on a banned list seems rather unimportant” – you had a very different opinion about Tramadol back in the day, especially when it was linked to British cycling and Team Sky. When you call yourself ‘cynical’ you mean ‘bigoted’.

  17. I think this is a dual purpose drug for racers.
    1. Sleep/muscle relaxer
    2. Growth hormone secretagogue: a class of drugs which act as secretagogues (i.e., induce the secretion) of growth hormone (GH).

    Who wouldnt like a bit of extra growth hormones in a 3 week race?!

  18. Does being a professional cyclist automatically imply your drug test samples can be used for research and publication, so additional consent is not required?

  19. and, vaguely on the same subject, L’Equipe tells us that Leonardo Piepoli, the celebrated and once-banned Saunier-Duval “chaudière”, has been recruited by Movistar as a trainer. Were they really that desperate for results?

    • Agreed! They get rid of the big loudmouth from the documentaries, IMHO a smart move but then hire the “Flying Trullo”? What’s next, the “Cobra Modenese” (his partner in crime) in the other team car? Why is Max Sciandri involved with this team?

    • He’s been training quite a few pros in recent years, but said he was more an advisor and mental coach rather than a trainer experienced in sports science. It was eyebrow-raising when he was working with the likes of Formolo, Bettiol and Amador (a Movistar link), odd to see him hired for a whole team. We’ll see what the role actually is.

      • Ya really gotta wonder – there’s nobody out there but this guy with the kind of knowledge/expertise you seek? Why anyone would risk their reputation by associating with cheats like this is beyond me. Really Formolo? And Bettiol, a guy racing for a team that blows (or used to before the boss got the MBA?) a big anti-doping horn? WTF? How is the sport EVER going to get past the doping stench when cheats like this can find work in it?

        • Quite so Larry. Why on earth do Movistar want to tarnish a reputation by appointing Piepoli, a former rider without, to my knowledge, any specific qualification or competence – beyond cheating of course. An interesting excercise would be to dredge through WT and PT teams and see just how many of thier managers, DS, trainers, riders and soigneurs had a doubtful past. Several dozens as a minimum.

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