The Lance Armstrong saga: a wake-up call for drug reform in sports.

For cycling enthusiasts and LIVESTRONG supporters, October 2012 will forever be imprinted in our memories as the month of damning revelations and the demise of a hero. Literally millions of people worldwide believed in Lance Armstrong. For more than a decade, he inspired us with his phenomenal comeback and unrivaled good works in the fight against cancer. Sadly, he duped us. On January 17, after three more months of denial and increased seclusion, Armstrong came clean with Oprah Winfrey as a vast audience watched. The Armstrong question now has been answered. For the sake of his children, he finally admitted to using performance-enhancing drugs and is now seeking amends. Like no other story about drugs in sport, this one should rally us to action. It is no longer about Armstrong; it is about the charade of drugfree sport with all its nuances and complexities. We can only imagine the immense pressures in professional and world class sport. We understand why top athletes have networks of coaches and advisors to support training and maximize competitive effort. Their livelihood and prominence depend on it. Fans, the media, and corporate sponsors want to see splendid athletes competing at the highest level, so every potential aid is explored. Science and technology have spawned performanceenhancing advances, each with its own controversy. For example, cyclists benefit from improved bicycle materials and design, swimmers from bodysuits, and endurance athletes from altitude tents. All manner of dietary strategies and mental training techniques are used to gain an advantage. We see how doping could be viewed as just another tool. The World Anti-Doping Agency updates its extensive list of prohibited substances and methods annually. Notable on the list are anabolic steroids, erythropoietin, growth hormone, stimulants, narcotics, and blood doping. Banned drugs either impart an unfair advantage or are used to mask those that do. Many also pose significant health risks. National and international sports federations follow this antidoping code or a slight variation of it. Recent reports confirm doping is widespread in professional cycling, and most ‘‘dirty’’ cyclists are never caught. Doping is entrenched in other sports too; baseball, football, track and field, and weight lifting are obvious ones. Insiders are savvy and know how to beat the system. They live with the deception, while the public believe doping is limited and controlled by drug testing. Athletics like politics has its cover-ups, detections, and apologies. Following the United States Anti-Doping Agency report in October, many hoped Armstrong would see the light, admit his misdeeds, and show remorse. With his admission in January, he has an oddly unique opportunity to make a real difference, again. He could be a powerful force in dismantling the charade surrounding drugs in sport. Time will tell what role he takes. From youth leagues and pick-up games to national tournaments and the Olympics, we love sports. They are an outlet for our innate drive to play and compete, and cherished entertainment for young and old. Many pleasant memories are related to sport. We have all played a sport, ran a race, or competed on a team. Indeed, many learned about hard work, cooperation, and fair play through a sport. At the top levels though, the power of money reigns and ideals take a backseat. Questionable short cuts and secret strategies become necessary for getting ahead. Or so it seems. If doping in sport is to be eliminated, professionals need to stand up and admit the scope of the problem. Let us not shield the public from the hard truth. We all have been complacent. Fans overlook misdeeds and shady dealings as long as no one gets caught or is hurt. Then when a scandal breaks, we are outraged V for a few weeks. Like the Romans who filled the Coliseum 2,000 years ago, spectators still revel in the display of fierce competition but are not concerned with the details of preparation. Sport is a joy and a dilemma. It can be simple and pure but also complicated and corrupt. Armstrong’s saga is a stark reminder that doping in sport is insidious. Despite decades of well-intentioned and serious efforts, the current antidoping system is falling short. The recent stripping of Address for correspondence: Phillip B. Sparling, EdD, FACSM, Georgia Institute of Technology, School of Applied Physiology, Atlanta, GA 30332; E-mail: phil.sparling@gatech.edu.