Sports Doping - Winning At Any Cost? Horizon

Our sporting heroes are glamorous and rich,

idolised by generations of fans.

Their bodies are like highly-tuned machines whose every move

is watched by millions.

There's something about men and women competing at the highest level

and doing things with their bodies that are almost superhuman.

That, to me, is as compelling as the best drama.

But whether you're a fan or not, you must have noticed that,

with the Olympics coming up on August 5th,

sports is once again hitting the headlines for all the wrong reasons.

Russian athletes won't be able to compete at this summer's Olympics.

The former tennis world number one Maria Sharapova failed a drugs test.

Lance Armstrong has been labelled a serial cheat.

I've been investigating the controversial and dangerous

world of sports doping.

The hospital didn't think he would make it through the night when we took him in.

You have no sex drive, impaired erectile function

and, in about 10% of the cases, depression.

I found that, for some elite athletes,

doping is a gamble they think worth taking.

I went straight to the front, where I belong.

'I've discovered some of the extraordinary lengths

'cheaters will go to to avoid detection...'

This is one of the least glamorous things I have ever done -

making fake urine in a hotel room.

'..and that, as quickly as science can develop legitimate new medical treatments...'

So he is really the Mr Universe of mice?

'..they're hijacked by people who want to cheat.'

I got an e-mail from a coach in Pennsylvania,

-wanted me to inject his entire team.

-Really?!

But this culture of doping is no longer confined to elite sport.

It's now filtering down to the general public.

It's thought that hundreds of thousands of people in the UK

are now using steroids.

Some needle exchange programmes reporting over 600% increase

in around ten years.

Many of these users are young men and women simply driven by

the desire to look good.

As a doctor, it really worries me that the substances

people are taking are easily available online,

you get them in the post, and they are completely unregulated.

So I want to find out how common performance-enhancing drug use

really is and what it's doing to the body.

For top-class athletes,

the potential rewards of success on the world stage are enormous -

fame, money, glory and maybe a place in the history books.

With that much at stake, it's not hard to imagine why someone

might take risks to get an edge over the competition.

'My investigation into the murky world of performance-enhancing drugs

'will take me inside one of the world's leading

'drug-testing laboratories...'

Black-market suppliers may be the same people who are selling

hard drugs like cocaine and heroin.

'..I'll discover if there is a way to legitimately boost your performance in sport...'

You've been electrically doping.

You've just been a baby and not tried!

'..and I'll encounter some of the most shocking material

-'I've ever seen online.'

-Ten units, mix it.

I'm going to put this right in the side of my leg, guys.

It is a little bit like science 200 years ago - scientists

experimenting on themselves.

But, before I do, I'm going to meet one of my sporting heroes.

'Ladies and gentlemen, welcome back to the working week.

'We'll make it the best it can be...'

I'm on my way to meet a man called Tim Montgomery.

And, at one point, Tim was the fastest man in the world.

He ran the 100 metres in 2002 in 9.78.

'Good start from Chambers but he's headed by Montgomery.

'Montgomery's got half a metre. And Montgomery wins it!

'9.78 - a world record!'

Now, he's subsequently been stripped of that record because

he was caught cheating.

But I guess I just think of him still as one of the fastest

people in the world.

Tim retired from competition after he was banned from doping

and he now trains athletes in Gainesville, Florida.

-It's Tim, right?

-Yes.

-How are you doing?

-Just fine.

-It is very good

-to meet you.

-Very good to meet you also.

'Today, he's not working with an athlete.

'He's going to be putting me through my paces.'

You know, I've not got really any world records in any athletic events

so... What are you going to do with me this morning?

Since I know you're a doctor, you're brainy,

-I'm going to work with your mind.

-OK, OK. That's good, that's good.

-I like that.

-And your body just a little bit.

Ooh! Ah!

-You just do this for nine seconds.

-Argh!

-But the process is very painful.

-Argh!

'So much for working with my mind.'

-Ooh!

-Bring it up off the ground here.

-Ooh! Ooh!

-Oh, yeah!

'It becomes very quickly apparent that there's more to running

-'fast than meets the eye.'

-Now go forward to here. Without coming up.

Just go straight through it.

-There you go! There we go!

-Oh!

-See? Yes!

-Yes!

-'While I'm finding this a bit of a challenge...'

-Uh-uh.

-Oh.

-There you go.

-Like this?

-Keep your arms back.

'..Tim's flair for running shone through from an early age.'

Going slow, not fast. There you go, there you go.

There we go. Good.

What's the kind of first thing you remember, going, "I run fast"?

-Well, my dad making me race my sister for ice cream.

-Really?

-Yes.

Did you always get the ice cream?

She beat me one time and then I went and started training.

So did you not get the ice cream that time?

I didn't get the ice cream that time and that made me start

running around the house, running up the hill, just doing crazy training.

-But, right there, my desire to win began young.

-Mm-hm.

There you go.

-Well, that's really... Really feel that burning.

-Yes.

'This drive, combined with bags of natural talent, meant he rose

'quickly through the ranks to become one of the top junior sprinters.'

Lock it inside the heels.

I end up breaking the World Junior Record at 19 years old when

-I'm in college.

-At that point, what are you imagining?

Are you then imagining a career as a professional athlete?

Soon as I cross the finish line as a World Junior Record,

-my mind was like dollar signs!

-Really?

-Where the cheque at?!

-Ha!

-Where the cheque?

-9.96. Are you the first junior to run under ten?

-Under ten.

-Wow.

-And they come back to me and say, the track is three centimetres

-shorter, so we're going to take that away from you.

-Oh!

Right then, I start rebelling against authority for track

and field. So I told myself, you know what?

You take this away from me, I'ma get something that you can't take away from me and get that world record.

-Now my mind's on the world record.

-So that was when you immediately...

Immediately that record went, you wanted to be the fastest man in history?

-Man in the world. Period. Didn't care what it took.

-OK.

'After a morning of training,

'I get my chance to try and beat Tim on the track...'

'..something his competition also found hard to do.'

'The US track star won his first Olympic medal,

'a silver in Atlanta, aged just 21.'

So you ran clean for a long time?

You were winning races, breaking records,

and then you started taking drugs. So what changed?

-Why did you do that?

-It wasn't enough.

I was still losing on occasions.

I just didn't feel like I was going to be able to beat the guys

naturally.

When I started reading about PDs and steroids and everything,

it was just like, this is going to make you a superhero.

And, when I found out that that was going to be the way for me to

get ahead, I might have swallowed once but I didn't swallow twice.

I went right for it.

And, when I done it, I went straight to the front, where I belong.

That is very interesting to me - the idea that drugs got you to

your full potential, where you should be.

I got to say, steroids did get me to my full potential.

'Tim was taking a complicated cocktail of substances.'

I was taking...

I took testosterone before, I took EPO before,

I took insulin before, I took human growth hormone before.

So, over time, you start to see a change. You start to feel a change.

And now you know it's starting to work.

And now you start to ask for more and more and more.

And which ones do you think worked? Did they all help?

I don't know cos I was taking all of them!

You were taking them all at once?

You've got this, like, sort of suitcase full of illegal drugs.

Does that ever feel strange?

Do you ever open up that bag and go, what am I doing? This is strange?

Oh, no, because I was taking probably 25 pills to 30 pills a day.

-Really? Vitamins and all this other stuff as well?

-Yes.

So that all just looks like what it is to be an athlete, right?

You've got different shoes, you eat differently,

your life is so different to a normal human being that

-the drugs are just part of that?

-Right.

'But while Tim was seeing results on the track,

'drugs were affecting his body in negative ways, too.'

-What about side effects?

-You never think about it.

-Really?

Now, I'm going through it, you know.

There's just so many things that I used to do

that I cannot do any more.

Your body is not working as well as it used to because of the drugs?

Right. And that's just part of the side effects that you don't

realise that's going to happen to you later on.

'Tim's world record was wiped from the record books because

'he admitted taking banned substances.'

In fact, five of the eight runners in that final

were eventually caught doping

or became involved in a doping scandal.

A lot of people would say, well, you took drugs.

But I don't think you see it that way, do you?

I don't because I'm for real.

I still call myself the world record-holder.

Because it's a very slim margin of athletes in the 100 metres

that's not using drugs. And that's why sprinters don't bad-mouth me.

They understand the trenches of the 100 metres.

It was amazing to be able to meet one of my sporting heroes and

really extraordinary to hear him being so honest about how

he was seduced by performance-enhancing drugs.

But he's certainly not the only athlete to have ever taken them.

'My twin brother, Chris, has some strong feelings about how

'many are doping in the pursuit of fame and glory.'

Having Canadian parents, we both remember Ben Johnson winning

the 100 metres gold at the Seoul Olympics...

'That's the go first time. And Ben Johnson's got a brilliant start.

'It's Johnson away in clear. Lewis is not going to catch him.

'Johnson wins it! Lewis second. Christie third.'

..and the shock, two days later,

when he was stripped of his medal for doping.

I do remember being very proud that a Canadian had won an Olympic

gold medal in this sprinting, and then the shame.

Yeah, I remember that.

Ever since then,

I have fundamentally believed that

it is near universal at the top level of sport.

No!

No! What do you mean? In sprinting?

I mean, in sprinting and cycling,

I think there are a lot of people taking drugs.

Why wouldn't everyone else take drugs too?

Why isn't it also in football, in rugby, in tennis?

I find listening to what you're saying extremely uncomfortable

because these people are my heroes!

I much prefer the idea that the guys in the gym,

who look better than me,

have just worked a bit harder and the people I'm watching on telly win

the races have done it cos they're talented and they train hard.

'I'm still not convinced that everyone is doping

'but, while Chris' views might seem a bit extreme,

'they do make me want to dig deeper into this controversial subject.'

So what exactly are performance-enhancing drugs?

More than 300 different substances have been banned by Wada -

the World Anti-Doping Agency.

They range from relatively benign health store products,

like diuretics, to prescription medications, like these,

and even illegal drugs, like cocaine.

And the thing they all have in common is that they've been judged

to give athletes an unfair advantage in either training or competition.

Wada statistics show that in 2014

half of the top ten

banned substances found in athletes

were anabolic steroids,

synthetic testosterone taken to build and repair muscles.

Also high on the list were diuretics, drugs that can be

used to clear banned substances from your system to avoid detection.

People even take drugs originally only intended for animal use,

veterinary medicines.

Every year, the list of banned substances gets longer,

as does the list of athletes caught taking them.

The World Anti-Doping Agency think as many as one in ten athletes

could be using performance-enhancing drugs.

But some think the real figure could be even higher.

Whatever the true number, it's clear once you start digging around

in this murky world, the statistics can be surprising.

39 British rugby and rugby league players

are currently banned for doping.

More than 50 American football stars

were suspended for substance violations last year,

and nine of the last 20 winners of the Tour De France

have been stripped of their titles.

But it's not just elite athletes who take performance-enhancing drugs.

Just as training techniques and specialist equipment filter down

from the top, so too does doping behaviour.

These kinds of drugs are now being used at all levels of sport...

..as amateurs try to move up through the rankings,

tempted by the short cut.

But the fastest-growing group of users are people taking them

simply because they think it can help them look good.

And the most common substances they are taking are

muscle-building anabolic steroids.

'I'm meeting Gary and Natalie Whittaker.

'From the age of 20, Gary competed as a bodybuilder,

'using steroids to help make him bigger.'

We've got photos here of you. This is you at your absolute peak, right?

-Yeah.

-Did you feel healthy when you were doing that?

-Yeah, fine. Yeah.

And what does it feel like to be that guy?

A fantastic feeling. Just want to be big, just want to be strong.

Respected. Powerful. Invincible.

Did it ever seem bad to you to be taking the steroids?

Were you ever worried about it?

No, not at all. It was second nature, really.

Yeah. It was natural, injecting steroids two, three times a day.

Were you getting them on the internet or buying them in the gym?

You can actually get them on the internet, but, yeah, buy them from anyone down the gym.

Just see a big guy, ask him what he's taking, how he's taking them,

who's he get them off, and get a price list just like that. No problem.

Then before you knew it, you was on all the time, constantly.

Cos if you had a week or two off, you'd lose size, lose strength.

Your joints would ache, your body would ache. You wouldn't feel good

that you couldn't come off them, that's eventually why I stayed on

for like 14, 15 years straight,

cos I felt as though I couldn't come off them.

Gary's now stopped taking them for health reasons,

but his story is becoming increasingly common.

It's Saturday morning at a typical gym in north-west London.

And lots of people here are doing their weekly workout.

Come on, Kamil! Come on!

Press! Press!

Stop, stop. Hold it.

-Yeah! Hey!

-LAUGHTER

'While a gym like this is perhaps not my natural environment...'

-Do you think I can get it off the ground?

-Definitely.

-One way to find out.

'..the guys are quick to include me in their strongman training.'

-Let's go!

-OK.

Do I get the full...?

You're not going to slap me or anything?

'Though for my first-ever log lift,

'they've kindly taken the weights off.'

Come on. Up. That's it.

HE STRAINS No, no.

I think I got it like that much. Oh!

So, why do you do this, Kamil?

I like it. I come first time, I want to look nice for my wife.

-What does your wife think now?

-Now she's saying I'm too big.

LAUGHTER

You guys are in that world of like...

Strongman is what you are doing, right?

Is there a lot of performance- enhancing drugs in strongman?

Yes, there is. I mean, in the gym setting, yes, there is.

Is it possible to do this without taking steroids?

-Yeah.

-We are doing it without taking steroids.

-We don't take nothing.

Do you see people taking drugs in this gym?

-Yeah, there are quite a few, yeah.

-Yeah?

When you come in the gym, you see, I don't know, 40kg guy,

and after one month you see 80kg, the same guy,

so what do you think - he's taking or not taking?

Not possible.

'I've invited sports scientist Dr Pete Angell to the gym to tell me more.'

'He did research on the effects of anabolic steroids on the heart.'

What do we actually know about the scale of the problem in the UK?

Well, that's a difficult area because no-one really wants

to admit to doing it. Recent data has suggested around 60,000 users.

-But most people assume this is a gross underestimation.

-Really?

And anywhere up into the hundreds of thousands are actually

using on a regular basis.

'It's one thing to take a substance hoping that it might help you

'beat a world record, but Pete's research is shining a light into

'what's driving the use of steroids among the general public.'

We've got some people that are doing it for their jobs,

whether they're security or even in some forces,

or in the emergency services.

And we've got some people that are just recreational, they just want to look better.

It's a performance and image-enhancing drug as well.

This is kind of going through all walks of life now.

'But by experimenting with steroids to try and change the way they look,

'people are putting their health at risk.'

What do we know about, if you like, the side effects of these drugs on the body?

Things like gynaecomastia, growth of breast tissue.

Testicular atrophy.

Male pattern baldness. Acne.

Those kind of things.

'Despite this, the rate of steroid use appears to be going up.'

We're getting an increasing amount of information from

needle exchange programmes which are really on the increase.

Over 600% increase in around ten years.

You know, we have needle banks because of HIV and hepatitis,

viruses like that.

Do we see the same problems in IV steroid users?

Well, we're actually seeing an increase in infections.

You used to hear anecdotal stories of some gyms where they would have jabbing rooms.

You even heard stories of people lining up and the guy

walking along with one needle and just jabbing.

And obviously that creates a whole plethora of health-related issues.

As a doctor, I've seen the devastating effects of diseases

spread through shared needle use,

and I find it mind-boggling that people are still willing to take the risk.

But even if you're not sharing needles, anabolic steroids

are chemicals that can affect every single part of your body.

Amateur bodybuilder Gary Whittaker used them constantly for 15 years.

And that had devastating consequences.

I got a sign my kidney was starting to fail when I filled up with water.

Didn't feel well, my vision was going.

I went to hospital, and got told my kidneys were starting to fail,

if I carry on taking the steroids I would be on dialysis.

So I gradually cut them down, and then when I met Natalie,

I said to her, "I have a problem with my kidneys,

"I might have to be on dialysis one day,"

thinking I'd be about mid-50s, early 60s, but no, it came earlier than that.

Late 30s my kidneys started to fail. Didn't feel very well.

Rushed into hospital and got told that I needed to go on dialysis

straightaway cos both my kidneys had failed.

-I had no function on any of them whatsoever.

-Wow.

So that's when I knew totally that they were totally gone, totally failed.

-How ill were you at that point?

-Very ill.

Throwing up black.

Drinking a pint of water and throwing the whole lot up

-straightaway and it was coming out black.

-Wow.

-No energy.

Hospital didn't think he'd make it through the night when we took him in. He was in such a bad way.

They put him on dialysis straightaway.

'In an extraordinary act of love,

'Natalie gave up one of her kidneys in a transplant that saved

'Gary's life, and they now have two children together.'

If your kids, when they were older, wanted to get into bodybuilding,

-would you tell them not to take steroids?

-100%, yeah. No way.

-What about you, Gary?

-Yeah, 100%. Yeah.

-Really?

-I want my son to train, but not take any drugs at all.

-Really?

-No.

'Strangely, I found Gary very relatable.'

We all balance benefits and harms all the time doing all kinds of

fun or interesting or exciting things.

And his story was kind of no different.

And there are people who will say, "Well, he only got into that much trouble because he took too much,"

but that definitely isn't true.

These are dangerous drugs, and what we're finding out now is that the

kind of health problems Gary had are just the tip of the iceberg.

Science is only just discovering what the long-term effects of

steroids on the human body really are.

They first became popular in the general population in the 1980s.

And those who started taking them then are now reaching middle age -

the age when health issues start to show up.

At the forefront of this research is Harvard professor of psychiatry Harrison Pope.

He is a lifelong fan of all kinds of sports,

and has been researching steroid use in athletes since the 1980s.

Of all the different drug subcultures I have studied in my career,

steroids are the most secret.

I have countless people come into my office and talk about

all the marijuana they smoked

or all the cocaine they snorted,

but I will someone who clearly is a steroid user when I watch them

coming through the door, who will then deny to my face

that he has ever used these drugs.

His work has shown that steroids are addictive in around 30% of users.

When they stop taking their steroids,

their own testosterone level has fallen virtually to zero because

steroids have shut down the body's own manufacture of testosterone.

You have no sex drive, impaired erectile function,

and in about 10% of the cases, depression.

And so there is a huge temptation to resume taking the steroids

to make the bad feeling go away.

So there's a self-perpetuating quality here that is hard to break.

As well as having profound psychological effects,

steroids may also be chemically addictive.

If you take male hamsters and you put them in a cage where they

can self-administer by poking their noses against a lever,

male hamsters will self-administer testosterone to the point of death.

If you give the male hamsters a drug that blocks the effects

of morphine or other opiates,

it will stop the testosterone addiction, suggesting that

whatever steroids are doing, they are tickling the same

receptors somewhere in the brain as opioids do.

Whether you are addicted or not, evidence is now growing that

anabolic steroids have long-term impacts on the brain.

It's been found in the laboratory that if you expose brain cells

to very high levels of testosterone or other steroids,

the cells die prematurely.

They go through their cycle and commit suicide too early.

'All of these boxes will open up one by one to reveal some patterns.'

To see what effect this might have in the real world, and in the first

test of its kind, in 2012 Professor Pope used a range of cognition tests

to assess the memories of two sets of bodybuilders.

'Now touch the box where you saw this pattern.'

One group were long-term steroid users, and the other group were not.

'You have completed the level.'

There were striking differences between the steroid users

and the non-users.

What we found was that the degree of impairment on

the visual spatial memory tests was strongly correlated with

the total number of years of lifetime exposure to steroids.

In other words, the longer that you have been taking your steroids,

the worse you did on these visual spatial tests.

Former steroid users did just as badly on the tests as current users,

suggesting that once the brain damage has occurred, it's irreversible.

If it is true that steroids really do accelerate cell death in

neuronal cells, it would be very worrying,

because this would mean that men who take steroids over long periods of time

might be at greater risk for developing a dementia at a younger age.

And now there's growing evidence that brain damage isn't

the only long-term side effect steroid users have to worry about.

Of all the long-term effects of steroids, it is the effects on

the heart that scare me the most.

The heart is a muscle. Steroids affect muscles.

The heart in fact is the strongest muscle in the body,

and it's the only muscle that never rests.

So it is not surprising that we are finding increasing evidence

of these long-term cardiac effects.

Professor Pope used an echocardiogram to look at whether

steroid use had any effect on the way the heart functions.

This is an image of a heartbeat,

and in the upper panel we have a non-steroid user and you can see

that all the tracings are pretty much superimposed

on one another, so that all aspects of the heart muscle are beating

coherently, in a nice, firm, powerful beat.

By comparison, on the lower panel we have

a weightlifter of the same age, same degree of weightlifting experience,

but who has used steroids for many years.

We see that the steroid user has a much less coherent beat,

and the force of the beat is weaker than it is for the non-steroid user.

This reduction in function

directly affects how much blood the heart can pump.

In a normal individual you would expect the percentage of the blood

in the ventricle that gets expelled with the beat

should be at least 55% of the blood in the ventricle,

and in the normal weightlifters, virtually all of them

are 55% or above, whereas in the steroid users we had

quite a number of people who were as low as 40,

and some even going down into the 30s, which is a profound

deficiency to see in an otherwise healthy man in his 30s or 40s.

There is good scientific agreement around the scientific community

that this is clearly associated with anabolic steroid use.

For Harrison, all this evidence tells a cautionary tale.

It is very hard to know just how big this public health problem is going to be.

But there have been several million men in the United States alone

who have tried anabolic steroids, and tens of millions worldwide,

most of whom have not yet reached the age of risk for developing the

long-term cardiac complications and neurological complications as well.

Now, imagine by analogy that widespread cigarette smoking

did not exist prior to 1980, and that the vast majority of

cigarette smokers were still under the age of 50 now.

In that scenario, there would be the occasional case of lung cancer,

the occasional report of emphysema,

but we would have no idea of the full magnitude of what was about to hit us.

And what worries me is that

there may be an analogous situation with steroids,

that we will start seeing a lot more pathology as this wave of

users begins to move into older age.

As we understand more about the long-term effects of steroids,

the consequences to our health are becoming increasingly scary.

It makes me even more shocked

that people would experiment with these drugs just to look good.

And now there are new substances available that may be even more dangerous.

Anabolic steroids are still the most popular kind of drug

for people looking to build muscle in the general population,

amateur athletes.

But there are people who think that those are now outdated and old-fashioned.

When Arnold Schwarzenegger was taking steroids, he was taking drugs

that were approved for medical use to treat real illnesses.

But these new molecules have never been approved for human use.

They have not gone through clinical trials.

And yet their use does not exist in the shadows.

You can watch videos on the internet of people taking them.

So, this is the real thing, guys.

I've got IGF-1 LR3 in there, it's 50mcgs,

and I'm also shooting HGH Frag, 500mcgs, post workout.

And I'm going to do that right here, guys. They are legal.

While they are banned in competitive sport, these drugs are so new

they are completely unregulated, meaning anyone can buy them.

I'm running a more pharmaceutical grade GH...

He's selling, or at least advocating the use of, drugs that have

not been proven to be safe in humans,

that have very profound effects on people's bodies.

And to do what? To get bigger muscles.

I got my syringes up here. I label them. That is IGF LR3

I just put LR3. Ten units, mix it.

I'm going to put this right in the side of my leg, guys.

Easy peasy.

It is a little bit like science 200 years ago,

of scientists experimenting on themselves.

It's not a big statistical trial,

it's just a community of people trying a thing.

MK-2886 is now able

to activate these androgen receptors.

This guy is talking about selective androgen receptor modulators.

They did not exist when I began medical school,

which wasn't that long ago.

But they haven't gone through a clinical trial. We don't use these.

No doctor in the world will prescribe these.

Let me just give you my personal experience. I am a guinea pig.

I must say, it's not been approved for human use.

Putting that out there.

If you know where to get some of these SARMs...

you can get them.

It is amazing how seductive it is.

I don't want to look like him,

but I would like to look like a movie star.

The standard that I hold myself to now comes from television

and movies and magazines in a way that I think was different to

even 15 or 20 years ago.

I'm embarrassed that I don't have a six-pack,

that I've got the dad bod,

that I've got a tummy, my man boobs.

And on bad days when I feel like it's been very hard to work out,

very hard to eat right,

the idea that I could take an injection and make it all

a bit easier seems pretty appealing.

Just put that back. HGH Fragment.

I'm going to put this and take this,

I'm going to shoot this subcutaneous.

I'm going to shoot that right there. Go in here. Boom.

I can't believe I'm even wrestling with it, really.

It's... You know, I think because I, like everyone else, would like

to look a bit better and would like a magic injection to do it,

but this is not the way.

These are dangerous drugs. No-one should do this.

A lot of people want to know,

"How much side effects do you get from steroids?

"You're on all these dosages, how do you feel?"

Guys, I feel perfectly fine.

Ultimately I think anyone making videos about this on the internet

is exploiting a group of vulnerable and poorly informed people

who are not taking these drugs for what I would say

are important reasons like serious medical issues.

At the heart of the doping story is an arms race.

On one side, drug manufacturers and athletes who are constantly

looking for new ways to get around the law.

On the other, scientists whose job it is to safeguard our health.

Professor David Cowan runs the UK's drug control centre at

King's College London, one of the world's leading sports doping laboratories.

It's here that athletes' samples are tested,

here that careers can be potentially destroyed.

One of David's main concerns is that users have

no way of knowing where their drugs come from or what is really in them.

Unfortunately, a lot of substances are available very easily

through the internet.

There seems to be very little regulation,

very difficult to control.

You don't know what you're going to get in the packet.

This is just one of the source of supply that we had,

which ostensibly is supposed to be a growth hormone.

In fact, when we analysed it,

it did not contain any growth hormone at all.

Growth hormone happens to be a fairly expensive drug.

You might have to pay as much as £100 for a vial.

Fortunately, this is relatively harmless for someone misusing it,

other than damaging their pocket.

By not knowing what's in your counterfeit drugs,

you could be playing Russian roulette with your life.

And because of the potential profit

to be made on performance-enhancing drugs,

some are being pushed by the same people who deal in illicit drugs.

What we're finding are

the black market suppliers may be the same people

who are selling hard drugs, the drugs like the cocaine and heroin.

And the conditions these counterfeit drugs

are being made in are shocking.

People are making injectable materials in garages.

That means that you may be injecting a load of bacteria like E. coli,

which can cause serious harm, can even kill a person.

Unfortunately, people who buy it have no idea

because they take a lot of trouble on making the packaging look OK,

but obviously they don't take the same care with what's inside.

Erm... It's disgraceful.

As well as monitoring the illegal supply chains of drugs,

the laboratory at King's is also a key weapon in UK Anti-Doping's

fight against the use of drugs in elite sport here in Britain.

They analyse more than 7,000 blood and urine tests

across 40 sports every year.

But because athletes who want to cheat can take these drugs

during training and not just on race day,

UK Anti-Doping CEO Nicole Sapstead believes they have a difficult job.

Whether we're actually catching people is incredibly

difficult to quantify.

I've always said that if you really want to be

a sophisticated cheater, you're probably one step ahead of

anti-doping organisations like us, but we do have some tools available.

We have a tip-off line, which enables other athletes, or

even the public, to tell us if they think that individuals are doping.

We have a national registered testing pool,

which means that they have to tell us where they're available

to be tested every single day of the year.

And then we are able to store samples to re-analyse and that

in itself must be a frightening prospect for

athletes who are choosing to dope.

Samples can now be kept for up to ten years and tested when new

techniques or methods are developed.

This year, over 30 athletes from the Beijing Olympics and more

than 20 from London who originally tested clean have been

retested and come back positive.

BUZZER

So, the authorities do have some success.

But when there's fame, glory, and millions of pounds on the line...

BUZZER

..it can become a cat and mouse game,

as athletes try all sorts of ways to avoid being tested.

And there are some who manage to get away with it.

BUZZER

Lance Armstrong doped for years without getting caught.

So, how do they do it?

Well, there are a number of ways to avoid giving

a sample in the first place.

Tim Montgomery has admitted to going on a cruise when

he knew the officials were coming.

And if there's nowhere to hide when the inspectors come,

don't panic - to pass a urine test,

you can use one of the weirdest devices I've ever come across.

In his autobiography,

world heavyweight boxing champion Mike Tyson admitted to using

this strange gadget to pass drug tests before and after fights.

So, I've just received this box and I'm quite sceptical about it,

but I really want to see if it does what the makers claim it will.

In this box is an extremely lifelike fake penis.

And I'm about to show it to you.

Those of you with a sensitive disposition should probably

look away now.

HE CHUCKLES

So, this is... Wow! Wow!

So, that is amazing.

I was not expecting this to be that good,

but this is really quite a convincing fake penis.

Maybe a little small.

I've always thought that training for elite high level sport

would be, you know, quite glamorous and quite a noble endeavour.

Instead, this is one of the least glamorous things I have ever done -

making fake urine in a hotel room with

a plastic penis in front of me,

but I guess if you really want to win...

This really feels like cheating,

in a way that maybe taking a few pills or a few injections doesn't.

This really is... Obviously you're doing something wrong

if you've ordered this.

What I'm quite impressed with about this is the level of

attention to detail. This is a little sticky thermometer here.

The hot pack should be facing away from my body.

All right, so, I now use the safety pin

to attach the bag of fake urine...

Ow, oh... Argh!

Why is it leaking?

I've got it everywhere.

Oh, no.

Oh!

Yeah, I think this is it.

So this just straps round here.

HE CHUCKLES

So you've got to imagine that this is inside my trousers.

OK, there is a tap under here.

You've got to remember the Olympic inspector is standing right

over my shoulder, watching.

I can give it a bit of a squeeze with my arm. OK, here we go.

HE LAUGHS

I'm just getting it everywhere!

OK, although it's a bit of a mess,

I think if I had a few more goes, I could do a decent job at this.

And you don't have to use fake urine.

I could fill the bladder with real urine and that's what

Mike Tyson was doing - using someone who was clean and using

their urine to pass his test.

This device may seem extreme but it shows that some athletes

will do anything to win.

The ultimate prize for somebody who wanted to cheat would be to find

a way of doping that was completely untraceable.

Research taking place at the University of Florida

offers exactly that.

The tantalising promise of an undetectable advantage,

one gained by so-called gene doping.

This is the future of performance enhancement.

Making permanent changes to our bodies at the genetic level

with just one simple injection.

'Professor Lee Sweeney became involved in the world

'of sports doping by accident, because of his research

'into how to stop muscles wasting away as we get older.'

That is a very fundamental medical or scientific ambition,

-to try and stop ageing.

-That's right.

I always used to say to people

in the lab, "What good is it

"if you live 20 years longer if you can't walk around the room?"

So I said we should focus on not making people live longer

but we should focus on making them live better,

especially by giving them more muscle

so that they don't lose their mobility.

Muscles deteriorate in the elderly

because their bodies stop producing IGF-1,

the protein that makes muscles grow.

So Lee figured out a way of topping up the IGF-1

in the muscles of mice using gene therapy.

And it turned out when we injected them in middle age and waited

till they got old, they didn't lose any of their muscle strength.

They were as strong when they were old as they were when they had been young.

-You stopped age-related muscle loss?

-On our first try.

-Wow.

-We were quite excited by this, as you might imagine.

He had found a way to reboot the system in elderly mice,

but his next result was even more surprising.

If we injected them when they were really young,

then they got much bigger muscles than they ever would have had,

and they kept them through their whole life.

Lee and his colleagues had invented what became known in the press

as the Schwarzenegger mouse.

Young mice whose muscles grew large without exercising.

The idea of gene doping

had been born.

Certainly got the attention of the athletic world,

and I was immediately, the day that paper came out,

I started getting phone calls and e-mails from athletes and coaches

saying, "Is this something you can do?

"Because I need it or my team needs it", or whatever.

It was wild. I had no idea that was coming.

So you're literally getting phone calls from people

who have read your scientific paper.

I got an e-mail from a coach in Pennsylvania,

-wanting me to inject his entire team.

-Really!

Does some part of you want to yell at him and go, "This is not safe, these are children in your care"?

I tried to very politely explain all of the reasons

this was a bad thing and a rotten thing to even ask.

'But despite the initial success,

'ten years on, Lee's treatment remains unproven in humans.

'He's now trying to cure a devastating illness

'called muscular dystrophy that affects young boys,

'focusing on the other main protein involved in muscle growth,

'myostatin.'

IGF-1 drives muscle growth,

myostatin is there to put the brake on muscle growth,

so the body maintains its muscle mass by creating a balance

between how much IGF-1 there is and how much myostatin there is in the muscle.

So you block the myostatin and that allows the muscles to grow freely?

Yeah, cos now the IGF-1 signalling is unchecked

and so you can get more muscle.

'A single injection to the liver

'stops myostatin working throughout the body,

'making all the muscles grow larger

'like the mouse you can see on the right.'

So this one is really broad across the shoulders.

He does look like he's been in the gym.

The muscles in this animal could be anywhere

-from 25-50% larger than normal.

-Really?

All of the brakes have been taken off and IGF-1 is allowed

to make as much muscle as it can. This guy has never exercised.

-This guy just sits in the cage and has giant muscles.

-Wow.

'But when you see the myostatin mouse running alongside a normal mouse,

'it becomes obvious that muscles aren't everything in sport.'

So you really can see the difference between those two.

That is extraordinary.

It looks like a carthorse, he's just sort of slogging away.

-It is the bodybuilder trying to run the marathon.

-Yeah.

Whereas this other one is very agile and nimble.

And can take off in quick little spurts.

So he is really the Mr Universe of mice. He's not a useful size,

he's just impressive.

He could probably hold his own at weightlifting

and certainly at calendar poses, but that's about it.

I guess I began thinking about doping,

thinking about using hormones that our bodies naturally make

to exaggerate the body's normal state.

And now we're talking about gene therapy,

about molecules that block hormones in very complicated, specific ways.

This seems almost impossible to regulate

or govern or prevent people doing,

is that the sense you have?

Well, you know, certainly, agencies like Wada are quite concerned

by this because there are lots of different strategies

you could use once you get into gene therapy

that could elude detection, so I think it will be an arms race

once the doors open and gene therapy becomes something

the athletes can access, and at that point,

it's going to be tough to keep up.

So all the research that I've seen today that Lee's doing

is incredibly exciting, and I spent the day really hoping

that he succeeds, not just in curing fatal childhood illnesses

but also making old age better for all of us, but the problem is

that the more successful that research is,

the easier it is to cheat as an athlete.

But what if there was a way to legally increase

your sporting prowess and make your way to fame and fortune?

Almost everyone in the UK begins their day

with a cup of tea or coffee,

and that's because it contains caffeine.

If you're anything like me, you need that just to survive the morning,

but how does caffeine affect athletic performance?

To answer that question, I've roped in my identical twin brother, Chris.

How are you feeling, Chris?

Lousy, because Xand has deprived me of caffeine for 48 hours.

Can we get on with this?

'We've gone without tea or coffee for two days because this afternoon

'one of us is going to be doped with caffeine

'by sports nutritionist Dr Mayur Ranchordas.'

So, Mayur, what's the plan today?

We're going to do a battery of tests to get your baseline measures,

so we're going to measure your reaction time,

look at your grip strength,

see how high you can jump

and we'll finish off with a 1km time trial on the treadmill.

'After we've seen how we perform without caffeine, it's time to dope.'

I have the gums. Chew those for me, please.

All right, off we go.

Why can't we just have a cup of coffee?

Because the mode of delivery with the gum means that you absorb

the caffeine in your mouth, which basically means that

your plasma caffeine levels increase quicker,

so it's a faster-acting method of delivery

compared to a cup of coffee.

'It takes 20 minutes for caffeine to hit peak concentration

'in the blood stream...'

Here we go!

'..and then it's time to do our tests again.'

This is pathetic, on your left.

'One of us has been given a 300 milligram dose.'

-9.4.

-Read it and weep.

'That's around the same as two strong cups of coffee.

'While the other has chewed on a placebo.

'It's thought that caffeine improves performance

'by affecting the central nervous system.'

We know that it reduces your perception of effort during exercise.

It can improve the ability to produce strength and power.

We know it can keep you alert and enhance your reaction time.

That's good, that one. 33.

'So, did it work on us? The results were pretty convincing.

'I was the one who got doped while Chris got the placebo,

'and in every test except the hand grip,

'my performance improved over the baseline tests.'

So with the gum, I got 2% better over a kilometre

and Chris got 1.5% worse.

The 1-2% improvement is the difference between

getting a medal and finishing outside of the top three.

'And of course, winning a medal can bring fame and glory

'and can secure that lucrative sponsorship deal.

'There's now a large body of evidence that shows caffeine

'improves performance in a range of sports by up to 3%,

'and athletes do use it.

'Mayur recommends it to the Premier League footballer players he advises.'

'But if it works, then why isn't banned?'

The problem you have with trying to ban caffeine is that

it's so widely available, you have it in cola, energy drinks,

chocolate, tea, coffee,

so trying to monitor that,

you're entering this real grey zone area.

At that point, surely, you could start to think about banning,

I don't know, bananas. Presumably, you could do a trial

that proved bananas were better than no bananas for performance.

Exactly, it's the whole carbohydrate argument that if you give

someone carbohydrate you can extend performance and we know that

if you give someone a carbohydrate drink,

we know you can enhance performance that way,

so where do you draw the line?

From specialist nutrition to hi-tech equipment,

every aspect of an athlete's life has the potential to be made over.

And the latest place that they're looking to improve performance,

completely legally, is in the brain.

Today, Chris and I are taking part in another test...

..to see if we can change the way our brains behave during exercise.

-Hi, Lex. Chris.

-Hiya, Chris.

-Hi, I'm Xand.

-Hi, Xand, nice to meet you.

Very nice to meet you.

'The man who will be playing with our minds is Dr Lex Mauger.'

We'll be performing a technique on you

called transcranial direct current stimulation.

So what were going to be doing is passing

a very mild electrical current over an area of the brain

called the dorsolateral prefrontal cortex,

and the intention of that is to try to reduce the pain that you feel during exercise,

and we expect the effect of that

is to improve your endurance performance.

So you're running an electrical current through our brains?

-Essentially, yes.

-Is that going to hurt?

No, the sensation that you should feel during this

is a mild tingling sensation.

Maybe a slight burning, perhaps a bit of itching,

but that should be fairly transient.

You might feel it for the first few seconds or couple of minutes.

'Lex's research has shown this kind of brain stimulation

'can make athletes push themselves further

'because they feel less pain.'

That is interesting to me, I guess,

how much pain is involved in athletic performance?

The main reason that I don't run fast a lot is cos it hurts.

-Like when we ran the marathon.

-That's laziness, that's not pain.

It was not that the pain was unendurable,

it was that I was going to put up with pain for another four hours.

Four and a half, as it turned out!

'Lex wants to know whether brain stimulation

'will help us cycle faster for longer.

'One of us will be stimulated

'while the other will be receiving a sham treatment.'

So we're ready to go with the stimulation now.

We're going to ask you to sit quietly for 10 minutes.

'We'll both feel the same sensations...

'but neither one of us will know who's getting the real thing.'

That's quite unpleasant.

Oh...

It's like a little needle being stuck in my shoulder and in my forehead.

-Stimulation is over.

-Right, up you go, we'll get you on the bikes.

'We have to cycle 8km as fast as we can.'

We're going to go in three, two, one...

Off you go.

'During the race, Lex monitors our breathing and heart rate

'to see if our effort decreases as the pain sets in.'

'In his research to date, Lex has shown

'that an athlete cycling until exhaustion

'can improve their performance by up to 20%.'

'Enough to win you the Olympic marathon by half an hour.'

'But for this test,

'he has two twin brothers competing against each other.'

'And there's no scientific way of factoring in the rivalry between us.'

'Because Chris cycles to and from work every day,

'I sort of expect him to beat me.'

'But as we get close to the end, I'm in the lead.

'And I stay there until the finish line.'

'An unexpected win to me.

'And Chris suspects I've been stimulated.'

You were stimming!

You've been cheating with your brain.

You've been electrically doping.

If you found out now that I was the one that was stimmed,

-would you feel like I'd cheated?

-Yes.

But you'd just have been a baby and not tried.

'And Chris was right.

'Lex had stimulated my brain.'

'Not only did I win

'but the metabolic data showed I'd pushed my body harder.

'Obviously this wasn't a scientific experiment.

'But our test does back up Lex's impressive results

'in the lab, where he's shown massive gains in performance.

'For some athletes, that means

'transcranial direct current stimulation is worth trying.'

I think it's likely that teams are doing this already and some

have been fairly open about its use and have actually been

partnered with companies producing these devices,

but it's important to note that this is not illegal.

It's not controlled by anti-doping.

It's something that athletes can engage in if they want to.

They're not going to get penalised for doing this.

'While this technique may be unproven so far, it's these kinds of

'performance-enhancers that will become more common in the future,

'as athletes try harder to get around the system.'

For many people, it's devastating to hear

that their sporting heroes have been cheating to win.

The morality of the entire sports industry can come under question.

Because the rewards of success are so great for elite athletes,

they seem more and more willing to experiment with their bodies.

As a doctor, the people I'm really worried about

are the general public.

Because the evidence is now clear that the effects

of performance-enhancing drugs on the body can be shocking.

From deadly heart conditions to permanent brain damage

and even organ failure.

The risks associated with taking these substances are terrifying.

And my concern is that as doping behaviour becomes normalised

in amateur sports and in gyms across the country,

it's the next generation who will be most at risk.