Your handy guide to the TUE controversy
The plethora of excellent reporting on WADA’s hacking scandal, which broke last week, has made it difficult to keep up. So here’s a handy guide to cycling’s latest TUE controversy. We hit all the big points and link out to related stories if you want more detail.
A group in Russia hacked a World Anti-Doping Agency (WADA) database and is slowly releasing Therapeutic Use Exemption (TUE) documents for athletes from many sports and nations. They cast a wide net, from Chris Froome to Rafael Nadal.
British riders Froome, Bradley Wiggins, Callum Skinner, and Laura Trott have all had TUE documents released. Australian Jack Bobridge saw his released as well.
The group calls itself Fancy Bears’ Hacking Group, and its website is covered in quirky, old-school bear animations. This is funny, but the subject is quite serious.
Why does it matter?
Fancy Bears claims that the documents prove athletes are doping, but this is a cynical (and inaccurate) view of TUE documents.
Highly simplified, a TUE is a doctor’s note that allows an athlete to use otherwise banned substances when that substance is required to stay healthy. They are rarely released to the public due to medical privacy laws.
The irony of Fancy Bears’ language (which uses phrases like “Here is the next batch of doping athletes”) is that a TUE is the only legal way to take banned substances.
But wait, isn’t knowingly taking a banned substance still, like, doping?
This is where things get interesting. There is an argument to be made (and it has been made) that TUEs are doping, particularly since it’s a system we know has been abused by athletes. It’s a gray area, really.
There’s no doubt that some athletes occasionally need a banned medication. Think asthmatics, or riders suffering from other respiratory problems. Getting rid of the TUE system, as nice as that sounds in a black and white world, is not a realistic solution.
“It’s something that needs reform,” anti-doping researcher Paul Dimeo said. “But I don’t have the easy answer, and I don’t think anyone really does.”
TUEs are intended to normalize a condition, bringing an athlete back to baseline. When they’re used to push an athlete above baseline, that’s a problem. That’s doping.
The CIRC report mentions TUE abuse. We know it happens. It also specifically mentions a few of the drugs that Froome and Wiggins got TUEs for as being ripe for abuse.
This is not the first time TUEs have generated controversy in cycling. Simon Yates was banned for four months earlier this year after a doctor failed to process a TUE application. Froome, too, been questioned about a pair of TUEs in his past.
How would you abuse the TUE system?
For a rough analogy, let’s step into the way-back machine to grade school. You’re on the cusp of an A in chemistry. You forgot to do your homework. So your mother, who has a vested interest in your success because her comfortable retirement depends on you getting into med school, writes a note to your teacher promising that you did, in fact, do your homework. But the gerbil ate it. That damn gerbil. She swears up and down. You take the corner of a piece of paper and snip the edges so it looks like a gerbil bit it. The teacher accepts the note and gives you the A.
In this analogy, your mother is a shady team doctor, the enabler. The falsely gerbilized paper is an ailment like asthma that can be treated with the desired doping product (the A). The teacher is WADA, or the UCI’s TUE panel, which approves TUEs. You’re a bike racer who wants to ace the Tour de France.
According to CIRC, and to Jorg Jaksche, there is a vast army of vested mothers and shady gerbils in cycling’s past. Depending on whom you ask, Fancy Bears may have just proved that the problem remains.
What about the Wiggins and Froome TUEs? Were they doping?
Wiggins first: He’s had six TUEs, three in the second half of 2008, all for salbutamol, an asthma drug. It’s been established that Wiggins has asthma. Nothing shady here — this sort of thing is why TUEs exist.
Three more TUEs were for Triamcinolone acetonide. That’s a corticoid steroid also used to treat asthma (among other things). It’s a substance that also helps burn fat and reduces fatigue, according to athletes who have admitted taking it. It’s a known performance enhancer when used in sufficient quantities.
Two of the three TUEs for Triamcinolone acetonide were administered via intramuscular injection just before the Tour de France, first in 2011 and then in 2012, the year Wiggins won the Tour. The other was administered before the Giro d’Italia in 2013, which Wiggins dropped out of after 12 stages.
This is interesting because 1) Wiggins wrote in one of his autobiographies that he didn’t use injections, while these are clearly injections; and 2) Triamcinolone acetonide is a powerful drug that medical professionals like Jeroen Swart say is not a “first line therapy.”
In an interview with CyclingTips, Swart explained that “either they have prescribed it as a preventative medicine, which doesn’t sit well with me, or he had such serious symptoms that they were completely uncontrollable and that just happened to happen coincidentally a couple of days before he contested a Grand Tour.”
Further, corticosteroids can be taken orally or topically without a TUE. But they don’t have the same purported performance enhancements in these forms.
A Wiggins spokesperson clarified that Wiggins, in his book, meant he didn’t have any intravenous injections, not intramuscular injections. Which brings to mind Bill Clinton’s classic line, “That depends upon what the meaning of the word ‘is,’ is.” It doesn’t exactly pass the common sense test.
Froome’s TUEs were less controversial. They were for prednisolone, another corticoid, and came in late May 2013 and late April 2014. But these are nothing new; their presence in Froome’s medical history was already public.
So should I be angry?
Yes and no. None of these TUEs indicate doping. Froome and Wiggins had TUEs. Doctors said they needed the medication. The question is whether athletes should have such TUEs at all.
David Millar said that the drugs Wiggins took should be banned completely. But he’s not a doctor, and the TUE docs would apparently disagree.
The greater issue is one of trust. From a broader perspective, the incident casts doubt on the otherwise clean image Sky has put forth for half a decade. Sky previously stated that it would rather pull a rider out of a race than provide such powerful substances to them. That clearly was not the case.
To the TUE skeptic, it suggests a willingness to push the rules, if not outright break them. The leaked TUE documents are also proof that Sky has not been as transparent with media and fans as it has previously touted.