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Laura Weislo

Is an arsenal of legal medications and supplements replacing doping in pro cycling?

CHATENAY FRANCE FEBRUARY 25 Different drugs are displayed which may be used when doping with EPO on February 25 2015 in Chatenay France Photo by Frederic T StevensGetty Images.

In the 12 years since Lance Armstrong's lifetime ban for doping shook the sporting world and turned the cancer survivor's one-time hero status into that of the most notorious villain in pro cycling, the landscape of the sport has been drastically altered. However, the stunning recent performances of riders like Tadej Pogačar, who broke Armstrong's climbing record on the Pla d'Adet, have revived suspicions.

There is no disputing that the level of professional cycling has risen beyond that of the EPO-fuelled era of the 1990s and 2000s, with Mathieu van der Poel smashing the speed records in Paris-Roubaix and the Poggio climbing record during Milan-San Remo and Pogačar breaking Marco Pantani's record ascent of the Plateau de Beille

Radio France published a report on Friday that delves into the possible methods riders use to boost their performances and finds little to account for the recent surge in speeds.

The investigation suggested that some riders could be using a cocktail of legal painkillers, supplements such as ketones, asthma drugs and possible micro-doses of illegal substances. It concluded that the tendency to "stuff riders with medication" could be lowering the barriers to anti-doping rule violations. 

Two cocktails of medication on offer at certain teams are reportedly called the 'Bomba' and 'Magic Box'.

Radio France interviewed riders, team managers and anti-doping authorities, and found that many riders are offered a wide range of medications that are not on the WADA prohibited substance list, such as a combination of Voltaren (a prescription non-steroidal anti-inflammatory drug), caffeine and paracetamol or, according to another rider, a mix of paracetamol, caffeine, the bronchodilator theophylline and a muscle relaxer called thiocolchicoside.

"Riders who wanted it helped themselves. It bothered me, it's not my mindset," the anonymous rider stated. "In any case, it's not thanks to that that some people climb the passes three times faster than 20 years ago!"

A separate report this year by Le Temps raised concerns over the possible use of the powerful opioid painkiller Tapentadol in the peloton.

Jean-Pierre Verdy, the former head of the French Anti-Doping Agency, said the combination of drugs effectively amounts to legal doping.

"All the drugs that take away pain, that allow you to relax, to eliminate cramps, to recover a little faster... All these authorized products, put together, become doping," Verdy said to Radio France. 

Riders can also legally take otherwise banned drugs using a Therapeutic Use Exemption. The practice is above board but can be used to bend the rules to allow the use of some substances that can be performance-enhancing without punishment.

"I noticed that 80% of the riders in the peloton were asthmatic and with their TUE, they could take Ventolin. But Ventolin, taken in high doses, is anabolic," Verdy said.

The performance manager of the French Cycling Federation, Emmanuel Brunet, is concerned that the overuse of medications risks creating an arms race that could bring pro cycling back to its drug-fuelled past.

"This is a major concern for us," Brunet said. "One of the most devastating deviant effects is to start seeing the same thing among young people. We know that the trivialization of medication in the past facilitated doping twenty years ago."

Riders continue to be under pressure to perform in order to keep their jobs, a situation exacerbated by the UCI's promotion/relegation scheme. Points equal a position in the WorldTour and an entry into the Tour de France, which is important for sponsors and key to the futures of teams.

The use of ketones and carbon monoxide rebreathers adds another layer to the conversation. Ketones are thought to improve recovery but can also increase the body's production of EPO, as can the inhalation of carbon monoxide. Both practices can be expensive and the danger to the athletes' health in using them is unknown.

The Radio France report states that ketone use continues even in teams who are part of the Movement for Credible Cycling (MPCC), which has advised against their use, as has the UCI, who started research into the supplement in 2021.

"Like the UCI, MPCC has been asking riders and teams from the beginning not to use ketone bodies until the research commissioned by the UCI is known," the organisation's president Roger Legeay told Cyclingnews

"This is a precautionary principle because we do not know whether there is an improvement in performance and what the short- and long-term effects are.

"We should know a response and recommendations towards the end of next year."

The MPCC successfully lobbied for the addition of Tramadol to the prohibited list but, without a test for the use of ketones, a similar campaign against ketones would be difficult.

"To date, ketone bodies are not banned by WADA, which has no intention of blacklisting them unless additional information is provided on their dangerousness and performance enhancement," Legeay said. "Unlike corticosteroids and tramadol, there is currently no method to detect the use of ketones."

The UCI played down the possible performance-enhancing effects of carbon monoxide rebreathers, telling Radio France, "the scientific data do not allow us to attribute to carbon monoxide effects on performance, greater than those observed following training at altitude", while WADA said they are "looking closely at the potentially excessive use of this device".

Aside from these legal options, improved equipment with more aerodynamic bikes and clothing can account for some of the increased speeds, but Brunet still sees a gap in explaining the superior performances of riders like Pogačar.

"Among the World Tour teams, everyone has more or less the same type of tyre, bike or clothing. Almost everything is manufactured in the same place. If there is a difference, it could probably come from genetics", but, he added, "we did not notice it when they were riding in the junior and espoir categories".

Pogačar dismissed suspicions after closing out his incredible 2024 season with a fourth victory in Il Lombardia, saying, "Cycling is a sport where in the past, people were doing everything they could to their bodies, to be better, unknowing what it does to your health, and they were risking their life...

"We now realise that cycling is a really dangerous sport. Like with an accident with your heart, you cannot push it over the limit, you need to stay healthy. And if you want to risk your health for a 10-year career, it's a waste of your life and it can be stupid."

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