Confessions of a drug user

Confessions of a drug user

by Hal Higdon

My primary physician recently sent me to a lung specialist to see if we could cure the asthma-like symptoms that had plagued me since October, the aftermath of a bout with bronchitis the previous winter. I could barely breathe when I ran--if I could run--and sometimes I awakened in the morning gasping for breath.

The specialist prescribed Advair, which is actually a combination of Fluticasone Propionate and Salmeterol. It is dispensed by an oral inhaler. I had been using another inhaler, Combivent, for several months, but while Combivent relieved my symptoms, it did little to prevent them. With the new inhaler, I was amazed at the sudden improvement in my breathing. I could run free again!

One minor problem: The ingredients in Advair are on the restricted substance list of the United States Anti-Doping Agency. Salmeterol, specifically, is listed as a stimulant. It increases alertness and blood flow to the muscles, states Jeff Podraza, Pharm.D., manager of drug references for the USADA. That means that if I'm tested at the World Masters Championships in Puerto Rico this summer, I could get caught using a "performance-enhancing drug." I could be suspended for two years. Any medals I won (and I have won four gold medals at previous Championships) could be stripped from me. Worse would be the embarrassment to me as a recognizable spokesman for running as a healthy sport.

Advantages for an endurance athlete

The advantages of an endurance athlete taking Advair seem questionable to me. Too much stimulation could cause a marathoner problems if he goes out too fast in the early miles. One side effect from my inhaler is dehydration. I often awaken with a dry mouth. That is probably due to the Fluticasone suggests Dr. Podraza, who also cites Salmeterol's anabolic properties. Salmeterol is a so-called Beta-2 Agonist, which is used to increase the weight of livestock in feed lots. Athletes apparently can use it to gain strength and weight, although that too has pluses and minuses. I can't see how the ingredients in Advair would do me much good as an endurance athlete, but still: they are on the USADA list.

But how do you explain the large number of elite athletes who suddenly seem to have asthma? Consider that among athletes surveyed at the Olympic Games in Sydney, 10 percent took asthma medications in the three days before being drug tested, although only 1 percent of the general population has asthma. Australian Olympians who declared themselves asthmatic increased from 10 percent to 20.6 percent from 1988 to 2000. According to the late International Olympic Committee medical chief Alexander de Merode, the number of those using asthma drugs at the Olympic Winter Games ranges between 70 to 80 percent. Do these athletes know something that the rest of us do not know?

Risking suspension

Must I risk suspension if I continue to use my asthma medication and am drug-tested in Puerto Rico this summer? Not necessarily, as I learned after calling the USADA's drug reference line: 1-800-233-0393. Athletes with questions about medications, prescribed and unprescribed, are encouraged to do so. They also can visit the USADA Web site to check a list of banned drugs. I called the toll-free number and left a message. Dr. Podraza called back within the hour. He explained that while the ingredients within Advair are restricted substances, my physician could provide me with permission to use my inhaler. There is a form for that purpose on the Web site.

But if I didn't know that, or showed up at the Worlds without realizing that my medication was a banned substance, I could face suspension for two years. That happened to an American female sprinter at a previous World Masters Championships. She got busted for using a common hormone, Estratest, which unfortunately contains testosterone. Today's athletes need to remain extra alert to assure staying clean. Even over-the-counter medications and dietary supplements can get you in trouble if you don't know what's in them.

It was a lot simpler for us in the old days. We simply ran.

Hal Higdon is a Senior Writer for Runner's World. He has competed in eight Olympic Trial races, his best performance fifth in the 3000 meter steeplechase in 1960. This essay originally appeared as a Bell Lap column on the Runner's World website.

Higdon's Home Page