Following the tragic death of the cricketer Tom Maynard there has been a recommendation that hair testing should be carried out on sportsmen and women to enable the detection of drug use. Is this feasible and what are the benefits?
A young man on a night out takes some cocaine, MDMA (ecstasy) and drinks a lot of alcohol. This isn’t that uncommon. According to the latest Home Office Figures at least once per month approximately 325 000 adults between 16 and 59 use cocaine and 180 000 use MDMA (1 and 0.5 % of the adult population respectively). Meanwhile it is estimated around 85-90 % of adults drink alcohol regularly and 13 % of the population indulge in ‘binge drinking’ (again, Home Office stats).
The results of toxicology testing of Tom Maynard indicated the alcohol in his system was approximately four times the legal drink drive limit. This suggests he would have been seriously affected by alcohol, a drug which impairs coordination, judgement and behaviour. He was also found to have used cocaine and MDMA.
It was recommended by the Coroner that hair testing be bought in to help the cricket authorities to supplement the current tests and help to detect any drug misuse by the cricketers.
What are the current tests for cricketers?
Currently cricketers are tested for drugs under the World Anti Doping Agency (WADA) code. These tests are urine samples given in and out of competition. The drugs that are looked for vary depending on whether it is an in or out of competition sample. Out of competition WADA are only interested in drugs which may give significant performance benefits in the future (such as EPO or testosterone), whilst in competition they are looking for things that may also affect the performance on the day (such as stimulants).
Both cocaine and MDMA are classed as stimulants and are only banned in competition for cricket.
The penalty for testing positive for either cocaine or MDMA in competition is a two year ban from sport.
The Football Association (FA) has introduced out of competition urine testing for ‘social drugs’ as part of their role in helping their players. These tests run in conjunction with the WADA directed testing outlined above. If a player fails a test for ‘social drugs’ (typically cannabis, cocaine and MDMA) the penalty ranges from a warning to a 6 month ban. This is accompanied by an education programme for all young footballers.
What can hair offer over urine samples?
The Coroner suggested hair was used and the cricket authorities agree they will look into that avenue. Testers can find most drugs of abuse in hair and urine samples.
When a drug is incorporated into the hair it gets locked in place and stays there until the hair is cut from the head. As head hair grows at around one centimetre per month if someone has hair 6 centimetres long we can go back and test their drug use over the past 6 months!
Contrast this to blood and urine:
Blood offers the best method of detecting if someone is currently under the influence (useful for driving offences and such like). Cocaine may be detectable in blood for 12-24 hours after use.
Urine offers the best hope of catching recent use. Cocaine and its breakdown products remain in the urine for a couple of days.
The downside to urine sampling is that you would not catch someone who had taken the drug a week or two ago. This would mean if a user knew they may be tested they could abstain for a few days and be clear of drugs. [Cannabis is an exception and may be detected much longer in some scenarios]
You can screen back over a long time period with a single hair sample, it would take many urine samples to give the same coverage.
What are the downsides to hair testing?
The major one is that you would have to force everyone to have hair to compete! To make testing worth while the hair sample would have to be at least 1 centimetre long (1 months growth). Do you penalise athletes who want to have a shorter hair style or who are bald? Other body hair is available and can be tested, but less well studied in terms of the growth rates and incorporation of drugs.
You cannot pinpoint when a drug was taken with hair testing (currently). The toxicology report for Maynard suggested that his levels were consistent with daily use. This is very hard to say. Was it daily use? A big binge once a week? That is impossible to tell from a single reading.
That point leads on to another big one – civil liberties. Is it your employers business if you are taking drugs at the weekend and they are not affecting your work? With hair testing you cannot tell if someone used drugs on two Fridays during the month or at work!
The way forward?
My suggestion would be to look at the FA programme and supplement that with hair tests. The hair sample will give the coverage to tell if someone has any history of drug use, whilst urine will tell you whether the drug use was in the last few days.
I would also add alcohol to the list of drugs screened by hair tests. It is possible to look at whether someone is a potential problem user of alcohol due to the build up of various markers in the hair.
Currently WADA do not accredit laboratories to use hair samples for doping control, so the use of hair samples would be purely for social drugs rather than performance enhancement. With that in mind:
The tests give best results in conjunction with each other rather than separately.
Please also see my ‘Drugs in hair introduction‘ for further background and feel free to sign up for future updates!
It’s a very sad case Dr B. What a talented man he obviously was.
It’s interesting that cocaine and ecstasy are classes as stimulants and therefore banned. I would be very surprised if a sportsperson’s performance was actually enhanced from taking these drugs. Would it be more appropriate for the team managers to test for drugs with the aim of targeting players whose performance was actually reduced by their drug taking?
As for the hair length, would you spot the sportspeople taking drugs by their bald heads?!
Hi Sophie, thanks for the comment. The stimulant effect in competition could mean that they are able to bowl a bit faster or run a bit quicker than without. I am not sure MDMA would do much for their aggression though.
I think you are completely spot on with the targeted testing approach. Also sports do take seriously the education of their players around the use of drugs including alcohol. Again the FA are very good on this. For performance enhancing drugs the testers already target certain sports more and individuals they have doubts on more than others too.
I think the hair length issue will actually be a very big sticking point in negotiations.
Thanks again
What are the costs of hair analysis vs urine? Is sample prep more complex? Don’t know if athletes may object to having hair samples taken – I don’t think they mind too much giving urine (non invasive) and blood (all done in a few minutes) but hair?
I think a more effective out of comp urine testing programme would do the trick, a good deterrent if you know you are likely to be tested regularly on an unannounced basis off season.
This of course would require some investment from the authorities, the FA may have the funds but other sports like cricket?
Good questions CB and some good points. Hair testing need not be any more expensive, but would depend on the methodology used. You can still use an immunoassay screen followed by mass spec confirmation (as for most workplace type urine screens), or a single extract for a broad screen of drugs straight to a mass spec based technique.
The sample prep is a little more involved than urine but not much when you have a large scale operation.
I think the urine testing has drawbacks, mainly window of detection if you are looking at social drugs.
Taking hair should be quicker and easier than blood or urine with none of the waiting hours to produce a sample that happens sometimes. I can see some young people having personal objections to having a hair sample taken though. The sample required is about the thickness of the cable on a mouse. This doesn’t leave a big bald patch on the head.
Funding – cricket isn’t as well off as football so we’ll see what they can come up with.
Thanks for your thoughts!
It’s very interesting to read all the comments made above. You’ve also raised the issue of funding in cricket for more comprehensive testing. I come from the part of the world where cricket is a multibillion dollar business with players often experiencing burnout and fatigue issues due to tight schedules. So far nobody has failed a dope test. It would be interesting to see if hair testing is trialed as a sampling method in this part of the world for monitoring doping.
I remember back in the late 90′s early 0′s some local rock climbers here in Sheffield starting to complete and became nervous about in-competition hair samples being taken with the culture in the climbing scene for ‘social drugs’. The trend for dreadlocks and long hair in general did seem to change to very short hair around that time although I’m sure more due to a coincidental change in fashion than anything else.
Tom Bonnen popped a positive for cocaine a few years ago and I believe he was suspended more due to his status as a national role model in Belgium than for any WADA violations. Bringing the sport into disrepute is enough for a ban depending on the national body’s perspective on things.
If the testers took a mouse cable’s worth of hair each month then after a couple of years everyone with long hair could look like Glen Plake.
Cheers Ben, I didn’t realise climbing was a competitive sport to the extent they might do drug testing!
If I remember correctly Boonen was never suspended by the sporting authorities but by his team? He tested positive three times out of competition over three years. The Tour de France also suggested he didn’t enter one year due to that.
I think rather then Glen Plake there would be a lot of Michael Klim look-alikes if this was bought in : )
What do you make of this story from Boston finding “the present state of hair testing for drugs of abuse … does not meet the standard of reliability necessary to be routinely used”?
Hi John,
Thanks very much for the link, I hadn’t seen that.
A few comments on the article (not the full report which I will have to try and get hold of):
Interpretation – I see this as the biggest issue with hair testing. How the drug entered the hair is not certain, we can perform measurements to help aid this (to see whether it is likely to be from external contamination) but as I showed in the paper on methamphetamine lab children it is still possible to test positive even if it is very unlikely you have used a drug (given other factors such as passive exposure).
The report states ‘A reported positive test result is not necessarily conclusive of ingestion’ – I agree to an extent. It proves that the drug is within the hair sample tested. The analytical methods are sound, but how the drug got there is not entirely known – see above!
However, some of the excuses listed do not seem to be very convincing, brushing powder off a seat? I would suggest their evidence handling procedures need to be looked at!
Dose response relationships are one other area that needs to be looked at with caution, I didn’t like the way the Maynard inquest was told his levels in hair were those of someone who used daily – how was that determined?
I think their is enough literature on the subject and enough evaluation has been completed to use hair in various scenarios, but with some level of caution in making things black and white.
Interesting thoughts tho’, may well write them up a little more later!
Thanks again
Tom