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!