Anti-Doping 101

USADA is committed to making sport safe, fair, and authentic at all levels of competition, through independent and comprehensive anti-doping programs. One key component of a successful anti-doping program is strategic drug testing, in accordance with the World Anti-Doping Code. USADA’s gold standard testing program utilizes in-competition testing at events and no advance notice out-of-competition testing, which can occur at any time and any location. Athletes selected for testing may be required to provide urine, blood, dried blood spot, or any combination of these sample types during a sample collection session. This applies to U.S. Olympic and Paralympic athletes, International-level athletes, as well as non-Olympic and Paralympic athletes.

For in-competition testing, a doping control officer, known as a DCO, or a notifying chaperone will show their credentials, notify the athlete of their selection for testing, and escort the athlete to an official doping control station located in a safe and secure area for collecting and processing a sample. The athlete must remain in direct observation from the time of notification until the test has concluded. Athletes are required to report to doping control immediately, unless a valid reason is discussed with and permitted by a DCO. Some valid reasons include performacing a cool down exercise, attending a medal ceremony, competing in further competitions, receiving medical attention, locating a representative or an interpreter, or other justified circumstances agreed to by the DCO.

For out-of-competition testing, an athlete is located and notified for testing without any prior notice. While there is no doping control station for out-of-competition testing, the toilet area must be safe and secure for both the athlete and DCO. The athlete must remain in direct observation of the DCO from the time of notification until the test has concluded.

Some athletes are in a Whereabouts pool, which means they are required to provide Whereabouts information, or details of their schedules and locations. The information provided by an athlete allows a DCO to locate them for no advance notice testing, at any place and time. Before a test, the DCO is responsible for reviewing the athlete’s Whereabouts information to find them at the location they have listed in their Whereabouts filing. For example, if the test attempt is made at a large training complex, the DCO should check all relevant areas where the athlete may be located. If an attempt is made at a personal residence, the DCO should make multiple attempts to locate the athlete by knocking and/or ringing doorbells at the front door or main building access point. If the DCO is attempting to locate an athlete in the registered testing pool, or RTP, during their 60-minute time slot, the DCO is expected to remain at the location listed in the athlete’s Whereabouts until the end of the 60-minute time slot. The DCO is expected to use common sense and reasonable effort in attempting to locate the athlete for testing.

Whether the sample is collected in- or out-of-competition, athletes will be asked to select a sealed sample collection vessel from a choice of vessels. The athlete will inspect the collection vessel to ensure it has not been tampered with or damaged before opening the packaging. There are a variety of sample collection kits used by Anti-Doping Organizations, or ADOs, and while the kits may look different, all sample collection equipment used by World Anti-Doping Code Signatories and their designated sample collection agents is WADA compliant.

During in- or out-of-competition testing for minor athletes, a minimum of two sample collection personnel will be present during the sample collection process: one to witness the passing of the sample and one to observe the personnel witnessing the passing of the sample. Minor athletes are highly encouraged to identify an athlete representative, who can support the athlete throughout the sample collection process and who may observe the DCO or chaperone when the athlete is providing a sample.

As outlined in the World Anti-Doping Code, athletes with an impairment may request modifications to the sample collection process. Athletes with restricted mobility or limited dexterity, visual impairment, or intellectual impairment may receive accommodations, such as assistance from a representative or DCO during portions of the sample collection process. Should an athlete require additional equipment to provide a sample, such as catheters and drainage systems, it is the athlete’s responsibility to have the necessary equipment available and understand how to use it.

During the urine collection process, athletes are required to provide at least 90 milliliters of urine under the direct observation of a DCO or a witnessing chaperone. If an athlete is unable to provide the required volume, the athlete will store the partial sample in a secure vault provided by the DCO, and will use another collection vessel to provide the remaining sample when ready. An athlete must maintain control of their sample until the sample is sealed. For partial samples, the sample is sealed and monitored by the DCO until the athlete is ready to provide a complete sample. When a valid urine sample totalling at least 90 milliliters is collected, athletes will select from a choice of sample security kits. The DCO should instruct the athlete to check that the alphanumeric codes on the bottles match and correspond to the barcode on the outside of the box. This is an important step because the athlete’s name will not appear on the documentation sent to the lab. Once the athlete is satisfied with the kit and the sample code numbers have been verified, the athlete will divide their sample between the “A” and “B” sample bottles. The DCO will check that the specific gravity of the sample meets the minimum requirement. Additional samples will be collected if the initial sample is not within the required range.

Blood samples are also sometimes collected from athletes. During blood sample collection, a licensed phlebotomist, known as a Blood Collection Officer, or BCO, will perform the blood draw. To account for changes in blood plasma volume, the athlete will be asked to remain seated for at least 10 minutes before providing a blood sample. For all blood collection (not including DBS), athletes will need to wait 60 minutes after training and competition. The amount of blood drawn is less than two tablespoons and is unlikely to affect performance. Complications from blood draws are rare but can include dizziness, bruising at the puncture site, and arterial puncture or laceration. Site reactions such as bruising or swelling can be minimized by applying pressure to the collection site for at least five minutes, avoiding strenous exercise for at least 30 minutes, and keeping the bandage on for at least two hours. If you have experienced complications from previous blood draws, please inform the USADA DCO or BCO before the blood draw begins. Once the blood sample collection process has been completed, the BCO will label the blood tubes with the sample code numbers, and the samples will be secured in a blood security kit. For ABP blood draws, athletes will be asked supplementary questions that are important to the analysis of the sample. For example, athletes may be asked about recent exposure to high altitudes and other extreme environments, as well as recent exercise and blood loss.

Over the years, anti-doping experts have conducted research to make blood collection easiser for anti-doping organizations and improve the athletes’ experience. Dried Blood Spot, or DBS testing, remains an innovative method for collecting blood samples without venipuncture. For DBS testing, an FDA-approved sterile collection device is adhered to an outside portion of the upper arm, or the abdomen if the arm is not available. The DCO will apply a device to clean skin and push the red button to start the collection. There is a small prick, which means the device is working properly. This testing method allows USADA to collect a series of small capillary blood spots with the push of a button and requires about 25 times less volume than traditional blood collection methods. The collection may take up to 10 minutes. The device is removed, as well as the collection cartridge from the device and placed into a compartment of the tamper-evident security kit. After collection, DBS samples can be transported without refrigeration and can be stored for longer periods of time, leading to greater opportunities for blood collection and sample analysis. Although DBS testing is scientifically advanced and precise, it cannot fully replace liquid blood collections for the purposes of the ABP.

With the continued advancement of science, USADA prioritizes innovation for the benefit of clean athletes. Athletes can expect to see micro-capillary blood collection devices, such as the Tasso+, more frequently as these devices offer a convenient and virtually painless way to collect liquid capillary blood. These needle-free devices adhere to the upper arm and collect approximately 500 microliters of blood, which is six times less than a standard venous blood draw. Blood collected from these devices can be analyzed for the same substances as venous blood samples, including the parameters used in the Athlete Biological Passport.

During the sample collection process, athletes should declare any prescription and non-prescription medications, injections, blood transfusions, and/or dietary supplements they are taking on the Doping Control Form, or DCF. If an athlete is taking a prohibited substance or prohibited method and has been granted permission to use the otherwise prohibited substance or method via a Therapeutic Use Exemption, or TUE, the athlete should note that on the DCF. Declaring all medications, supplements, medical procedures, and TUEs on the DCF is essential for fairness, transparency, and the athlete’s own protection in the sample collection process.

During this time, athletes can also indicate if they wish to consent to research. Consenting to research means that once all analyses have been completed and the sample would otherwise have been discarded, the sample may instead by used by WADA-accredited laboratories for anti-doping research, provided that the sample can no longer be identified as belonging to the athlete. This research is crucial to keeping anti-doping science on the cutting edge, which plays a major role in our ability to protect clean sport.

Once complete, the DCO will ship the sample(s) to a WADA-accredited laboratory and will document the chain of custody for the sample to protect the sample’s integrity. The official sample collection documentation that accompanies the sample(s) to the WADA-accredited lab does not include the athlete’s name or other identifiable information. The sample may be stored at the laboratory and retested in the future. An athlete will receive notification by electronic mail from USADA confirming that the analysis has been completed. If the sample(s) were collected by another anti-doping organization, the athlete may not receive the results or any form of notification.