New Pitfall of drug testing:Asthma Medication

[Tigercat]

http://sports.espn.go.com/nfl/news/story?id=2687451

If you haven't heard, Hollis Thomas, DT Saints, has been nailed for a 4 game suspension for steroids.

Here is the kicker, he takes a certain kind of steroids, a kind that is unrelated in effects to the kinds you take for muscle growth, for asthma attacks! Here is a guy that for years has given his time and donations of 10s of thousands of dollars to asthma charities. (Just a search for Asthma and Hollis Thomas will show years of dedication to Asthma awareness, especially amongst children.)

Now add to all this that the medication, Advair, which he took, isn't on the banned substance list.

Thomas has been appealing this suspension for most of the year, and the NFL just now decided to fully reject the appeal of this suspension. That kind of delay, and the fact that a stand-up coaching staff in the Saints are completely supporting him, tells me that its the inhaled steroids that has to be at issue.

I can't imagine that any workplace should be able to get away with suspending an employee for a month because of a false positive with asthma medication, hopefully the NFL won't.

[flounder]

I'll give you asthma.

[Tigercat]

I'll give you asthma.

Damn bottom feeder fish. Baked stuffed flounder is good though, even if it destroys my airways.

[QuikSand]

Is there any particular reason to believe this sroty is any different than the legions of other steroid users/cheaters who get caught and then blamed something harmless for an alleged "false positive?"

I read the linked article, and other than the affirmation that he has been a user of the aerosol medication, there's nothing else to back up the argument. That seems to have been enough to convince the ESPN headline writer, and the hometown fan... but is there anything more (publicly) to this story?

Maybe he's telling the truth, and is just a casualty of so many cheaters-then-liars who went before him. From the story, it's certainly also possibe that the guy has been wantonly abusing clearly banned substances, and has just decided to use this asthma medication as the plausilble-enough alibi like every other cheater summons at this time.

[Tigercat]

Is there any particular reason to believe this sroty is any different than the legions of other steroid users/cheaters who get caught and then blamed something harmless for an alleged "false positive?"

I read the linked article, and other than the affirmation that he has been a user of the aerosol medication, there's nothing else to back up the argument. That seems to have been enough to convince the ESPN headline writer, and the hometown fan... but is there anything more (publicly) to this story?

Maybe he's telling the truth, and is just a casualty of so many cheaters-then-liars who went before him. From the story, it's certainly also possibe that the guy has been wantonly abusing clearly banned substances, and has just decided to use this asthma medication as the plausilble-enough alibi like every other cheater summons at this time.

I think there is more reason to believe its the medication than not, but certainly either is possible.

Add to the reasons I gave initially, this is a player in the twilight of his career where a resurgence of strength was never an issue as much as getting lighter and quicker to stay on the field. Its possible he took the 'roids, but personally that possibility doesn't add up for me.

But then again a punter was caught once, so anything is possible...

[JPhillips]

I've always known my asthma medication had steroids. He may not have been doping, but a professional athlete has no excuse for not knowing whether he's taking steroids.

[Mr. Wednesday]

corticosteroids != anabolic steroids

Athletes get injections of the former into injuries to ease swelling.

[Mr. Wednesday]

I'm interested in the NFL's position here. The appeal is on the grounds that his test was a false positive due to the asthma medication. Does the NFL feel that this is not credible? If it is credible, then I would think that he would potentially have recourse through the union or even through the courts (ADA).

[Bee]

Is there any particular reason to believe this sroty is any different than the legions of other steroid users/cheaters who get caught and then blamed something harmless for an alleged "false positive?"

I read the linked article, and other than the affirmation that he has been a user of the aerosol medication, there's nothing else to back up the argument. That seems to have been enough to convince the ESPN headline writer, and the hometown fan... but is there anything more (publicly) to this story?

Maybe he's telling the truth, and is just a casualty of so many cheaters-then-liars who went before him. From the story, it's certainly also possibe that the guy has been wantonly abusing clearly banned substances, and has just decided to use this asthma medication as the plausilble-enough alibi like every other cheater summons at this time.

Well it sounds like the doctor was expecting a false positive on the drug test because of the asthma medication, so I think this case is different than all the other ones. I think this is the first time I've heard of someone getting nailed for taking a prescription steroid. Most of the other cases have been people taking "supplementals" that were supposedly mis-labeled or tripping and accidentally injecting themselves with something or whatever. As more information comes out, my opinion could easily change but with the limited info being reported this sounds a lot different to me than previous cases.

[QuikSand]

Well it sounds like the doctor was expecting a false positive on the drug test because of the asthma medication, so I think this case is different than all the other ones. I think this is the first time I've heard of someone getting nailed for taking a prescription steroid. Most of the other cases have been people taking "supplementals" that were supposedly mis-labeled or tripping and accidentally injecting themselves with something or whatever. As more information comes out, my opinion could easily change but with the limited info being reported this sounds a lot different to me than previous cases.

Well, he *is* the team doctor, after all.

There's really nothing in the linked article (which is all I have read) to suggest that there is really any link at all between the asthma meds and what he tested positive for. He might well have come up positive for a horse tranqulizer, for all we know. And the team doctor could be doing his job by submnitting an argument that the asthma meds might have been responsible for a false positive of a completely different variety than he actually tested. Without details of any sort (other than a statement from a doctor with a clear interest in the case) I just don't see how we fast forward to the conclusion that the guy is getting screwed here by a false positive. Does the NFL really want to screw its players and teams so badly that they would ignore compelling evidence of a claim like his?

If it turns out that the positive test actually fits the profile for the kind of potential "fasle positive" that one might expect from eaxctly the sort of corticosteroids that he uses for asthma, then that would certainly strengthen the case. So far, there's no indication that this is true (nor that it's false, of course - there are just no details at all). We just have no information -- it's certainly possible that this guy has been a steroid abuser for years, and has always known that if/when he ever got caught, he could just raise the "false positive from my asthma meds" defense, which would sound vaguely credible.

[albionmoonlight]

The thread dedicated to this issue on the Saints' message board, which I have only glanced at in a driving-by-a-car-wreck sort of way, invokes, inter alia, Hitler and the Casey Martin case. It's turning into quite the train wreck from what I can see.

Personally, I think this has to fall under my somewhat new mantra for athletes/entertainers/politicians/Federlines: When the facts that I know present an open question as to whether the individual engaged in illegal/unsavory behavior, I assume that the individual did in fact engage in the behavior. Though I will occassionally be wrong, I will be wrong a hell of a lot less than if I gave the individuals the benefit of the doubt.

[Bee]

Well, he *is* the team doctor, after all.

There's really nothing in the linked article (which is all I have read) to suggest that there is really any link at all between the asthma meds and what he tested positive for. He might well have come up positive for a horse tranqulizer, for all we know. And the team doctor could be doing his job by submnitting an argument that the asthma meds might have been responsible for a false positive of a completely different variety than he actually tested. Without details of any sort (other than a statement from a doctor with a clear interest in the case) I just don't see how we fast forward to the conclusion that the guy is getting screwed here by a false positive. Does the NFL really want to screw its players and teams so badly that they would ignore compelling evidence of a claim like his?

If it turns out that the positive test actually fits the profile for the kind of potential "fasle positive" that one might expect from eaxctly the sort of corticosteroids that he uses for asthma, then that would certainly strengthen the case. So far, there's no indication that this is true (nor that it's false, of course - there are just no details at all). We just have no information -- it's certainly possible that this guy has been a steroid abuser for years, and has always known that if/when he ever got caught, he could just raise the "false positive from my asthma meds" defense, which would sound vaguely credible.


You're absolutely right in that we don't have all the information and as more comes out my opinion may change. The question though was if there was anything that makes this different than the previous onslaught of "accidental" users. At this point I'd say yes. I could be wrong, but I don't remember ever seeing a team doctor come out to defend someone in a similar manner. I also don't remember anyone ever using a prescription to asthma medication as an excuse. While I don't know much about steroid testing, I wouldn't be surprised that someone with severe asthma who uses inhaled steroids could test positive. All the other excuses I remember seemed to revolve around taking "supplementals" or cold medicine or whatever and they always sounded like weak arguments to me from the outset. This just seems more believable and with a team doctor and health professor supporting his story to some degree gives it more weight in my book than any of the previous cases that I remember.

Now I am not going to jump onto the bandwagon that he got screwed by the NFL. While I don't think there's enough info to dismiss his version of the positive test, I also don't think there's enough info to discount the decision made by the NFL. I do think it's possible the NFL made this decision based on info not public, I also think it's possible this was done to avoid future cases of people using asthma medicine to mask steroids. Again, there's not really enough info that I've seen to judge the NFL decision either.

At the end of the day, this is the most believable reason I've seen for a positive steroid test (from my admittedly limited knowledge of the testing). Doesn't mean the NFL was wrong, but this is the first time in one of these cases where I'd like more information before dismissing the "false positive" test result as nothing more than someone trying to make wild excuses for being caught.

[Tigercat]

The thread dedicated to this issue on the Saints' message board, which I have only glanced at in a driving-by-a-car-wreck sort of way, invokes, inter alia, Hitler and the Casey Martin case. It's turning into quite the train wreck from what I can see.

Personally, I think this has to fall under my somewhat new mantra for athletes/entertainers/politicians/Federlines: When the facts that I know present an open question as to whether the individual engaged in illegal/unsavory behavior, I assume that the individual did in fact engage in the behavior. Though I will occassionally be wrong, I will be wrong a hell of a lot less than if I gave the individuals the benefit of the doubt.

And if it was anyone else on either line, using almost any other reason I would doubt too. But this is a guy who dedicates a lot of his free time to asthma awareness. And its not like he is marque enough to be doing charity work for notoriety alone either. He doesn't seem to have been in the position where he would have any reason to be desperate enough to take steroids(again, he needed to get smaller and quicker before the season), nor desperate enough to use as an excuse the illness that he works so hard to build awareness of.

But yea, thats just my take. Skepticism towards any positively tested athlete is easy to understand.

[bryce]

I'm an asthmatic, and I had no idea my inhaler was a steroid, actually. Interesting. If that is indeed the root of the 'positive' steroid test result, I do hope the NFL makes an exception, though I wouldn't count on it. Asthma is one of those diseases/conditions that, it seems to me, isn't taken very seriously by those unafflicted with it, for whatever reason (probably not understanding it or not relating to it, though, would be my guess.)

[Deattribution]

Contrary to the explanation by New Orleans Saints defensive lineman Hollis Thomas that his positive drug test resulted from asthma medications, two football officials with knowledge of the case said a performance-enhancing drug was to blame.

Hollis Thomas says his positive drug test was caused by the asthma medications he takes.

The N.F.L. suspended Thomas for four games Tuesday for violating the league’s banned-substance policy. A drug test Aug. 7 found clenbuterol, a banned drug that helps burn fat and promotes muscle growth, in Thomas’s body.

Thomas, a 6-foot tackle who is listed at 306 poundsand goes by the nickname Tank, has struggled with his weight and with asthma for his entire career. He was traded to New Orleans in April after nine seasons with the Philadelphia Eagles and has flourished for the resurgent Saints, registering 3½ sacks and 43 tackles through 12 games.

The loss of Thomas, 32, comes at a crucial point for the Saints (8-4). New Orleans plays at Dallas on Sunday in a game that could help determine home-field advantage in the National Football Conference playoffs. He will miss the last four games of the regular season, but will be eligible to return for the playoffs.

His agents, Michael Bauer and Ron Slavin, cited a letter used in their appeal in which the Saints’ doctor, John R. Amoss, said it was “highly plausible” that asthma medications were responsible for the presence of clenbuterol in the urine sample. In the letter, Amoss wrote that Thomas’s severe asthma required treatment with high doses of inhaled steroids and other drugs. Amoss wrote that the combination of drugs probably produced a “false-positive” result.

“If Hollis Thomas was taking clenbuterol with the five or six asthma medications he was on, he probably would have had a heart attack,” Slavin said in a telephone message Thursday evening. “It doesn’t make sense for a guy to be taking clenbuterol, especially a guy of his size.”

One football official, who was granted anonymity because he was not authorized to speak publicly about the case, said the drug found in Thomas’s system could not have resulted from a combination of the medications. If the drugs that Thomas was prescribed by the team doctor were the only medications found in his system, he would have won his appeal, the official said.

N.F.L. players can seek medical exemptions after testing positive for a banned substance. If a drug has been prescribed by a doctor for a legitimate health reason, the violation can be settled and no suspension is issued.

Advair and albuterol, drugs that Thomas was taking for his asthma, are included on the N.F.L.’s list of prohibited substances. But they were not cited as violations because they were prescribed by the team doctor, the official said.

“As long as what is found in the system is what the doctor prescribed you, you are fine,” the official said. “But in this case, there was something else besides what the doctor prescribed.”

The second football official, who was not authorized to speak publicly, confirmed what the other official said.

Drug-testing experts also questioned the team doctor’s written argument. Clenbuterol is not a steroid, but it cannot be obtained legally for human use in the United States. Only veterinarians treating horses with severe breathing problems similar to asthma can prescribe the drug.

“I have never heard the proposition put forth that this combination of drugs would produce a positive test for clenbuterol,” said Dr. Gary I. Wadler, an associate professor of medicine at New York University and an adviser for the World Anti-Doping Agency.

Clenbuterol is not more effective at treating asthma than the other medications Thomas was taking for his breathing problems, Wadler said. The drug is available for human consumption in some South American countries and has been used to increase muscle growth in show animals and athletes.

Wadler said that athletes had used clenbuterol before, most notably during the 1992 Barcelona Olympics, when two American shot-putters tested positive for the drug and were disqualified. The former pitcher Jason Grimsley told federal prosecutors that he used clenbuterol, human growth hormone, amphetamines and steroids during his career.

In a telephone interview Wednesday, Slavin said the extreme heat and humidity at the Saints’ summer training camp at Millsaps College in Jackson, Miss., made Thomas’s asthma worse and prompted doctors to recommend new drugs.

In the appeal to the league, dated Nov. 17, his agents argued that a suspension would violate the Americans With Disabilities Act because Thomas was treating “his chronic, life-threatening asthma in a contract year.”

Amoss, the Saints’ team doctor and an assistant professor at Louisiana State University, declined an interview request. A team spokesman also would not comment.

More than 60 active players, and about 60 players who retired or were cut before their results were determined, have tested positive since the N.F.L.’s testing for performance-enhancing drugs began in 1989. So far this year, at least five players have tested positive.

At the Eagles’ training facility Wednesday, Thomas’s former teammates said they were surprised and dismayed by the positive test.

“Almost everything is against the rules in certain quantities,” said defensive tackle Sam Rayburn, who said he had talked with Thomas. “Even caffeine is considered a performance enhancer if it’s in a great enough quantity. You got to be careful. You can’t even drink too much Mountain Dew. The easy way to stay out of trouble is not just to take anything.”

Seems reports that it was simply medicine are a bit skewed.... surprising...(not)

[CU Tiger]

Something to keep in mind.
The NFL's "steroid policy" includes a number of drugs that have no anabloic effect.
Amphetamines (ephedrine for example) are part of the steroid policy. As are a number of legal supplements. (Adrostendione, in all peptide forms, Tribulus Terrestris, and elevated DHEA, to name a few on my personal shelf) all available at your local GNC can get you 4 games.

The NFL is really borderline legal here and IMO is waiting on someone to sue them ADA or more aptly HIPA violations. Just imagine the fallout of a I took DHEA (legally) for help with ED out of embarassment and now they prevent me from earning a living and forced me to disclose my medical condition....its not too far of a reach, and could be course altering

[Eaglesfan27]

Something to keep in mind.
The NFL's "steroid policy" includes a number of drugs that have no anabloic effect.
Amphetamines (ephedrine for example) are part of the steroid policy. As are a number of legal supplements. (Adrostendione, in all peptide forms, Tribulus Terrestris, and elevated DHEA, to name a few on my personal shelf) all available at your local GNC can get you 4 games.

The NFL is really borderline legal here and IMO is waiting on someone to sue them ADA or more aptly HIPA violations. Just imagine the fallout of a I took DHEA (legally) for help with ED out of embarassment and now they prevent me from earning a living and forced me to disclose my medical condition....its not too far of a reach, and could be course altering


How would it be a HIPPA violation if the player (the employee) signs a waiver and allows the NFL to access their medical records, which I imagine they do as a condition of their employment? Similarly, if they allow properly prescribed asthma medications but don't allow certain steroids that have no place in the treatment of asthma, I don't see how this is an ADA violation.

[CU Tiger]

How would it be a HIPPA violation if the player (the employee) signs a waiver and allows the NFL to access their medical records, which I imagine they do as a condition of their employment? Similarly, if they allow properly prescribed asthma medications but don't allow certain steroids that have no place in the treatment of asthma, I don't see how this is an ADA violation.

2 ways.
#1 the players give them access, but legally you can not be forced to sign away public disclosure rights. Since the NFL is considered public interest,... I would take this case and have fun with it.

#2 Use my above DHEA/ED analogy. This would be covered as well. You would be forcing a player to disclose a medical condition (or face sanctions) that did not effect job related perfomance. Remember you cant force an employee to tell you why they cant work if they say I feel ill....much less make them say they have troubles in the bedroom.

I had dinner 2 weeks ago with around a dozen other attorneys. Over an hour was spent on this very subject. I knwo of at least 2 that said they would mortgage their homes and practices to challenge the NFL on teh very ED/DHEA example if they could find said player. And BTW DHEA ha been know to produce extremely high anabolics in some individuals, while having little to no effect on others...

The NFLPA doesnt want this fight yet...widely thought because they are protecting other discretions..but it IS coming WHEN is the question.

[primelord]

And if it was anyone else on either line, using almost any other reason I would doubt too. But this is a guy who dedicates a lot of his free time to asthma awareness. And its not like he is marque enough to be doing charity work for notoriety alone either. He doesn't seem to have been in the position where he would have any reason to be desperate enough to take steroids(again, he needed to get smaller and quicker before the season), nor desperate enough to use as an excuse the illness that he works so hard to build awareness of.

But yea, thats just my take. Skepticism towards any positively tested athlete is easy to understand.

How does the fact that he dedicates a lot of his free time to asthma awareness suggest he didn't use another steroid. I don't think anyone is questioning whether or not he actually has asthma and takes Advair. However it seems entirely possible that somoeone might have suggested to him that he could try to use the fact that he takes Advair to calim that a dirty test was a false positive. I don't doubt that he is a good person. Using steroids doesn't make you the devil anymore than a wide receiver pushing off does. HE is just breaking the league rules.

As for being desperate enough to blame this on his asthma medication, we are talking about a lot of money here. Just because he needed to get smaller and quicker doesn't mean steroids wouldn't help him. If he starts replacing a lot of fat with lean muscle mass he will get smaller and quicker.

I think what it boils down to is that the NFL has had quite awhile to look at the evidence here. Negative steroids tests are bad for the league. I can't imagine why if they didn't have solid proof (or at least believe they have solid proof) that it was not a flase positive that they would deny his appeal. What would they gain from it?

[molson]

Something to keep in mind.
The NFL's "steroid policy" includes a number of drugs that have no anabloic effect.
Amphetamines (ephedrine for example) are part of the steroid policy. As are a number of legal supplements. (Adrostendione, in all peptide forms, Tribulus Terrestris, and elevated DHEA, to name a few on my personal shelf) all available at your local GNC can get you 4 games.

The NFL is really borderline legal here and IMO is waiting on someone to sue them ADA or more aptly HIPA violations. Just imagine the fallout of a I took DHEA (legally) for help with ED out of embarassment and now they prevent me from earning a living and forced me to disclose my medical condition....its not too far of a reach, and could be course altering

I'm not HIPAA expert, but it seems everyone had asummed it doesn't apply to the NFL. After all, the league requires teams to publically disclose players' medical conditions for weekly injury reports, and players are certainly required to disclose medical conditions to their own teams.

[CU Tiger]

NFL and NFLPA signed an agreement to allow injury reporting that would alter playing time.

No injury that does not impact football decisions is covered.

Many question the legality of the agreement.