The limits of standard drug testing are well known in the doping world, but not to the average sports fan.
A test for steroids doesn't come back positive or negative, for example, the way a pregnancy test does. Instead, a mass spectrometer measures hormonal levels to see whether they are within established limits, so the readouts require a certain amount of interpretation. And because athletes have been known to sue over positive tests, Don Catlin, the former UCLA Olympic Lab director, has always said he doesn't call a test positive unless he believes he can defend it in court. Plenty of readings have appeared positive but were murky enough that he felt he couldn't officially fail the athlete.
With steroid testing, what testers usually are looking for is how much testosterone there is in the body compared to epitestosterone, another hormone the body produces. The average person produces the same amount of each, so if someone has twice as much testosterone, that's typically a sign he or she is getting additional testosterone from somewhere.
But because some people have higher levels than others, WADA, USADA and most groups agreed to set the threshold higher to allow for those anomalies. The current standard is that a 4-to-1 ratio of testosterone-to-epitestosterone is considered a positive test. To make sure, most programs then conduct a carbon isotope ratio test to see whether an athlete's testosterone is his or her own.
But that system was proven easily beatable. One of Victor Conte's contributions to the sports world was reinforcing that most doping should be done in the offseason. Athletes can disappear for weeks, usually telling testers they would be one place while actually heading to another. They'd use whatever they wanted, knowing that by the time they resurfaced, the drugs would be undetectable. The benefits would be felt for months. An athlete needed to take only small amounts of testosterone, usually a patch or a cream, that would keep the athlete strong but stay below the 4-to-1 T/E level. To make sure the levels weren't too high, Conte regularly sent athletes' blood for testing.
To further beat the system, chemist Patrick Arnold developed "the clear," or THG, to avoid detection, and Conte passed it on to athletes, knowing that testers weren't looking for the drug. And knowing that testers were comparing testosterone and epitestosterone levels, he offered "the cream," which contained both. If track coach Trevor Graham, whose perjury trial began Monday in San Francisco, hadn't blown the whistle, it's possible that testers still wouldn't know THG was out there.
-- T.J. Quinn and Mark Fainaru-Wada