Dope opera: is nandrolone a medicine or doping agent?

The identification of false positive doping tests in sport is pivotal to administering justice to the athlete. Nandrolone is a performance- enhancing drug. Although Nandrolone and its metabolites are on the World Anti-doping Agency list of banned substances, the detection of its abuse may become challenging. Testing positive for Nandrolone is defined as a concentration in the urine exceeding 2 ng·ml-1. It is a strict liability offence. An international athlete tested positive for Nandrolone metabolites in his “A” sample in 2008. The athlete sought immediate legal and medical advice and was advised to exercise his rights of a B sample analysis. There was a variation in levels in A (6.2 ng.ml-1) and B (5.6 ng.ml-1) samples. There are statutory defences which can be argued on legal or medical grounds. One such medical exemption is an application for a therapeutic use exemption certificate, for a legitimate medical condition, to an empowered medical committee before competition. Such exemption allows the sporting participant to use certain specified medical products, but urine and or serum levels of those drugs or its metabolites are required to be within a specified therapeutic range. Problems arise when the therapeutic range is unknown and when there may be co-administration of the same drug in a performance-enhancing design. A recent unique case highlights the difficulties the enforcement agencies have in securing a conviction against a deliberate doping offender versus an accidental doping violation while administering justice and fair-play.