Macleod: Doping Charge Dropped, Suspension Lifted

Scott MacLeod, the Scotland and Scarlets forward, has had the doping charge against him discontinued and his provisional suspension for a potential anti-doping violation lifted, after a thorough investigation by UK Sport and an independent review panel. MacLeod was found to have an elevated testosterone level (or T/E - the ratio of testosterone to epitestosterone) in the A sample he provided during unannounced out-of-competition testing earlier this year.Scott MacLeod, the Scotland and Scarlets forward, has had the doping charge against him discontinued and his provisional suspension for a potential anti-doping violation lifted, after a thorough investigation by UK Sport and an independent review panel.

MacLeod was found to have an elevated testosterone level (or T/E - the ratio of testosterone to epitestosterone) in the A sample he provided during unannounced out-of-competition testing earlier this year.

Now the doping charge against him has been discontinued and he is free to resume training with his club and playing with immediate effect.

This decision follows a meticulous inquiry and is based on UK Sport's changed view of the case and that of their expert panel, after analysis of MacLeod's B sample and their consideration of submissions by the player.

MacLeod submitted that his elevated T/E ratio was due to his consumption of a significant amount of alcohol the evening before the doping test.

Scientific research referenced by UK Sport's expert panel (and also in the 2006 case of Northern Irish athlete Gareth Turnbull) has indicated that acute ingestion of alcohol can temporarily elevate the T/E ratio significantly.

It was initially considered by UK Sport, and consequentially by an independent review panel, comprising - Stewart Hillis, director of the sports medicine centre and professor of cardiovascular and exercise medicine at Glasgow University: Sheriff Bill Dunlop; and Michelle Jeffrey, a sport and exercise doctor with the Scottish Institute of Sport - that MacLeod had, based on the A sample, a "case to answer" per the World Anti-Doping Agency's protocols. This was all prior to analysis of the B Sample by UK Sport's laboratory. It was analysis of the B Sample, which first confirmed the existence of alcohol in the player's system.

These protocols state that when an athlete's T/E ratio is above 4:1 and it also deviates significantly from the normal range of values (reference is made to a 30% upper limit on the normal variation), then this is proof of the administration of a source of testosterone even when, as in MacLeod's case, the testosterone has the same carbon signature as natural testosterone. The burden then falls on the athlete to prove that the elevated level is due to a physiological cause or pathological condition. It is now accepted by UK Sport that, in light of the results of the B sample analysis, MacLeod has satisfied that burden and Scottish Rugby has accepted that decision.

Scott MacLeod said: "I am glad that this ordeal is finally over and look forward to resuming my playing career with Scarlets and Scotland. I never thought that an impromptu night out to celebrate the news that I was going to become a dad for the first time would lead to all this.

_x001C_Nevertheless, I feel very frustrated that my sample was not tested for alcohol at an earlier stage of these proceedings - given the severity of the charge that I was facing, I would have expected that the alcohol test should have been performed as a matter of routine. Had that been the case, I would have been able to establish my innocence at a much earlier stage, I would not have been suspended and the details of this case would not have become public._x001D_

Gregor Nicholson, Scottish Rugby's International Administration Manager, said: _x001C_It has been a long and frustrating case for Scott MacLeod, some aspects of which demonstrate an urgent need for a review of T/E protocols and whether A samples should be routinely analysed for the existence of alcohol, ultimately by WADA but also by UK Sport.

_x001C_Scottish Rugby is also making representations to the IRB in relation to how the IRB's anti-doping regulations (and therefore our own anti-doping regulations) deal with the complicated and uncertain nature of such cases.

_x001C_Until then, all players who are subject to doping control, including out-of-competition unannounced testing, should take heed of the very real danger of acute alcohol ingestion causing a temporary elevation of their T/E level, to the extent that they could face having to formally explain, to a legal standard, the reason for the finding in order to avoid a doping charge.

_x001C_Scottish Rugby will be highlighting the importance of this case to all players and enhancing player education on the subject._x001D_

Notes to editors:

A copy of the full independent Review Panel report will be published on the Scottish Rugby website once available.

SCOTT MACLEOD T/E CASE - CHRONOLOGY

10 March 2006 Scott MacLeod selected by UK Sport at Scotland squad training at Murrayfield for a random no-advance notice doping control test under Scottish Rugby's testing programme. Returns a _x001C_Negative But_x001D_ result for an elevated T/E with a negative IRMS (Isotope Ratio Mass Spectrometry) which showed there was no evidence of testosterone administration. The elevated T/E is not sufficiently high to be deemed an adverse finding or to trigger a longitudinal study. Result referred to player's doctor to discuss possible reasons.

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25 January 2008 Scott MacLeod selected again at random by UK Sport at a Scotland squad day at Murrayfield. Sample provided at 11.12am.

14 February 2008 UK Sport results notification letter to Scottish Rugby regarding an Adverse Analytical Finding for terbutaline and also an _x001C_Atypical T/E Ratio_x001D_ above the WADA reporting threshold of 4:1. The two different findings are dealt with separately. The T/E result has a negative IRMS but a longitudinal study requires to be undertaken by UK Sport to determine whether the elevated T/E ratio is due to a physiological or pathological condition or whether it constitutes an Adverse Analytical Finding which may constitute an anti-doping rule violation. Player so advised and is provisionally suspended. This suspension is only in relation to the terbutaline finding as provisional suspension does not apply during the T/E longitudinal study.

18 February 2008 A Scottish Rugby appointed Judicial Committee finds that the player's failure to have a valid Therapeutic Exemption Certificate (TUE) for terbutaline to treat his asthma means that an anti-doping rule violation has been committed. The player is issued with a formal warning but is cleared to resume playing.

March/April 2008 Two further no-notice doping control tests carried out on the player as part of the longitudinal study.

10 September 2008 UK Sport letter to Scottish Rugby (received 12 September) reporting on their review of five samples - the 25 January sample, two previously collected samples and two subsequent samples. Accompanying detailed documentation includes the WADA Guideline on the Reporting and Management of Elevated T/E Ratios, WADA Technical Document TD2004EAAS, Drug Control Centre documentation on the analytical report, and the written opinions of three independent experts. UK Sport's conclusion is that the elevated T/E in the 25 January sample is an Adverse Analytical Finding and there is _x001C_a case to answer_x001D_. (One expert's report made comment on research into the effects of acute alcohol ingestion in raising the T/E ratio and that testing the sample for alcohol would help to rule this out as a possible explanation of the elevated T/E.)

15 September 2008 Scottish Rugby confirms to UK Sport its proposed formal review process per its own Anti-Doping Regulations, which mirror the IRB Anti-Doping Regulations. UK Sport indicate that they expect we may have some queries.

24 September In order to ensure clear, accurate and complete information for the required formal Scottish Rugby Preliminary Review, and also for the player, Scottish Rugby submits to UK Sport 25 questions and points for clarification. These include questions on whether there is any further research on the effects of alcohol on T/E ratios and whether the A sample was indeed tested for alcohol. Also, whether there are any other known cases of an elevated T/E with a negative IRMS which was deemed an Anti-Doping Rule Violation (ADRV).

3 October UK Sport response to Scottish Rugby Questions paper including that they are not aware of any further research on the effect of alcohol on T/E ratio, that the A sample was not tested for alcohol as it is not a WADA requirement, and that they do not have any precedent cases of an ADRV for an elevated T/E with negative IRMS (but see 20 October).

8 October Scottish Rugby refers the case and full documentation to an independent Review Panel comprising Professor Stewart Hillis, director of the sports medicine centre and professor of cardiovascular and exercise medicine at Glasgow University; Sheriff Bill Dunlop; and Dr Michelle Jeffrey, a sport and exercise doctor with the Scottish Institute of Sport. The Review Panel's task per Scottish Rugby's Anti-Doping Regulations 16.3 and 20 is simply to determine whether an anti-doping rule violation may have been committed, in which case the formal judicial process, including the provisional suspension of the player, then begins.

16 October Scottish Rugby Review Panel report received (2300hrs). Comment is made regarding there being no prescribed standard of proof for determining whether an ADRV may have been committed and that this is a very low benchmark against which to measure whether a player should be subjected to the ordeal of judicial proceedings. However the Panel concludes that in considering whether an ADRV may have been committed, they have to reply in the affirmative.

17 October Scottish Rugby telephone call and letter to Scott MacLeod regarding conclusion of the investigation and review confirming that an ADRV may have been committed, there is a case to answer, he is provisionally suspended pending resolution of the case, has the right to a hearing and has an opportunity to have the B sample tested.

20 October The player's agent refers to the 2006 case of Northern Irish international athlete Gareth Turnbull whose raised testosterone was accepted by an Irish Sport Anti-Doping Disciplinary Panel as having been induced by alcohol ingestion.

21 October Scott MacLeod formally requests B sample analysis including test for alcohol. Scottish Rugby supports the alcohol test request. UK Sport indicate initially that they will request that the lab tests for alcohol but that as it is not _x001C_standard procedure_x001D_ this will depend on the lab and possibly WADA agreeing. Later confirmation received that the lab will test for alcohol.

28 October B sample analysis starts.

4 November Two UK sport letters to Scottish Rugby. One letter confirms the presence of alcohol in the sample but that the analysis method used by the lab is not a validated method nor is it within the scope of their WADA accreditation. The other letter, along with the Drug Control Centre Analytical Report, states that the B sample confirms the elevated T/E in the A sample and that Scottish Rugby is now required to bring disciplinary charges against the player.

5 November Telephone call and confirmatory email to Scottish Rugby from UK Sport's lawyer stating that although there seems to be a case to answer based on WADA defined protocols, it is appropriate, as further evidence emerges, to continue to review whether the player might be able to meet the burden of explaining the elevated testosterone in his sample, and therefore to hold off the next step of the disciplinary process. Scottish Rugby agrees to put the disciplinary process on hold and, as requested, puts the player's lawyer in touch with UK Sport's lawyer.

18 November Player's lawyer submits player and witness statements to UK Sport lawyer to confirm the player's explanation of the cause of the elevated T/E, namely acute ingestion of alcohol between the hours of 7.30pm and 3.00am the night prior to the player's selection for the doping control test.

20 November UK Sport letter to Scottish Rugby along with a supplementary independent expert report which concludes that _x001C_it is more likely than not that the cause of the elevated T/E was the player's acute alcohol ingestion in the period 8 to 15.5 hours before the sample was collected_x001D_ and that _x001C_it would be appropriate not to proceed any further with the case against the player._x001D_ The letter confirms that it is up to the Scottish Rugby to decide whether it agrees with this view.

20 November UK Sport letter and supplementary independent report referred to the independent Review Panel.

21 November Independent Review Panel supplementary report received recommending that no further proceedings be taken against the player and that the interim suspension be lifted. Scottish Rugby formally notifies Scott MacLeod that it will not be proceeding with the alleged charge and that the provisional suspension is lifted with immediate effect.





EXPLANATORY NOTES

1. IRMS analysis measures the carbon isotope value of the testosterone and an assessment is made as to whether these values are consistent with natural testosterone or not. A _x001C_positive_x001D_ IRMS analysis is deemed to be confirmed proof that the testosterone is exogenous (not produced by the body naturally). However a _x001C_negative_x001D_ IRMS analysis, whilst not consistent with the administration of testosterone, is not deemed to be conclusive proof that the testosterone is definitely endogenous (produced by the body naturally). Scott MacLeod's case differs from other well known testosterone cases such as those of Floyd Landis and Denis Mitchell when a positive IRMS analysis was reported.
2. An abnormal ratio of testosterone to luteinising hormone can also be an indicator of the administration of testosterone as it stops the production of LH by the pituitary gland and causes LH levels to fall. In each of Scott MacLeod's analysed samples the T/LH ratios were within normal range.
3. WADA specifies that T/E levels normally can vary by 30% from the mean value and where a suspicious test result is found to be _x001C_significantly different_x001D_ from the athlete's mean value it will constitute proof of the administration of a source of testosterone. UK Sport's response to a question from Scottish Rugby on this issue indicated that a 30% variation is not an absolute upper limit.
4. The longitudinal study showed that based on screening levels of 4 samples (excluding the reference sample) Scott MacLeod has an elevated mean T/E of 3.3:1, just below the WADA threshold of 4:1 which requires further investigation. The 25 January sample had a screening level of 7.1:1, an elevation from his mean T/E of 115%.
5. In the Turnbull case, his mean T/E ratio of 2.1:1 increased to 5.8:1 in the reference sample. (He also had unusually high levels of testosterone, epitestosterone and luteinising hormone.)
6. Research referenced in the Turnbull case (Seppenwoolde-Waasdorp) showed that whilst the effects of alcohol on the T/E ratio varies from one individual to the next, one subject had a 269% increase in his T/E after drinking alcohol. Other research referenced in the Turnbull case (Falk), which demonstrated that an increase in the T/E ratio may be ascribable to the ingestion of alcohol, dates back to 1988. According to expert opinion in the Turnbull case, there has been no significant research on the effects of alcohol on T/E ratios since the Catlin paper in 1997 which warned _x001C_until further details are available, one may prudently consider that large and inebriating doses of ethanol may increase the T/E ratio for several hours after ingestion_x001D_. The Irish Anti-Doping Panel stated that it was inconceivable that regard should not be had to the (available research) papers/studies in evaluating whether or not the testosterone level might be alcohol induced. It is understood that ethical considerations have meant no more recent research on this matter has been conducted.
7. Whilst WADA does not specifically warn laboratories to pay attention to alcohol as a critical factor in T/E cases, their documentation does reference several of the research papers on the subject including Falk and Catlin.
8. According to expert opinion in Turnbull, the T/E ratio peaks 8-10 hours after the consumption of alcohol.
9. It was initially suggested by UK Sport's expert panel that a possible explanation of Scott MacLeod's test result could be administration of LH and an androgen (which causes increased secretion of testosterone). However in Turnbull, expert opinion was that whilst this was theoretically possible, it would seem remarkable as you would need to repeatedly keep on injecting the LH as it has such a short life (rapid loss after 1-2 hours and slower loss up to 10-12 hours). In MacLeod's case therefore he would have had to injected LH sometime after 11pm the evening prior to giving his sample (which was an unannounced collection by UK Sport). Reference was also made in Turnbull to the fact that had exogenous testosterone been ingested, for the IRMS to return _x001C_negative_x001D_ the synthetic testosterone would have to have been designed to have the same carbon signature as endogenous testosterone. Whilst this was said to be possible, there was no evidence of synthetic testosterone with the same carbon signature. Further research referenced in Turnbull (Karila et al) showed that LH concentrations increase after alcohol administration.
10. In Turnbull, it was accepted by both prosecuting bodies (the Athletics Association of Ireland and the Irish Sports Council) and the determining body (the Irish Sport Anti-Doping Panel) that an increased testosterone level induced by the consumption of alcohol should be treated as if it were a physiological condition.