UKAD's extensive investigation into the package (sometimes referred to "the Jiffy bag") delivered to Team Sky during the 2011 Critérium du Dauphiné cycling race in France has concluded.
No anti-doping charges will be brought in relation to the package as a result of that investigation and all interested parties have been informed accordingly. This will remain the case unless new and material evidence were to come to light.
UKAD’s investigation was particularly challenging in light of a lack of contemporaneous medical records. This aspect of the investigation serves as a reminder to all those responsible for medical record-keeping within sport to ensure that medical record policies are fit for purpose, and that such policies are systematically followed.
On 23 September 2016 UKAD started an investigation following information we had received that a possible anti-doping rule violation may have been committed by Team Sky at the Critérium du Dauphiné in June 2011.
The possible anti-doping rule violation in question concerned the alleged contents of a package that was delivered to Dr Richard Freeman in France. Information was received by UKAD that that package contained a substance called triamcinolone. Triamcinolone is a glucocorticoid that is prohibited in-competition when administered in certain ways. See box 2 for more information on triamcinolone.
Throughout the course of its investigation UKAD has interviewed 37 individuals, including current and former employees of British Cycling and Team Sky (riders, medical professionals and other staff), and been provided with and reviewed a voluminous amount of documentation.
Insofar as UKAD has been able to establish facts, we have drawn the following conclusions:
· At some point during the Critérium du Dauphiné, a request was made by Dr Freeman (one of Team Sky’s doctors at that time) for a package to be delivered to him.
· Shane Sutton arranged for Simon Cope (then a coach with British Cycling) to pick up that package and to bring it over to France.
· Mr Cope said that the package was left for him at the British Cycling offices and left on a desk sealed in a Jiffy bag. There was a post-it note on the package that said “To Simon, for Dr Richard Freeman”.
· Mr Cope travelled to Manchester to pick up that package and then, at some later point, he travelled to Gatwick on 11 June. Then he took a flight out to Geneva hired a car and took it to the end stage of the Critérium du Dauphiné on 12 June and passed the sealed Jiffy bag over to Dr Freeman.
Dr Freeman stated that the package contained Fluimucil, which is not a prohibited substance under applicable anti-doping rules. Sir Bradley Wiggins’ recollection was that he was treated with Fluimucil on the evening of 12 June 2011. He said he did not know what was in the package.
Put simply, due to the lack of contemporaneous evidence, UKAD has been unable to definitively confirm the contents of the package. The significant likelihood is that it is now impossible to do so.
What is Fluimucil?
· Fluimucil is the brand name of a medication that contains the active ingredient acetylcysteine. It is used to treat a variety of respiratory disorders such as bronchitis when there is an overproduction of mucus. Acetylcysteine helps to remove the mucus that is obstructing the airway.
· The use of acetylcysteine is not prohibited in sport.
· Fluimucil is not licensed as a medicine in the UK but is licensed for use in other countries across the world. Nevertheless, UK doctors can still prescribe Fluimucil to patients if they follow General Medical Council (GMC) guidelines (that is, its use is in the best interest of the patient and there is no other suitably licensed medicine that will meet the patient’s need).
What is Triamcinolone?
· Triamcinolone is a glucocorticoid that is prohibited in-competition when administered by a systemic route (that is, oral, intravenous, intramuscular or rectal) but is not prohibited out-of-competition.
· Triamcinolone is permitted at all times when administered by a local route of administration such as an injection into a joint or when applied topically to the skin.
· Glucocorticoids are therapeutically used for their anti-inflammatory and immunosuppressive effects. In particular, triamcinolone has many indications for use:
i. Intra-articular injections (permitted)
Alleviating joint pain, swelling and stiffness associated with rheumatoid arthritis, osteoarthrosis, and common musculoskeletal injuries.
ii. Intramuscular injection (prohibited in-competition)
Allergic states, autoimmune diseases, musculoskeletal injuries, rheumatologic diseases, and in emergency medicine.
iii. Nasal spray (permitted)
Seasonal allergic rhinitis.
iv. Topical (permitted)
Skin conditions such as eczema.
· The potential performance-enhancing effects of glucocorticoids may include exerting:
i. Neuro-stimulatory effects
Increase feelings of vigour and lessen the sensation of exertion during endurance exercise which may delay the onset of fatigue.
ii. Metabolic effects
Lead to a more efficient utilisation of energy sources by the muscles during moderate intensity exercise (e.g. sparing glucose stores). This preferential use of fat may also promote weight loss.