The full USADA report on Alberto Salazar has been leaked - Here it is

rjm33 wrote:

A typical IV dose of L-carnitine is 50 mg/kg. = 3,000 mg total dose for a 60 kg. person. It can be given by a slow IV injection over 2 to 3 minutes from a large syringe. The dose of 3,000 mg is only a 15 mL injection of L-carnitine at 200 mg/mL. There is no need for an IV bag and an infusion that lasts over an hour.

So this point along with the "squeezing" of the IV bag has stood out to me. The squeezing of the bag especially. Hear me out on this.

A little over a year ago I had to visit the ER at the local Army Base for treatment for Kidney Stones (chronic for me). They started what was is called a Heparin Lock, or a catheter in a vein, flushed with heparin to prevent a clot from forming in the catheter. No IV Bag/line was attached. So I didn't have an IV per se, just a "needle in my arm" When they gave me pain med and anti nausea the LVN came in with a 50ml bag of saline with the meds mixed in. He attached the small bag, with a line, to the catheter already in my arm and proceeded to squeeze the bag. I asked him why he was pushing the meds so quickly. I am a former military medic so I'm always curious about my treatment. What he told me might be important here. He said that in that ER (could be a local rule) only RNs could hang an IV with medication in the IV. But LVNs could INJECT the same meds. So to get around this they were having him rapidly infuse the medication by squeezing 50 ML of Saline w/ the meds. This was, by their rules, an injection and not an IV.

Let's see if Dr Brown/AlSal/Nike/Lawyers say they didn't transfuse an IV over 50ml, but instead it was considered an injection because of the "squeezing" of the bag...

Just a thought

rjm33 wrote:

An IV infusion of just 1 of the 100 mL bags would be a total dose of 21.49 grams (= 21,490 mg) of L-carnitine. They administered 1 to 4 bags total.

A typical IV dose of L-carnitine is 50 mg/kg. = 3,000 mg total dose for a 60 kg. person.

Playing devil's advocate, are you saying only 1/7th of the IV bag would be needed (3000mg dose into 21500mg bag)? That would equate to about 14 mL of fluid.

Positive Contribution wrote:

Anyone else curious about Mark Wetmore and Adam Gouchers name coming up? Reading "Running With The Buffaloes" I was amazed how Gouchers could train at that high a level while starving himself. The book mention a few times how he never ate lunch. I guess you can get away with that in the short term and that rate of training really caught up with him. Enter Dr. Brown.

Positive Contribution wrote:

Is anyone else surprised to see Solinksy tangled up in this? Seems like the use of thyroid meds in his case was clear cut cheating (perhaps only within the spirit of the rules). Why wasn't he mentioned in the brojo's article? To me, he is as guilty as the lot. Sad day.

Really curious why these other big names found in the report aren't getting as much attention regarding their potential complicity with either Salazar or Brown. The bulk of vitriol, understandably, is being directed at Salazar/Oregon Project, who have largely become whipping boys in this drama. However, if this report is indicative of anything, I think these revelations show that a larger audit needs to be performed on all elite running groups. For example, the collective LRMB largely insinuates that Schumacher's group, which includes Solinksy, doesn't need to resort to such measures. But given that it seems there is clear overlap in resources being used (Nike money, Brown's services, which even can be seen as implicating Wetmore), why is only the Oregon Project being targeted here?

rojo wrote:

I don't know about labels. I may not label you a doper, but I certainly think you should be sanctioned if it was more than 50 ml. You can't willfully violate a law and not be punished. Ethiopians training in some remote village don't have access to IVs - you shouldn't either particularly when they say it's not allowed unless it's a clinical study or hospitalization. If you are hospitalized, I've got no issue with it.

Ignoring the weak argument about poverty and access to IV's....

What do you think is a proper sanction for violating the 50 mL rule? 2 year suspension for all athletes involved? Does that seem fair to you? That would include Ritz and Welling in addition to Rupp.

Personally, I don't think anything more than a slap on the wrist would be warranted.

mise en scene wrote:

Really curious why these other big names found in the report aren't getting as much attention regarding their potential complicity with either Salazar or Brown. The bulk of vitriol, understandably, is being directed at Salazar/Oregon Project, who have largely become whipping boys in this drama. However, if this report is indicative of anything, I think these revelations show that a larger audit needs to be performed on all elite running groups. For example, the collective LRMB largely insinuates that Schumacher's group, which includes Solinksy, doesn't need to resort to such measures. But given that it seems there is clear overlap in resources being used (Nike money, Brown's services, which even can be seen as implicating Wetmore), why is only the Oregon Project being targeted here?

In my opinion, it is because the only allegations of antidoping violations are against NOP and its members.

A lot of people think use of thyroid hormones, pain medication, supplements, etc. are unethical and against the spirit of the sport. Those are practices which were clearly shared by other coaches and athletes. I won't tel anybody how they should feel about the use of those substances, but the facts are that these substances are not prohibited by the WADA code and their use is not an anti-doping violation.

The only violations of antidoping regulations included in the report are insinuations that there may have been improper use of testosterone (the evidence for this seems weak to me) and the infusion of greater than 50ml of fluid in a 6 hour period. Those are actions only alleged to be undertaken by members of the NOP.

jewbacca wrote:

What do you think is a proper sanction for violating the 50 mL rule? 2 year suspension for all athletes involved? Does that seem fair to you? That would include Ritz and Welling in addition to Rupp.

Personally, I don't think anything more than a slap on the wrist would be warranted.

Depending on all of the circumstances, some athletes might be eligible to have their sanction cut in 1/2 if there was ruled to be no significant fault or negligence.

Cooperating athletes would be able to have their sentence cut in 1/2.

These two reductions can be cumulative, which means the sanction could be reduced to 1/4, but not further.

Mr. Obvious wrote:

jewbacca wrote:

What do you think is a proper sanction for violating the 50 mL rule? 2 year suspension for all athletes involved? Does that seem fair to you? That would include Ritz and Welling in addition to Rupp.

Personally, I don't think anything more than a slap on the wrist would be warranted.

Depending on all of the circumstances, some athletes might be eligible to have their sanction cut in 1/2 if there was ruled to be no significant fault or negligence.

Cooperating athletes would be able to have their sentence cut in 1/2.

These two reductions can be cumulative, which means the sanction could be reduced to 1/4, but not further.

You're talking about a 2-year suspension?

I guess I'm asking if that seems appropriate given the fact it's a technical infraction (and assuming the violation really did occur). Going back to the saline drip example, it would seem awfully harsh to receive a 2-year ban for an illicit IV bag.

How much discretion does USADA (or is it WADA) have in issuing penalties? Does it automatically go to a 2-year ban, or, like a judge, can they give a reduced sentence outside of the circumstances you listed above? I'd assumed they could do anything they wanted up to and including 2 years.

I wish we had insiders at Nike and the USADA to tell us how much Nike pays USADA to make a full 180 on this report and state in the final version that everyone is clean.

jewbacca wrote:

You're talking about a 2-year suspension?

I guess I'm asking if that seems appropriate given the fact it's a technical infraction (and assuming the violation really did occur). Going back to the saline drip example, it would seem awfully harsh to receive a 2-year ban for an illicit IV bag.

How much discretion does USADA (or is it WADA) have in issuing penalties? Does it automatically go to a 2-year ban, or, like a judge, can they give a reduced sentence outside of the circumstances you listed above? I'd assumed they could do anything they wanted up to and including 2 years.

So, I am stringing this together and am more than open to correction on any of this:

I believe this is a violation of section 2.2 of the WADA Code--Use or Attempted Use of a prohibited method.

According to section 10.2 of the WADA code, violations of section 2.2 result in a period of ineligibility of 4 years, if it can be established that the violation was intentional, and 2 years if it was not. Intentional is defined as The term, therefore, requires that the Athlete or other Person engaged in conduct which he or she knew constituted an anti-doping rule violation or knew that there

was a significant risk that the conduct might constitute or result in an anti-doping rule violation and manifestly disregarded that risk. Sections 10.4 and 10.5 established elimination or reduction in the period of ineligibility where there is no fault or negligence or where there is no significant fault or negligence.

So, it gets pretty tricky. And the findings would have to be very fact-intensive to even begin to guess at the penalties.

1. You would have to establish that the anti-doping violation occurred to the comfortable satisfaction of the arbiters. There is certainly some evidence of this, but it is not a slam-dunk case, I don't think, as it depends on inference.

2. Athletes could show no fault or no significant fault through a preponderance of the evidence.

3. Some athletes could likely show substantial assistance and cooperation.

So penalties could range anywhere from a finding of use but with no fault or negligence and no period of ineligibility to a penalty of 6 months to a period of four years.

Whether that seems appropriate is a philosophical question which everybody would have to answer for him/herself.

Generally I don't think there is a ton of discretion to apply penalties outside of the guidelines. Such things usually trigger an appeal to CAS by WADA.

The guidelines themselves certainly have some wiggle-room, so one athletes might be judged to have no fault and another no significant fault and I believe that these decisions and decisions about assistance and cooperation, while ultimately decided by the arbiters, may be within the discretion of USADA to make recommendations to the panel (I believe this is essentially what USADA did with the US Postal Riders who cooperated, essentially working out a plea deal. I'm not even 100% sure if such agreements have to go before arbiters, or if both parties agree that can be the end of it if WADA doesn't appeal).

There are at least one other interesting question, which I am not sure I know the answer to:

This is a case, if brought, of a non-analytical positive. NADOs have very, very little discretion in bringing cases with adverse tests, but I do not know how much discretion they have in non-analytical cases. It is hard to even determine a standard, because each case is different. So theoretically they could decline to charge some athletes and charge some others, although such a decision might be hard to justify if the underlying fact/evidence pattern was similar.

I suspect (but this is just my speculation) that this is the reason USADA has not charged anybody yet. I think they would desperately like to have penalties for cooperating athletes which are minimal to none, with much harsher penalties for the big fish of Salazar, Brown, Centro, Rupp, etc. I suspect they do not have enough evidence to justify widely different penalties and can't justify harsh (and differential) penalties for a technical violation and can't make a case for more substantial violations.

sbeefyk1 wrote:

I wish we had insiders at Nike and the USADA to tell us how much Nike pays USADA to make a full 180 on this report and state in the final version that everyone is clean.

Zero. The federation has all the authority. Lanana knows nothing. Coe knows even less.

Flotrack says they removed two things from the report.

Does anyone know what the two things were or their context in the report?

Because if they made changes, then how about Fancy Bears, did they make changes to the report before they purposely leaked it to the press?

rojo wrote:

He wanted them to get a drug that no one else had access to as he thought it would take 2-3 minute off their marathon time

Maybe this is just semantics, but do you really want to label L-carnitine a drug?

Mr. Obvious wrote:

The only violations of antidoping regulations included in the report are insinuations that there may have been improper use of testosterone (the evidence for this seems weak to me) and the infusion of greater than 50ml of fluid in a 6 hour period. Those are actions only alleged to be undertaken by members of the NOP.

I guess my point was: If we as a collective want to determine our judgement based on these insinuations then it should be applied to all athletes named in the report - if the idea is that Dr. Brown more or less forces NOP athlete-patients to go against the "spirit of competition" then why would any non-NOP athlete who sees him be treated differently (after all, they're all going out of their ways from the Pacific Northwest down to Texas to see him)? Is the implication that he's on Salazar's payroll so non-NOP athletes don't get the good stuff?

Gotta bee wrote:

rojo wrote:

You do realize that Farah had run 12:57.94 before joining the NOP?

So he was better and more accomplished than Ritz and Rupp.

A lot of people ignore this, he was also in medal contention with 200m to go in 2009 world champs 5k, up against the defending world champ and the greatest runner of alltime maybe in his best shape ever.

Possibly most significant: Rentao claims he told Mo BEFORE he joined Salazar that based on his 12:57 and previous season, he thought he could/would become world champ the next year with the right preparation/improvement. so he was already pegged by a true expert as the possible next world or olympic champ. Everyone in their rush to talk about Mo's improbable improvement under Salazar leave that out.

dear god its people like you who dont want to see the reality.

L-carnitine fine ok, but when you are INJECTING it in high dosages to try and achieve a performance enhancement then its a problem

its not they are taking v-D, its they are taking WAAAAAAAY more than is considered healthy....again for the performance enhancement that salazar figured out happens (thanks to guinea pigs like magness)

no one is saying that taking supplements and vit are bad, but when you start MACRO dosing them, and having them injected thats when you are going too far.

answer this for me. do you think it would be ok for a 13yr old trying to run fast to have his coach injecting him with macro dosages of carnitine and vit d? and tell him not to tell his parents or other athletes?

Mr. Obvious wrote:

themanontherun wrote:

Can someone please explain, in simple terms, why large infusions of L-carnitine are banned in the first place?

L-Carnitine is not banned. It does not matter how large it is.

Infusions of greater than 50ml in a 6 hour period are banned.

And just to be clear about how this works at the sports federation. The IAAF agreed to formulate anti-doping rules for their sport using the WADA standards.

The IAAF->USATF has all the authority to sanction. In the unlikely event of a sanction, they direct the athlete's NADO to execute the sanction. Since this is Track and Field brought to by Nike, that's not going to happen.

WADA only makes/maintains a standard. They have no authority over the sports federations. The worst they can do is publicly state something is/isn't WADA compliant either at a lab or at a sports federation.

Please enlighten me: at what point does the dose become "MACRO" or "unnatural." What if I could gain that dose from a plant or animal source? Stop being naive/romantic. Plenty of vitamins can/are injected if needed (B12, iron supplements). Would you want your 13 year old running 120 mile weeks? Should we ban that too?

i agree with spencer wrote:

dear god its people like you who dont want to see the reality.

L-carnitine fine ok, but when you are INJECTING it in high dosages to try and achieve a performance enhancement then its a problem

its not they are taking v-D, its they are taking WAAAAAAAY more than is considered healthy....again for the performance enhancement that salazar figured out happens (thanks to guinea pigs like magness)

no one is saying that taking supplements and vit are bad, but when you start MACRO dosing them, and having them injected thats when you are going too far.

answer this for me. do you think it would be ok for a 13yr old trying to run fast to have his coach injecting him with macro dosages of carnitine and vit d? and tell him not to tell his parents or other athletes?

when doctors figure out how much a healthy person needs. now salazar being a mad doctor figures out by giving his guinea pigs higher and higher dosages, then f*ck orally its time to inject this stuff so it works faster. then after he tweeks the dosage he gives it to his real runners.

somewhere you seem to think this is legit. so making magness do all this experiments was ok? you think kids see this and wont think "oh man i need to start injecting this sh*t, i mean its legal!!"

nice way to be a moron

I see what you are saying and I don't mean to argue but something seems not quite right about that.

If someone is doping, I want to see them caught. USADA started by investigating mainly suspicions about testosterone, which they ultimately cannot prove. They did a lot of testing and investigated. That seems right and I think its good that people reached with their concerns.

Then USADA also investigate all of NOP's other activities. Some of these are done by other groups but they are not investigated. Now the report used in the Texas proceeding has leaked and a bunch of people have had their names tarnished. You have to read pretty carefully to know that thyroid medication is used by runners in other groups or that the L-Cart is more of a technical violation. Plus, the way information is presented in the press, it is easy to think Brown only works with Salazar.