The Hidden Toll of Anti-Doping Proceedings
“You’ve tested positive”. Words that no athlete ever wants to hear.
The news arrives, almost always without warning: a letter or an email coldly informs them that they’ve tested positive for a banned substance – often one they’ve never heard of – and that they now face a ban that could end their career, destroy their reputation, and jeopardise everything they’ve worked for.
One minute on top of the world, and the next, cast out, labelled a cheat, and left to navigate a hostile and complicated process without any support.
This is the reality of anti-doping. And yet, the impact of the process – the trauma, isolation, and despair it causes – is dangerously overlooked.
A deeply unpleasant process
There are several thousand positive tests each year globally.
Some of those cases will relate to athletes who sought an unfair advantage. In many cases, however, the case has nothing to do with cheating but is the result of inadvertent exposure – through contaminated supplements, medication, food or some other environmental exposure.
Regardless of the circumstances of a positive test, the ensuing process is deeply unpleasant. No athlete is ever prepared for it.
Athletes are conditioned to believe that only cheats commit anti-doping rule violations. They also know that, irrespective of how the substance entered their system, anyone who has tested positive will carry an asterisk next to their name for life. So, when an innocent athlete is told they’ve failed a test, they often react with shock, disbelief, fear and sometimes anger.
That is all compounded as the legal process stretches on – for weeks, months, or sometimes years – with uncertainty, public scrutiny, and professional exile hanging over them.
For many of those affected, sport is not just a job – it’s a lifelong passion and is an integral part of the athlete’s identity. Often, sport is the only thing they have known since they were children, with education and other opportunities sacrificed in pursuit of sporting success.
In some cases, the mental strain becomes unbearable, and athletes contemplate the unthinkable. It is a reality that anti-doping organisations (ADOs) all too often overlook.
In 20 years of defending athletes in anti-doping proceedings, I have seen athletes react in all manner of ways. Some are remarkably resilient; they remain calm, focused, and able to function under extreme pressure. But they are the exception. Many are overwhelmed – unable to cope with their reputation, career, and future being suddenly under threat.
And this is something that very few ADOs appreciate. They don’t see the athlete break down in tears. They don’t hear about the sleepless nights, the fear, the torment and the despair.
Instead, ADOs often behave as though they are operating in a vacuum.
Too often they approach these cases with a “win at all costs” mentality – intent on doing what it takes to secure a ban. This can mean withholding potentially exculpatory evidence, failing to disclose key scientific findings, disregarding alternative explanations for the presence of a substance and conducting proceedings in an ultra-aggressive manner.
That is all exacerbated by ADOs making public announcements about ongoing cases long before their resolution. It’s bad enough to discover you've tested positive – it's a thousand times worse when the entire world knows.
In the age of social media, an athlete isn't facing one opponent, but thousands – online, in the media, and even among peers. Criticism is no longer confined to a newspaper headline or a passing comment. It’s immediate and constant, global and personal, and is often read by athletes in real time, on their own phone, in their own home.
To make matters worse, ADOs’ submissions often adopt an aggressive and accusatory tone – sometimes based on weak or untested evidence. They seem to forget that the athlete will often be reading every word, internalising every allegation, and wondering what will be left of the life they built.
Indeed, ADOs often give the impression that they have forgotten – or do not care – that they are dealing with human beings. Whilst they would argue that they must conduct their work dispassionately, that does not preclude them from acting with sensitivity and empathy. Words and tone matter.
Families Pay the Price too
And it isn’t only the athletes who suffer.
Families – who are so often forgotten in the process – carry a heavy emotional and financial burden. In many cases, the athlete is the main or sole breadwinner. A sudden ban or provisional suspension doesn’t just threaten their career; it places their entire household in jeopardy. Mortgage payments, school fees, and day-to-day living costs become sources of immense anxiety.
For partners and parents, feeling helpless whilst watching someone they love spiral into distress is devastating. For children, the abrupt disappearance from competition of a parent who has suddenly become someone other than their normal self can be confusing and traumatic.
The uncertainty of the proceedings only deepens this stress. There are seldom swift resolutions; anti-doping investigations can stretch over months or even years. Families are left in limbo – financially unstable, emotionally drained, and with no clear sense of what the future holds.
And then there are the parents – so often the quiet, unseen foundation of an athlete’s journey. From the earliest days, they are the ones waking up at dawn, scraping together the money for coaching, equipment, and travel, driving their child to tournaments and training sessions, sacrificing holidays, weekends, and often their own careers to help them chase their dream.
They’ve invested years of effort, hope, and belief in their child’s success, only to watch it unravel, often in the most public and humiliating way. Many feel helpless, shut out of the legal process, watching the emotional collapse of their child and the possible erasure of everything they built together as a family.
441 Pages. Zero Support.
What makes this more troubling is just how comprehensively mental health is ignored by the regulatory framework.
The World Anti-Doping Agency (“WADA”) has produced an extensive body of regulations to govern anti-doping globally. The World Anti-Doping Code alone runs to 136 pages. Add to that the various International Standards—for laboratories, testing and investigations, results management, education, privacy, and therapeutic use exemptions—and you have 441 pages of rules.
Across all those hundreds of pages, there is not a single reference to the mental health of athletes facing anti-doping proceedings. No guidance. No requirement. No suggestion that these individuals should be treated with any form of psychological care or sensitivity.
The lack of any policy is evidence that it is an issue that is simply not being considered – or at least not taken seriously – by ADOs.
The risks are real
The human cost of anti-doping isn’t theoretical.
In 2013, Belgian cyclist Jonathan Breyne attempted suicide after being informed he had tested positive for clenbuterol. Breyne, only 22 at the time, swallowed a large quantity of pills the day after receiving the notice. “I have done nothing to deserve this,” he told a journalist hours before the attempt, “but how do I prove that?”
He survived, but only narrowly.
Four months later he was fully exonerated by the UCI as they accepted that his positive test was caused by meat consumed in China (where clenbuterol is regularly and legally administered to livestock). However, that was very nearly too little, too late; a man, who had done nothing wrong, very nearly died at the hands of the anti-doping system.
He is not alone. In 2010, Polish teenager Kacper Szczepaniak, just 19 years old, tried to end his life after learning he had tested positive for EPO. His father fortunately found him in time.
More recently, the Australian swimmer Shayna Jack revealed that during the drawn-out fight to clear her name, she came close to taking her own life. After being informed of a positive test for Ligandrol—a result she always maintained was due to unintentional contamination—Jack felt alone, disbelieved, and broken. “I was done with the process,” she said, describing the day she decided to take her life while at home alone. She later received psychiatric support and successfully reduced her ban from four years to two.
And in 2023, Nigerian sprinter Divine Oduduru disclosed that he had attempted suicide four times, following his six-year doping ban. When he eventually spoke out, he said he’d reached a point where he simply “wanted to end everything.”
Tragically, some athletes have been successful in their suicide attempts.
In 2010, former Great Britain rugby league star Terry Newton took his own life while serving a two-year doping ban. One of Newton’s friends explained that “… the comfort blanket of rugby league was taken away and he found himself unable to cope."
The same year, Olympic gold medallist Antonio Pettigrew – who had admitted to past doping as part of the BALCO investigation—was found dead in his car after overdosing on sleeping medication. His suicide came after being stripped of his Olympic medal and years of public fallout.
These stories are not about doping. They are stories about people and about the consequences of a system that forgets it is dealing with human beings.
Documented psychological harm
ADOs have long been on notice of the immense psychological trauma caused by anti-doping proceedings. Despite mounting evidence from researchers, athletes, and mental health professionals, meaningful safeguards remain absent:
1. 2011 – WADA-commissioned study (Piffaretti):
A WADA-commissioned report found that sanctioned athletes suffered social isolation, public stigma, financial distress, and significant mental health problems. The report’s author – Dr Piffaretti – recommended a program called WINDOP, aimed at providing mental health monitoring and reintegration support. To date, no such programme has been implemented.
2. 2017 Macolin Anti-Doping Summit:
Frustrated by the lack of progress following his 2011 publication, Dr Piffaretti reiterated his concerns in a presentation titled “Psychological Aspects of Anti-Doping: The Decision to Dope and the Impact of Getting Caught.”
Piffaretti emphasised the significant mental health consequences athletes face following anti-doping rule violations and urged for a more compassionate approach, psychological support and rehabilitation.
3. 2020 – Global survey of Olympic organisations:
A survey of 22 sport organisations – including the International Olympic Committee and National Olympic Committees representing five continents – revealed that none had in place a structured support programme or system for supporting doping-sanctioned athletes. On the contrary, it was noted that organisations often sever all ties with, and access to support for, athletes who are charged with anti-doping rule violations.
4. 2022 – Call to Action for Safeguarding in Anti-Doping:
Piffaretti and co-authors published a commentary titled “Call to Action for Safeguarding in Anti-Doping”, renewing their appeal for reform. They explained how treating doping purely as a moral failing disregards athlete vulnerability and exacerbates psychological harm. They called for the integration of safeguarding and mental health support into anti-doping policy.
5. 2023 – Study on biopsychosocial harm post-sanction:
A paper titled “Life after doping: do the consequences of an anti-doping rule violation threaten athletes’ health?” by Frans van der Kallen et al. documented the profound biopsychosocial consequences following a doping charge – such as a loss of identity, social isolation and a decline in mental and physical health. The study underscored the need to treat doping cases not just as rule violations, but as complex human experiences with serious health implications.
Whilst most of these warnings concern athletes who have been sanctioned (not just charged) the upshot remains the same: WADA has failed to implement any serious mental health safeguards for athletes involved in any anti-doping proceedings. The consequences are clear—and so are the risks of further tragedies like those of Terry Newton and Antonio Pettigrew.
Conclusion
Some may argue that competing in elite sports is a privilege and that if an athlete breaches anti-doping rules – whether inadvertently or deliberately – the consequences are of their own doing.
But that’s not the point. Whether an athlete has deliberately or inadvertently broken the rules, the emotional and psychological toll of an anti-doping case can be overwhelming – particularly in the age of social media. These are human beings – often young, often isolated – who are suddenly facing public shame, the end of their careers, and an uncertain future. No one can predict how any given athlete will react to that kind of pressure.
The responsibility of ADOs must be not only to enforce the rules, but to do so with compassion, sensitivity and common sense.
ADOs need to rethink their approach to anti-doping prosecutions, before another athlete is pushed beyond the brink.
As a starting point, serious consideration ought to be given to keeping confidential the names of (a) athletes who have been charged but not sanctioned; and (b) athletes whose doping violation was inadvertent and/or caused by contamination (as has long been proposed by the United States Anti-Doping Agency). No athlete involved in such cases should have to be put through the turmoil of a public announcement. What benefit was gained by the public knowing Jonathan Breyne tested positive when it was later proven that his test result was caused by contaminated meat?
ADOs would likely also benefit from formal guidelines or policies requiring certain steps to be taken in order to offer support to athletes who might need it. Amongst the hundreds of pages of regulations published by WADA, no such guidance yet exists. That needs to change, and fast.
A myriad of other suggestions have been made to WADA over the past 15 years as to what might be done differently.
WADA evidently does not like those proposals or considers them unworkable, given that it has not adopted any of them. If that is the case, then it ought to be identifying other solutions. It has had long enough to do so and, as the global regulator for anti-doping, it has a duty to do so before any more lives are ruined.
Authored by
Mike Morgan
Partner