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What the First Enhanced Athletes Learned About Performance Enhancing Drugs

AI-generated swimmers

Las Vegas

Greetings from the launch event for the first Enhanced Games in a noisy night club in Las Vegas. The news has just broken that a proposed event dubbed the “doping Olympics” will run almost a year from now in this very spot — at the Resorts World venue in Las Vegas. I’ve had an early look at the plans and The Economist has just published its news piece which focuses in on the enhancement protocol, and the medical and scientific oversight.

The launch also revealed that one of the first athletes to trial the protocol broke a world record only two weeks into a roughly three month enhancement protocol. Kristian Gkolomeev broke a record for the 50m freestyle swim (long course) previously held by Cesar Cielo with a time of 20.91 seconds, achieving 20.89 seconds, and won a cool $1m from the Games. This will be transformative to Kristian, who says he has not done well financially out of competing at the highest levels in athletics.

Yesterday I spent some time with Kristian, the accomplished swim coach Brett Hawke, and two other swimmer who will compete in the Games next year. I also spoke with Australian James Magnussen (aka “the missile”), and Ukrainian butterfly swimmer Andrii Govorov. These conversations, along with chats with Guido Pieles, the cardiologist who leads the medical and scientific oversight for the athletes, have revealed some subtle but important points about how performance enhancements are going to be used, and what has been learned so far in a trial run.

The Seven Lessons So Far for Performance from The Enhanced Games

1. Start cautiously

Contrary expectations the substances that will be used for the first games are actually rather limited. They are only medications approved by the Food and Drug Administration—albeit for other indications than performance enhancement. As described in my piece for The Economist, the protocol offers testosterone esters, anabolic steroids, growth hormone, and EPO. But there is no obligation on athletes to use any particular enhancement or in any particular quantity—that is ultimately down to the athletes and their own doctor.

Each athlete who is enhancing follows a three month protocol. Yet as Kristian found, the results can be rapid. For the Games next year, two cycles of enhancements are planned. One later this year, and another prior to the Games.

And it isn’t a free for all. Dr Pieles says they have ruled out the use of peptides, short chains of amino acids that can enhance protein synthesis, metabolism and improve recovery. He believes these remain too controversial, that some may be carcinogenic, and says they are not approved medications.

2. Have a great deal of medical supervision and screening. Really. A lot of it. And contrary to assumptions about the risks to health from enhancements, it is actually plausible that they may turn out to be healthier on the protocol than off it.

There is a bit more detail about the medical supervision in The Economist piece, for those interested. What is interesting is how the athletes feel about it. James Magnussen described it to me as significantly more rigorous than anything he had experienced previously in his high-level swimming career, including the Olympics.

James: People say, Oh, you're an athlete, you must be super healthy. Well, by the nature of what we do as elite athletes, nothing we do is healthy. It's not healthy to train for 36 hours a week and push your body to the limits we push it to. But no one ever checked to see if my heart was coping with with that stimulus to that it was keeping up with that workload. No one checked my liver function, my kidney function, my hormone levels, that was all just assumed. He's an athlete, he's healthy, and he gets up on the blocks and he races—actually quite to the detriment of my health. There were times where I was injected with painkillers just to get on the blocks and race for my country. And that's not healthy. That's not good for my longevity or my health in general”.

James also highlights that his cardiac health biomarkers *improved* on the protocol. His resting heart rate, for example, went down significantly (to 28 beats per minute), his blood pressure lowered, his cholesterol lowered. He feels the protocol improved his health and well being, rather than creating long-term risks.

3. Individualisation and tailoring to a person, sport, and an event is crucial for the best performances

James was the first athlete to try the protocol, and much of it was then uncharted territory. As shown in a new documentary James didn’t get the same benefits from the protocol. Doctors had suggested to James that it could take four to six weeks before he noticed any physiological changes or effects on performance. However, within the first ten days he had put on 10 pounds (of muscle), and had become physically quite impressive. He was a very strong responder to the protocol but that wasn’t actually a good thing.

Brett Hawke, the swim trainer, explains: “we deal with an element that is very unique, which is water. And so we have to consider buoyancy. We have to consider drag and resistance. And the bigger you get, the stronger you get, the less buoyant you become, the the more drag and resistance you create, the faster you go in the water, the more resistance you create, the frontal resistance.”

Kristian was able to learn from this experience. He describes the approach to his protocol as “micro dosing” a smaller amount of enhancements, having understood the specific physics of swimming. This was enough to give him increased energy levels, really good recovery and a lot more confidence (which James also reported on the protocol).

4. Work toward small but significant gains, not big ones

Brett is thoughtful about his learning process with the two athletes.

Brett: One of the mistakes I made in my own head was thinking that these performance enhancing drugs were going to dramatically improve performance and that is not the case. What I now expect from these enhancements is minimal effects. And I'm actually only trying to achieve minimal effects in training, which cumulatively will add up into hopefully a better performance.

Initially I thought maybe I can take a full second off in the 50 freestyle, and that just isn't reality. What I came to realise is.. we're looking for about point three of a second, which is, which is dramatic in a 50 freestyle, but it's not so dramatic that it's unrealistic. So we were looking for point three with Kristian, and that's what we ultimately found. And so now I'm going in with a much more conservative approach, of like, we can tweak this and over time he will make progression. I found it very ineresting too, because I had a different perspective on that, you know.

5. The X factor: recovery and nervous system recovery

One of the biggest effects on athletes came with improved recovery. But not all parts of their body recoverd equally quickly.

James: the training almost five months, not one day did I wake up tired, sore, grumpy. I was jumping out of bed each morning ready for the next training session. I'd have to have a break before my next session that afternoon. And sometimes I was saying, can we just go again like I want to I want to train more like I want to do more. I need to do more. And what I didn't realise is, you know, I kept training and pushing my body further and harder, and physically, I was getting the effects and and and recovering, but my nervous system wasn't recovering at the same rate.

High-level athletes learn over many years how their bodies respond to training and what they need to do to recover. A new enhancement protocol throws that up in the air. Brett echoes this particular element of the learning:

Brett: Initially I made the mistake of looking at just as one way, as there's the physical gains we were going to make. So let me just compare it to you working all day. Let's say you and I working all day on a computer. Yeah, at the end of 12 hours, what is the most fatigued part of your body? Probably your brain. Your brain, exactly right? So this is the part that I didn't consider. Is that, yes, you can work for 12 hours effectively, and you can come back and work for 12 hours again. But neurologically, you're fatigued. You're exhausted. So mentally, you know, the more stress you put on the body, the more neurological fatigue. There’s no enhancement in the world that can help the nervous system recover just as fast as the muscles. So these guys were, yes, they were dramatically recovering in half the time, but neurologically over time, the fatigue would add up, interesting, and the enhancements didn't help. So it didn't matter what you did over the course of a month. By the end of the month, your nervous system was shot. And again, this is part of the learning that I had to learn with James, is that I was pushing him and pushing him and pushing him and pushing him. That was weird. And then his nervous system was taking a hit, and it wasn't recovering as fast as his muscles. So he would run into training and say, I feel great today, but then over time, he would get slower in the pool.

6. Enhancements cannot replace elite talent and hard work

The enhancements help make small but significant cumulative gains, but everyone felt that they were only valuable if one was already an elite athlete. James says that drugs don’t give necessary skill acquisition or the years of exposure to training methods. He says he firmly believes an athlete needs to be in the top 1% before the performance enhancements are added on to give a chance of breaking a world record.

7. Transparency and openness about performance enhancements are already proving valuable and will become more so

   Much of the discussion feels as though these are the first real conversations about how such medications can be used sensibly and safely in athletic performance. Kristian believes the Games will play a role in educating people more broadly on the use of the safe use of performance enhancements and eventually help many people live better, healthier and live longer. James argues that athletes need to be “really open and honest” about their experiences and help each other. Nonetheless it is also true that, for now, the precise medical protocols used are not published—something the Games describes as being medically confidential and says it won’t publish this sort of information to as not to encourage misuse by the public.

   On that topic, one of the concerns is that these competitions will encourage young people to seek out enhancements. James says elite sport is not something to be copied by everyone—which is, in any way, is done under intensive medical supervision. He says athletes should be positive role models in making sacrifices such as working and not drinking or smoking. Brett points out that it isn’t even possible for kids to simply pick up these prescription medicines, and face far bigger risks such as alcohol misuse. The Games itself turns the worry about the influence of kids on its head, saying that athletes can be role models for “how to use enhancements: transparently, responsibly, and under proper medical supervision”.

   Maybe that is right, maybe it isn’t. But the broader goals of Enhanced, for advancing human performance and longevity for everyone, means that the gains are potentially far more expansive to human wellbeing than a few world records for a handful of men and women. Today the internet is stuffed with influencers doing crazy things that are copied by youngsters and this seems rather tame by comparison. But ulimtately it will depend on the message that the Games and its future iconic athletes sends to youngsters. Hopefully, this will be “don’t try this at home kids”. Though, truthfully, if the ultimate goal is to expand access to these medications for enhancement, that message is a difficult one to send.

8. Fairness and pay really, really matter to athletes

In my conversation with Andreii, who is currently the world record-holder in the 50m butterfly, he was compelling on the topic of why he has recently signed to participate. The Games, he says, is “fair. It is completely transparent. I’m going to quit official sport and I’m never going back.” In quitting he will forfeit his chance to compete at the next Olympics. But the potential gains are huge. Both financially in this financially instable occupation, and in terms of being able to continue to be the fastest butterfly swimmer in the world.

Andreii: I went into deep thinking of the future life and of the philosophical aspect of what is to be an athlete, and what sport gives me, and what I give to people through sport. And if you know the term of ikigai, you know ikigai? [The Japanese concept that roughly translates as the reason for getting up in the morning.] It’s a balance between, what do you like to do what you're good at. How can you make money, and how can you affect the world? Ikigai is the point where all these things cross.”

He feels he has already accomplished fame, and the Games offers him something different. He is critical of the health implications and lack of support in traditional high-performance sport, saying that by definition it is “100% unhealthy”, due to lack of proper recovery patterns, overload, burnout and mental illness. He feels he paid with his health to achieve within the traditional system thanks to this lack of support.

Andreii recalls his financial struggles to keep healthy. Blood tests every two weeks would cost him $250, on top of this was nutrition, coaching fees, managers, massage therapy, and cryotherapy. Seven years ago the montly costs could be between $10,000 and $12,000 seven years ago. And all this money had to be found. The Games offers both medical and financial support—along with the chance at winning some big prizes.

A year from now, athletes will vie for supremacy in the 50m and 100m Freestyle, as well as the 50m and 100m Butterfly swimming events. Track and field competitors will contest the 100m sprint and the 100m/110m hurdles. In weightlifting, participants will demonstrate their prowess in the snatch and the clean and jerk disciplines. (Note to readers: I have actually no idea what these weightlifting competitions comprise, having simply read this from the press release.) Each individual event carries a prize purse of $500,000, with $250,000 for first place. There are also appearance fees and record-breaking bonuses including $1m for breaking world records in the 100m sprint and 50m freestyle (and $250,000 for breaking other records). The first two, though, are described as “the two definitive tests of raw human speed”.

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