3 Less Obvious Angles About Amanda Kendall’s Doping Suspension

Editorial content is the opinion of its author and does not necessarily reflect the views of SwimSwam.

Earlier today, SwimSwam reported on the 3-month doping suspension of U.S. National Team swimmer Amanda Kendall. Kendall, her attorney, and USADA all acknowledged her personal fault for the issue, if unintentional, but there are 3 key points to this case that I want to focus on separate from that, which I think are going to be largely overlooked in the typically (and appropriately) ravenous response to any doping case:

1. She didn’t actually fail a test

A percentage of you who are going to comment are going to read this headline, and not this sentence, and perceive this to be excusing her test. This is not that.

The reason this is crucial is that Kendall, who was taking a banned substance, was only caught and punished because she confessed when asked. This story is going to provide incentives for people to lie on their declarations, hoping they won’t get caught, even if scientifically that’s unlikely. She was taking a banned substance 7 days before she was tested, and the test came back clean.

That’s bad news for the integrity of the testing system, if the biggest loophole is “just don’t tell the tester that you’re taking any medicines,” although her confession probably saved her time on her suspension.

2. Inhaler abuse is real in sports

Kendall was prescribed her inhaler by a doctor, for acute, temporary symptoms that it sounds like would benefit from inhaler use.

But, this is a gateway into a broader conversation about inhaler use in swimming.

I got my first taste of this phenomenon when I was in high school and print newspapers were still a thing. The Houston Chronicle ran an investigative story on inhaler in Houston club swim teams, including looking at The Woodlands Swim Team – one of the most successful clubs in the state. The story was done by Richard Justice – now a national baseball writer, but also the parent of a daughter who swam collegiately at the University of Houston. The story involved doctor shopping to find one who would prescribe asthma medicine.

• See that Houston Chronicle article here.

Since then, the problem doesn’t seem to have improved. A recent study by Popular Science found that athletes with asthma are more likely to win medals at the Winter Olympics than athletes without asthma – a counter-intuitive statistic. The study cites a professor at the University of Kent who says that “up to 70 percent” of swimmers have asthma.

The results are inconclusive, but inhaler use is being looked at as a potential culprit for the disparity. According to the CDC, about 8% of Americans have asthma. One could imagine forces of selection bias acting in both directions on the swimming population – asthmatics avoiding the sport because of chlorine’s ability to inflame the condition, or in the opposite direction doctors who recommend swimming as a treatment for asthma in order to help force the lungs to expand.

Full disclosure: I had moderate asthma as a child that at least once required hospitalization, was prescribed swimming as a treatment, along with an inhaler, by a doctor, who was not my mother, who was also a doctor. I don’t remember when I stopped using my inhaler, but it was sometime around age 12 or 13. I still occasionally have mild bouts of exercise or allergy-induced asthma, but have more-or-less outgrown it.

But in either case – the math on numbers of elite athletes diagnosed with asthma just don’t add up, and needs more investigation. Every time this subject is broached, parents come to the comments, saying that anybody who claims inhaler abuse is belittling their child’s condition of “real asthma.” But that’s not what’s actually happening. We’re trying to make sure that healthy individuals aren’t using the condition as an excuse to gain an edge.

3. Comparing the suspension to the last similar TUE violation

The last TUE violation that feels similar to this (the athletes were open about taking a medication, under a doctor’s direction, but failed to take the proper administrative steps) was the case of Brazil’s World Record holder Etiene Medeiros. In 2016, she failed an anti-doping test for asthma medication that she was prescribed by a doctor.

Medeiros did file a TUE, but according to reports, her doctor failed to list this specific medicine among the others she was taking. She was consistent in filing appropriate TUEs throughout the year, but at some point hit an administrative lapse.

Medeiros received just a warning, whereas Kendall received a 3-month suspension.

• The similarities: both were taking prescribed asthma medications, both of which would have been cleared with proper TUE paperwork.
• The differences: One case was adjudicated by the USADA, one by the Brazilian Anti-Doping Authority. In Medeiros’ case, she was regularly filing a TUE, while in Kendall’s case, she was not. Kendall’s was prescribed for treatment of bronchitis, an acute condition, while Medeiros’ was for treating an ongoing condition, asthma.

Both stories carry an equal level of credibility, given the respective circumstances, and there are some nuanced differences that can explain the different suspensions. Overall, I would deem these suspensions ‘consistent with each other’ based on the facts presented.