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Living at high altitude is popular, since lower oxygen levels there boost red-bloodcell counts in a natural way—which, in contradistinction to chemical means, is permitted. It also makes it harder to interpret ABP results, leaving room for chemical enhancement as well. Remote places, moreover, are harder for out-of-competition testers to reach.
生活在高海拔地區是很受歡迎的，因為那里的低氧水平能夠以一種自然的方式增加紅細胞的數量，這和化學方法不同，這是被允許的。同時它還使得對運動員生物護照(ABP)結果的解釋更加困難，為化學增強留下了空間。此外，賽外測試人員很難到達偏遠地區。
Another option is to get advanced warning of out-of-competition testing from corrupt or sympathetic officials. Asbel Kiprop is a Kenyan runner banned in 2019 for failing an EPO test. He told the AIU he had often been warned of supposedly unannounced tests. Tip-offs give athletes time to dilute their blood, or to wait for microdosed drugs to clear their bodies. If all else fails, they can simply hide in a cupboard when the testers come knocking. If elite athletes go AWOL too often, they can be sanctioned. But as a fail-safe, it can be a useful tactic. "The principle", says Dr Tucker, "is never take a test you won't pass."
另一種選擇是提前從腐敗或容易策反的官員那里收到賽外檢測的警告。阿斯貝爾·基普羅斯是一名肯尼亞跑步運動員，因未能通過EPO測試而于2019年被禁賽。他告訴田徑誠信委員會(AIU)他能夠收到有關秘密測試的情報信息。這讓運動員有時間稀釋血液，或者等待微劑量藥物清理身體。如果這些辦法都沒有奏效，那么他們可以在測試者上門時躲在櫥柜里。如果精英運動員經常擅自離開，他們會受到處罰。但作為一種保險措施，這可能是一種有用的策略。塔克博士說：“原則是永遠不要參加你通過不了的測試。”
WADA's task, meanwhile, is made harder by the fact that, unlike dopers, it must operate in the open, leaving its methods vulnerable to attack. One way to interpret official limits for some substances, says an observer, is as a sanctioned value up to which athletes can push. Natural variation between people means the allowable limits for some substances must be reasonably generous, leaving room for athletes to boost them artificially.
與此同時，由于測試必須公開進行，測試在明，興奮劑使用者在暗，這使得測試方式很容易被鉆空子，世界反興奮劑機構(WADA)的測試任務也變得更加艱巨。一名觀察人士表示，解讀某些藥物官方限制的一種方式是，將其視為運動員所能達到的認可值。人與人之間的自然差異意味著某些藥物的許可限度必須夠大，從而為運動員人為地提高自己留下空間。
Such variations, says Dr Tucker, are one reason why the ABP, which tracks changes in an athlete's physiology over time, is difficult to apply to steroid doping. Natural levels of steroid hormones vary widely between people. Even within an individual they can fluctuate sharply, depending on stress, sleep deprivation and the like. And because a doping ban can be fatal to an athlete's career, anti-dopers must err on the side of caution. WADA's processes are tuned to minimise the number of false positives, in which innocent athletes are wrongly accused. That means they will generate plenty of false negatives, in which the guilty are incorrectly cleared.
塔克博士說，由于ABP追蹤的是運動員的生理隨時間的變化，所以這種自然差異是ABP難以應用于類固醇興奮劑的原因之一。類固醇激素的自然水平因人而異，且差別很大。甚至在個體內部，它們也會因壓力、睡眠不足等因素而急劇波動。由于禁藥對運動員的職業生涯可能是致命的，反興奮劑者必須慎之又慎。為避免在假陽性中無辜的運動員被錯誤指控，世界反興奮劑機構調整其程序以盡量減少假陽性的數量。這意味著它們將產生大量的假陰性結果，其中有罪的人就成了漏網之魚。
Money and national pride complicate things further. Though WADA oversees the anti-doping system for many sports, it relies on national authorities to do most of the legwork. "Many countries have really improved their approach to anti-doping over the past few years," says Dr Catlin. "But not everyone has the resources to do that." In 2013 Renee Anne Shirley, a former boss of the Jamaica Anti-Doping Commission, said a lack of resources meant her organisation had conducted only a single out-of-competition test in the months before the 2012 London Olympics, at which Jamaican athletes won a dozen medals. WADA itself is not exactly flush with cash. Its budget for 2021 is $40m—less than some individual athletes earn in a year.
金錢和民族自豪感使事情變得更加復雜。雖然世界反興奮劑機構監督許多體育項目的反興奮劑系統，但它需要依靠國家當局來做大部分的跑腿工作。卡特林博士說：“在過去幾年里，許多國家確實改進了反興奮劑方法，但并不是每個國家都有資源這么做。”2013年，牙買加反興奮劑委員會前主席蕾妮·安妮·雪莉表示，由于資源缺乏，她的組織在2012年倫敦奧運會之前的幾個月里只進行了一次賽外測試，而牙買加運動員在倫敦奧運會上贏得了12枚獎牌。世界反興奮劑機構本身的現金也并不充裕。2021年它的預算是4000萬美元——比一些運動員一年的收入還要少。
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