More than 60 athletes have tested positive for meldonium

More than 60 athletes, including Olympic medalists and world champions, have tested positive this year for meldonium, the performance-enhancing drug that Maria Sharapova admitted to using, according to antidoping officials.

Meldonium, developed in Latvia for heart patients, aids blood flow and is not approved for sale in the United States. It was placed on the World Anti-Doping Agency’s banned list this year after being monitored by the agency in 2015.



“Regarding the number of meldonium positives, I can tell you that it was at 60 adverse analytical findings (since January 1st) recorded on Monday and that number is growing,” Ben Nichols, a spokesperson for WADA, said Thursday in an email.

Many of the athletes who have tested positive have not been publicly identified because their cases are still being adjudicated. But Sharapova, the 28-year-old tennis star and commercial powerhouse who is the most prominent athlete known to be affected so far, made her case public Monday by announcing that she had failed a test for the drug. She said she had used meldonium, also known as Mildronate, for medical purposes since 2006 on the recommendation of a family doctor. She said she was unaware that it had been placed on the banned list for 2016 and had failed to click on a link to the updated list sent to her by email by antidoping authorities.

She has taken full responsibility and is not contesting the finding.

Other athletes to test positive include: Semion Elistratov of Russia, an Olympic gold medalist in short-track speedskating; Pavel Kulizhnikov of Russia, a world champion speedskater; Davit Modzmanashvili of Georgia, an Olympic silver medalist in wrestling; and Abeba Aregawi of Sweden, a world champion runner.

“We are not really at any stage surprised when a substance is put on the list and all of the sudden there are positive cases,” David Howman, WADA’s director general, said Thursday.

“The reason for it being on the list is it’s being used and has been used to enhance people’s performance, and that was the reason for this substance first to be monitored for 12 months,” he added. “There was ample warning, if you like, given when it was put on the monitoring list in 2014 for people to say, ‘Hey, we have to be careful here.’ And they weren’t.”

Howman, however, resisted attributing the wave of positive tests largely to negligence by athletes.

“I don’t know if you can say what any main reason is,” he said.

Although Sharapova represents Russia, she has been based in the United States since she was 7. It remains unclear where she had procured or used meldonium, which can be purchased in Russia and some Eastern European countries without a prescription. A spokesperson for the Food and Drug Administration told The New York Times this week that it is illegal to import unapproved drugs into the United States, but that the agency will allow imports for personal use in some situations. In general, only a three-month supply is allowed in such cases.

“Maria was at all times in compliance with the F.D.A. guidelines,” John Haggerty, her lawyer, said Thursday in an email. “The F.D.A. has guidelines pertaining to the personal import of drugs, and Maria was in compliance with them.”

Sharapova will be suspended provisionally by the International Tennis Federation on Saturday and is awaiting a tribunal date. She could face a ban from competition for up to four years, although several antidoping experts have said she is more likely to face a suspension of no more than two years based on a preliminary analysis of her case.

Several of her major sponsors, including Nike, quickly suspended their connections with her.

But Head, which has had an exclusive racket deal with Sharapova since 2011, declared its full support for her on Thursday in a statement in which Johan Eliasch, the company’s chief executive, committed to renewing Sharapova’s contract.

“The levels of dosage that I believe she has been taking is significantly below the levels where this meldonium substance would have any impact on her athletic performance,” Eliasch said in a telephone interview.

Eliasch, who said he had examined her case closely but not yet spoken directly with Sharapova, said he had made the decision to release the statement independently and said he was prepared to deal with the fallout if information prejudicial to Sharapova’s case emerged.

“If that is the case, too bad,” he said. “I have made my case based upon the circumstances as we know them, and I have absolutely no doubt she has been 100 percent transparent.”

He maintained that, for now, community service would be an appropriate penalty.

“She should teach kids tennis for three months,” he said.

Community service is an unlikely outcome.

“You are running a $30-million-a-year sole proprietorship, and it depends on you remaining eligible,” Richard W. Pound, the former president of WADA, said Thursday, referring to Sharapova’s reported annual income. “What was she thinking? Either she or her team really screwed up.”

Eliasch said WADA should have set acceptable levels for the drug to allow for its legitimate medical use instead of banning it outright. In his statement, Eliasch said it was “common ground within the scientific community” that for meldonium to have a performance-enhancing effect, “it has to be taken in daily dosages of 1,000 to 2,000 milligrams.”

Haggerty has said Sharapova’s usage was far below the performance-enhancing levels.

Howman declined to discuss Sharapova’s case specifically, but he said that very few substances on WADA’s banned list had a threshold. He said two of those were marijuana and glucocorticosteroids. He said that when meldonium was being monitored in 2015, experts did not make a formal recommendation for a threshold.

“None of the experts in the world that we deal with, and that’s across all countries and all sports, made that submission,” Howman said.

Sharapova has said she had been prescribed Mildronate because she was falling ill frequently, had a deficiency in magnesium and irregular echocardiogram results, and also had prediabetes and a family history of diabetes.

Among the reasons for WADA’s decision to ban meldonium were recent studies that showed increased use of the drug and its widespread use among Russian athletes. One of the concerns was that healthy athletes were using the medicine to improve performance instead of treating genuine medical problems.

“It would be pretty astounding if we had 60 or 70 athletes who suffered from heart conditions and had to take this substance,” Howman said, referring to the number of positive tests so far in 2016. “On the other hand, if there are one or two of them, then you start listening, but then you also have to sit back and say, ‘Well, why then didn’t they seek a therapeutic-use exemption?’ ”

Such exemptions, granted only after review, allow athletes to use otherwise banned substances. It was unclear whether Sharapova would apply for a retroactive therapeutic-use exemption for meldonium, which could avert a ban if it were approved.

This article originally appeared on New York Times, a global partner of The Express Tribune.