Chelsea winger Mykhailo Mudryk is facing a lengthy ban from football after testing positive for a banned substance.
Mudryk, who insists he has done nothing deliberately wrong, reportedly tested positive in October for meldonium and is awaiting the results of the “B” sample from the same test.
If he is found guilty, the Ukrainian could be banned from football for up to four years, although that sentence will be subject to significant scrutiny in the coming weeks and months.
Meldonium is not an unfamiliar name to experts in the doping world.
What is meldonium?
“Meldonium is a medicine prescribed for conditions such as angina, when there is reduced blood flow [known as ischaemia] to the heart tissue which causes a reduced delivery of oxygen,” Dr Liam Heaney, senior lecturer in bioanalytical science at Loughborough University, told The i Paper.
“It works by shifting fuel use from fatty acid oxidation to glucose oxidation; glucose is easier to metabolise than fatty acids [i.e. less oxygen is required] and so it reduces the metabolic load on the cells which alleviates the issues with reduced oxygen supply.”
It is not approved for use in the United Kingdom or the United States, but it is manufactured in Latvia and licensed in a number of Eastern European and Baltic countries.
In an athletic setting, it is considered potentially performance-enhancing because the process of oxidising glucose rather than fatty acid creates less “oxidative stress”.
Heaney, who has also worked in a research capacity in a Wada-accredited lab, added: “That would, theoretically, decrease the onset of some aspects of fatigue and increase the rate of recovery.
“Improved glucose oxidation may also lead to a decrease in the reduction of lactate accumulation which would be considered as beneficial for recovery.”
When was it banned?
Meldonium was added to the World Anti-Doping Agency (WADA) banned list in 2016, having spent a year on the Wada “monitoring program” and after a four-year process concluding in the substance being prohibited.
The monitoring program found “high prevalence of the use of meldonium by athletes and teams of athletes”, and then-Wada president Craig Reedie said it was “a big concern because it’s clear that people are abusing the drug.”
At the 2015 European Games, a study found more than eight per cent of athletes tested were using it, less than half of whom were declaring usage officially. Usage was particularly widespread in Russia.
However, after it was banned, Latvian manufacturer Grindeks insisted that it “cannot improve athletic performance but it can stop tissue damage in the case of ischemia”.
Sergei Sheremetiev, a physician with the Russian ski-jumping team, revealed that he would give it to his athletes approximately twice a year.
Sheremetiev said: “It’s a good drug. Until they banned it, we used it in many types of sport: hockey, skiing — in those where there’s pretty serious strain.”
And the inventor of meldonium, a Latvian scientist called Ivars Kalvins, said in an interview that using meldonium should not be construed as doping, although conceded that it was “very popular” with athletes because it allows [them] to train under maximum strain”.
“Athletes can train without being afraid that if they inadvertently overstep their limit, they will end up in hospital with a heart attack or die on the field,” Kalvins insisted.
Who has been banned for meldonium use?
The drug hit headlines in March 2016 when Maria Sharapova, a five-time major winner in tennis, tested positive for meldonium just a few weeks after it had been added to the banned list.
The Russian player insisted she was innocent of deliberately breaking the rules, saying she had taken a drug called “mildronate” for the previous 10 years after having it prescribed by her family doctor. Mildronate is the common trade name of meldonium, but Sharapova did not realise that’s what it contained.
Her explanation was accepted on appeal by the Court of Arbitration for Sport, which reduced her suspension to 15 months and said in its judgment that she could not be considered “an intentional doper”.
Sharapova was one of nearly 200 athletes, predominantly from Russia and Eastern European countries, who tested positive for meldonium in the months following it being initially banned.
At the 2018 Winter Olympics, Alexander Krushelnitsky was stripped of his curling bronze medal after testing positive for the substance, but Mudryk is arguably the most high-profile case since Sharapova.
