Speed skater Kei Saito receives first doping ban of 2018 Winter Olympics

 Japanese speed skater Kei Saito left Pyeongchang after testing positive for acetazolamide, but the substance is a curious inclusion on the doping list.

As long as there has been Olympic competition, there have been Olympic athletes seeking out a competitive advantage. Sometimes this involves training advances. It can be as simple as better nutrition or as wild as the latest technological advances in equipment. And yes, sometimes it involves doping with the pharmaceutical enhancements.

More than a century ago, athletes were taking strychnine and brandy to boost their Olympic performance. The history of sports has been riddled with amphetamines and anabolics, beta-blockers and blood boosters, and all sorts of other foreign substances.

The 2018 Winter Olympics in Pyeongchang are not immune to this reality of competitive sport. On Tuesday, Japanese short-track speed skater Kei Saito left the Olympic village and returned home after testing positive for the substance acetazolamide. He was the first doping ban of the 2018 Games.

What exactly is acetazolamide?

The World Anti-Doping Agency lists acetazolamide among the “Diuretics and Masking Agents” on the fifth page of its current list of banned substances. As such, WADA views this drug not as a performance enhancer but rather as a cover-up for other doping substances.

Acetazolamide is a carbonic anhydrase inhibitor. Its primary use is for glaucoma, edema, and epilepsy. The drug is commonly prescribed both as a preventative and treatment for altitude sickness.

It works by increasing the rate at which the kidneys process and excrete bicarbonate. This causes the blood to carry more oxygen and reduces its carbon dioxide content. When traveling to higher elevations acetazolamide helps individuals efficiently process the oxygen-thin air. Pyeongchang is located at 2,300 feet above sea level.

The IOC and WADA focus primarily on its diuretic properties. This oxygen enhancement is a less-discussed side benefit of the drug. Enriching the oxygen content of blood has long been a goal of doping efforts, from blood doping to several generations of synthetic erythropoietin (EPO). While the physiological impact of the drug has not been substantively studied from an athletic perspective, this could be another ancillary benefit of this particular masking agent.

What does this mean from a competitive standpoint?

Saito’s only event for Japan was supposed to be the 5000-meter short track relay. Following the announcement of his provisional suspension, Saito agreed to voluntarily leave the Olympic Village and return home. The Japanese speed skater, however, made sure to assert his innocence in a statement:

"I am shocked by this as I have never tried to commit doping.I have been trained in anti-doping. I have never taken a steroid so there is no need for me to mask something, and I never had to drop weight by using this medicine. So I have no motivation to use this.I want to prove my innocence but I do not want to burden my team so I accepted this decision."

Noteworthy was the complete denial by Saito. Given the drug’s beneficial impacts for individuals at altitude, Saito could have tried to mount a therapeutic-use argument. Instead, he unequivocally denied taking acetazolamide. The Court of Arbitration for Sport will review the doping case following the Winter Olympics.

Forced to regroup and find a new team member, Japan finished fourth in its qualifying heat in the men’s 5000-meter relay on the short track. Whether Saito would have substantively changed that result against a field that also included South Korea, the United States, and Hungary is a counterfactual to which we will never know the answer.

Next: What’s the difference between speedskating and short track?

What we do know, though, is that the Olympic doping controls are indeed working as intended. Whether justified or not, acetazolamide is quite clearly listed on the WADA list of prohibited substances. And the substance set off red flags in Saito’s A sample.

How it plays out from here in the Court of Arbitration for Sport remains to be seen. But for the 21-year-old Saito, his first Winter Olympics experience ended before it ever really began.

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