From Ajax goalkeeper to Tour participants: they preceded Hessmann (and why they may or may not have been punished)

Jumbo-Visma made a sudden announcement on Wednesday night, revealing that rider Michel Hessmann had tested positive for doping on June 14, 2023, during an out-of-competition test in Germany. The Dutch team stated that the substance detected was a diuretic drug, commonly known as a 'pee pill' But what exactly does this entail?

The Dutch Doping Authority provides a concise explanation on its website: "Diuretics, often referred to as pee pills, increase urine production and expedite the elimination of (doping) substances. Examples include furosemide, bumetanide, and chlorothiazide. Masking agents like probenecid reduce the excretion of (doping) substances.

Due to this masking effect, these urine pills are included in the anti-doping list, although they do not inherently enhance cyclists' performance. The crucial point is that taking a urine pill would not have made Hessmann cycle faster uphill, even if he had consumed one daily during the Giro, won by Primoz Roglic. While detailed explanations from Jumbo-Visma or the rider himself have not yet been provided, the team stated, "We are awaiting the results of further investigation. Michel has been suspended by the team until further notice," on Wednesday.

What are diuretics and where can we know it from?

"Diuretics are medications that stimulate the kidneys to produce more urine," explains the Doping Authority. "This not only accelerates urine production but also increases its volume. Diuretics are prescribed to manage high blood pressure and alleviate fluid retention in the body. In the realm of sports, diuretics find application for three main reasons: weight reduction (for instance, in judo, one can shift to a lower weight class using this method), dilution of doping substances (creating a masking effect), and 'drying out,' commonly employed by bodybuilders."

Hessmann is certainly not the first athlete to return a positive result for diuretics. A prominent case in the Netherlands is that of Ajax goalkeeper Andre Onana, who received a 12-month suspension in 2021 after testing positive for furosemide. Onana claimed the tablet was inadvertently from his wife's medication. In 2015, Manchester United's midfielder Fred faced a similar penalty when a diuretic was detected in his system. Similarly, Portuguese footballer Deco faced allegations but was later acquitted after a positive test. Additionally, Telstar player Kevin van Essen was suspended for two years in the same year; his defense attributed the incident to a contaminated supplement. Similar examples abound across a range of sports, including tennis and even billiards.

Diuretics in cycling: who preceded Hessmann?

Examples of diuretics in cycling are not uncommon either. In 2018, Belgian cyclist Kevyn Ista received a warning after traces of furosemide were detected in his system. Ista was able to demonstrate that the substance had entered his body unintentionally. Former Movistar rider Francisco Ventoso tested positive for the same drug during an out-of-competition check in 2009, resulting in a nine-month suspension that was eventually overturned. Italian cyclist Michael Bresciani faced a two-month suspension in 2017 after traces of the drug were found in his system. Bresciani claimed the drug had entered his system through contaminated food from his mother, who was using the medication.

In the 2011 Tour de France, Alexander Kolobnev tested positive for diuretics, leading to his expulsion from the tour by his team, Katusha. However, he was later cleared by the Court of Arbitration for Sport (CAS) in February 2012, citing medical reasons for the positive test. Another instance occurred one year later at the Tour de France when Fränk Schleck tested positive for Xipamide, which is also a diuretic. He received a one-year suspension as a consequence.

A similar incident occurred with Iljo Keisse during the 2008 Six Days of Ghent: he tested positive for Hydrochlorothiazide, another drug belonging to the diuretics group. After a long and drawn-out case, resulting in a suspension, the Belgian was eventually vindicated, and the UCI even had to pay him compensation. In a similar vein, Canadian Jack Burke was acquitted in 2013 following a positive test. He was able to demonstrate that the substance entered his body through contaminated water. It's important to note that in Hessmann's case, the specific drug and concentrations involved have not been disclosed.

Herman Ram: "If there is negligence, punishment does follow"

Herman Ram was the head of the Dutch Doping Authority until 2021, thus possessing extensive experience with drugs of this nature and related cases. In response to Ajax goalkeeper Onana's positive test, Ram previously commented, "Furosemide is present in various medications. It is on the doping list due to its potential for masking. Positive tests for furosemide are not uncommon and are often attributed to inadvertent drug use."

"Only when there is an absolute absence of guilt or negligence does no penalty apply. Instances of this nature do exist. For example, an athlete testing positive after consuming contaminated meat in a foreign country where such an occurrence wasn't reasonably expected. Similarly, an athlete once inadvertently ingested cocaine via tea consumption. In such cases, no punishment was issued as the athlete couldn't have anticipated these scenarios. However, negligence would result in a penalty."

So, what options does Hessmann have? "The one-year suspension for Onana suggests that the disciplinary committee isn't presuming deliberate doping violation. Otherwise, the penalty would be considerably longer; the standard sanction in that scenario is four years. Evidently, the committee considers the possibility of mitigating factors. A one-year suspension represents the lower end of the range within which the disciplinary committee operates," Ram explained.