The Indian MHA saga set to complete four years

It has been nearly four years since proceedings were launched by the National Anti-Doping Agency (NADA) against 11 ‘offenders’ who tested positive for the stimulant methylhexaneamine (MHA).

Last month (August, 2014), the National Anti Doping Appeal Panel (NADAP) disposed of the cases of athletes Saurabh Vij and Akash Antil, leaving just one appeal, that of swimmer Richa Mishra, to be decided.

Hopefully, the decision should come this month, just after the fourth anniversary of MHA having made its debut before a disciplinary panel back in 2010.

Methylhexaneamine when it was added to the Prohibited List by the World Anti Doping Agency (WADA) in 2010 was a relatively unknown substance. At that time it was thought of as an ingredient used in a nasal decongestant since Google searches produced that information, without making it known that the medicine was no longer available in the market.

The tale of massage oils & soaps

Soon it was also publicized as a naturally-occurring substance since it was considered to be available in geranium plants, especially its root extracts.  Probably, the supplements manufacturers needed to show that MHA was a natural substance in order to freely market it. Around the same time, word spread that massage oils, bath soaps and other cosmetic products contained geranium and hence they contained methylhexaneamine. There was even a suggestion that some cooking oils contained geranium and thereby MHA!

Today Wikipedia has this to say about methylhexaneamine. 

More and more studies have claimed that geranium does not contain methylhexaneamine, though manufacturers of dietary supplements continue to claim otherwise. There is no evidence to show that massage oils or beauty soaps or face packs, claiming to contain geranium also show the presence of methylhexaneamine.

The National Anti Doping Agency (NADA) got a batch of VLCC products tested at a private laboratory and it was proved that the products did not contain MHA. A similar claim was also made by the VLCC company in the Nirupama Devi (judoka) case when it was alleged that its products had led to a ‘positive’ result for MHA in the athlete’s case.

Cutaneous absorption unlikely

It was also claimed in the Nirupama case that went up to the Court of Arbitration for Sport (CAS) that it was highly unlikely that the kind of levels of the substance found in the Indian athlete’s urine sample could be possible through cutaneous absorption.

It was routinely claimed by various people including athletes and lawyers in the Indian context that massage oils and soaps containing geranium could trigger a positive test for MHA.

‘Just use the soap for a few months and you get a positive for MHA’, seemed to be the argument.

Nirupama was handed down a two-year suspension by CAS, on an appeal by WADA, overthrowing the ‘reprimand’ ordered by a disciplinary panel and upheld by an appeal panel in India. The order came on November 8, 2013.

On September 23, 2013 an appeal panel in India reduced a suspension from two years to one year in another MHA case, that of  swimmer Jyotsana Pansare who belonged to the famous 'batch of 11'. She was the only one among the 11 to get a reprieve like that.

Pansare got it since the appeal panel ruled that the MHA “entered the athlete’s body by use of cosmetic face pack etc”.

The panel further wrote in its order, “there is no question of these being used for enhancement of performance and it was not intended to enhance her sports performance.”

Pansare did not make any claim about having used any particular product that contained geranium or MHA. Nor did the panel seek such information from her nor for that matter did NADA offer to test such substance at the NDTL if that could be made available.

NADA chose not to reveal

Curiously, NADA, which tried in vain to bring in evidence based on laboratory report in respect of the Nirupama case at a late stage before the appeal panel headed by Justice C. K. Mahajan (retd.) did not attempt to present the same evidence before the appeal panel headed by Justice M. L. Varma (retd.) in the Pansare case.

In fact Pansare’s lawyer, Vidushpat Singhania, did argue that the panel in the Nirupama case had considered the argument about cosmetic products having led to the positive test. It was accepted by the Varma panel and it agreed that the “benefit of that case” should be given to the swimmer.

Out of the 12 original MHA cases, one, that of weightlifter Sanamacha Chanu had ended in a quick decision, since her’s was a second offence. She never tried to bring in cosmetics or massage oil into the argument and received an eight-year sanction.

Six wrestlers were all given a reprieve of 314 days as the Varma panel ruled that there were delays that could not be attributed to the athletes and the punishment of two years coupled with the disqualification of all results dating back to sample collection date was too harsh.

The Dinesh Dayal disciplinary panel had suspended all 11 athletes for two years with effect from decision date (Nov 5, 2012), more than two years after the cases began. It also annulled all results from sample collection date.

Last month, athletes Saurabh Vij and Akash Antil also received reprieves for 314 days in tune with the decisions given in the wrestlers’ case. Vij is facing a second charge, of steroid use. That decision was left pending though the panel had concluded its hearings since the question whether he could be sanctioned for a second offence could only be taken after the first one was determined.

The Varma panel upheld the annulment of all results for eight of the 11 cases_one ongoing_setting aside the order of the disciplinary panel only in respect of disqualification of results in the Pansare case!

Amar Muralidharan argues differently

Just one more case has so far deviated in the batch of 11 from the majority of the rest. Swimmer Amar Muralidharan’s father Cdr Muralidharan, appearing for Amar, argued more on technicalities rather than plead concession because of delays.

He argued about the mix-up of sample code numbers (with that of Pansare), the delay in getting the sample across from Jaipur to Delhi, the doubts about the chain of external and internal custody, laboratory procedures etc. The panel rejected his appeal.

Amar Muralidharan has approached CAS, but it is to be seen whether the swimmer has a second window of appeal available after having exhausted his right of appeal in India.

Meanwhile, methylhexaneamine, which raised quite a debate in anti-doping circles in India initially_why should it be banned if it is to be found in daily use products, was a question often asked_has remained the No. 1 choice stimulant across the world since getting into that slot in 2010.

There were 123 MHA cases in 2010, accounting for 21.4 per cent within the drug category of stimulants, 283 (39.4 %) in 2011, 320 (45.9 %) in 2012 and 169 (31.9 %) in 2013.

In India there have been 67 cases of methylhexaneamine reported and dealt with by the disciplinary panel, seven of them having been in combination with other more potent drugs  and, in one case, along with a charge of tampering with doping control procedure.

In two cases, both involving rowers during the 2011 National Games, the athletes were exonerated because of flaws in the doping control procedures.

Taken off the shelves

Methylhexaneamine, in the meantime, has been banned as a supplement ingredient in many countries following adverse reports including death of two US soldiers.

One of the more popular supplements containing MHA, Jack3d, today has its variants in Jack3d Advanced and Jack3d Micro, after supplements containing MHA were ordered to be removed from the markets of some countries including Britain, Canada and Australia. In the US, the FDA has issued warnings

 regarding the sale of MHA supplements (also known by its synonym dimethylamylamine or DMAA). The new Jack3d does not contain MHA, it has been claimed.

However, MHA continues to be one of the 'popular' substances among athletes around the world, whether by accident or design. The recent instance of Botswana’s female 400m runner Amantle Montsho is a case in point. She is facing disciplinary procedures after having been disqualified from the Glasgow Commonwealth Games.

Athlete Laxay Sharma was the last of the Indian cases of MHA to be disposed of by the disciplinary panel with a two-year sanction last month.

Anti-doping authorities including WADA have issued warnings that methylhexaneamine could be marketed through a variety of names including 4-methyl-2-hexanamine, 4-methyl-2-hexylamine, 2-amino-4-methylhexane and 2-Hexanamine, 4-methyl-(9CI), apart from dimethylamylamine (DMAA) and dimethylpentylamine, the last two more common names found among the labels.

Mislabelling

Misleading labelling of supplements had led to a few athletes being given reprieve in the previous years, forcing WADA to issue a clarification in 2011 that MHA could be marketed under different names and athletes needed to be careful.

NADA’s refurbished website does not have a supplements warning or for that matter a methylhexaneamine warning even though the old website had one on MHA, placed there after more than two years of the substance being brought into the Prohibited List. Let us hope the NADA website will evolve and improve in due course.

Methylhexaneamine continues to be in the ‘specified stimulants’ category of the Prohibited List of WADA. That means a ‘positive’ result due to MHA could be argued as accidental and not an effort to enhance performance to get a lenient sanction.

What effect the new Code, to be effective from January 2015, will have on the use of supplements containing MHA is difficult to tell. The new Code contains a clause related to ‘Contaminated products’ that can attract just a ‘reprimand’ at the lowest end of fault or negligence.

The Indian appeal panel did take more than a year to deal with the 11 MHA cases_ with one of them still pending_with the last two having stretched beyond 21 months.

There seems to be a new-found urgency with the disciplinary panel hearings now since positive cases reported in June last have already been disposed of. 

It is a welcome sign that the NADA and the panels have realized the importance of delivering justice speedily unlike in civil suits. The kind of leeway given to defence lawyers in the 11 MHA cases can still delay matters. The only way to pre-empt such tactics would be to prescribe a procedure and fix a timeline as the CAS does.