In an agreed settlement with the FEI, announced today (May 28), US riders Hannah-Sue Burnett , Jennifer Brannigan and Aylssa Phillips have all been suspended for a year (through November 2018) and fined 1,500 Swiss francs ($1950) each as a result of their positive drug tests at the CIC3*Ocala-Reddick horse trials in Florida in November 2017.

All three tested positive to the stimulant amphetamine. Alyssa also tested positive for canrenone and Jennifer to methylphenidate and its metabolite ritalinic acid. One medical use of amphetamine is for treating narcolepsy and ADHD, popularly sold as Adderall. Methylphenidate is also used to treat those conditions. Canrenone is a diuretic.

When I was growing up in England during the ‘60s and ‘70s, the kids who messed about at the back of the classroom, or couldn’t concentrate on tasks the rest of us found absorbing, were labelled naughty and/or stupid. Nowadays they would almost certainly be diagnosed with dyslexia or attention deficit hyperactivity disorder (ADHD). And, my goodness, there sure is a lot of the latter about. Well, there has to be if, from the tiny handful of riders dope-tested each year in FEI sport, all three positives from a single event involve event riders suffering from ADHD.

The girls and/or their supporters argued all along that these were legitimate, prescribed meds, though when the positives were first announced other less charitable theorists on social media pointed to Adderall as a widely available party drug.

As it’s turned out, all three have been able to show they really do have ADHD, and there was no intention to enhance performance. Their only sins were a) ignorance of human anti-doping rules – something they share with about 99% of the riding population, it seems – and b) a failure to apply for Theraputic Use Exemptions (TUEs). All had openly declared their prescribed meds to doping control at the event but apparently not realised this isn’t the same thing as obtaining a TUE. Again, they are by no means the only people to misunderstand this distinction, as we documented here last winter.

Hannah-Sue, Jennifer and Alyssa all applied for retroactive TUEs after the positives were advised and were rejected. That rejection was pretty predictable, given what has happened to others in the same position. All three have now obtained TUEs, going forward, though none will have a use for them for a while yet.
In an “agreed settlement,” substantially less information is published than in reports of an FEI Tribunal hearing. We do, though, know that Jennifer provided comprehensive documentation about her prescribed use of Concerta and Vyvanse to treat ADHD symptoms as well as depression, and of her concussion history “which at times makes her forgetful and impulsive.” So did Alyssa, though exactly when she was diagnosed is unclear.

It must have been especially painful for Hannah-Sue to have to disclose long-term personal issues in the pursuit of proving her innocence. ADHD expert Dr Goodman from John Hopkins University said she “has a history of clear ADHD symptoms since childhood that are persisted chronically with impairment over the course of her life.” It was so disruptive that she dropped out of 6th grade and was home-schooled. She later dropped out of college. Medication was recommended when she was 10, but her parents were “philosophically opposed.” Her brother and his children have also been treated for ADHD.

Widely-published research estimates that ADHD affects only 2-5% of adults. Why so many of them appear to be equestrians, if the Ocala Three are representative of the afflicted population, is quite a mystery. When all this first blew up, some armchair medics advanced the interesting theory that eventers are more likely to succumb to ADHD in adulthood because of the adrenalin spikes generated by cross-country jumping.

What is clear is that not nearly enough information about human anti-doping is put “out there” by governing bodies; the onus tends to be on clean sport for equines. Hannah-Sue – who is quite a senior rider, after all – also said she could not recall receiving any anti-doping education for at least five years. That’s pretty damning – yet is a common to many other previous human cases too.

The non-recreational drug cases handled by the FEI since 2007 mostly involve riders who hadn’t thought about applying for a TUE or told their doctors they were sportsmen and thus liable to dope-testing. Some, like Hannah-Sue had already ridden at major events or even the Olympics; how does anyone progress to elite level equestrian sport without their team management drilling them about what they can put in themselves as well as their horses?

The FEI seems to be more engaged than it used to be with human doping, though as yet isn’t very good at “announcing” developments or education programmes. I only discovered the FEI had set up a working group a year or so ago, whose brief included recreational drug use by riders, from some archived papers. Human doping was also a topic at the spring 2018 FEI sports forum, though the discussion was somewhat light on figures about the frequency of human testing. The few stats available show that up to 2016, at least, rider sampling just a droplet compared with the thousands of horses tested each year.

One thing still strikes me a bit odd about the Ocala decisions. The FEI has accepted there was no intent whatsoever to enhance performance. So why the one-year suspensions? In all previous cases where prescribed meds were involved, and where it was agreed TUEs would have been granted had they been applied for in time, no-one was suspended by the FEI. They were variously fined, disqualified and/or told off. OK, one of them did get a one-and-a-half month suspension – but that was handed down separately by his national federation, not by the FEI. One rider “done” for smoking cannabis got only three months.

Neither were any of these past offenders obliged – unlike the settlement terms imposed on Jennifer, Hannah-Sue and Alyssa – to help educate other riders about anti-doping in future and to complete an anti-doping course. All in all, the Ocala Three do appear to-have-been-made-an-example-of. I wonder why.