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In the same week that the 2016 Tour de France kicked off (an event perennially maligned by performance-enhancing drugs) and Russia appealed the ban that will prevent its track and field athletes from competing in the Rio Olympics (thanks to widespread, state-sponsored doping), veteran sports journalist Mark Johnson debuted his new book Spitting in the Soup: Inside the Dirty Game of Doping in Sport.

Johnson’s book explores the history of doping in sports, going back 150 years to a time when pills meant progress, for both athletes and society. His reporting exposes the real focus of elite sports — not fair play, as long-standing myths would have us believe, but to push the boundaries of human performance. Spitting in the Soup takes a bitingly honest look at the role teams, coaches, governments, the media, scientists, sponsors, sports federations, and even spectators have played in doping in sports. We spoke with Johnson about the truth behind performance-enhancing drugs, and what it will take for elite athletes to come clean.

Is it true that sports doping wasn’t always a bad thing?

It wasn’t a bad thing for roughly the first 100 years of pro sports. Professional sports began during the industrial revolution — the 1870s and 1880s — when more and more people poured into big European and American cities, creating a market for entertainment, whether it be in a velodrome or a soccer field. Doping during those times was considered the hallmark of a professional athlete, a sign of dedication to the craft, a morally responsible action to promote human progress.

What caused the shift?

For a while, society’s attitudes toward drugs were fairly optimistic — drugs solved problems, deeply entrenched problems, like polio, and were seen as sort of miraculous. Chemistry, as the solution to better living, was celebrated.

Then, in the 1960s, a couple things happened. One, the medical community became more aware of the potential health risks of drugs. In the late ’50s, we had this massive disaster with Thalidomide, which is a drug that was administered to pregnant women to help them deal with morning sickness; it turns out that this drug was causing horrifying birth defects. We also started to see greater addiction problems with amphetamines, especially in 1968 and 1969, when you started to have a lot of Vietnam veterans coming back addicted to heroin and amphetamines. And there were larger social anxieties about drug use in everyday culture: I went back and looked at testimony from hearings that California state legislatures held in the mid 1960s, and they made an express connection between what they saw as a moral and political decay that was being supposedly caused by recreational drugs — pot smoking hippies — and problems in sports. That’s when they started to pay a lot more attention. It didn’t help that in 1960, at the Rome Olympics, a cyclist named Knud Enemark Jensen died from heat stroke in the 100-kilometer time trial, and his death was falsely attributed to amphetamines, or that in 1967, Tom Simpson, a British cyclist, died while racing on Mt Ventoux, and his death actually was related to amphetamines.

So doping fell from favor, at least morally. But professional athletes continue to get busted. What’s going on?

There were larger political and commercial forces that were coming into play in the Olympics at the same time the anti-doping forces were starting to take root. In a way, the anti-doping infrastructure and bureaucracy really didn’t have a chance against these larger forces.

Give us an example.

At the 1976 Olympics in Montreal, the U.S. got clobbered by the Communist states. They took home over 200 medals, I believe we took home 91. It was a real embarrassment. And within the context of the Cold War, this was something that couldn’t continue. We didn’t compete in the 1980 Olympics because it was in Moscow and we boycotted it, and in 1983 [a year before the Olympics], then-President Ronald Regan had a luncheon with U.S. Olympic Committee executives at the Biltmore Hotel and said: “I know we won’t let those kids down and won’t short-change our country by doing anything less than a first-class job.” So, you had Regan putting pressure on the U.S. Olympic Team to deliver medals. The Olympic Committee and the coaches knew full well that the East Germans and the Soviet Union had a state-sponsored doping program. So while the executive branch wasn’t saying explicitly dope, the executive branch was saying don’t embarrass us. The U.S. Olympic Committee was already under similar pressure from their corporate sponsors. These are enormous forces that were pressing against a still-relatively nascent anti-doping force.

All of that begs the question: Will anti-doping efforts ever work?

The World Anti-Doping Agency (WADA) issued a report in 2013 that studied the efficacy of world anti-doping drug tests. The conclusion: Less than 2 percent of the doping athletes are being found. Does that mean 98 percent are clean? No way. WADA then said, in the same report, that if we throw out the tests for asthma and marijuana, less than 1 percent of the doped athletes are being found. So the structure we have today doesn’t work — and that’s not a criticism of WADA, it’s something that WADA itself has acknowledged. They mentioned in their report that doping is a factor of political and human issues, not just some technical issue that we can get rid of by having more surveillance and stricter punishment. That’s been the approach so far, and it isn’t working.

So what can we do?

One approach that’s been suggested by a lot of academics: Instead of taking a blanket approach that says that any doping is evil and inherently wrong, let’s look at the forms of doping that are really harmful to athletes, and focus on getting those out.

You can pluck out the Lance Armstrongs all day, but those economic and political forces are going to remain, and they are very powerful forces to keep doping in sport, not to mention the continued demand for greater spectacle. The crime-and-punishment infrastructure that’s been built around anti-doping makes sense on an emotional level, but it doesn’t address the fact that doping is a collective enterprise. It’s not just acts of individual moral degenerates, which is the easy way to look at it. It’s much harder to say, hey, we’re all in this together. Unless we start looking in the mirror, we cannot start to seriously deal with this problem.