Maria Sharapova fails drug test: what is meldonium and how did she use it?

Maria Sharapova's failed drug test
5-time Grand Slam winner Maria Sharapova has admitted to testing positive for banned substance meldonium

Former World No. 1 Maria Sharapova announced in a press conference yesterday that she had failed a drug test at the Australian Open. Speaking at a press meet in Los Angeles, the Russian said “"I did fail the test and take full responsibility for it.”

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Following serious speculation that she had been about to announce her retirement, Sharapova played it off – "I know many of you thought that I would be retiring today but if I was ever going to announce my retirement it would not be in a downtown Los Angeles hotel with this fairly ugly carpet," she said.

"For the past 10 years I have been given a medicine called mildronate by my family doctor and a few days ago after I received a letter from the ITF [International Tennis Federation] I found out it also has another name of meldonium, which I did not know."

Five-time Grand Slam winner Sharapova has been provisionally suspended from the sport as of the 12th of March.

The 28-year-old played in the year-opening Grand Slam, going down to World No. 1 Serena Williams at the quarter-finals on the 26th of January this year – which is also the day she says she provided the sample in question.

Meldonium, which Sharapova says she had been taking for the better part of a decade, was not a banned substance under WADA (World Anti-Doping Agency) regulations until a rule change that became effective on the 1st of January this year.

"It is very important for you to understand that for 10 years this medicine was not on Wada's banned list and I had been legally taking that medicine for the past 10 years," Sharapova told assembled reporters.

She went on to say she “….received an email on 22 December from Wada about the changes happening to the banned list and you can see prohibited items - and I didn't click on that link.”

What’s next for Sharapova?

The World No. 7 will see a ban from the sport, although it is unclear how long this ban will be, given the circumstances. According to regulations, the ban could be as long as 4 years, but if what Sharapova says is true, and the meldonium was in fact medication for health issues, she will receive what is known as a TUE or Therapeutic Use Exemption for it.

Sharapova’s lawyer John Haggerty says she had "abnormal electrocardiogram readings" and "some diabetes indicators", which prompted the doctor to recommend medication, including meldonium.

This was backed up by her one-time coach, former tennis pro Jeff Tarango, who said "If it is something where her heart in 120C weather would just give out without taking this then I'd rather she took it."

Lawyer’s statement and possible length of ban

Haggerty, who represents Sharapova and will do so throughout the doping issue, said in an interview with Sports Illustrated that he had contacted the International Tennis Federation to discuss what he described as a “laundry list of extremely mitigating circumstances that once taken into consideration would result in dramatically reducing any sanction that they might want to impose on Maria.”

The standard suspension period for intentionally using a performance-enhancing drug is four years, while in the case of unintentionally using a substance, it is two years. However, if the ITF believes Sharapova’s account that her level of negligence was minimal, it can reduce the ban to even one year. Sharapova could possibly reduce the ban even further if she appeals whatever sentence the ITF hands out, in the Court of Arbitration for Sport.

Other players who have been banned

Sharapova, if she faces a ban, will not be the first player to do so. A number of her predecessors and contemporaries have seen bans from the sport for drug use, both performance-enhancing and recreational.

Most recently, Croat ace Marin Cilic, who won the US Open in 2014, was banned for nine months from professional tennis – a ban that was later reduced to four months, after being found using glucose in tablet form.

Serbia’s Viktor Troicki saw a 12-month suspension a year prior after refusing to take a blood test outright, claiming a phobia of needles.

Czech ace Barbora Strycova saw a backdated 6-month ban from tennis after testing positive for a banned substance, which she says happened as a result of a weight-loss supplement she had been taking.

Most notable among tennis’ drug bans, however, are former World No. 1s Martina Hingis and Andre Agassi, who were both suspended from the sport for recreational drug use. While Hingis tested positive for cocaine, Agassi had been using crystal meth.

The American’s struggles with drug abuse and alcoholism are well-documented, most notably in his autobiography Open - and he has since gone to rehab for them.

Repeated health issues

Her struggles with injury over the years have been well-documented, but Sharapova’s heart issues allegedly only came to light after a “battery of tests” by her doctor, says lawyer Haggerty, who also said those tests showed “abnormal electrocardiogram (ECG) readings” and indicated Sharapova might have diabetes.

"Regrettably, when they added this to the ban list on 1 January of this year, she did not pick that up,” he told reporters.

Meldonium and its use in performance enhancement

In line with what her lawyer said, meldonium is in fact used by heart patients – most specifically those suffering from repeated chest pain or angina, but after finding a number of athletes using the drug, WADA added it to their list of banned substances.

The anti-doping agency, although it only formally added it to the list on the 1st of January – which Sharapova says she missed out on seeing – communicated the news to players and teams in October 2015.

Many current and former players have spoken out in support of Sharapova, the legendary Martina Navratilova among them. The Czech-born former No. 1 said on Twitter she thought it was an ‘honest mistake,’ while another former no. 1, Jennifer Capriati, was not as supportive.

Also read: Jennifer Capriati goes on a Twitter rant against Sharapova

Update: Sharapova’s team have said they will not be asking for the testing of her b-sample.

More details awaited.