rug use in sport is not new. Athletes have used performance-enhancing substances since ancient times. The last half of the 19th century saw the beginnings of modern medicine and, not coincidentally, a significant growth in the use of drugs to improve athletic performance.

At the time, use of stimulants among athletes was commonplace, and moreover, there was no attempt to conceal drug use, with the possible exception of some trainers who guarded the proprietary interest of their own special doping recipes. Swimmers, distance runners, sprinters and cyclists used a wide assortment of drugs, including sugar cubes dipped in ether; mixtures of brandy and cocaine; caffeine; cordials containing alcohol; and even nitroglycerine and strychnine.

Not until after World War I was there any widespread attempt to admonish doping in sports, much less designate it as cheating. By 1933, the word doping had become a normal part of the English language. Although physicians and others continued to speak out against doping, the International Olympic Committee did not take any action until 1967.

During the 1967 Tour de France, the British cyclist Tom Simpson collapsed and died. His autopsy showed high levels of methamphetamine, and a vial of the drug was found in his pocket at the time of his death. The impact of his death was extensive, in part because it was the first doping death to be televised.

His death substantially added to the mounting pressure on the I.O.C. and member federations to establish doping-control programs, which they did at the end of 1967. A year later, another cyclist, Yves Mottin, died of excessive amphetamine use two days after winning a race. Concerns over a level playing field aside, athletes dying on television was bad for business, and drug testing was held out to the unsuspecting public and journalists as the cure-all.

Nearly 40 years later, drug testing is still the major strategy in the fight against doping. But let's state the obvious: If drug testing worked, we would not be reading about doping scandals on a weekly basis. The major problem with drug testing is not that it marks innocent people as being guilty (a false positive) but rather that it is unable to catch cheaters (a false negative).

In 2003, the United States Anti-Doping Agency conducted 6,890 drug tests. Only six (0.09 percent) were positive. These results do not measure the use of performance-enhancing strategies for which no tests are currently available. These include the use of drugs and other substances like human growth hormone, insulin, insulin-like growth factor, sodium bicarbonate and creatine, as well as techniques like blood doping.

Complicating this situation are designer drugs like THG, which we have heard so much about. But the current use of anabolic steroids and other synthetic hormones and blood substitutes may soon become passé; athletes may soon be able to inject genes to enhance performance.

The bottom line today is: Unless you are unlucky, careless or have an I.Q. somewhere at or below room temperature, you are probably not going to be caught by a drug test.

This raises the question, Is the apparent ineptness of our drug testing purposeful? Over the past four decades, elite-level sports have grown into a multibillion-dollar global entertainment industry. Doping scandals arguably threaten the marketing of sports because advertising strategists tend to stress the virtuous aspects by portraying the purity of competition, the notion of fair play, and that victory is the result of hard work.

On the other hand, it can be argued that doping, if done surreptitiously, can greatly benefit the sports business by creating for the fans bigger-than-life athletes capable of bigger-than-life feats.

It is our society that emphasizes and rewards speed, strength, size, aggressiveness and, above all, winning. Thus, the behavior of athletes and sports officials in the matter of doping is congruent with their customers' desires. This notion is supported by the number of sports federations that for decades have covered up the doping problem, conveniently looked the other way or instituted drug-testing programs that were doomed to fail (like that of Major League Baseball). When the Dubin Commission — formed in Canada after the sprinter Ben Johnson tested positive for steroids in 1988 — investigated the extent of doping in Olympic sports, it referred to a "conspiracy of silence" and a "pact of ignorance" among those in sports organizations when it came to discussing drug use.

Even with gaping loopholes in drug testing, during the past 15 years we have continued to be bombarded with a steady stream of major doping scandals: Ben Johnson, the East Germans, the Communist Chinese, Michelle Smith, the Tour de France, the revelations of anabolic steroid and amphetamine use in baseball, and now Balco. This latest scandal stands apart in several ways. First, star athletes from multiple sports (track and field, the National Football League and Major League Baseball) appear to be involved. Second, and far more important, the president voiced concern in his State of the Union address about the impact that doping among elite athletes has on our children.

As with the many major scandals of the past 10 years, drug testing had little or nothing to do with bringing the Balco case to the public's attention.

It was a former East German athlete and her husband who were courageous enough to remove Stasi files from the notorious Leipzig laboratory that documented the heinous doping activities that had taken place. It was the French border police who intercepted the drug-packed car of a team trainer and helped expose the culture of doping so pervasive in pro cycling. It was Australian customs agents who caught Chinese athletes trying to smuggle human growth hormone. It was a disgruntled coach who mailed a syringe containing THG to the United States Anti-Doping Agency lab and the subsequent actions of the Drug Enforcement Administration, the F.B.I. and the Internal Revenue Service that led to the startling revelations of Balco.

The litany of scandals appears to have had a strong effect on the public and even on the athletes, some of whom have spoken out. Indeed, if sports fans were asked if they were against doping, many would say yes. But a far more relevant question is whether they were upset enough to turn off the television and not watch sports. Judging by the continuing profitability and popularity of both amateur and professional sports, most would probably answer no.

If we do not have the willpower to turn off our television sets in protest of doping, will we have the stomach to tolerate federal arrests, prosecutions and convictions of our sports icons?

Dr. Charles Yesalis, professor of health and human development at Penn State University, and Dr. Michael Bahrke are authors of "Performance-Enhancing Substances in Sport and Exercise" (Human Kinetics, 2002).