An independent tribunal just handed tennis star Maria Sharapova a two-year ban from the sport for testing positive for meldonium, a substance that Sharapova has been taking for a decade but wasn’t added to the WADA’s list of banned substances until last year.

Sharapova’s defense was that she was prescribed meldonium in 2005 for legitimate health reasons, and only went on taking it after it was put on the banned substances list because she didn’t pay close enough attention to the updated list. The tribunal didn’t buy that argument, determining that Sharapova went out of her way to keep her meldonium intake secret—she stopped seeing the doctor who prescribed it to her in 2013, and failed to tell her newer doctors that she was still taking the drug—and only used it because of the physical advantages it offered. From the report:

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But from 2013 onwards Dr. Skalny was no longer her doctor. She has no excuse for failing to disclose her use of Mildronate or to seek advice from a specialist doctor as to whether its continued use in competition was permissible. The tribunal finds it hard to credit that no medical practitioner whom she consulted over a period of 3 years, with the exception of Dr. Yasnitsky, would, in accordance with standard medical practice, have asked her what medications she was taking. In any event Ms Sharapova should have disclosed that she was regularly using Mildronate in case there was a possibility of adversely affecting another treatment prescribed.

That leaves the issue as to why Ms Sharapova was systematically using Mildronate before matches, and in particular at the Australian Open in 2016. In the tribunal’s view the answer is clear. Whatever the position may have been in 2006, there was in 2016 no diagnosis and no therapeutic advice supporting the continuing use of Mildronate. If she had believed that there was a continuing medical need to use Mildronate then she would have consulted a medical practitioner. The manner of its use, on match days and when undertaking intensive training, is only consistent with an intention to boost her energy levels. It may be that she genuinely believed that Mildronate had some general beneficial effect on her health but the manner in which the medication was taken, its concealment from the anti-doping authorities, her failure to disclose it even to her own team, and the lack of any medical justification must inevitably lead to the conclusion that she took Mildronate for the purpose of enhancing her performance.

Even more interesting than the tribunal’s conclusion, however, is the look this report gives us at the incredibly shady shit that goes down with Russian athletes. Sharapova first visited the doctor who put her on meldonium in 2005, when she was just 18 years old, and he prescribed her 18 medications and supplements that were meant to develop “the optimal individual plan of medical and physiological monitoring and targeted correction of functional reserves, and its implementation in the practice of the athlete’s preparation and maintain the proper functional regime.”

Sharapova continued to receive care from this doctor up until 2013, and by that time his list of recommended medications and supplements had grown from 18 to 30. Sharapova eventually cut the doctor loose, in part because she was overwhelmed by all of the pills she had to take, but she continued taking three substances that he had recommended, including meldonium.

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You can read the full report below:

Photo via AP