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We live in an age of “paradoxical pharamacological puritanism”

Jul 17, 2012, 9:41 AM EDT


Via Sullivan, a pretty great essay by Greg Downey about just how irrational the anti-PED crusade is in sports. After an extended — really, really extended history of doping in sports — Downey notes that, hey, the entire world is using various forms of steroids and other performance enhancers yet, for some reason, athletes are expected to be using them less and less. The money quote:

The irony is that we punish severely the people who could use steroids the most, the athletes who have the most legitimate need for them if they are to recover and perform at the levels we like to watch on television and in stadiums. Using steroids because we no longer get the same erections we once had, or because a middle-aged man has less energy than he did at twenty (or a woman has less libido than considered ideal), is increasingly considered normal, while the list of substances banned for people like Mark McGwire grows longer and longer, the invasive tests intended to expose any transgression more and more extensive. As a society, we suffer from a paradoxical pharamacological puritanism, expecting medical technology to change our lives and yet demanding that it not change our games.

I understand the idea of the unfair playing field being problematic. But it’s possible to have a level playing field without going on a fatwah against PEDs. We don’t, in sports anyway, seem to have any appetite to see what is safe, what is not, what is useful, what is not and to actually figure out how various drugs could be used in ways that are truly helpful to athletes as opposed to something that only provides some sort of unfair advantage to one over another based on the latter’s unwillingness to do something that could harm him.

The result: we have a blanket prohibition like any other sort of blanket prohibition which results in secretive use and, in all likelihood, a continued unsafe and unfair playing field.

But I really am struck by the disparity between our personal use of all manner of PEDs as a society and our demand that athletes be so damn pure. I guess it’s a function of part of our enjoyment of sports being the notion that these people are doing things we could not possibly do. Which used to be hitting a baseball really far. And now includes recovering from injuries without drugs that would be really, really useful in that regard.

  1. kopy - Jul 17, 2012 at 9:58 AM

    If MLB allowed its players to use steroids, and then the players suffered health consequences as side effects, would that open MLB up to legal liability? I can’t imagine players using PEDs without MLB trainers being involved, unless the league would just not check for them and have its players keep using them with private trainers or in bathroom stalls with teammates.

    • Kevin S. - Jul 17, 2012 at 10:13 AM

      Well, there’s the little fact that properly used under a doctor’s supervision steroids wouldn’t really have health effects that are really any more adverse than any number of other behaviors professional athletes engage in. Of course, Congress decided to ignore the entire medical community on this one when they banned them back in the late 80s.

      • natslady - Jul 17, 2012 at 10:27 AM

        Kevin S–This is kind of the way I feel. A complicated issue. Tommy John and LasiK are allowed, as were Zimmerman’s cortisone shot and Michael Morse’s blood transfusions–but these are under medical supervision.

        (I wouldn’t compare medical treatments to “other behaviors” because that could include DUI’s… The wisdom of affluent young men is a different question altogether than what are acceptable performance enhancements–and accelerated healing IS a performance enhancement.)

        If you have a rigorous sanctioning program for trainers, in fact, if you disallow athletes under MLB and MiLB contracts from accepting “treatment” from unsanctioned trainers and physicians, you might be able to limit the under-the-table use of steriods.

        I’m sorry to see the recent rash of injuries, especially Votto and Joey Bats.

      • Kevin S. - Jul 17, 2012 at 11:06 AM

        Sorry if I wasn’t clear – I meant other behaviors relating to playing your sport. Football, in particular, induces players to do many things that are far more damaging to their long-term health than a doctor-monitored steroid regimen would be.

      • natslady - Jul 17, 2012 at 11:14 AM

        Kevin S–thank you for the clarification. The record of the NFL is not good on protecting the long-term health of its players. I would not like MLB to go down that road since a main consideration of a young person to choose baseball over football is the length of his career. You can see where I stand (with Rizzo) on the Strasburg shutdown. You don’t get to the Hall-of-Fame on one brilliant season–though you may get a ring, that’s true. This is not an easy issue, IMO.

    • drewsylvania - Jul 17, 2012 at 10:42 AM

      IANAD, but it seems likely that health consequences are or will be happening for the legions of players that drink energy drinks, or lots of caffeine, and then perform strenuous activities. These drinks can cause irregular heartbeats, which are not a problem if you’re resting, but seem to be life-threatening with strenuous exercise.

  2. natslady - Jul 17, 2012 at 9:58 AM

    We had extensive discussions here in NatsTown (and also Stephania Bell on ESPN) as to why Ryan Zimmerman’s cortisone shot was a “legal” steroid, and similar discussions when Michael Morse had blood infusions (also “legal”). I guess the best you can expect are that the rules are clear (are they?) and all athletes have to follow the same rules.

    So the comparison is not layperson-to-athlete but athlete-to-athlete. Looking at the situation for NFL retired players (and I don’t just mean concussions), do we really want to artificially hasten the healing process?

    • The Dangerous Mabry - Jul 17, 2012 at 10:16 AM

      Cortisone shot legality is because corticosteroids and anabolic steroids are completely unrelated. Here’s something you can read:

      • natslady - Jul 17, 2012 at 10:30 AM

        I read all that. Doesn’t affect my main point. I was not confusing the types of “steroids.” I was making the point that accelerated healing is a performance enhancement. Cortisone shots if used to excess are as dangerous as other “steroids.”

      • natslady - Jul 17, 2012 at 10:34 AM

        Read that LONG AGO during the discussions of RZ’s shots. Not relevant to my point.

      • natslady - Jul 17, 2012 at 10:36 AM

        Sorry, not sure how I got two posts there, was trying to “edit” and the second one (which was actually my first try) got put up. Didn’t mean to seem rude.

      • Francisco (FC) - Jul 17, 2012 at 10:59 AM

        Alas Nats Lady, there is no edit function…

      • The Dangerous Mabry - Jul 17, 2012 at 11:16 AM

        I raised the issue due to your use of the term “legal” steroid, since there’s really no meaningful pharmacological comparison between cortisone and banned drugs, and I think that term only confuses the issue. Now given that your point is that it’s unclear why some products designed to promote healing are allowed and some are not, I understand that, and it’s a point worthy of discussion.

        One meaningful distinction may be that there don’t appear to be any benefits to products such as cortisone in an otherwise healthy individual, whereas stanozolol and its ilk can be used for applications other than healing and recovery.

      • natslady - Jul 17, 2012 at 11:40 AM

        Dangerous M–sorry for the confusion. This is where I have to get off the train, because I’m not in any way qualified to assess by medical criteria what should be legal to shorten or improve the healing process. To the layperson (me) the line seems somewhat arbitrary, and according to Craig’s article, not necessarily based on the best science.

        Once amphetamines were removed from the clubhouse, if players want to stay alert they have to, I dunno, get enough sleep?

  3. sabatimus - Jul 17, 2012 at 10:26 AM

    I’d amend the article by putting the word “psychotic” in front of “paradoxical pharamacological puritanism”.

  4. anythingbutyanks - Jul 17, 2012 at 10:37 AM

    Our daily lives and the professional careers of athletes are two wholly different animals, Craig. While the steroid era doesn’t bother me the way it does others, since I honestly don’t think any mediocre player suddenly became great as a result of steroids, I can understand why others are concerned about the “purity” of the game. The obvious difference between resolving erectile dysfunction and enhancing one’s athletic accomplishments is that athletes benefit disproportionately from their steroid use in the form of compensation, celebrity and a lifetime of social, political, and other open doors not available to others because of their achievements. The more apt comparison is a co-worker who cheated in order to gain lifelong career-enhancing advantages like advanced degrees. As a result of their cheating they are more likely to enjoy better pay, more opportunities, professional recognition and so forth, FOR THE REST OF THEIR LIVES. Your erectile dysfunction drug doesn’t do that unless you knock over the right woman, and even then she’ll always own you no matter how long a leash she gives you.

    • natslady - Jul 17, 2012 at 11:26 AM

      There are two issues here.

      (1) Level playing field; enforcement of whatever rules are in place.
      (2) Whether the most “medically appropriate” rules are in place.

      With regard to “cheating,” I am less concerned whether Barry Bonds and McGwire made themselves into stars with PED’s–they didn’t–than whether teenagers and marginal minor league players THINK they can get the edge with PEDs because Bonds and McGwire used them. Baseball being “a game of inches,” it may not take a lot of an edge to get off the bus and into the private jet. So your point on that is well-taken. But I’m not sure it addresses #2, which is what Craig is getting at–even though his comparison was not well chosen.

  5. anythingbutyanks - Jul 17, 2012 at 10:46 AM

    Not that this hasn’t been said before, perhaps ad nauseum, but the best athletes combine strength, speed, decision making, body control, timing, endurance, health, vision and other elements into one unit. Steroids can enhance strength and maybe speed directly, but these are only a small part of the bigger picture. For sluggers the effect of steroids is probably less than a change of venue from playing in San Diego to playing in Cincinnati would be. Just wanted to establish clearly that I don’t have a particular problem with the “steroid era” so that my previous comment can’t be discredited on that basis.

    • Francisco (FC) - Jul 17, 2012 at 11:03 AM

      That’s perfectly fair take, I just want to add though, that without extensive studies we can’t really know how much of an effect steroids had/have on a slugger. Do they add 10 feet to long fly balls? 20 feet? How about the % of line drives? So your speculation is well… speculation. Unless you’re basing it on some facts I’m unaware of.

      • paperlions - Jul 17, 2012 at 12:52 PM

        Based on the available data, steroids don’t appear to have had much of an effect on offense…and if they did, it seems that they likely were offset by steroid enhancement in pitching (e.g. all the relievers that went from throwing 90 mph to 96 mph over one off season)…in fact, one could argue that steroid use by pitchers may have resulting in more power as the speed of the pitch contributes to the distance it will fly when hit squarely.

        Anyway, people that live in the mother’s basements have looked for the signal of steroids in offensive production, all they can find is the signal of smaller parks that were being built back then (as opposed to the larger, pitcher-friendly parks that are the norm now) and the changes in ball composition….from natural to synthetic fibers, which hold less water, making the ball lighter…and changes to the design of the rubber core.

      • Kevin S. - Jul 17, 2012 at 2:05 PM

        You forgot two rounds of expansion.

      • yahmule - Jul 17, 2012 at 2:39 PM

        Ah, the mother’s basement slam. Always the hallmark of someone with a strong argument to present. Followed up quickly with the “but everyone else is doin’ it” argument. That one really impressed my kingergarten teacher.

        Simply stated, PEDs increase strength and quickness.

        Increased quickness equals increased bat speed.

        Increased bat speed means hitters can wait longer on pitches, giving them a tremendous advantage.

        Apparently PEDs had no effect on offense and all these guys just happened to hit more than 60 HRs in a condensed time frame by coincidence. Imagine that. And to think, when Maris set the record (and it remains his record) the stress damn near ruined him. Ah, piss on him. Nobody wanted him to have the record anyway.

      • paperlions - Jul 17, 2012 at 6:02 PM

        Yahmule, if you believe that, then you must think that everyone started taking steroids at the exact same time, because everyone in the league’s performance went up (and then eventually down) together. Generally, in association with changes to ball composition.

        ….and the mother’s basement comment was an ironical reference, and a pretty obvious one.

      • yahmule - Jul 17, 2012 at 6:43 PM

        Actually, I do think PED usage dramatically declined at about the same time. Like when MLB finally began testing for banned substances and magically home runs and overall scoring declined simultaneously. I don’t think the mother’s basement comment was obviously ironic. I think it was a sincere expression of frustration on the part of somebody who not only drinks the Kool-Aid, but tries to make sure everybody else gets a cup, too. That said, I’m done discussing this with you. Anybody who tries to blame that unprecedented offensive explosion on some bullshit ball composition excuse is beyond hope. You’re as intellectually disingenuous and willfully ignorant as any religious fundamentalist or Tea Party member, so I’m going to leave you to your delusions.

      • Francisco (FC) - Jul 17, 2012 at 8:21 PM

        All I see is a bunch of speculation: “faster, quicker” How much faster? How much quicker? Tangible measurements that can be used to say: by taking this so and so increased his fly ball rate by x % resulting in y % more HRs, etc. I’d be happy to read studies on the subject.

        At a minimum though it can be argued that Big Mac taking steroids allowed him to recover from injuries faster (recovery is well documented). In effect, getting more plate appearances than otherwise, enabling more chances at hitting HRs. Of course that doesn’t tell me how many more PAs…

    • Liam - Jul 17, 2012 at 7:44 PM

      yahmule: Post hoc ergo propter hoc.

  6. yahmule - Jul 17, 2012 at 11:12 AM

    If PEDs were made legal in sports, it wouldn’t really matter if there were long term health issues. All players would pretty much have to use them or be placed at a severe competitive disadvantage. In fact, players who refused to narcotize themselves willingly would face pressure to do so “for the good of the team”. Those who refuse to submit will be labeled as puritans or worse.

    • paperlions - Jul 17, 2012 at 12:54 PM

      That is a nice story. Fortunately, used under proper supervision, nearly all PEDs that could possibly help baseball performance have only short-term and mild side effects on most people….which is why the AMA was against the steroid laws passed 2 decades ago.

      • yahmule - Jul 17, 2012 at 2:26 PM

        So, the players who don’t want to ingest those chemicals had better just shut up and get with the program.

      • paperlions - Jul 17, 2012 at 2:55 PM

        No, they can simply choose not to do it….just like players that don’t want to lift weights or run to stay in tip top shape don’t have to.

  7. sdelmonte - Jul 17, 2012 at 11:17 AM

    I have been saying a lot of what this article says for years now. It’s good to see that slowly but surely, my minority opinion is not so lonely as it once was.

  8. drmonkeyarmy - Jul 17, 2012 at 11:24 AM

    The long term health risks associated with using hormonal steroids as a means of recovery and performance enhancement far far outweigh the benefits. Essentially causing levels that would be in excess of traditionally accepted values. Using these same steroids, under the supervision of a doctor, in order to restore levels to normal values is a completely different animal. Comparing the two and making statements like, “everybody is doing it, why shouldn’t athletes” is ignorant.

    • paperlions - Jul 17, 2012 at 12:55 PM

      Funny, I can’t recall anyone every finding any long-term effects of such steroids when they are used as doctors would prescribe them.

      • drmonkeyarmy - Jul 17, 2012 at 1:07 PM

        Look at the duration of use and approved indications of such use. Also, being monitored and making sure target levels are reached instead of seeking super targeted levels is important too. Let me see if I can drag up a clinical study for TRT and post it.

      • yahmule - Jul 17, 2012 at 2:29 PM

        Funny, but I don’t remember your exhaustively researched, peer-reviewed papers on this topic being published in any medical journals.

      • paperlions - Jul 17, 2012 at 2:54 PM

        Because I, nor anyone else, need to do that research, as it was done decades ago. There are no documented long-term ill effects of steroid usage as long as the user doesn’t go over-board. Nearly every OTC medication can have long-term effects if used in excess.

  9. offseasonblues - Jul 17, 2012 at 12:46 PM

    To me this: “… something that only provides some sort of unfair advantage to one over another based on the latter’s unwillingness to do something that could harm him.” is the entirety of the issue. If there’s no risk then the stuff would be available over the counter and we wouldn’t be talking about it.

    I have never heard anyone talk about demanding purity except you Craig. What have I missed? (Probably a lot, but there’s only so many hours in the day.)

    • paperlions - Jul 17, 2012 at 12:57 PM

      That’s the thing, there is no evidence that using steroids has significant health risks when used as prescribed under doctor supervision. It is not the use of anabolic steroids that is bad, it is their abuse. The two are not the same.

    • Walk - Jul 17, 2012 at 2:41 PM

      Funny thing is a lot of the banned items you can pick up at gnc and at wal mart nutrition center. I know they have a number to call to check if an item is on the list of stuff that will make you fail a test but how would you like to have to call that number every time you get a cold? How about if you change your lotion or toothpaste, this is getting beyond ridiculious to me and seems to be invasive. Changing gears slightly, i noticed something about two years ago, a ball player started the game without glasses or contacts went up to hit then put on contacts. I thought it was a bit odd at the time. Well i saw a game last year where the announcer told a story about a player that had no need of glasses but had contacts just for when he played a game. What do you folks think about that? How widespread is that? I am sorta on the fence but i tend to think that is a bit unfair to those that wear glasses and play.

  10. cleverbob - Jul 17, 2012 at 1:14 PM

    What’s frustrating to me is the (seemingly) arbitrary determination of “go” vs “no go”. Why are some products that can be purchased at the GNC down the street completely acceptable, while others from that same exact store are not? Creatine makes you bigger, but its innocuous because you can get it premixed with your protein shake?

    I’ve managed to remain pretty clueless on the whole matter, so maybe my thoughts are just uninformed ramblings.

  11. tuftsb - Jul 17, 2012 at 1:38 PM

    A few points:

    Due to the 1994 DSHEA, otc supplements were not examined closely. At one point 25% of all supplements were contanimated with illegal steroid-like subtsances and 10% had illegal amphetamine-like substances. The House member that got this through? Henry Waxman.

    If we ban certain substances from sports that are not illegal to the general public, aren’t kids smart enough to try to use those for enhancement? We gave them the roadmap!

    There has never been a scientific test of steroids, due to the ethical concerns of human guinea pigs.

    Parents get their kids to fake symptomos for adderall and ADD drugs, which have been proven to boost test and college board scores. What is worse, a few million kid’s lives being changed due to drug aided competition for admission to the best schools or a home run record’s sanctity?


  12. mminpacbeach - Jul 17, 2012 at 2:41 PM

    In graduate school, we learned a term “psychopharmacological McCarthyism” which means that drug use is a crime, merely by association with the demographic that uses a certain drug. For example, hippies were thought to use hallucinogens, blacks were associated with cannibas use, and Chinese immigrants had the reputation of opium smokers. These are all illegal drugs. Yet alcohol and tobacco stay legal and they cause more mayhem and illness than the others. It’s very backwards.

  13. bigleagues - Jul 17, 2012 at 2:57 PM

    I will try posting this for a 4th time today, now using a completely different browser . . .

    Speaking of that “blanket prohibition which results in secretive use and, in all likelihood, a continued unsafe and unfair playing field” . . . . how is it that Carlos Ruiz has escaped scrutiny thus far this season?

    I’m not a PED witch hunt kind of guy, and I’m with Craig completely on the need for a more rational approach to PED’s future in professional sports.

    However, the rules are the rules (and 100-years of player performance trends are just that) and if Ruiz doesn’t scream PED user/abuser than Barry Bonds and Mark McGwire didn’t either.

    In the past three seasons Ruiz has gone from slightly above average production to becoming Brian McCann in 2010, back to average in 2011 and then a full-fledged morph into Mike Piazza this season . . . at age 33 . . . while playing 79 of his team’s 91 Games behind the plate.

    Out of nowhere . . . Carlos Ruiz is in the process of putting up one of the TOP 5 greatest offensive seasons of any Catcher in Major League Baseball history . . .

    Since 1901, among Catchers, qualifying for the batting title, with a minimum of 70 Games Started behind the dish, and at least a .350 BA, .400 OBA and .550 SLG here is where Ruiz currently stands . . .

    Player        HR   BA  OBP  SLG Year Age   G  PA   R   H 2B RBI BB SO   OPS
    Mike Piazza   40 .362 .431 .638 1997  28 152 633 104 201 32 124 69 77 1.070
    Joe Mauer     28 .365 .444 .587 2009  26 138 606  94 191 30  96 76 63 1.031
    Bill Dickey   22 .362 .428 .617 1936  29 112 472  99 153 26 107 46 16 1.045
    Carlos Ruiz   14 .353 .413 .596 2012  33  82 305  44  96 24  50 17 38 1.009

    Provided by View Play Index Tool UsedGenerated 7/17/2012.

    And NO ONE seems to be taking note of how absurd his performance is.

    I’m led to believe that the knee-jerk anti-PED crusaders have been lulled into a false sense of security – once again choosing the comfort of myth over reality.

    • cleverbob - Jul 17, 2012 at 10:07 PM

      The thought crossed my mind that he’s having a ridiculously monstrous year, but I just want to give him the benefit of the doubt for no other reason than he’s Chooch and we love him. I know, willful ignorance and all that, but unless and until MLB says otherwise I’m happy for him.

    • anythingbutyanks - Jul 18, 2012 at 11:10 AM

      Let’s wait until we see where he sits at the end of the season before we decide. Many average players have played out of their minds for a few months but where unable to sustain it over the course of a season or multiple seasons.

      • bigleagues - Jul 18, 2012 at 11:48 AM

        There is certainly a lot of truth to what you say. I’m not making any final judgements over Ruiz performance. I’m just pointing out that his performance to this point sticks out like a sore thumb – because of his age and the position he plays – and none of the PED Police seem to be on patrol. And the reason for that, I contend, is that they have a false sense of security invested in the current testing program and ignoring the fact that PED technology is constantly adapting and evolving to avoid detection.

  14. steveohho - Jul 17, 2012 at 3:36 PM

    Look at American policy on anything and you will see that Puritanism, whether you define it as “the haunting fear that someone, somewhere, may be happy” or as the haunting fear that someone will make a decision about their life on their own without getting permission from an authority above is flourishing.

    MLB’s incoherent policy on PEDS is just another example of this menace that plagues us all.

  15. foreverchipper10 - Jul 18, 2012 at 12:46 PM

    odoriferous, olfactory abominations.

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