Performance enhancing drugs: what can we do

Given the recent suspensions of 13 Major League Baseball players as a result of the Major League Baseball investigation of the Biogenesis Clinic, I re-read a most insightful book called The Juice, written by baseball radio talk show host Will Carroll and published in 2005.

Carroll made many observations worth recounting, three of which are:

• The use of performance enhancing substances to gain an edge in sports is not a recent phenomenon. As Carroll wrote at the beginning of the 3^rd chapter: “The use of performance-enhancing drugs in sports is as old as sports itself.” In fact, Carroll cites experts who claimed that the Soviet Union and Eastern Bloc countries, which used performance-enhancing drugs to gain an advantage over many Olympic competitions, learned from the United States athletes, who cheated well before the Soviets, and from the Germans, who began the process of using PEDs for the 1936 Olympics.
• The boundary between those substances that give an athlete an “unfair advantage” and those which have arguably more benign purposes is blurred. Curt Schilling, who has been highly vocal in his critiques of baseball players who have used PEDs, used a local anesthetic to help manage his ankle-related issues during the 2004 season, a season that culminated in the famous “bloody sock” game during the playoffs. Other athletes like Andy Pettite and Mark Mulder, then with the Oakland Athletics, have used PEDs to accelerate their recovery from an injury.
• There are two different challenges in regulating PEDs. First, some PEDs are essentially unique combinations of legally available substances and chemicals. Laws banning PEDs or regulating their use must specifically describe what is being banned, especially if the use or sale of the substance will result in criminal liability. Therefore, it becomes easier to evade the law by designing and using a substance sufficiently different from what is banned that it cannot be addressed by enforcing the law.

Second, some abuse comes from repurposing completely legal drugs. As Will Carroll states:

“Take, for instance, a drug that for the past five years..has become one of the most abused drugs in sports. Doctors…purport that it has miracle-healing abilities when injected into aching joints. They also use it stimulate muscle growth….Taken improperly, a person using this drug could be sent into shock, and deaths have been recorded due to misuse….The simple solution would be to ban this drug….What is the drug? Insulin. Millions of diabetics lead a normal life because of its easy availability. It is also misused as an ergogenic aid or in a new, controversial healing technique called prolotherapy.”

• The biggest challenge in detecting these drugs is that the most reliable state-of-the-art testing processes can never detect substances designed to avoid getting detected by these tests. If we think about testing as a defensive tool by the governing body of a sports league or a competitive event like the Tour de France or the Olympics, and cheating as the offense, the offense is almost always ahead of the defense.

However, there is a more important insight in this debate which I do not see presented all that publicly: in a world in which young athletes and their parents are trying to gain every edge possible for the possibility of being a professional or, at the least, getting into a better college or getting a scholarship to any college, there are many parents who are either actively working with their children to get performance enhancing drugs or, at best, looking the other way.

The article in the August 10, 2013, digital edition of the Ft. Lauderdale, Florida, Sun Sentinel to which I have provided a link below should not surprise anyone who has watched or participated as a coach in scholastic or travel sports. I was an assistant coach in our town’s baseball program, and I accompanied my younger son to chess tournaments for over nine years. I also watched all our children participate in various sports like soccer, indoor track, baseball, and tennis.

What struck me about all these activities was the desperation and fanaticism of many of the parents, who believed that their children were highly talented and sought every edge for them. As an assistant coach, I once attended a four-hour coaches meeting during which much of the discussion was focused on ways to prevent parents or coaches from “gaming” the system to give their children extra edges. I even experienced one coach/parent who changed my in-game scoring entries days after a game to enhance the batting average of a player he favored over my son. These were judgment calls in games in which he was not in attendance, or was not actively involved.

As I have written about before in this blog, the sad fact is that, over time, those athletes who got favored positions in college programs tended to be among the most talented, but the big differentiator between them and those who did not make it was the amount of wealth their parents deployed for extra instruction, travel sport participation, and equipment. Darien High School produced multiple college-level baseball players, and one who recently signed with the Colorado Rockies organization, Devin Burke, all of whom were exceptionally talented athletes who single-mindedly dedicated themselves to excellence.

However, when my son James was a teammate with Devin and with others who went on to participate in college baseball programs, he saw comparable exceptionally talented players competing on all-star teams for Stamford, Norwalk and other less-wealthy cities. Those boys did not go as far as their talents would have taken them, because they did not have the financial resources backing them.

Even in chess, I watched parents going the extra mile for their children. My son James competed against Fabiano Caruana, written about years ago in The New Yorker as “the next Bobby Fischer.” Caruana is a gifted chess player who lived up to his promise: he is ranked #2 in the world and beat Fischer’s record in becoming the youngest Grandmaster in history. James actually won and drew in two of five matches against Caruana when they were at middle school ages. Caruana started competitive chess far earlier than James, but James was 18 months older when they played.

The difference between James, who stopped just short of becoming an international master and Caruana, who went on to be one of the best players in the world, is that Caruana’s parents not only recognized his talents, but moved him to Europe, so he could regularly compete against the best players in the world. He had a wealthy financial backer, but, most important of all, his parents were 120% behind him.

Caruana and other great chess players do not use performance enhancing drugs, but the common theme across all competitive activities is that great athletes and chess players probably never succeed without a close partnership with their parents and/or other adults committed fully to their success.

As a result, I find it difficult to believe that everything that has gone on with these athletes happened completely independently of their families somewhere along the way. I am not suggesting that the families participated as actively in the process of securing illegal performance enhancing drugs as is suggested in the Sun Sentinel article, but the tone and values to which these players adhere is set very early in life.

The notion that these athletes are “outliers” and “bad apples” that, once suspended or banned, will “clean up” the sport is naïve. Too much money and power are at risk in all major sports today, not just in terms of getting to the professional ranks, but getting into better colleges and universities and getting a jump on a lucrative post-athletic career.

There will be no permanent “solution” to this problem, just as there is no permanent “solution” to people who “cheat” within the framework of other rules. Bill Belichek “cheated” by employing spies to help the Patriots gain an edge, just as there are strong indications that the New York Giants had a spotter with binoculars who relayed signals to Bobby Thompson to let him know what Ralph Branca was going to throw before he hit the “shot heard ‘round the world.”

Oddly enough, we celebrate clever “cheaters” in games like baseball, football, basketball, and ice hockey, players who take advantage of loopholes in the rules or who figure out how not to get caught, although we honor golf as a sport with high integrity. (I will say that golf, particularly as it is staged abroad in match play competition, has more gamesmanship than American purists like to admit.) “Cheating” is too difficult a concept to define and its acceptable boundaries are too blurred for it to be the centerpiece of an anti-PED campaign.

The only strategy that I think can ultimately work in reducing the use of PEDs in sports is that they are terrible for the long term health and well-being of the athletes and their families. We have reduced tobacco usage and alcohol and drug abuse significantly over the last 30 years by sustained, multi-dimensional public health campaigns. There is ample evidence of the bad health effects of PEDs in sports: look at the early deaths of athletes like Lyle Alzado and John Matuzsak in football or Ken Caminiti in baseball.

We need more stories from the front lines from users who have been harmed and who regret having made the pact with the devil. We need a much more thoughtful campaign that includes the inclusion of anti-PED content in entertainment programs. More law enforcement will help, only because it sends a message about what is right and wrong, but it is inadequate without a much broader and better designed set of campaigns.

This will not work quickly or completely, but if we are serious about dealing with the PED problem over the long run in a sustainable way, this is the only way to go.