elitefts™ Sunday Edition

The use of performance enhancing drugs (PEDs) in sports is considered by many to be a problem, not just for the sake of fair play but for our society as a whole. Parents are concerned with the message that athletes who use PEDs send to their children. This message teaches them that cheating is OK and is almost necessary if you want to be the best at sports or in life. Education about PEDs is very important for young people in order to warn them about the health risks, as well as the moral implications, involved with taking PEDs like steroids. However, what commonly ends up happening is that experts and the media will tend to embellish information in order to scare people to potentially elicit the response that suits their motives.

Dr. Gary Wadler, author of Drugs and the Athlete was quoted in several different scientific studies and publications stating that steroids are killing people. The problem with testimonies like this is that, without long-term research, there isn't any way of scientifically proving what he says is right or wrong. Dr. Wadler has gone on record several times stating that steroids are dangerous and were responsible for the death of NFL all-pro defensive lineman Lyle Alzado. Alzado died from a brain tumor and told Maria Shriver in an interview that steroids were the cause of his tumor (Wadler et al 1989). This happened well before the NFL gave any thought to the dangers of concussions. Being dubbed the most dangerous man in the NFL, it is much more likely that Alzado’s brain tumor was caused by the concussions that probably numbered in the double digits throughout his professional career. With all the recent studies done on the effects of concussions on past and present NFL players, the data indicates that 64 percent of retired football players have their activities of daily living affected by injuries sustained while in the NFL (King et al 2012). Therefore, it is impossible to determine cause and effect of one versus the other in this case, considering that Alzado abused steroids and most likely suffered multiple concussions.

Dr. Norm Fost, professor of medical ethics at the University of Wisconsin, is very involved in the ongoing PEDs debate. He has a much different view on PEDs in sports than Dr. Wadler. Dr. Fost argues that everyone on the planet uses performance enhancing technology and drugs to better our lives. “Cars enhance our abilities to get from point A to point B. Computers make our work more efficient. Caffeine helps us start our day. Alcohol enhances our ability to have fun at a party. So why is it that when we are referring to athletes in this regard, there is a Salem witch trial-like response? We seek to persecute athletes for doing something that we are all guilty of ourselves,” Dr. Fost stated. What Dr. Fost is trying to convey is that it is human nature that drives us to use tools to better ourselves and our lives. PEDs are simply one tool combined with many other tools—like an impeccable diet, a world class trainer or coach, or a high tech training facility, that athletes use to improve their performance.

Background information

Before we dive deeper into more of the moral issues surrounding PEDs, further clarification is needed to understand that not all PEDs are created equal. There are as many different types of PEDs as there are types of performances that need enhancing. The word “steroids” is usually the blanket term for all PEDs, but in reality, steroids are only one piece of the proverbial pie. The main PEDs being used by athletes are androgens, erythropoietin, human growth hormone, insulin, and stimulants.

When the media discusses “steroid” use, they are most often referring to a class of PEDs called androgens. Anabolic-androgenic steroids (AAS) are drugs that mimic testosterone’s effects in the human body. AAS stimulate protein synthesis, which is how one would build a large quantity of muscle in a short period of time. Their main function is to build muscle quickly, and they benefit athletes whose sports involve muscular strength and size. The adverse effects in adult men potentially include acne, accelerated male pattern baldness, elevated cholesterol (because steroids are a form of cholesterol), enlarged breast tissue (referred to as gynecomastia), testicular atrophy, and infertility. Oral steroid use has been shown to cause liver damage when taken in high doses. However, there was little to no information in regards to what a high dose actually is (Yesalis et al 1998).

Next, we have erythropoietin (EPO). EPO is used predominantly by endurance athletes such as marathoners and cyclists. It is a glycoprotein hormone that regulates red blood cell production. The biggest limiting factor for VO2 max is your oxygen carrying capacity, and if you have more red blood cells, you can carry more oxygen to your muscles, which improves your aerobic capacity. One of the biggest dangers with taking EPO is that your hematocrit, the ratio of blood cells to plasma, is increased. This can be cause for concern when exercising or during competition because if you have very viscous blood, your heart will have to work harder to circulate blood throughout your body. The biggest concern for blood dopers is the possibility of developing a blood clot and dying while asleep. When blood doping and EPO were first starting to be utilized by cyclists, there were several cases of athletes dying in their sleep from blood clots (Yesalis et al 1998).

Human growth hormone (HGH) is next on the list. HGH is a peptide hormone that has a synergistic effect with testosterone. It helps you increase muscle size and strength as well as burn fat. One of the main selling points of HGH is that it is nearly impossible to test for with conventional drug screening. There are little to no reported side effects when used in moderation. This makes it an ideal drug for pro athletes and “gym rats” alike. The main downside of HGH is the cost compared to the other types of PEDs. One cycle of HGH can cost up to three times that of an androgen cycle of equal length (Yesalis et al 1998).

Insulin is most commonly correlated with diabetes and obesity. It is a peptide hormone that promotes glucose utilization and protein synthesis and regulates the metabolism of sugar. When taken in conjunction with testosterone, it is widely considered to be the most anabolic hormone out there. Insulin could be one of the reasons why bodybuilders today are so much bigger than they were in Arnold Schwarzenegger’s era. With all the enhanced benefits, the risks were enhanced as well. You could easily inject too much insulin at one time and go into hypoglycemic shock. There have been some studies that suggest taking too much insulin can lead to insulin resistance, which is the cause of type II diabetes (Yesalis et al1998).

Stimulants are the last PEDs that I will discuss. A stimulant is anything that gets your heart rate elevated. These consist of things like your morning “cup of Joe,” ephedrine, amphetamines, and anything with caffeine in it. Stimulants increase your time to exhaustion as well as tolerance to pain. The side effects for stimulants are typically mild. Jitters are common for those with a low tolerance and they may keep you up at night if you take them too close to your bedtime (Yesalis et al 1998).

The biggest argument against the use of PEDs is the moral aspect. The drugs are against the rules in every major sport and are illegal without a prescription in America. The rules are what define sports, and anyone who decides to use PEDs in sports is breaking the law and cheating the game. Dr. Charles Yesalis, author of The Steroids Game, is one of the leaders in the crusade against PEDs in sports. He has said in the past regarding PEDs and cheating in sports, “Listen, if I could bring a Glock 9mm on to the field during a football game, I would have a distinct advantage over even the biggest player on the other team. I could just shoot him. But I’d be breaking the law and violating the rules of the game. It’s the same thing.” What Yesalis is getting at is that gaining an advantage is easy if you disregard the laws and rules of the sport.

Androgens are a Schedule III controlled substance, which means that they have a low potential for abuse and are at low risk for psychological and physical dependence. They have the same potential for abuse as Tylenol with codeine. The DEA no longer sees androgens to be as dangerous as cocaine, methamphetamine, heroin, and ecstasy.

Another argument against PEDs in sports, and in general, is that they are dangerous. There are many dangerous substances out there that are perfectly legal. Tobacco is perfectly legal and is even credited for being one of the staple crops that built America. However, tobacco can potentially be one of the most harmful substances you put into your body. According to the CDC, tobacco is responsible for 475,000 deaths per year. Alcohol is responsible for 75,000 deaths and anabolic steroids are responsible for three. Yet, the first two are perfectly legal. Sure, there are undesirable effects from the use of PEDs, but it can be argued that none are more dangerous than the sports themselves.


Figure 1.

Figure 1. shows the mortality rates of people who use tobacco and alcohol compared to anabolic steroids. It should be noted that 45 million people use tobacco and nearly 100 million people use alcohol. There isn't any such quantitative data for anabolic steroid users (Center for Disease Control 2011).

To be continued...


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