Steroid Use Legitimate in Sports?

Steroid Use Legitimate in Sports?

Let's be clear about something: if Roger Clemens used anabolic steroids, he broke the rules. End of discussion. The common assumption - that the muscle-building drug was not banned until 2002, after he allegedly juiced - is simply not true. Major League Baseball outlawed steroids in 1991, and although it took 11 more years for the players' union to finally agree to random drug tests, the commissioner has always had the power to punish cheaters. Especially if, say, a former trainer admits in a sworn affidavit that he jammed needles into a certain pitcher's butt.

So defend Clemens all you want. Maybe Brian McNamee is a liar. Maybe he didn't supply his one-time friend with steroids and human growth hormone (HGH) more than a dozen times. Heck, maybe Clemens really did pitch into his mid-40s because of rigorous workouts and a nasty split-finger fastball. But whatever you believe (or want to believe), don't get lost in loopholes that don't exist. If the Rocket took 'roids, he's a cheat - whether it was 1998 or 1993 or 2006. Same goes for HGH. Although it wasn't banned by name until 2005, the league's drug policy has long prohibited the use of behind-the-counter meds without a valid prescription. And since HGH is only approved to treat AIDS patients and children with growth hormone deficiencies, no ballplayer can possibly produce a genuine doctor's note.

No, Roger's Hall-of-Fame reputation will not be rescued by a technicality (or the fact that he doesn't have "a third ear" growing out of his forehead, as he told Mike Wallace). When he testifies in front of a U.S. congressional committee next week, his only chance at redemption is to prove that the other guy is the fraud. He must convince the politicians, and us, that his 24-year career - 354 wins, seven Cy Young Awards - really was done au naturel.

Except, of course, for all those legal substances he pumped into his body. Because those are fine. Vitamin B-12. Lidocaine. Cortisone. And, oh yes, Vioxx, which Clemens "popped like Skittles" to mask his aches and pains. True, none of those drugs can transform a skinny wimp into Arnold Schwarzenegger. And none is against the rules of the game. But Clemens' expected defence - that he took everything but steroids and HGH - is hardly inspiring. If anything, it proves that some of those Cy Youngs really do belong in his medicine cabinet. Steroids or not, he spent his career at the very edge of that fine pharmacological line that separates "gaining an advantage" from full-blown cheating.

"It's certainly confusing, that line between what we say is okay, and what we say isn't okay," says Michael Bahrke, a steroids researcher at Penn State University. Stay away from 'roids, the rules state, but go ahead and load up on creatine. Can't bend your elbow? Take a shot of this and you'll be throwing by tomorrow. And don't forget to knock back a couple of Red Bulls before you take the field. It'll give you wings! "Where exactly do you draw the line?" Bahrke asks. "It's murky territory."

So murky, in fact, that some in the medical community are starting to speak the unthinkable - that perhaps steroids aren't so bad after all. The risks are wildly overblown, they say, and a "Reefer Madness" mentality, driven by moral panic and misguided righteousness, has hijacked any reasonable debate. "Medically speaking, the rules are incoherent and hypocritical," says Dr. Norman Fost, a pediatrician and director of medical ethics at the University of Wisconsin. "We tolerate many other things that enhance performance, and we allow athletes to do things that are much more risky than taking steroids."

Fost isn't suggesting that you order some Stanozolol for your 11-year-old son. Children shouldn't be injecting steroids any more than heroin. What bothers him, though, is this notion that any consenting adult who touches them is doomed. "It's an interesting distraction from serious ethical issues in sports, like the phenomenal rate of permanent disability or the criminal behaviour of elite athletes," Fost says. "Rather than talking about real issues - like alcohol and chewing tobacco, things that really do cause harm - we pretend like we care about the health and safety of athletes by focusing on these two or three drugs that really cause very little harm."

That might be stretching it a bit. But consider the most common side effects: severe acne, baldness, shrinking testicles, and breast development in men. Appealing? No. But not lethal, either. And in most cases, reversible. "Journalists have exaggerated the adverse effects, there is no doubt about that," says Dr. Charles Yesalis, an epidemiologist who has written four books about steroids. "Can you hurt yourself with them? Yes, I believe you can. They are too powerful a hormone. But I would say that about virtually anything, from Aspirin to cold medications to penicillin. There is no harmless drug."

Three years ago, Yesalis and Bahrke co-authored a research paper for the U.S. President's Council on Physical Fitness and Sports. They noted that more than one million Americans have tried steroids at least once, and that some lab studies have linked steroid use to liver deterioration, increased aggressiveness, and reproductive problems. Their conclusion, however, was not the stuff of headlines. "Although anabolic steroid use has been associated (mainly through case reports) with a number of adverse and even fatal effects, the incidence of serious effects thus far has been extremely low," they wrote.

For decades, steroids have been prescribed for legitimate therapeutic reasons, from stimulating bone growth to treating chronic wasting diseases, including cancer. That alone, Yesalis says, proves that the drug can be used safely - in moderation. But because there has never been a single study that measures the long-term side effects, it's impossible to know where that boundary is. Are some people injecting way too much? If they cut back, would the dangers diminish? Adding to the unknown is the fact that most of the well-publicized horror stories don't involve pure steroids, but black-market vials produced in Tijuana and sold online. Police have seized countless knock-off concoctions that were brewed in bathtubs and laced with everything from car wax to urine. "A lot of people ask me, 'Can you take small amounts of anabolic steroids and still be okay?' " Bahrke says. "I think in a lot of cases you can. But when you start to abuse it and mix it with other substances, then the answer is different."

Fost goes one step further. He believes that even if the genuine stuff is a death wish, it's certainly not the only hazardous substance in the clubhouse. Some of the most common remedies for athletic injuries have equally serious side effects. Those Vioxx pills that Clemens loved so much were yanked off the shelf amid fears they caused heart attacks and strokes. In France and Denmark, Red Bull energy drink is now banned after an 18-year-old student downed four and promptly died. And then there's cortisone, the anti-inflammatory wonder shot that has prolonged many careers. It is known to trigger euphoria, depression and irregular heartbeats, all while whittling away at your joints. "There are athletes who have serious permanent disability from injecting cortisone and playing with pain," Fost says. "God gave us pain for a reason. It's a signal to stop doing what you're doing."

Which begs the question: if taking steroids to hit more home runs violates the spirit of the game, doesn't cortisone? "For some reason, putting a shot into a joint to allow you to play seems acceptable," says Lawrence Spriet, a nutritional sciences professor at the University of Guelph. "Whereas, say, taking amphetamines is unacceptable." Well, sort of. Baseball banned stimulants, unless a player can prove he suffers from attention deficit disorder. At last count, 103 Major Leaguers - four full teams' worth - have been diagnosed with ADD and carry a prescription for amphetamines. "I'm a big sports fan," says Yesalis, laughing at the double standard. "I just happened to pull the curtain back long ago, and I know what the wizard is doing. They've perpetuated this notion of clean, elite sport and this notion that there is always a few bad apples in the barrel. That's bulls-t. There are only a few good apples and they don't win."

Maybe it would be simpler, then, if baseball just banned all the self-important rhetoric. Cheaters will cheat, and no matter how hard the league tries, ridding the sport of steroids and HGH will not magically recreate the glory days of Babe Ruth. Yes, The Babe didn't juice. He also didn't down Gatorade. Or protein shakes, or Ritalin, or any other miracle substance found at your local supplement shop. It's hard to imagine that Ruth even drank water that didn't come with hops and barley.

But the comparisons simply don't work. Being an athlete in the 21st century involves so much more than God-given talent. And as long as there is medicine in the training room and millions of dollars in the contracts, the final score will always depend, at least a little, on how far the next Roger Clemens is willing to stretch his conscience. And, of course, whether his strength and conditioning coach can keep a secret.

See also SPORTS MEDICINE.

Maclean's February 18, 2008