War on Drugs, con't

Just to be clear: I'm not advocating that steriods be legalized. In fact, I think that's probably a terrible idea.  I'm simply puzzled. The professional sports establishment is in the midst of a major witchhunt against alleged users of performance enhancing drugs. But no one--so far as I can tell-- has articulated a coherent explanation for what should be banned and why.

"James," one of the commenters on the "Free Fernando Vina" post brought up the issue of Lasik eye surgery. That's a very good example.  It is perfectly legal for an athlete to undergo "performance enhancing" eye surgery, that moves him from, say, the 50th to the 95th percentile in sight. It is not legal for that same athlete to take "performance enhancing" hormones that move his testosterone from the 50th to the 95th percentile--even thought the additional advantage of the eye surgery may be greater than the additional advantage  conferred by the exogenous testosterone. Now, there may be a perfectly valid distinction between those two interventions. But what is it? Shouldn't it be spelled out before we drum Roger Clemens and Barry Bonds out of the Hall of Fame?

Similarly, it is perfectly legal for an athlete to get  painkillers after an injury, so he can continue playing (and, I would point out, risk further injury.) It is not legal for that athlete to take Human Growth Hormone, in order to speed his recovery from that same injury.  Again, why? What is the distinction? Why is it okay to play hurt but not okay to try and not play hurt? There may be a perfectly valid reason here as well.  But don't we need to spell out what it is?

I realize that the people running major league baseball and the NFL are not philosophers. But the intellectual sloppiness with which this current crusade has been conducted is appalling.

Comments

[Deepak]

Hear is my analogy. Assume everyone has the same book to read and learn from upon which they will be tested.

Person #1 ends up losing a couple of pages due to poor manufacturing quality. The person requests for those two pages to be restored and is given permission to do so

Person #2 sneaks in to the back and adds 5 more pages with extra information the others do not have access to. Person #2 ends up finishing the test faster than everyone else, since the person had more data points to incorporate.

Person #1 = lasik
Person #2 = steroids

And if I abhor anything else in the world is when someone smart cheats, or in the relatively unimportant world of athletics someone already strong and talented does the same

Obviously the analogy is not perfect and there is a lot of murkiness about what is allowed and what isn't, but steroids are not justified, regardless of that.

[Josh King]

How about an alternative formulation?:

Person #1 = HGH
Person #2 = Cortisone injections

And remember, prior to the 2003 baseball season, steroids would apply to Person #1, as a player was not cheating by taking them.

[Tray]

Okay, Deepak, what if I lose velocity on my fastball because of natural aging, or injuries to my arm, and so I take steroids to restore my old abilities? That seems more analogous to Person 1 than Person 2. I don't understand why you can surgically fix your eye or arm to recover from injuries/aging but you can't take a drug to help recover from the same. Besides, why should we even accept the line you draw? Is it somehow more justifiable to restore your eyes to their original powers at birth than it is to get laser eye surgery if you don't have an eye problem, just to make them even better than 20/20? If you're a naturally drowsy person is it more permissible to take stimulants than if you're a reasonably energetic player who just wants that extra pep in his step? And how, if we draw your line, do you deal with "natural" types of performance enhancement, like something as unobjectionable as weightlifting, that don't restore a natural ability that was lost, but rather, add pounds of muscle to naturally small frames? Do you also draw a line to the effect that performance enhnacement obtained by hard work is okay, but enhancement obtained by popping a pill is not? And if so, why? I think all these distinctions make more sense in a sport like track, where you're really trying to determine who the naturally fastest man in the world is. But baseball isn't about determining who's most naturally gifted at hitting a ball over a fence. It's a team sport; all these milestones are just ancillary to the enjoyment of the game, and besides, a home run record is cumulative, it doesn't tell us who the best home run hitter is, just who hung around for the longest. Moreover, field sizes vary, racial composition of the league changed over time, the baseball itself changed, so all this worry that the hallowed record books are being tainted seems silly to me, as they never really meant much in the first place.

[RED]

I think the answer, in large part, comes down to the league being uncomfortable taking the word of athletes who say that they take HGH just to get healthy.

If everyone who used HGH only did it to treat injury (HGH-related health issues aside), the sports community might look the other way. Heck, they might applaud it in the same way they applaud the athlete who takes a shot of painkiller and gets back out on the field.

But faced with having to rule on whether a player was taking a particular substance for legitimate (healing) or illegitimate (advantage) reasons, it is much easier to just ban the substance altogether. Particularly when there are other approved ways to help the healing process medically.

To me, a great analogy is medical marijuana. Government officials, police departments for the most part, do not want to be in the position of having determine if the user has a legitimate need. It's much easier for them if weed is illegal and they can just arrest everyone who has it. The level of bureaucracy needed to manage a legal program for an otherwise illegal susbtance is more than most want to go through. Particularly if they aren't convinced that smoking marijuana is the *only* treatment for the users' ailment.

The situation that is even more laughable than the Vina example is when track and field athletes get banned for years because they took cold medicine.

RED

[Doris]

Yes you can compare steroids to Lasik as well as high performance swimsuits (or body shaving), low sweat rates (no need for hydration = saved time from not needing it and saved energy from your body not ‘consuming’ it), shoes with springs in their heels (now banned), super powered shock absorbent pads, or anything that can give you an edge in a competition. I think the issue that ‘gets’ us is more with what you put INTO your body and the “habits” of current society.

The best example I can think of to compare with steroids is caffeine. They are both drugs that you do not need since we can certainly survive without them (something we cannot say about pain killers, since we can faint or loose consciousness due to pain). We all know that caffeine increases our attention span, so two equally smart people with the same exact starting point (hours of sleep, study hours, etc etc) go to a 2-hr test, one drinks coffee and one doesn’t. The one that drank coffee will be much more attentive and can concentrate better so will probably do better than the other person. So did the person that drank coffee should be punished? No, not really simply because coffee has become a habit in our current society. Make the test 10 hrs and probably they will average out to be the same since the effects are not that prolonged.

It will be interesting to see 50 years from now, what would happen. Either steroids become part of our habits or they do not. Then again, you can play the game and compare steroids with any other substance, vitamins, antioxidants, anything that you can ingest one way or another. Who knows maybe we will start drinking metal/polymer nanoparticles to make our bones stronger yet our ligaments more flexible… let’s create the best monster ever!!... oops I meant athlete.

[Sean McIndoe]

The difference is the risk involved. We currently believe that long-term steroid use brings the risk of significant future harm. (For argument's sake, put aside whether you actually believe that to be true.) Meanwhile the risk of lasik surgery is minimal.

Why does that matter? Because when you allow one athlete to use "performance enhancers", that athlete will be taking somebody else's job, or spot in the lineup, or share of the payroll. The other guy is under enormous pressure to give himself the same advantage. If the cost of that advantage is serious long-term health problems, then you've created a terrible situation for current and future athletes. Far better to ban the dangerous performance enhancers for the good of all athletes.

[Briefly stated]

Mr. G... It is ok to kill pain with otc or valid script, but not ok to bulk up (HGH does that)with self medicated substances requiring a script...my take.

[Paul Soldera]

Isn't the distinction between eye surgery and steroid use a simple 'common acceptance' one? Baseball players use their eyes for things other than baseball. Everyone has the right to improve their vision. Filling yourself full of steroids only really helps you hit the ball longer of throw the ball faster. It doesn't help you drive a car, do your taxes, or watch your kids.

I can find less of a good distinction for the pain versus HGH argument.

[gbaked]

from south park:

"Taking steroids is just like pretending to be handicapped at the special Olympics. Because you are taking all the fairness out of the game."

http://www.southparkzone.com/episodes/803/Up-the-Down-Steroid.html
(If you have never seen this episode, I highly recommend it)

I have been racking my brain on this issue ever since I read Vina pt1. Its a situation where I know the answer:

Steroids are wrong.

However, for the life of me, I can not tell you why I am so sure of it.

This is an issue that is hard to analogize. Its not the same as a musician getting stoned to write a song, because music is not a competition. You risking harm to yourself does not prevent me from fulfilling my dream.

Lasik eye surgery is a completely different situation. If the surgery gave the ability to see twice as well, but came with a large and very serious health risk, then it could be comparable. In addition to that, there is no other way to advance your eye sight. No matter how hard you try, you can not work out your eyes to see better. However, you can work out your muscles to grow stronger. Lasik eye surgery is not a shortcut

Here is how I think about it...

Say there were only 30 major periodicals in the US. To write for one of these was not only lucrative, but something that required years of training and put you in stiff competition to keep your job.

You are a young writer who shows some promise. You have been writing your entire life to make it to this spot. You gave up all other major professions to follow your dream. It required getting up early before school and writing. It required staying late, while your friends were hanging out watching TV to get in some more hours at the library. Everything you have ever done was for this.

Then, while you are reaping the benefit of the hard work and living your dream... A new drug comes out. It causes people who take it to understand the english language better then those that dont. Its basically the eqivilant of all the extra time you spent in the library studying, and the hours of practicing your writing skills. However, with it, comes a very large heath risk.

Should you... after working your entire life, after beating out hundreds of thousands of others who grew up with the same dream, be forced to contemplate risking your health in order to keep what you worked for and deserve to have.

Should young writers, who look up to the roughly 750 professionals be led to believe that risking your health, and taking shortcuts is the way to achieve what they dream?

What is the distinction? I think it is as simple as honor.

[Nerdsavant]

Hmmm. My opinion is that baseball should be a game decided by who has the greatest natural talent. It seems to me that steroids and HGH turn the game of baseball into a game decided by who can afford the most and newest treatments to enhance their natural talent. And that's a different contest altogether.

[Jeff Lichtman]

One important distinction between eye surgery and anabolic steroids is in the potential for long-term harm to the athlete's health. Steroids can cause terrible health problems: liver and kidney failure, for example. The risks of eye surgery are much lower both in terms of probabilities and effects.

The rewards of steroids are high enough that many athletes are in the position of having to use drugs in order to win (or even keep their jobs). This wouldn't be a problem if it weren't for the risks. For example, if someone discovered that eating ten carrots a day would allow a player to hit fifteen more home runs a year, everyone in baseball from Little League to the Major Leagues would eat lots of carrots and no one would worry about it. The difference in this fantasy scenario is that carrots don't hurt anyone.

The comparison to using pain killers to play with an injury is more apt. This practice is widely accepted, but should it be? Why isn't it considered unethical for a team doctor (or trainer) to give someone a shot of lidocaine when the result could be career-ending (or even life-threatening in the most extreme cases)?

Another thing to consider is the effect of a performance-enhancing-drug culture on young athletes. Steroids are bad for adults, but they're *terrible* for children. Kids emulate sports stars - if they think the guys in the big leagues are using, the kids are more likely to use. There are barriers to kids getting eye surgery and shots of lidocaine so they can play better (one big barrier is that a parent or coach has to participate in the process). The barriers to using steroids are much lower, since a kid can buy and use drugs illicitly.

In the long run I doubt we'll be able to do much about performance-enhancing technology. In the future there will be performance-enhancing gene therapy, for example. What can anyone do about that? Perhaps in the future such things will be so common that people will simply accept it as a part of sports.

[Dave]

The question that begins (!) to clear this up for me is: "What's the problem?" The problem, as others have pointed out is that a. some medical treatments have serious side effects and if some athletes use the treatments it puts pressure on their competitors to use them as well, and b. that common usage among highly publicized athletes will cause a trickle down to younger, more vulnerable ones.

There is also an issue of fairness, but that can be addressed by enforcing any set of rules rigorously.

On the basis of these problems, my conclusion is that any intervention that creates pressure on kids and competitors to do something harmful must be policed and everything else is fair game. Of course, defining and determining harm isn't obvious...

[Quidam]

Gosh, there is so much conflict around what constitutes 'performance enhancing' and what doesn't. Where would we stand if we took 'performance' out of the picture?
If people want to improve their eye sight, should they be able to? Well we've already answered that one. What if a taxi driver or a bank manager were injured and wanted to speed up their recovery? What if you or I were injured and we wanted to speed up our recovery? Shouldn't we be able to?
OK, steroids are potentially harmful. So is smoking, so is obesity, so is sky diving. As long as a person is aware of the risks, isn't it their choice?

[Jae]

Here are a few points I haven't really seen made yet.

1. I do agree with you, Malcolm, that much of how this steroid controversy has played out has seemed somewhat arbitrary. But lets not forget, baseball, football, and just about every game in the world is subject to its own set of relatively arbitrary rules. Why is the distance between any two bases 90ft? Why are there 3 outs in an inning? Why is a first down 10 yds instead of 12? These rules are the result of a continuing evolution of what's perceived to be fair after being tested at countless games, season after season. Currently, the rules have evolved to the point where steroid use (but not LASIK) is seen to be cheating. Unfair? Perhaps, but that's what happens when you choose to be governed by an arbitrary set of rules.

2. Actually, my last point is not completely accurate, as there is one thing that supersedes any arbitrary setting of a rule. It's important to remember is that professional sports are run as businesses ... wildly profitable businesses. Not only that, they are government protected monopolies as well. Their staggering revenue is directly dependent on the ticket-buyers perception of fairness in the competition they witness. A fan's purchase of sports apparel is predicated on the belief in their team's superiority on a level playing field. Anything that takes away from that belief, or jeopardizes the previously mentioned monopoly, is of direct threat to the team owner's bottom line. Therefore an non-proportionate amount of effort is spent on protecting that image. The public (and media) have chosen to highlight a perceived threat to fairness and the owners (and subsequently, the players) have naturally reacted swiftly to defuse that threat in the quickest possible way.

3. Lastly, you have not addressed what I believe to be the best reason on why to harshly treat steroid use. That the success that pro athletes enjoy when using steroids is an implicit endorsement for kids to start abusing them at a young age. Properly prescribed and regulated, steroids can have indispensable therapeutic qualities, but improperly used (and really, do you expect children to use them correctly?) they can have devastating long term effects. I don't believe you've mentioned this aspect of the steroid controversy, have you?

[michael webster]

Malcolm;

I am in agreement with you about the philosophical laziness of those who equate "performance enhancing medicine" with "cheating".

We need to go back to the early 70's and the dominance of the Eastern Bloc at the Olympics to understand the above equation.

Once it was understood how individual could mimic, enhance, and improve their natural training with the use of medicine, society had choice: ban the new knowledge, or publicize the new knowledge.

We chose, wrongly, to ban.

We should have chosen to publicize and make available this new medicine to all.

Here is what we are faced with: athlete A whose genetic make-up allows him/her to train longer than his/her competitors, but athlete B can mimic this genetic advantage by taking medicine X, and training harder.

Who should be rewarded: A who is a natural, or B who has to work harder and take medicine X?

Obvious to me: Bonds and Clements go to the Hall.

[chiwan]

One problem: this is not to say that steroids have or do not have serious health risks in the future.

but any athlete, coach, doctor, trainer can tell you that painkillers, pain numbers, and all those things that athletes use and are URGED to use and are seen as heroic for using (i.e. Schilling on his ankle), are incredibly bad for your body.

so it's not even about comparing what may be beneficial like lasik and potentially harmful like steroid.

it's about: why is it okay for athletes to harm themselves with painkillers but not okay to harm themselves with steroids/hgh?

[Calvin]

Laser eye surgery restores eyesight to normal levels, it does not improve eyesight beyond normal levels. It is the correction of a disability, not a performance enhancer. Lasik is no more cheating than wearing glasses or contact lenses is cheating.

[Jeff S.]

To me, the whole "unfair advantage" argument doesn't carry much weight. As I see it, the problem with drugs like steroids is that, because they confer such a huge performance advantage, if they aren't prohibited then using them can become necessary to succeed at the highest levels of sport (see: cycling). By itself, this doesn't directly affect more than a handful of professionals, who (it can be argued) should be allowed to decide whether they're willing to accept the long-term health risks of steroid use (which I'm told can be minimized by proper medical supervision) in exchange for more/longer success in their sport. Unfortunately, when this happens, the use of performance-enhancers becomes a prerequisite not only to succeed at the highest levels, but to compete in them at all. This affects more than just the few professionals who can afford proper medical supervision: it affects everyone who wants to compete at any level (see: bodybuilding; yes, they solved this by having separate "clean" and "dirty" competitions, but can you imagine this sort of arrangement for baseball?).

To me, the litmus test shouldn't involve the effectiveness of a substance/procedure/whatever, but whether it's safe enough to be used by competitors at all levels of sport, regardless of how it was obtained. Hence, creatine (safe enough to be sold over-the-counter), LASIK surgery (only realistically obtained by a trained medical professional) and lidocaine injections (ditto) are ok, but steroids, and, apparently, HGH/insulin are not.

[Dawn]

There's just one problem with the argument about steroids and the health of athletes: We know that some athletes will cave into the temptation of pushing the limits with their bodies, and their health, to win. Yet we don't do anything to prevent those things from happening. As far as I'm aware, there are no active programs in place to prevent eating disorders in gymnasts or runners, for example.

[John Allsopp]

There seems to be an elephant in this blog, and the entire debate.

Repeat after me "drugs are bad".

Viewed through this prism, it seems to me the whole drugs in sport imbroglio makes sense.

"What about pain killing injections?" you ask. There seems to be a clear distinction between long term habitual use (bad), and "one off" use of drugs to treat specific, instance related injuries.

Without accepting that the morality of drug use (which is of course fundamentally irrational - cocaine is bad, but nicotine and alcohol are fine) as the underlying shaper of narrative, we will not move forward in this debate.

Drugs are not bad, rather, their use achieves outcomes. Some of those outcomes are less desirable than others. With identifying and demonstrating the badness or otherwise of those outcomes, we are simply exercising increasingly circular, and to tell the truth rather dull rhetorical arguments.

But I don't hold out a tremendous amount of hope of reason entering this, or any drug related discussion any time soon - at least at the operational level.

john

[Calvin]

John, I liked your comment, but I don't agree with the comparison of alcohol and nicotine with illegal drugs. Alcohol use is restricted and regulated and when alcohol use has been found to result in consequences associated with "harder" drug use, alcohol has been, as in the case of absinthe, banned. Society has evolved coping mechanisms to deal with alcohol, coping mechanisms that do not exist for other drugs, despite this alcohol abuse is still a problem. The fact that alcohol use/abuse is still problematical despite cultural coping mechanisms and regulation, is probably the best argument for the prohibition of far more addictive drugs for which society has evolved no coping mechanisms.

The same pragmatic standard should apply to drug use among athletes, the fact that there are grey areas and borderline cases should not be an argument against the basic principle that an athlete should succeed through his or her own effort, dedication and intelligence.

[michael]

Malcolm,

I totally agree with your confusion about drugs. In the sport of cycling which I am tangentially involved in as a designer it is illegal to take EPO that boost an athletes red cell count and thus improves oxygen delivery to the muscles but quite legal to train at high altitude or sleep in a hyper baric tent which achieves exactly the same result physiologically.

Great blog,

michael

[Maya]

The difference is that anyone can wear contact lenses which gives you the same advantage as successful Lasik eye surgery. I don't think there is a ban on contact lenses for anyone.

The right to wear corrective lenses has, for a very long time, been accepted as a type of human rights issue that gives someone the ability to drive, learn in school, even to be safe. How do performance enhancing drugs qualify as a human right? As someone said before, there is no workout to better your eyesight.

This may not be the best analogy, but at age 4 I began to ride and care for horses, and competed in riding competitions beginning at 10 years old. Riding a horse while in pain is not really like playing football in pain, but if you've ever been kicked or trampled by a horse, you know what I mean.

We had a painkiller. It was called Tylenol. If an injury was so excruciating that we couldn't suck it up beyond that, it meant that the injury was serious and we stopped competing until we recovered.

At some point in 2005 or so, American society crossed the line into a world of Frankendrugs and Frankentechnology. Artificial hormones, 50 year olds having babies, genetic manipulation of the Chestnut tree, cloning endangered species, etc etc. Isn't anyone else disturbed by this?

Taking Frankendrugs to win a game is a recipe for disaster. Forget about the ethics of it. The essence of an athlete is someone who uses their body to get by obstacles. It harkens back to when the fittest could survive in nature by being in good shape. That is the purest form of athleticism.

The consequences of Frankendrugs are unpredictable and possibly irreverseable. For the sake of everyone's health, forget about the ethics of it and let's respect the human body the way it evolved from nature.

[O]

You're absolutely right to pose the question. I did the same (pat on the back) in our own sports email list.

My thinking is this:
An athlete should not be forced to risk their personal health to compete. The problem with steroids is health, not performence enhancement. Working out is performence enhancements. Vitamans may be. But anythign that is "unhealthy" should be banned. You should not be forced to sacrifice future health for present achievement. There is certainly a line that has to be demarcated and the usual fuzziness will persist around that line, but that doesn't mean you shouldn't draw the line somewhere.

This isn't a fully developped thought and there are nuances that need to be explored. Players certainly play through injuries even though they know they may injure themselves further (even permanntly). In this case, however, the player is playing up to an "uninjured" level -- he is not 'enhancing' his performance which means there is no advantage to this player by playing hurt beyond what would be otherwise produced when healthy (heroic feats, Willis Reed style, aside).

More discussion is needed, but I think this may be the right track? What does everyone think?

[Andy W]

I think it's interesting how this debate brings relevance to philosphy in everyday business...