Roid Age: steroids in sport and the paradox of pharmacological puritanism

The following post is based on a lecture I gave in the course, ‘Drugs Across Cultures,’ on steroids and performance-enhancing drugs. A very-beta version of a Prezi is available for the lecture on my Prezi account, but it still needs updating. I’m eventually hoping to do a webcast version of the lecture, so I’d love to hear your feedback — the lecture isn’t as detailed as this post.

Introduction

In 1998, when I was living in New York, my family managed to get tickets to a baseball game between the St. Louis Cardinals and the Chicago Cubs. I had been a Cardinals fan since before I ate solid food, and 1998 was a very good year to catch a Cards-Cubs game. Baseball fans around the US, still demoralized after the 1994 players strike forced the cancellation of the World Series, were thrilled in 1998 by a chase for the record in US Major League Baseball (MLB) for the most home runs in a season by a single player. Fans flocked back to stadiums for a carnival of power hitting that summer.

When I went to the game, Cardinal Mark McGwire and Cub Sammy Sosa were both on pace to break the record of 61 home runs in a season set by Roger Maris, a record that had stood for almost four decades. By the end of the year, both McGwire and Sosa would shatter the previous mark. Sosa finished that season with 66, McGwire with 70. The afternoon that I flew in from New York for the game, both McGwire and Sosa hit home runs, and I had one of my best days watching professional baseball. St. Louis was drunk on the excitement; ‘Big Mac’ jerseys were selling like school uniforms in July, and the hot, humid St. Louis air was crackling with the energy (or maybe we were all just drunk on the insane pollen count). After the sordid spectacle of millionaire players and multi-multi-millionaire owners kicking sand on each other and taking their toys home a few years earlier, it felt good to be a baseball fan again.

The home run chase was a riveting spectacle, in part because Sosa and McGwire were such different individuals. Sosa, from the Dominican Republic, had grown up poor. He legendarily played baseball with homemade bats and a glove made of milk cartons before signing with the Texas Rangers at sixteen. In contrast, the hulking, red-haired McGwire was from southern California; he hit a home run in his first Little League game when he was eight, the baseball equivalent of a Paul Bunyan story. McGwire’s brother played professional football. They were sporting royalty.

As a fan, I loved both Sosa and McGwire. As a Cardinals supporter, I was obliged to hate the Cubs, but mine was a shallow animosity. I was born in and had gone to Chicago for grad school, and loved the traditions of the Cubs. The fact that McGwire and Sosa seemed to genuinely like each other made the competition even more enjoyable. When McGwire hit his historic 62nd homer off the Cubs, even Sosa came out to congratulate him as both teams celebrated the feat (see Brooks 2008 for another account of the homerun record chase). Sports Illustrated named the two, jointly, ‘sportsman of the year.’ Professional baseball, battered by controversy and unsightly squabbling, seemed to be on the ascendance, a Golden Age of power hitting.

Although that 1998 homerun record chase by McGwire and Sosa arguably helped restore public interest in MLB, McGwire was not voted into the Baseball Hall of Fame in Cooperstown when he became eligible in 2007. He failed to make the cut in voting that year, and every year since, in 2008, 2009, 2010, 2011, and this year, 2012. Something had happened between 1998 and 2007 to sour the festivities.

In fact, McGwire’s record didn’t last long. Maris’ mark had stood for 37 years; McGwire’s lasted three. In 2001, Barry Bonds of the San Francisco Giants hit 73 home runs. Bonds had never hit more than 50 home runs in a season before 2001, and he had bulked up significantly going into the baseball season, leading to a swirl of rumors and innuendos. Dark clouds after the 1998 home run record celebration had begun to turn into a storm. By 2003, Bonds was dragged into the investigation of Bay Area Laboratory Co-Operative (BALCO) for supplying illegal performance-enhancing drugs after one of Bonds’ trainers was indicted for supplying steroids to athletes. Looking back through the lens of the BALCO trials, fans began to re-think the feats of McGwire, Sosa, and many other players who had injected… err, ‘introduced,’ so much hitting power into Major League Baseball since the 1990s.

Called to testify

In 2005, McGwire was subpoenaed, along with ten other players, to the House Government Reform Committee, specifically convened by the US Congress to discuss steroid use in Major League Baseball. In March, when called to testify before the Committee, McGwire refused to answer questions while under oath. His reputation suffered immense damage. Already an intensely private man, McGwire virtually disappeared from the public eye.

Finally, in 2010, with a cloud still hanging over his name and a job as the Cardinals’ hitting coach in the balance, McGwire admitted he had used steroids. As he said in an interview that year, ‘I wish I had never touched steroids. It was foolish and it was a mistake. I truly apologize. Looking back, I wish I had never played during the steroid era’ (quoted in ESPN 2010). McGwire insisted he had used steroids mostly to recover from injury: ‘I did this for health purposes. There’s no way I did this for any type of strength use.’ (Sosa, who even denied taking performance-enhancing drugs under oath during the Congressional investigation, apparently tested positive in 2003 although it was not publicly known; see Schmidt 2009).

Many in the public were even more outraged by McGwire’s admission. A section of Interstate 70 named ‘Mark McGwire Highway’ was stripped of the name by the Missouri legislature in 2010 (Summers 2010). Associated Press journalist Steve Willstein (2010), who originally broke much of the story of performance enhancing drugs in MLB, including McGwire’s use, publicly called for McGwire to be banned from baseball, even as a hitting coach. The Golden Age of power hitting turned out to have been the ‘Roid Age’ of juiced batters.

‘Andro’

In particular, McGwire admitted as early as 1998 that he took androstenedione, a precursor steroid or ‘prosteroid’ to androgens like testosterone. The journalist Wilstein (1998) had spotted a bottle of ‘andro’ in McGwire’s locker and asked a chemist about the substance. Androstenedione was sold legally as a dietary supplement under US FDA guidelines and was widely used by athletes at the time. Through an odd twist of US regulation, steroids were classified as ‘drugs’ and banned; but steroid precursors like androstenedione were technically considered ‘dietary supplements,’ and so legal over-the-counter, or for sale without a doctor’s prescription. The World Anti-Doping Agency banned androstenedione in December, 1997, the previous year, but the move hadn’t affected Major League Baseball, where a strong players’ union helped to slow the gradual roll-out of testing regimes (see Galbraith 1998).

With andro still legal in 1998, and available without prescription, sales of the product skyrocketed when McGwire admitted using the supplement; bottles of andro flew off shelves as McGwire was a walking, homerun-smacking ad for the effectiveness of the supplement. McGwire, like the manufacturers, claimed andro was ‘natural’ because it occurred in the body. Of course, so did testosterone, which was banned. In 2004, US President George Bush outlawed over-the-counter sales of andro when he signed the Anabolic Steroid Control Act, which made hundreds of steroids and steroid-precursors (prosteroids) Schedule III controlled substances, in essence reclassifying them from ‘food’ to ‘drugs.’

But the damage was done: McGwire had reached for sporting immortality during the ‘steroid era’ — the ‘Roid Age’. The result was a permanent asterisk behind every one of his achievements. McGwire wasn’t alone of course. The list of baseball players whose achievements are now tainted by suspicions that they used performance enhancing drugs includes too many to recount. In the 2010 interview, McGwire talked about the incredible shame he felt. He even called Roger Maris’ widow to apologise. Some commentators say that he – together with the generation of players tainted in the Roid Age – will likely not be inducted into Cooperstown for decades, until the sense of betrayal has decreased, at least among the veteran players and sportswriters who vote for induction.

The Roid Age

We are living in a Roid Age in sports, trying to figure out what is acceptable and what is not, what is ‘normal’ and what is dangerous, who is juiced and who is clean, when athletes strive for every possible advantage. With so much at stake, and such extraordinary resources put into sports performance – training and resources – the casualties have been many: titles and medals stripped, athletes banned, and reputations ruined. As I write this, the news is coming out that a number of Lance Armstrong’s former teammates have agreed with the US Anti-Doping Agency (USADA) to testify against the seven-time winner of the Tour de France.

For some, the stakes were even higher: Knut Jensen died in a cycling time trial at the 1960 Olympics, and the coroner found the amphetamine Ronicol. Cyclist Tommy Simpson died after the thirteenth stage of the Tour de France in 1967, his self medication with amphetamines and brandy too much for his body. Former professional football player Lyle Alzado, died at 43 of brain cancer; he blamed steroid use. Professional wrestler Chris Benoit hung himself after murdering his wife and daughter in 2007, his body was coursing with ten times the normal level of testosterone as well as a raft of other drugs. Other athletes who have died in strange circumstances may also be casualties; young, fit individuals, for example, whose hearts cannot bear the load of pumping overly viscous, ‘doped’ blood when they sleep and their heart rates drop.

But there are other casualties as well. Baseball pitcher, Bryce Florie, for example, didn’t take steroids, but he was hit in the face by a powerful drive off the bat of Ryan Tompson in 2000. Doctors were able to repair the bones broken in his orbit and cheek, but the blow took some of his eyesight, and his career ended soon after. Like many athletes who have had to quit because they came up against an adversary who was too strong, or did too much damage to their bodies, Florie wondered:

It was a crossroad in my life, and I’ve wondered whether steroids were a factor. This thought crept into my mind, as I was replaying it over in my head in the months after I got hurt. I’ve wondered whether the batter hit that ball harder than he was born to hit it, and whether that might’ve made a difference in milliseconds. I’ll wonder that the rest of my life. (Florie, n.d.) [Note: Thompson has emphatically denied that he took steroids.]

Sports Illustrated writer Tom Verducci (2012), in a recent piece on the ‘four Miracles,’ four minor league baseball pitchers, only one of whom ever really made it to the pros, outlines the deeper cost of steroids: the fact that people’s lives were shaped by whether or not they were corruptible:

the hundreds, even thousands, of anonymous ballplayers whose careers and lives were changed by a temptation that defined an era. It is also a story about the secrets we keep and the casualties we create when we allow the corrupt to go unspoken — especially when the corrupt is something far more horrific than steroids.

However, steroids themselves appear to be relatively safe, as long as they are taken at prescribed doses over limited periods of time. In some cases, they react badly with pre-existing conditions and use needs to be monitored, but most of the serious side effects come with sustained use at high doses.

Performance-enhancing drugs in modern sport

When I agreed to give a lecture on performance-enhancing drugs for my department’s course, ‘Drugs Across Cultures,’ the story of Mark McGwire came immediately to mind. Here was a man who had helped to re-establish a national passion for baseball, and yet his achievements were irreparably tainted by the suggestion that what he did was unfair, unsporting or unethical.

The story nagged at me, not simply because I so admired McGwire and his fall from grace was so precipitous. I felt, and still feel, that there was some odd cultural parsing of ‘ethical’ from ‘unethical’ at the fringe of human potential: dietary supplement was okay, steroid was not. Increasing red blood cell counts by re-injecting one’s own blood was morally reprehensible (‘blood doping’), by sleeping in a hypobaric chamber (as many athletes do) somehow less so. Freakish muscle and skill were idolized, until the taint of ‘andro’ and, more potently, steroids, entered the mix.

McGwire, in fact, was right: he had been caught in the ‘steroid era’ like so many athletes, a period when the meaning of athletic achievement could not be taken at face value. The fact hardly exonerated him of responsibility. But it made me wonder more about what made this particular form of ‘performance enhancement’ so reprehensible that this whole era of sporting achievement would have a shadow cast over it. Would the taint around performance enhancing drugs go the way of previous scandals, now taken for granted, such as the professionalisation of sport? Or is the rejection of steroids something more enduring?

I keep mulling this over because, as the London Olympics approaches, and the Tour de France wends its way around the bucolic Swiss countryside at the moment, we are almost inevitably going to see scandals break over charges of ‘doping.’ Thousands of the world’s most ‘enhanced’ individuals, many of them the beneficiaries of incredibly sophisticated technologies, will converge on these events, and a handful will be singled out as ‘cheats,’ their reputations and careers destroyed.

A brief history of doping

Athletes have long sought supplements to improve their performance. Competitors in the Classical Olympiad, vying for prizes that made them almost incomprehensibly rich for their age, used every advantage at their disposal. The Greek physician Galen reportedly prescribed ‘the rear hooves of an Abyssinian ass, ground up, boiled in oil, and flavoured with rose hips and rose petals’ to athletes seeking advantage over their adversaries (a recipe he probably got from Egyptian experts on the benefits of ground ass hooves).

In particular, since antiquity, people have known that the testes are responsible for producing many of the visible masculine traits of animals, including exaggerated musculature and aggression. Ancient evidence of gelding in domesticated animals, even the presence of human eunuchs, demonstrate that connections between testes, male reproduction, and secondary sex traits were well known, even before the advent of writing. According to Balko (2008), some Ancient Greek athletes ate crushed sheep testicles prior to competing; but then again, some ate live bees, too.

The modern era of sports-related doping and performance enhancing drugs, however, dates back to the nineteenth century. By the 1880s, French physiologist Charles-Édouard Brown-Séquard developed an ‘elixir’, a concentrated extract derived from guinea pig and dog testicles, that he believed would capture the essence of masculinity, including increased strength and intellectual ability.

In 1889, US baseball pitcher James ‘Pud’ Galvin openly injected the Brown-Séquard Elixir, especially toward the end of his remarkable career (Halverson 2011). In contrast to McGwire, Galvin was an early inductee into the Hall of Fame, as he was the first pitcher to notch 300 wins in the professional leagues (Coincidentally, Galvin was also born in St. Louis. But I digress…). In fact, as Halverson (2011) points out, Galvin was actually praised by the media at the time for demonstrating the value of the Brown-Séquard Elixir.

Continuing the ancient pattern of eating live bees, however, many athletes also used substances that likely offered more dubious benefit. Some competitors in 24-hour walking races took opium or alcohol, and the rage for six-day bicycle races saw riders experimenting with such performance enhancing substances as champagne, tobacco, brandy, nitroglycerine even koala nuts. Cyclists sometimes become so intoxicated that they had to retire from races if they over-‘enhanced’ their performance, suffering hallucinations from a combination of fatigue, sleep deprivation, and narcotics.

Cyclists, boxers, swimmers and runners in the late nineteenth century even took strychnine tablets with brandy and cocaine as part of their training. In the 1904 Olympics (in St. Louis, digression…), marathoner Thomas Hicks received two injections of strychnine and a good glass of brandy to revive himself during the race; he collapsed after he crossed the finish line. Another dose of strychnine might have finished him off (here’s strychnine at ‘Molecule of the Month’). Hicks had actually crossed the line second after Frank Lorz, but Lorz had used a performance enhancer forbidden even in 1904: he had caught a ride after the first nine miles, only jumping back into the race five miles from the end.

Adolf Hitler at the 1936 Berlin Olympics (probably high)

By the 1930s, an array of performance enhancing substances was being used in elite athletic competition. The US swimming team was unexpectedly defeated in many of the races in the 1932 Olympics by Japanese swimmers who were inhaling pure oxygen before swimming. By the Berlin Olympiad in 1936, amphetamines were the dominant performance enhancing drug, not just for the athletes; records recovered show that Hitler received eight injections a day at the height of his use (some say that he can be seen in film of the Olympiad exhibiting some of the signature gestures of amphetamine users, such as compulsive rubbing of the thighs). But this pattern of use was part of a much broader cloth: the British military, for example, gave 72 million doses of amphetamines to soldiers during World War II. Although authorities expressed ambivalence about performance enhancing drugs, this ambivalence did not seem to stand in the way of widespread use.

Research on steroids continued in Europe and the United States at the same time. In 1927, Fred Koch and Lemuel McGee at the University of Chicago derived a substance from bull testicles gathered at the Chicago Stockyards that successfully re-masculinized castrated roosters, pigs and rats. They had isolated testosterone and demonstrated its ‘androgenic’ effects.

In 1954, according to John Ziegler, team doctor for the US team, Soviet medical personnel out drinking one night revealed that virtually the entire Soviet team at the World Weightlifting Championship had used injections of testosterone in the lead-up to a dominant performance. Whether or not the account by the US doctor was true, the US team subsequently began using steroids extensively. They sought synthetic compounds as well that provided the anabolic, or body-building, effects of testosterone without the side effects, including excessive androgenic traits or hyper-masculinization.

Ziegler worked with pharmaceutical manufacturer CIBA to produce the anabolic steroid, methandrostenolone (Dianabol), in 1958. Dianabol sped recovery and encouraged increased muscle growth, allowing athletes to train harder and improving their results. Dianabol was Arnold Schwarzenegger’s steroid of choice as he won seven Mr. Olympia titles, and he wasn’t alone. The use of Dinabol spread from powerlifters and bodybuilders to other athletes: allegedly, the use of the steroid grew so pervasive that a research team trying to examine their effects among elite strength athletes like weightlifters, discus throwers and shotputters couldn’t find enough athletes who hadn’t used the drugs to act as a control group (found that on Wikipedia).

East German athletic ascendance

From the late 1960s until the fall of the Berlin Wall in 1989, the East German state athletic system embarked on a massive scientific project to improve the country’s sports performance. One centerpiece of this program, in addition to rigorous training and talent identification, was state-sponsored doping of the country’s most promising young athletes. The East German secret police, the Stasi, oversaw administration of the program from 1971 until the dissolution of East Germany, giving steroids to an estimated 10,000 athletes. The doses involved were sometimes well in excess of safe levels, and promising young athletes were put on anabolic steroid regimens while still growing and particularly susceptible to their effects, especially given long-term use.

State athletic officials had decided that the country needed to perform on the world stage – or, as Australians might put it, ‘punch above their weight’ – to demonstrate the superiority of communism over capitalism. A country of 16 million, driven by a government obsessed with the Olympic medal count, came to rival the United States and the Soviet Union as a sporting superpower, pouring scientific and personal resources into the pursuit of athletic excellence (see Longman 2004). As the website for the PBS Secrets of the Dead episode, ‘Doping for Gold,’ describes:

Rare glimpses of life behind the Wall suggested a sporting revolution. Talented children were handpicked for special sports schools. Coaches and doctors were employed full-time to train them. Sports festivals became highly anticipated national events. Successful athletes enjoyed freedoms not available to their fellow citizens. This was the communist equivalent of fame and fortune – they became the public face of the German Democratic Republic.

The project was enormously successful measured in terms of medals and world records.

Until 1968, East German athletes were only allowed to compete under the banner of a unified German team, even though the German Democratic Republic (GDR) had been established in Soviet-occupied areas of the country in 1949. The Mexico City Olympiad was the first time that the GDR marched under its own flag, and the national team collected nine gold medals. The total would double in each of the next two Olympics.

In 1972, East Germany finished in the top three medal winning countries in the Munich Olympics, even ahead of the host country, its cross-Iron Curtain rival. Perhaps the GDR’s greatest success were the 1976 Summer Olympics in Montreal and the team’s performance in the boycott-sullied 1980 Moscow games. In Montreal, East Germany took 90 medals, including the second-highest number of Golds – forty – besting the United States in the category.

In particular, the GDR women’s swimming team, known as the ‘Wonder Girls,’ were one of the most successful international sporting teams of the era. In the inaugural world swimming championships in 1973, they won ten of fourteen women’s events, setting eight world records in the process. In Montreal, the Wonder Girls won 11 of the 13 gold medals on offer. When the American swimmer commented on the deep voices of the women swimmers, the East German coach said, ‘We are here to swim, not to sing.’ In 1980, with the United States absent from the Moscow Olympics due to the Afghanistan-inspired boycott, East Germany again finished second to the Soviet Union in the medal tally, taking 126 medals, 47 of them gold.

The incredible ascendance of the East German Olympic team, especially the women, led many competitors and commentators to suspect anabolic steroids. The East German team officially said that their remarkable times were the result of a sophisticated weight-lifting and conditioning program. Not until the fall of the Berlin Wall would the causes be fully understood, even by the athletes themselves.

East German doping

When the wall dividing East and West Germany was pulled down in 1989, East German officials were frantically destroying records of all sorts. The German Central Investigative Unit for Governmental Crimes and Crimes Relating to Reunification discovered a ten-volume file in the archives of the Stasi, the GDR secret police, detailing drug use in the East German state sports programs. Other documents were sold by ex-East German officials. Moreover, the human cost of East German’s athletic achievements began to come to light.

Around 10,000 young people, identified as athletically promising, were given Oral-Turinabol, an anabolic steroid. Athletes including girls as young as eleven were told to take the ‘blue bean,’ which their doctors euphemistically referred to as ‘supporting means.’ Oral-Turinabol accelerated muscle growth and decreased recovery time, helping athletes to train harder and more frequently in the lead-up to events. The drugs had a particularly strong effect on female athletes, whose bodies did not normally produce as much testosterone, so the program targeted them throughout their development.

As East German song-writer and dissident Wolf Biermann put it, the program was ‘a large-scale animal experiment on living people’ (in Kettmann 2000b). According to Sherm Chavoor, a US swimming coach from 1968 to 1980, a visiting East German coach boldly asked him, when do you inject your athletes? When Chavoor said that drug use was dangerous; the coach allegedly looked surprised and said, ‘But bodies are expendable’ (Janofsky 1991). Or, as Werner Franke, professor of cell and molecular biology at the German Cancer Research Center at Heidelberg and performance enhancing drug researcher explained in a 2009 PBS documentary:

Doping in the West was always a clandestine thing, it was in small circles so it had nothing of the dimension and the thoroughness it had in the East. Doping in the GDR was different from the doping in the West of the world but it was also different from the doping in other parts of the East. It was German, it was orderly, it was bureaucratic, it was written up. (PBS 2008)

The records meant that the program could be studied after the fall of East Germany. Athletes like Carola Beraktschjan, a former swimming champion in breast stroke, learned that the ‘vitamins’ that they were told to take were actually anabolic steroids – Beraktschjan claimed that she took up to thirty some days. As she explained: ‘There was no question you would not take them. You had to play by the rules. We were vehicles chosen to prove that socialism was better than capitalism. What happened to our bodies was entirely secondary to that political mission led by Ewald.’

Manfred Ewald

Manfred Ewald was a particularly sinister figure in the whole story. A former member of the Hitler Youth and Nazi, he had switched sides following World War II, joining the Central Committee of East Germany’s Communist Party in the 1960s. He took over the country’s Olympics effort in 1964, becoming the Sportfuhrer. For twenty-six years, he led the East German sporting machine, during which time the small Communist country won 160 gold medals. For his efforts, IOC President Juan Antonio Samaranch awarded Ewald the Olympic Order in 1985 (in part to assure a boycott would not affect the Seoul Olympics). Ewald died in 2002 at age 76, but not before he was brought to trial for what the East German program had done to some of the athletes.

The longer-term effects were slower to appear than the world records: liver tumors, heart disease, testicular and breast cancer, gynecological problems, infertility, depression and eating disorders. The high doses given to some of the athletes, especially through adolescence and for many years of development, multiplied the problems. As many as 2000 of these former athletes had health problems as a result of the drugs, some of them severe: for the men, sterility, impotence, damaged hearts, and failing kidneys could be the result (see Longman 2004; Swift 2003). Swift (2003) reported that some of the male strength athletes who were given the heaviest doses had such enlarged breasts that they required reduction surgery.

Heidi Krieger

But for the women athletes, the androgenic or masculinizing effects of the steroids were even more perverse. Some women reported giving birth to children with birth defects years later. In one of the cruelest cases, 1986 European shot put champion, Heidi Krieger, nicknamed by her own coaches ‘Hormone Heidi,’ testified that she had severe physical and psychological damage from the drug regimen (Swift 2003). For women, Oral-Turinabol can result in deeper voices, increased body hair, severe acne and an increased sex drive. According to some researchers, Krieger took 2,600 milligrams of steroids in 1986, almost 1,000 milligrams more than Ben Johnson took before the Seoul Olympics. At the height of her fitness, she could lift 260 kilograms (573 pounds) (Kettman 2000b).

Krieger said she felt so damaged that she underwent a sex change operation after her sports career ended; she’s now Andreas Krieger. In a 2004 story in The New York Times, Andreas said that East German doctors ‘killed Heidi,’ his former, female self (Longman 2004). She testified in May 2000, that the drugs caused profound problems with her own sense of self:

I didn’t know any more who I was. The pills accelerated any transsexual tendencies I may already have had. I wasn’t able to identify with my body anymore and that led me to undergo a sex change. (quoted in Kettmann 2000b)

In 2000, 142 plaintiffs sued the German state for compensation. Of the women, forty had developed deep voices, fifteen experienced gynecological or reproductive problems, six found that their breasts simply disappeared (Kettmann 2000b). ‘They weren’t just strengthening women,’ said Franke, who ardently pursued compensation for the athletes. ‘They were virilizing them.’

The system was so corrupted by doping that former swimmer Ines Geipel, a member of the record-holding East German women’s 4×100 relay team, asked for her own 1984 national record to be struck down as invalid (Harding 2005). She had been taking steroids and felt that the achievement could not be recognized as legitimate. The East German doping program did not just imperil their health; the use of steroids meant that they would never know how good they could have been without the drugs. In the worst cases, the doping stole their health and their achievements, threatening their future as it undermined their past.

The andro connection

The connection between my disgraced baseball hero, Mark McGwire, and a massive state-run doping program run by a sinister former Nazi-turned-communist sports official, Manfred Ewald, may seem tenuous. The link, however, as writer Steven Kettman (2000b) points out, was andro. Manfred Ewald originally pushed the usefulness of androstenedione, a ‘testosterone booster,’ but not itself an anabolic steroid (a prosteroid), to evade Olympic drug-testing regimes. In a sense, McGwire and Manfred both used andro to maintain bodies built by steroids.

Biologists had known about androstenedione since the 1930s; Ewald recognised the value of the substance as a ‘bridging drug’ to maintain the gains his athletes made on anabolic steroids when they had to go off the stronger drugs prior to drug testing done at competitions. Given enough time, illegal drugs would work their way out of the athletes’ bodies, but going off steroids meant that the athletes started to lose muscle mass. East German athletes snorted andro spray before competing in some cases; the body metabolises the chemical so quickly that it would leave their bodies in hours. Arguably, the entire drug testing regimen of the East German national team was just to figure out who on the national team couldn’t travel abroad to compete because their bodies still had too much of banned substances, so much that they would be caught out by international testing regimens. Andro was one of the tools that the East Germans used to work around steroid bans.

Andro was rediscovered and introduced to the US supplement market in 1996 by Patrick Arnold, an organic chemist and amateur bodybuilder who ended up doing time in prison for his role in the BALCO scandal (see Dohrmann 2006). Arnold, like Victor Conte the founder of BALCO, eventually went to jail when their previously undetectable steroid, tetrahydragestrinone (THG) – called ‘the clear’ by athletes because it didn’t show up on tests – was uncovered by sports governing bodies. The drug was only discovered after a used syringe of the substance was mailed anonymously by a track coach to the U.S. Anti-Doping Agency in 2003. (Patrick Arnold continues to work in the supplement industry; his blog is here.)

In the 1990s, Arnold had been reviewing old patents and research reports on steroids and prohormones that had not gone to market, working on derivatives of these substances to produce both better anabolic compounds and drugs that were not technically illegal or being tested for in screenings. Until 2004, androstenedione, a former pharmacological tool in the East German athletic arsenal, fit the bill.

One of the many ironies of this story is that andro has not been show to work terribly well in carefully controlled studies. Systematic testing as part of the ‘Andro Project’ did not find that the prohormone supplement had an effect on muscle gains over placebos (see Broeder et al. 2000). In fact, a recent review of the effectiveness of various supplements concluded that the evidence that andro could raise testosterone levels was mixed; and that virtually no scientific evidence could be found that andro positively affected young men with normal hormone levels (Kreider et al. 2010). As the authors conclude: ‘Consequently, although there may be some potential applications for older individuals to replace diminishing androgen levels, it appears that prohormones have no training value’ (ibid.: 21).

I’m less skeptical about andro, however, because the sorts of controlled tests of these substances are typically not done on elite athletes; the fitness regimens in the tests really are not that arduous compared to what the East German swimmers or MLB players are going through (see also Hartgens & Kuipers 2004). In contrast, professional athletes are under tremendous physiological stress. In the MLB, for example, players must take the field day after day during the season. McGwire had struggled his entire career with chronic injuries as his body simply couldn’t recuperate from the damage his own musculature could do to it. And that was before he took steroids and andro.

Players’ testosterone levels drop over the course of a professional baseball season, especially as players struggle to keep healthy during the rigorous playing schedule. In these conditions, prohormones may have greater impact on performance as a remedial aid than they would in controlled studies, just as they might aid older men suffering from depleted testosterone levels. The irony is that at athlete like McGwire is probably on the knife’s edge between extraordinary physiological ability and debilitating injury throughout most of their career. With the stresses of competing at this level, the body is one bad night of recovery from going into a game unprepared to play, and suffering a serious injury.

Trying to hold the line

The International Olympic Committee (IOC) established the World Anti-Doping Agency in 1998, to determine which substances should be banned and test athletes for compliance. According to the World Anti-Doping Agency (WADA), ‘doping is fundamentally against the ethos of the spirit of the Olympic Games: the fair play. Many of the prohibited substances and methods are harmful to athletes’ health and can cause short and long-term damage.’ The position is a clear expression of what Peter Kramer, author of Listening to Prozac, refers to as ‘pharmacological calvinism’: ‘a general distrust of drugs used for non-therapeutic purposes and a conviction that if a drug makes you feel good it must be morally bad.’

For WADA, if a drug makes you perform better, it must be bad. The resulting list of banned substances is extensive. The current version runs to nine pages, including a range of anabolic substances, painkillers, sedatives, stimulants, diuretics, narcotics, enhanced oxygen transfer in the blood (blood doping), and masking agents to conceal the use of other substances (Note: live bees and asses’ hooves are not explicitly prohibited).

As John Hoberman (1995) has pointed out, however, WADA, the IOC, and other sporting bodies seek to hold a pharmacological line that is under attack from both inside and out. On the one hand, sports science has advanced to the point where athletes can avail themselves of an enormous range of supplements, interventions, medical treatments, and other procedures; many legal procedures, arguably, ‘enhance performance.’ Drug use has been widespread in sports since the 1960s, as the cases of the East German Olympic team and Major League Baseball in the 1990s make abundantly clear. Even athletes that are scrupulously ‘clean’ in terms of WADA’s guidelines likely receive a cornucopia of supplements, vitamin injections, and other substances that were unimaginable a generation ago. This pressure from within sports, as coaches, team physicians and athletes are under immense pressure to find any competitive advantage, constantly searches for loopholes or legal substances against the efforts of WADA.

The irony has not been lost on observers. In his 2002 obituary for Manfred Ewald, architect of the East German doping program, in The Guardian, Michael Carlson wrote:

Although in recent years international sport has intensified its drug testing policies, Ewald’s legacy remains one of triumph. … scientific training regimes are now the norm in all world-class sport, with support staffs outnumbering coaches, and centres of excellence taking on children at a younger and younger age. The goal may have changed from glorifying the state to making a profit, but the methodology remains worryingly familiar.

Kornelia Ender

But the pressure from outside WADA, from the public, also undermines the ‘just say no’ approach. In fact, one of the difficulties I had when lecturing on the subject is that the photos of East German women swimmers, the Wonder Girls, no longer evoke much surprise at all. When I showed photos of swimmers Kornelia Ender and Rosemarie Kother, whose musculature once scandalised audiences, students are underwhelmed. They’re accustomed to seeing women who have even more impressive physical development, even actresses and ‘fitness models’.

The widespread use of diuretics in bodybuilding, for example, has accustomed audiences to a degree of muscular ‘shredding’ – the visible appearance of striations and veins – that would have appeared freakish twenty or thirty years ago. A photo I showed of a bodybuilder and model from the 1950s, for example, looked comically underdeveloped (and the female model also had none of the enhancements we have come to expect in ‘glamour’ photography). Virtually any actor in an ‘action’ role, even Hugh Jackman, typically appears larger on screen than a ‘bodybuilder’ from before the Roid Age.

Similarly, even children’s toys increasingly offer examples of extreme muscle hypertrophy. Pope and colleagues (1999) found that, over the previous thirty years, the musculature of ‘action figures’ like G. I. Joe had increased markedly. Some of the male action figures had biceps larger than their waists and bodily proportions beyond the most muscular bodybuilders. The researchers found that even Star Wars action figures had been given a redesign, providing Luke Skywalker and Han Solo with bodybuilder chests and arms.

In this sense, we are still very much in the Roid Age, even if the athletes themselves may be ‘clean’ and well tested. The public has come to expect the types of bodies that steroids produce. Even if our athletes are not using illicit drugs, they are getting similar effects out of comprehensive conditioning and dietary programs. The gap between ‘juiced’ performances and those done by the rules are decreasing statistically. And the types of bodies being produced without use of banned substances are as astounding as those birthed from illegal steroids: linemen in the NFL are bigger than ever; female swimmers on the Australian and US national teams are as fit as the East German women were, and swim faster.

Is it ‘performance enhancing’ if there’s no performance?

The increasing expectations we have for our bodies has led to the spread of ‘performance enhancing’ drugs into areas of our lives where, arguably, there’s no ‘performance’ to ‘enhance.’ In Australia, steroids are the fastest growing category of controlled substance being interdicted by Customs, especially as they are now being ordered online and delivered through the postal system. Among the heaviest users are bodybuilders, members of bikie gangs (Australia’s stronghold of organised crime), private security ‘bouncers’ (also connected to bikie gangs), and police officers (yeah… that’s awkward).

Some bodybuilders get around Australian laws by going on ’steroid vacations’: trips to Thailand, especially, where they can freely purchase anabolic steroids, human growth hormone, and other substances at local pharmacies (see Duff 2012 if you really want to know more). The Australian ‘steroid vacation’ even has its first casualties: in 2011, Aziz ‘Zyzz’ Shavershian, one of Australians most famous amateur bodybuilders, died of an ‘undiagnosed heart condition’ in a Bangkok sauna. More recently, one of the bodybuilders featured in Duff’s story about expatriates ‘juicing’ in Thailand, Tim Sharky (born Ward Timothy John in New Zealand), formerly a loan shark in Australia’s Gold Coast, was arrested for allegedly stabbing a Canadian teacher (Angry Kiwi Beefcake Stabs Canadian English Teacher In Pattaya).

This is the outside pressure that John Hoberman (1995) points to on the use of performance enhancing drugs in sport. Increasingly, testosterone is being used as a form of therapy, initially for men suffering from hypogonadism or conditions like testicular cancer, but now to delay the normal endocrine effects of aging. Some proponents of male hormone replacement therapy argue that men undergo ‘andropause’ (or ‘mano-pause’) just as women undergo menopause, and that the condition should be treated if it causes symptoms like loss of libido, decreased erections, muscle loss, depression, nervousness, or mental issues (like forgetfulness or difficulty concentrating). Author and therapist Jed Diamond is probably the best known advocate of recognising ‘male menopause’ and treating the condition, primarily through diet, exercise and stress management. Other specialists are more likely to advocate testosterone replacement therapy.

In his book, Testosterone Dreams, Hoberman (2006) points out how the pervasiveness of testosterone for bodybuilding and anti-aging therapy erodes the legitimacy of keeping the drugs out of sports:

Such scenarios show how hard it can be to determine where therapy ends and performance enhancement begins. This uncertainty about the boundary between healing and enhancement changes our sense of what is “normal” and what is not. If I become fatigued while my drug-taking coworkers stay alert, their “supernormal” stamina may well recalibrate the very idea of normal functioning. Their greater productivity might eventually legitimize their doping habit and make it compulsory for everyone. In this work environment, it is the drug-free worker who is in a state of deficiency.

As muscular hypertrophy, even for men in their 50s and 60s becomes more and more normal and desirable, we should ‘listen to steroids,’ as Hoberman (1995) suggests. What the trajectory of steroids tells us is that, given the technology to ‘enhance’ ourselves, many of us will choose to do so, even if there are legal and medical risks involved. We will tend to force our bodies to conform to our ideals, often focusing more on appearance and pleasure than on health or long-term outcomes.

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.

Thanks for reading this far. This piece is still a bit of a work in progress, so I’d be delighted to hear what you think. With the work of John Hoberman and others, I’m reluctant to work the piece up into anything too academic as I feel there is little need to duplicate his work. If you’re looking for more on the subject, I’d strongly recommend his book.

Additional links

PBS Secrets of the Dead. ‘Doping for Gold.’
Documentary on the use of steroids by East German national teams.

Historical Timeline
History of Performance Enhancing Drugs in Sports at ProCon.org

State-Sponsored Drug Use Has Tarnished the Olympic Games by Richard Panek
Originally published in Women’s Sports & Fitness, May/June 1999. (An excellent piece that made me hesitate to publish this less well-developed article.)

Profile for Jed Diamond at Men Alive

References

Balko, Radley. 2008. Should We Allow Performance Enhancing Drugs in Sports? Reason (23 January 2008) Available at: http://reason.com/archives/2008/01/23/should-we-allow-performance-en/singlepage Accessed on 13 June 2012.

Broeder CE, Quindry J, Brittingham K, Panton L, Thomson J, Appakondu S, Breuel K, Byrd R, Douglas J, Earnest C, Mitchell C, Olson M, Roy T, & Yarlagadda C (2000). The Andro Project: physiological and hormonal influences of androstenedione supplementation in men 35 to 65 years old participating in a high-intensity resistance training program. Archives of internal medicine, 160 (20), 3093-104 PMID: 1107473

Brooks, Will. 2008. Sammy Sosa, Mark McGwire Changed the Game for the Better. Bleacher Report (12 Nov 2008)  http://bleacherreport.com/articles/81049-sammy-sosa-mark-mcgwire-changed-the-game-for-the-better. Accessed 9 June 2012.

Carlson, Michael. 2002. Manfred Ewald: East Germany’s drug-based sports mastermind (obituary). The Guardian 29 October 2002.
http://www.guardian.co.uk/news/2002/oct/29/guardianobituaries.sport Accessed on 29 May 2012.

Diamond, Jed. 1998. Male Menopause. Naperville, Ill: Sourcebooks.

Dohrmann, George. 2006. Is This Dr. Evil? Sports Illustrated (9 October 2006) http://sportsillustrated.cnn.com/vault/article/magazine/MAG1104278/1/index.htm. Accessed on 14 June, 2012.

Duff, Eamonn. 2012. Steroid Vacation. Sydney Morning Herald. 27 May 2012. http://www.smh.com.au/national/health/steroid-vacation-20120526-1zblt.html Accessd on 7 July 2012.

ESPN. 2010. McGwire apologizes to La Russa, Selig. ESPN. com. 12 January 2010. http://sports.espn.go.com/mlb/news/story?id=4816607. Accessed on 29 May 2012.

Florie, Bryce, as told to Buster Olney. ‘I’ll wonder the rest of my life.’ ESPN.com. http://sports.espn.go.com/espn/eticket/story?page=steroids&num=15.  Accessed on 13 June 2012.

Galbraith, Kate. 1998. Is Mark McGwire on Steroids? Slate (25 August 1998). http://www.slate.com/articles/news_and_politics/explainer/1998/08/is_mark_mcgwire_on_steroids.html. Accessed on 10 June 2012.

Halverson, Joe. 2011. Pud Galvin: The Godfather of Juicing. Bleacher Report (15 January 2011). http://bleacherreport.com/articles/573866-pud-galvin-the-godfather-of-juicing. Accessed on 11 June 2012.

Harding, Luke. 2005. Forgotten victims of East German doping take their battle to court. The Guardian (1 November 2005). http://www.guardian.co.uk/sport/2005/nov/01/athletics.gdnsport3 Accessed on 29 May 2012.

Hartgens F, & Kuipers H (2004). Effects of androgenic-anabolic steroids in athletes. Sports medicine (Auckland, N.Z.), 34 (8), 513-54 PMID: 15248788

Hoberman, John. 1995. Listening to Steroids. Wilson Quarterly 19(1): 35-45.
_____. 2006. Testosterone Dreams: Rejuvenation, Aphrodesia, Doping. Berkeley: University of California Press.

Janofsky, Michael. 1991. OLYMPICS; Coaches Concede That Steroids Fueled East Germany’s Success in Swimming. The New York Times 3 December 1991. http://www.nytimes.com/1991/12/03/sports/olympics-coaches-concede-that-steroids-fueled-east-germany-s-success-in-swimming.html. Accessed on 10 June 2012.

Kettmann, Steve. 2000a. E. German Olympic Dopers Guilty. Wired (18 July 2000). http://www.wired.com/politics/law/news/2000/07/37631  Accessed on 29 May 2012.
_____. 2000b. Girlz II Men. Berin Dispatch. The New Republic (3 July 2000).
http://www.tnr.com/article/politics/75138/girlz-ii-men Accessed 29 May 2012.

Kramer, Peter. 1993. Listening to Prozac. New York, NY: Viking

Kreider, Richard B., Colin D Wilborn, Lem Taylor, et al. (2010). ‘ISSN exercise & sport nutrition review: research & recommendations.’ Journal of the International Society of Sports Nutrition 7:7. Available at: http://www.jissn.com/content/7/1/7.

Longman, Jere. 2004. ‘DRUG TESTING; East German Steroids’ Toll: ‘They Killed Heidi’. The New York Times.’ The New York Times (26 January 2004)
Accessed at: http://www.nytimes.com/2004/01/26/sports/drug-testing-east-german-steroids-toll-they-killed-heidi.html?pagewanted=all&src=pm Accessed on: 29 May 2012.

Ostojic, Sergej M., Julio Calleja-Gonzalez and Marko Stojanovic. (2011). Steroid Prohormones: Effects on Body Composition in Athletes, Steroids – Clinical Aspect, Prof. Hassan Abduljabbar (Ed.), ISBN: 978-953-307-705-5, InTech, Available from: http://www.intechopen.com/books/steroids-clinical-aspect/steroid-prohormones-effects-on-body-composition-in-athletes.  Accessed on 15 June 2012.

PBS. 2008.  Doping for Gold. Program transcript. http://www.pbs.org/wnet/secrets/transcripts/doping-for-gold-program-transcript/95/. Accessed on 10 June 2012.

Pope HG Jr, Olivardia R, Gruber A, & Borowiecki J (1999). Evolving ideals of male body image as seen through action toys. The International journal of eating disorders, 26 (1), 65-72 PMID: 10349585

Schmidt, Michael S. 2009. Sosa Is Said to Have Tested Positive in 2003. The New York Times 16 June 2009. http://www.nytimes.com/2009/06/17/sports/baseball/17doping.html?ref=sports. Accessed on 10 June 2012.

Summers, Juana. 2010. Missouri Legislature strips Mark McGwire’s name off Interstate 70. STLToday.com (14 May 2010).  http://www.stltoday.com/news/local/govt-and-politics/missouri-legislature-strips-mark-mcgwire-s-name-off-interstate/article_5291b065-f434-5f5d-b9d3-8afa475ca1e4.html#ixzz1xRO1z6Yp. Accessed on 11 June 2012.

Swift, E. M. 2003. Bodies Of Evidence. Sports Illustrated.
Accessed at: http://sportsillustrated.cnn.com/vault/article/magazine/MAG1028547/index.htm Accessed on: 29 May 2012

Verducci, Tom. 2012. To Cheat or not to Cheat. Sports Illustrated. (29 May 2012) Accessed at: http://sportsillustrated.cnn.com/2012/magazine/05/29/baseball.steroids/index.html. Accessed on: 7 July 2012.

Wilstein, Steve. 1998. Legal in Baseball: McGwire uses nutritional supplement banned in NFL. Sports Illustrated (CNN) (22 August 1998). http://sportsillustrated.cnn.com/baseball/mlb/news/1998/08/22/mcgwire_supplement/. Accessed on 10 June 2012.
_____. 2010. Ban McGwire from Baseball. CNN Opinion (12 January 2010) http://articles.cnn.com/2010-01-12/opinion/wilstein.mcgwire.ban_1_steroids-and-human-growth-androstenedione-fame-ballot?_s=PM:OPINION. Accessed on 10 June 2012.

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29 Responses to Roid Age: steroids in sport and the paradox of pharmacological puritanism

  1. Jon Marks says:

    Nice piece. A couple of typos: “just so no” and “by” for “but” somewhere. I’m still fascinated by roids in baseball, from the standpoint that it is really, really hard to hit a 3-inch sphere coming at you at 90 mph with a wooden cylinder. It takes amazing eyesight and coordination. Players go into a horrible slump because some minor aspect of their swing or stride or stance is off by a tiny bit. Bulking up suddenly has to affect your swing; it can’t be just the same swing with more oomph. So in a sense I’m very impressed with McGwire and Sosa.

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    • gregdowney says:

      Thanks, Jon
      Tried to fix it up.

      Good point though about altered body dynamics. That would be a day-to-day problem constantly for the body to cope with, as muscle fatigue, etc. would be constantly changing the ‘baseline’ active body. It would be more pronounced in steroid users, like it is in adolescents during growth spurts. I hadn’t thought of it, but you’re right: imagine how Bonds would have had to readjust going into his record-breaking season. His body had changed so much!

      Obviously, I’m still very impressed with McGwire and Sosa. Even after the research, I still haven’t come down hard one way or the other on the implications.

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    • Eee says:

      Strength doesn’t allow you to hit the ball better, but speed does. Bat speed is a huge part of being able to hit a baseball, and to hit for power. Better bat acceleration allows you to wait longer on pitches, which allows you to make good contact on more pitches. The contact you do make will be more powerful. In addition, you have the added benefit of less fatigue going through the season.

      Professional baseball players tend to have ridiculously good eyesight and hand-eye coordination already; if you don’t have that, then no amount of steroids will make you a major leaguer. But if you’re already at a professional level, then the incremental gains you get on various fronts can rocket you from mediocre to All-Star quality.

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  2. daniel.lende says:

    Great post, Greg. Really enjoyed the writing in this one.

    So, comments. I guess I’ll stick to three: (a) classic anthro analyses to do on roids/enhancement; (b) injury management and recovery as central new area for these technologies and how we use and think with them; and (c) on achieving enhancement, and what that takes.

    The first thing I was struck by in the piece was how one central dynamic you described – increased regulation of elite athletes with an eye on “fairness” and joe-shmoo being able to enhance away – relates to work in anthropology on jealousy, shaming, fairness, and the like. There are some striking parallels – of how we admire and secretly are jealous of these paragons of physical virtue and sports achievement – and react with such emotion and meaning when they aren’t doing things the way we perceive culturally as being fair.

    What is interesting, however, is that we achieve social regulation in ways typical of our societies – bureaucratic regulation, shaming through the media, and striking from the public record.

    At the same time, I was struck by what is considered appropriate vs. inappropriate for enhancement plays on typical tropes of inner/outer and biological/social. Inner biological enhancement is a no-no; outer biological enhancement, like the sleeping chambers, is okay. Blood transfusions, taking the athlete’s blood out and then reinjecting it at a crucial point, violates that inner/outer dynamic. So I think there is some really good ground you could explore there.

    Onto (b): injuries and healing/recovery vs. enhancement. I was really taken by your argument about this approach over a baseball season. Michael Phelps has said something very similar about sleeping in one of those high-altitude chambers to aid with recovery. Floyd Landis’ use of testosterone (and whatever else) to recover from a bad day on the Tour and then put in an absolutely incredible day cycling the next day could be seen in that light (that attack still remains incredible in my mind, I remember how exciting it was to follow it because of how it played into the strategies and tactics that the Tour cyclists and teams use…). And for recovery, we get precisely into the grey area between healing and enhancement. So I think a lot of arguments will happen here next.

    And a technology game-changer here could be stem cell therapy, or gene therapy, where the athlete’s own stem cells are generated outside the body and then injected into the athlete to aid in recovery, particularly with injuries to tendons and nerves and so forth that don’t heal “naturally” as quickly as sports seasons go by. Peyton Manning supposedly did this for his neck, going to Europe from the US, where he could get the experimental therapy. So I expect the money and prestige and science and expertise involved in sports will be one thing that really drives along the expansion of stem cell therapy in everyday life.

    And my final point, (c) on enhancement. I do find it striking how you highlight that nowadays athletes can achieve physiques through training, nutrition, etc. that once would have been freakish, only seen as available through “natural gifts” or through steroid enhancement (or both!).

    That resonates with my work in addiction, particularly in therapy, where recovering people often have to learn that the consequences from use aren’t worth it (echoing the East German athletes) and, equally important, that they can achieve desired states in their lives without using drugs. It just takes more work, and often more patience. They can’t take the immediate short cut. But often times for people who use drugs, their lives are so damaged socially and structurally that it is very difficult for them to get to what we might (and they might) consider normal. So drug use makes a certain amount of sense, since their lives are often so overwhelming anyway (in part because of use, but also because they have so many of what get called “risk factors” – it is just that much harder to put together a stable life that feels at least decent). And particularly in the US, where drugs are used in such functional ways all the time, this sort of idea – of getting a desired state through a long series of steps – is often very hard for people to grasp. Depression? Oh, here’s the drug for that…

    I was struck by your evocation of the science and technology approach of Manfred Ewald, and how that has basically been disseminated everywhere now. That’s the larger point that is missing in most analyses of steroids and enhancement. This sort of technology/economic/social approach seems perfectly “normal” to us, and is often unquestioned – it’s the way you win, the way you get better, it’s admired – science and technology and money and expertise save the day! Very ethnocentric.

    Of course that viewpoint also misses that science/technology/money/expertise are so unequally distributed both within and across societies that our sense that this approach is both fair and good is almost laughable.

    A NYT article on The New Elitists resonates with that – the individual achievement is highlighted, and often democratized; but the structures that sustain that ability to consume, achieve, and so forth are left hidden. As Shamus Khan writes:

    And so if elites have a culture today, it is a culture of individual self-cultivation. Their rhetoric emphasizes such individualism and the talents required to “make it.” Yet there is something pernicious about this self-presentation. The narrative of openness and talent obscures the bitter truth of the American experience. Talents are costly to develop, and we refuse to socialize these costs. To be an outstanding student requires not just smarts and dedication but a well-supported school, a safe, comfortable home and leisure time to cultivate the self.

    For me, it’s not quite that we refuse to socialize these costs, but that we socialize them in such a way to reinforce individual self-cultivation. Those that can develop the talents, with the time and effort and money (and drugs and gene therapies as permitted/not censured) that entails, do so. The rest of us? Well, there must be some sort of trickle down effect, sorry, global diffusion, right?

    A comment almost as long as your post! Ha!!

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    • gregdowney says:

      Thanks, Daniel. I’ve had to read that twice, and probably still haven’t digested it all.

      Interesting point about the socialisation of the costs but the ideology and image of the individual athlete’s achievements. It’s something I’ve really been thinking about in fight sports, where the individual appears so isolated and yet depends so heavily on the corner and on the patterns and responses instantiated in cooperation with sparring partners, coaches and other individuals.

      The example of how the East German sports support model has spread even while most observers condemn the East Germans is especially intriguing to me because Australia was one of the first Western countries to adopt the Soviet bloc model of the sports institute. I was just talking today with a couple of coaches about how that model was affecting their sport — it tends to narrow the talent base although it throws resources at young people who show special promise. The result isn’t always the greatest ‘trickle down’ or ‘diffusion,’ as you point out. Far from it.

      Finally, the ‘recovery’ vs. ‘performance enhancing’ distinction can get so murky. For example, corticosteroids like cortisol, ideal for anti-inflammation and pain relief, are often legal in sports — we even hear of players getting shots of cortisol at a break in a game to be able to play on with injury. Arguably, though, it’s precisely this sort of playing while injured, a kind of artificial recovery, that may hold some of the greatest dangers for the athletes. They go back into the action carrying serious problems — concussions, severely compromised joints, broken bones — and risk something far more debilitating.

      If we base our guidelines on harm reduction, we may have to be willing, as spectators, to forgive athletes for NOT showing resilience. Right now, the sporting public in the West, I think, over-values the ability to play while hurt. We may have to acknowledge that they are human and encourage them to take better care of their bodies.

      Yeah, I know, I’m not holding my breath…

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  3. Thank you, Greg, for a wonderful tour through the history of performance enhancement and ‘pharmacological calvinism’!

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  4. Vishwanath says:

    Nicely researched. Thank you.

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  5. I echo the comments above–nicely done article–and raise one additional consideration: the spotlight on high-achieving women in track and field and in basketball whose masculine attributes may reflect endogenous, not exogenous, variation in androgens. In these instances, should these individuals, who gender-identify as females, be banned because of the advantage conferred because of naturally elevated T? If so, does this somehow unfairly single out T because it is the “male” hormone (which it is not)? If not, do WADA and other governing bodies begin to set limits for natural variation in GH and other endogenous hormones that confer an athletic advantage in specific sports?

    Finally, one note, while I think a discussion of the validity of AAS use in adults is one that should be open (especially given the aggressive ad campaigns for Low T and the like for non-athletes), the data cited here on the East German program (also Franke and Berendonk, 1997) underscore the fact that adolescents should be outside of this discussion– a point in which those with whom I have spoken who support AAS use agree and is evident, even if ironically so, in the interview of Chris Bell’s brother (Mike or Mark, forgotten which one) and his high school football team in Bigger, Stronger, Faster.

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    • gregdowney says:

      Leslie –

      A couple of great points and even more good questions. From what I’ve read about ‘sex checks’ in the history of the Olympics, it’s a fraught field, littered with ruined careers and dubious decisions, nevermind the fact that for a long time the tests were just plain humiliating. There was even a case of a woman who was disqualified for ‘not being a woman’ who soon after went on to have a child. Presumably, the officials who threw her out should have paused to think about what they were doing.

      We had a great documentary on SBS here in Australia recently on the case of Caster Semenya in South Africa. My heart broke for her, as she was getting kicked around so much by sporting officials. The delays in deciding alone were probably more than a person had to bear.

      I’m not 100% sure about how sex is tested in female athletes now. Judging from what happened to Semenya, I’m not sure the officials know either, or that it’s consistent. I do suspect a high T count would trip alarm bells, but the same is true with a high T count or testosterone-epitestosterone ratio in male athletes.

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  6. David Taylor says:

    I enjoyed this essay and found it very informative. As a cardiologist, I am interested in cardiovascular issues in high stress athletics, and “performance enhancing” drugs have a long history of pathological effects on athletes who use them.

    But — and I may be missing something here, not being an anthropologist — the question you raise, why do we ban steroids in sports but embrace them to counteract the effects of aging, seems simple to me. The key is competition. We try to create the illusion of a level playing field in competitive sports (we even use the sports metaphor of a level playing field), allowing the notion of ‘natural’ physical talent to be the key to competitive success. I know that there are many ways in which this idea is compromised, but we recognize these as compromises. Improving your sex life is not part of a competition, and there is nothing at stake: no one cares except you and your partner(s).

    Again, I acknowledge my naivete here, so forgive me if my point seems simplistic.

    As a final thought, however, I wonder if some of the cultural calculus that other comments allude to here might also embrace a wider variety of “performance enhancing” body techniques. Where does cosmetic surgery fit into this, if you’re a 22 year old woman who has been advised that your film career prospects will be enhanced with a little augmentation here, a bit of a nip there? Will we start asking all job candidates to wear exactly the same clothes? Am I getting silly?

    Thanks again for a fascinating essay.

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    • gregdowney says:

      Thanks, David, and yes, I do think you’ve got the point. The ideology of ‘fair play’ is so important that, even when we’re actually overlooking enormous loopholes, we fight for it as a society. That’s a cultural value, and not at all an obvious or natural or inevitable. And you’re right, the ideology of ‘fair play’ kicks in other places, but also abandons us in others.

      John Hoberman, whose work on this was really interesting to me, points out that orchestral musicians are also frequently abusing performance-enhancing drugs (including some to deal with anxiety and stage fright). And they are certainly competitive, including even blind auditions for seats in the orchestra. Hoberman also points out that they have reduced life expectancies, patterns of chronic injury, a win-lose system of auditions and performance reviews,… And yet we don’t drug test concert musicians. We also don’t drug test lots of other people who are in competitive fields — no drug tests for applicants for major research grants, no drug tests for commodities traders (although they might need them).

      We do drug test some very specific people who have high risk jobs, but professional athletes, who — let’s face it — play bloody GAMES for a living that will affect no one’s survival, we test into the ground, and then punish them brutally if they prove to be ‘dirty.’ You’re not being silly at all; you’re doing exactly what I would do as an anthropologist to try to see more clearly the peculiarity of the obvious. That is, it makes complete sense to drug test athletes to me as a sports fan, but why? To begin to peel back that common sense ‘of course’-ness about drug testing is to begin to see more clearly what’s at stake culturally. And also the way that our category of ‘fair’ and ‘dirty’ can sometimes be hair-splitting.

      So thanks for playing along with the anthropologist in me. Sometimes the simplistic points are actually quite weird when we take a step back. That’s one reason I love being an anthropologist and think that it can help us to see ourselves more clearly (as well as some other cool things too, like understand other people’s weird ideas).

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      • David Taylor says:

        Thanks Greg — your note makes fascinating points for this interested lay person, and you are absolutely correct; I’ve even been asked to prescribe beta blockers for musicians (I declined), and I always thought of this kind of performance as comparable to the sexual performance you mention, but it did not occur to me that musicians are also competing with one another for movement from last chair to first, etc.

        Again, this is a really interesting topic and an excellent essay that opens the eyes of many of us who have a vague sense that we apply standards in a very lumpy way, without understanding why. Medicine seems almost simple in contrast to these complicated cultural and social issues!

        I saw the link to this column on the Browser website, and I do hope that your essay gets the very wide reading that it merits. Thanks again.

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        • gregdowney says:

          David, you’ve made my day! One of the reasons that I got started blogging was because I didn’t think enough people in the general public were getting a chance to see how anthropologists thought about things. I know it’s odd, but — like other scientific and philosophical perspectives — it can be a really powerful way to analyze problems, maybe even see some dimensions that aren’t obvious otherwise.

          Getting intelligent readers to come along and check it out, to read what we (Daniel and I) write here with our collaborators, and sometimes to push back and question what we’re doing — well, that’s fantastic.

          So please check by with us again and see what else we’re serving up!

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  7. Janis says:

    “We will tend to force our bodies to conform to our ideals, often focusing more on appearance and pleasure than on health or long-term outcomes.”

    If anything better proves better than this statement that what we THINK is “fittest” is not in fact fittest, I have yet to hear it.

    If men’s testosterone levels fall as they age, it is because they are meant to fall. And keeping them from doing so is going against 450,000 years of evolution that has judged otherwise.

    Speaking as a woman, I am flabbergasted that grown men want to enhance what they think of as their manhood by taking a drug that will force them to remain in the most childish period of any man’s life: his 20s. How absolutely horrifying. I cannot imagine being a woman in her 40s trying to raise children in their teens with a husband who is acting no better than a teen himself.

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    • You’ve got it all wrong, ma’am.

      Testosterone levels fall as we age because evolution doesn’t care what happens after your children have been raised. We were designed without a gas pedal or a steering wheel; it mostly goes straight until it doesn’t anymore. There is a “correct” level of testosterone, and health is compromised when we have more or less. Thus, hormone replacement therapy. The goal isn’t to turn us all into raging teenagers, but rather to prevent dying. Your ideal of “evolution knows best” is unfortunate in that it causes millions of preventable deaths every year.

      If you’d like more references on the subject, please take a look at http://www.lef.org/protocols/male_reproductive/male_hormone_restoration_01.htm

      I for one would rather live in a state with a brutal performance enhancing regime than a state with a brutal performance limiting one. Here’s a nice short story to think about: http://www.tnellen.com/cybereng/harrison.html

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      • gregdowney says:

        Fenn –
        Good point, but it’s actually even more interesting that that. In the volume that Daniel Lende and I have coming out next month, Ben Campbell, a neuroanthropologist and researcher who works on some groups in eastern Africa, points out that the particular hormone-age profile of Western, industrialized men may not be universal. That is, among foraging groups and herders who live closer to nutritional equilibrium (that is, they sometimes go hungry), testosterone doesn’t go so high in youth and doesn’t drop off so much as men age.

        If that’s the case (and it wouldn’t surprise me), we could have a situation in men like we do in women, where our diet, sedentary lifestyles, etc. are actually changing our average endocrine profile over our lifespans and convincing us what is ‘normal.’ I’m alluding here to the drop in the average age of menarche, the large number of periods, and the change in the ratio of time pregnant to overall time fertile in Western women.

        Personally, I’m pretty fascinated by this (I suppose that’s why I’m an anthropologist). But if it’s the case, then the particular endocrine profile of being male and being female in places like the US is not ‘natural’ in the sense that everyone has the same profile.

        I’m not really worried about hormone replacement therapy. Naturally, from a global perspective, it probably wouldn’t rank really high as a priority for medical priorities.

        Thanks for the links!

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  8. Pingback: A few recent articles on steriods | Josh Orum

  9. Pingback: The Scienceblogging Weekly (July 13th, 2012) | Social Media Blog Sites

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  13. MosBen says:

    Really fascinating and thorough piece. It’s a topic I’ve tried to broach with my sport-loving and steroid-puritanical friends before. Thanks for such a thought provoking read.

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  14. MarcV says:

    Well organized (and referenced) article, however I am disturbed by the seemingly blase attitude you take to the use of steroids.

    I have taken various testosterone “boosters” over-the-counter despite the face that my testosterone levels are normal. But I do so as I enter middle age as a way to boost my gym workouts (though I’m not a body builder) and in hopes of an increased sex life (none yet). But I wouldn’t take actual steroids.

    Despite all the cataloging you’ve done on the harmful effects of steroids (the German athletes, professional wrestlers, etc), you use a loaded word like ‘pharmacological calvinism’ to criticize those who object to steroid use.

    I don’t quite understand the disconnect. Steroids can cause serious health problems. What is a teenager supposed to think if it is okay for grandpa to get steroid shots or athletes to get pumped up, but they can’t? I see some of these kids at the gym and as they compare themselves to others you just know they would jump at the chance to take steroids.

    Doctors are getting into the game for the profit motive. My own doctor offered to treat me with them despite my normal testosterone levels. I see many doctors in Florida eager to give them to any man complaining of fatigue or low libido. Is it right? Instead of suggesting that sports should allow steroids since so many civilians are taking them, isn’t it prudent to question the wide-spread use among “civilians”?

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    • gregdowney says:

      Marc –

      Virtually any drug can cause health problems, especially when used following the advice of other adolescents or amateurs, without medical guidance, and self administering. And you’re absolutely correct: the problem with the East German program wasn’t just that they were using steroids, as I tried to point out very clearly — it was massive doses of steroids (really massive) at a very young age, and particularly damaging to young women because of their known androgenic effects (although the suicide rate among the former male athletes was also profoundly worrying).

      Steroids ARE banned. And they’re especially banned for athletes, who undergo regimes of drug testing unlike anything else any other profession is forced to undergo. They must also submit to tests for non-performance-enhancing recreational drugs, but that’s another story. And yet, at the same time, the use of the same substances (the steroids, I mean) is expanding among non-athletes, especially in the ‘age management’ branch of medicine.

      I didn’t make up the contradiction — I’m just pointing it out. And it’s clear that the ban doesn’t work in many ways (that was the point about ‘steroid vacations’). My piece is not intended to suggest policy, but if you want my opinion, draconian testing clearly doesn’t work, prohibition has failed time and again, and, if steroids really ‘didn’t work,’ as some critics tried to argue, we wouldn’t be having this exchange.

      If you really want to know what I think — as of today, July 2012 — even though I’m in no position to make those sorts of decisions (I’m an anthropologist not a legal expert), I think we should make teams, leagues, owners and team doctors liable for the long-term health of athletes. Tie together the career of the athlete to the people responsible for looking after him or her so that the athlete can’t be discarded. Then, if there’s ever an injury or serious problem later, the ONLY defense for the teams, leagues, and owners (with their deep pockets) will be that they used the best possible medical advice available at the time, and that their first priority was athlete health.

      Then, if a team is using a dubious doctor or pushing the boundaries, the owner stands to lose the entire team in a liability suit. Obviously, there are issues — you’d have to screen complaints and suits — but they’re manageable issues. As long as athletes are disposable humans, as the East German doctor said, then I doubt very much that any sort of ban will work, or that teams will not find young people willing to run the risks. You’ve got to make it in the teams’ financial and practical interest to take care of the athletes.

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      • daniel.lende says:

        Greg,

        I really appreciate your responses to all the people commenting.

        I’m actually glad that Marc pushed you a bit, or the comment I saw on Twitter wanting “a stronger conclusion.”

        I’m beginning to think that many people do want this leadership, that they do want anthropologists to make judgment calls, rather than just saying “it’s complicated.”

        I really liked your comment about “it’s complicated, but here’s a way to think about it…” And you did that in spades in this essay. But obviously people do want more. And as someone who’s advocated for anthropologists to try their ideas out, to insist that we try out what we think will work (and learn from the inevitable mistakes, like so many other fields have), I’d love to hear more about what conclusions you do draw from your review.

        So here’s to making judgment calls. When things are complicated, there will be no right answer. But I do hope we begin to take the risk of giving the answers we think fit the complicated situations we face today.

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  15. Pingback: The marathon & Olympic movement on Huffington Post | Neuroanthropology

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  18. Helen Jennings says:

    i am interested in the side effects of steroids parfticularly corticosteroids and drugs like Prednisone. I would information about this.

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