Tech + Health

09.21.13

Reconsidering the War on Steroids

After a successful bout of testosterone therapy, Jonathan Miller now argues that professional sports should abandon a hypocritical and wholly ineffective testing program.

I’m coming clean: I use performance-enhancing drugs.

Indeed, I’ve had a serious testosterone problem.

Of course, unlike my fellow Jewish recovering politicians  (ahem…Mssrs. Spitzer, Weiner and Filner), my body doesn’t produce enough of the über-manly hormone. A few years ago, I was diagnosed with a free-testosterone level akin to an octogenarian eunuch. Who’d been dead for a decade.

The option of traditional testosterone therapy, however, frankly frightened me. I’d heard the woeful tales of back acne, hair in strange places, ’roid rage, the link to prostate cancer. I also remember vividly football superstar Lyle Alzado’s final days, his brutal death from brain cancer blamed on PED overuse. And as an ESPN Radio addict, I’d been bombarded for years by its omnipresent, perversely mixed messages: the screaming sports-host anti-steroid hysteria, interrupted every 20 minutes by snake-oily “Low T” elixir ads, using the kind of incredulous performance hype that would discomfit even Bernie Madoff.

So I tried an alternative route — medically sanctioned natural vitamins and minerals, prescribed by a well-respected medical doctor, whose practice focused on integrative health.

Nothing. And I was suffering.

While our sex-obsessed culture focuses on the libido-suppressing side effects of a “Low T” diagnosis, the ramifications for me were quite more significant. My immune system was shot; my body had become a petri dish for every new virus of the week. Worse, my mood and energy levels had plummeted: Despite enjoying perhaps the happiest and most successful years of my life, there were far too many mornings when I struggled simply to get out of bed.

So I bit the bullet.

Well, more accurately, I bit my lip every Wednesday and Sunday morning, when I used a tiny insulin needle to inject into my belly fat 0.5 milliliters of a clear, yellow-tinged solution—a blend of testosterone propionate and testosterone cypionate. More recently, nine bio-identical hormone pellets—each the size of a grain of rice–were inserted just under my skin, near my glutes.

There are many cases in which a doctor could conclude that hormone therapy--which helps a person rebuild muscle--is preferable to sport-sanctioned painkillers which might place the athlete at risk of further injury.

In return for the slightest, fleeting discomfort (I’m a baby; but both procedures were less painful than giving blood), I’m rewarded with a measurably higher quality of life. I’m a morning person again, and now have the energy both for a full day’s work and an aggressive exercise routine. I’ve lost weight, I sleep better; and most significantly, my frame of mind is sublimely serene—no Prozac-fueled euphoria, no Lithium-hazed mental dullness—just a rested, clear-headed self-satisfaction.

I’m me again.

I’ve also been buoyed by my simple, myth-shattering research about this “father’s little helper.” The widely publicized steroid-poster-boy horror stories—teen deaths, female athlete disfigurement, Barry Bonds’s gargantuan head. All were the result of PED misuse and overuse. Further, the link to prostate cancer has been vigorously disputed, and any connection to Alzado’s death is less scientifically reliable than Jenny McCarthy’s anti-vaccine campaign.

Indeed, Penn State Professor Emeritus Charles Yesalis, an epidemiologist who’s one of the nation’s most-quoted PED experts, insists that there is “no way, shape or form” that anabolic steroids, even when misused, are “a major killer drug,” such as heroin and cocaine, or even alcohol or tobacco. As with most drugs—Yesalis cites as examples aspirin, ibuprofen, Tylenol, and valium—“you put yourself at risk when you take steroids at high doses for protracted periods of use.” But when used as directed by a physician, schmoes like me, who aren’t naturally producing hormones critical to a healthy lifestyle, can see real benefits with few risks. “The logic of letting people get back to their natural level of testosterone,” Yesalis suggests, “makes common medical sense.”

The case for anabolic steroids becomes even more persuasive in the cases of men who are recuperating from muscle-skeletal surgery or debilitating diseases. Josh Bowen, a nationally celebrated personal trainer, credits judicious anabolic steroid therapy for the healthy recovery of some of his clients: “It speeds the injury process and allows them to get back to normal activities quicker.” And my fellow juicer/blogger Andrew Sullivan has written powerfully about the dramatic quality-of-life enhancements provided by steroids for men like him who are struggling with HIV.

So as Big Sport ramps up its War on Steroids by inflicting ever-more onerous punishments on PED users, it’s quite ironic that its trophy transgressor could possibly have been the exemplar for proper steroid use. Let’s not forget, in 1996, Lance Armstrong lie near death, diagnosed with testicular cancer: a testicle was removed, his lungs filled with a dozen tumors, some the size of golf balls, and lesions were found on his brain. We’ll shed no tears today for the disgraced cyclist because of the way he deceived the public and slandered honest people who came forward with the truth. But professional sport’s zero-tolerance policy toward doping seems draconian in the special cases of athletes recovering from degenerative diseases for which testosterone treatment might serve as an ideal remedy.

Then take the much more broadly applicable case of Ryan Braun. The baseball player admitted to using banned products to facilitate his rehabilitation from a “nagging injury.” While Braun may not be the most trustworthy witness, no one argues that he’s bulked up obscenely like the sluggers of the 1990s, when ’roids were all the rage. And the argument for denying testosterone therapy treatment for injury recovery, while allowing most every other widely accepted treatment, is medically illogical.

First, there are many cases in which a doctor could conclude that hormone therapy—which helps a person rebuild muscle—is preferable to sport-sanctioned painkillers which might place the athlete at risk of further injury. In his recent “The Ethicist” column  for The New York Times’ Magazine, Chuck Klosterman argues that “it’s difficult to explain why we’ve collectively agreed it’s O.K. for an injured football player to take a shot of Toradol to help ignore an injury, but not a shot of testosterone to help that injury heal faster.”

More significantly, PEDs, when administered appropriately, impose significantly fewer health risks than many sports-legal PESs (performance enhancing surgeries). Malcolm Gladwell recently illustrated the strikingly convoluted sports construct that forbids some athletes from overcoming genetic disadvantage through noninvasive, natural treatment, while permitting others to undergo laser eye surgery which imposes a small chance of blindness or Tommy John elbow repair, which raises dangers from infection as well as permanent nerve irritation and numbness.

Ultimately, however, the case against the War on Steroids rests less on debunking the perverse parsing of medical treatments, and more on a simple, indisputable notion: PED testing just doesn’t work.

As the high-profile BALCO and Biogenesis scandals clearly revealed, the underground illegal steroid industry is perpetually a step ahead of state-of-the-art drug testing techniques. It’s no wonder that so many the highest profile violators—Armstrong, Braun, Bonds, Mark McGuire, Sammy Sosa, yada, yada, yada…were outed by testimony, not testing. As Dr. Yesalis concludes, “if you and I had performed our jobs as well as drug testing has, we’d have been fired long ago. All it has done…is provide plausible deniability to journalists and fans who think they are watching clean sports because of drug testing.”

And that’s where we are left. As Klosterman posits, “the motive [of PED bans] is to create a world—or at least the illusion of a world—where everyone is playing the same game in the same way.” And that illusion, of a level playing field, is as fanciful as Kevin Costner’s field of dreams.

So, in the end, the consequences of Big Sport’s War on Steroids are morally antithetical to any notion of fairness, and ethically antithetical to its own purported justification, the long-term health of its athletes. Beneficial testosterone therapy is unavailable to men in precisely those professions that could most take advantage of the recuperative benefits, while the drug misuse and overuse continues, in shady, nefarious settings, enriching illegal suppliers and endangering the health of desperate athletes.