“As I have previously suggested, perhaps the Congress should examine whether the Dietary Supplement Health and Education Act–DSHEA, as it is commonly known–is being adequately enforced,” Fehr said [...]

I have got some news for Donald Fehr: They don’t sell steroids in the supplement aisle. They don’t sell the “cream” or the “clear,” either. That’s because this industry does a better job of policing itself than Major League Baseball ever could.

Clearly, Fehr was disingeniously trying to blame DSHEA for the problem baseball was having with anabolic steroids. He tried to use the supplement industry as a scapegoat for MLB’s problems and it deservedly failed.

But the supplement industry needs to pull their heads out of the stand, stop patting themselves on the back for a job well-done, and respond honestly to criticisms of their industry.

First, they have failed miserably at self-regulating the supplement industry. Steroids are currently sold in the supplement aisle. And they have been for over a decade. They were sold legally under DSHEA up until the loophole was closed by the Anabolic Steroid Control Act of 2004. They were even sold using pharmaceutical delivery methods most likely not permitted by DSHEA. And since 2004, supplement companies have continued to sell designer steroids. Supplement industry expert, William Llewellyn, clarified this for me in his comments to a previous post:

Designer steroids are still sold, as has been discussed above. SOmetimes they are not labeled as ingredients, but most often they are clearly listed. The fact remains, however, that synthetic designer steroids are considered unapproved new drugs, and are NOT covered by DSHEA as legal dietary supplements. Patrick Arnold was charged, and served time, for such a crime – no new law needs to be passed to address this.

Andro, norandro etc were covered by DSHEA because you could find them in most animals, and hence in the food supply. No animals, plants, etc naturally produce DMT, Epistane, methyl, 1-4ADD, etc etc.

I am sure there are only a few companies flaunting DSHEA and this doesn’t reflect the practices of the entire industry. But my point is that the industry is NOT doing a good job self-policing itself because the practice continues unabated.

Furthermore, significant percentages of dietary supplements have been reported to be contaminated with anabolic steroids and stimulants that are not disclosed in the ingredients. It would be nice to share my protein shake with my 6-year old daughter without worrying about the possibility of contamination due to poor quality control.

If the supplement industry is content to ignore the problem of poor self-regulation, then they share in the blame should a backlash against DSHEA occur as a result of the present-day steroid hysteria.

The next time you hear an “industry expert” say something like this (“Major League pain for supplements,” February 11)…

They don’t sell steroids in the supplement aisle.

Or this…

Anabolic steroids are not dietary supplements and dietary supplements are not anabolic steroids,” said Council of Responsible Nutrition president Steve Mister.

…please ask them to be honest for the sake of the future of DSHEA. Steroids and designer steroids are and have been sold, legally and illegally, as dietary supplements.

But I have to give credit to Rob Eder. In his closing comments, he sarcastically suggested that Fehr donate $20 million to help the FDA enforce DSHEA.

So where exactly did Fehr think the government would get the money to conduct that kind of an investigation? Rather than spend $20 million to pay for former Sen. Mitchell’s investigation, why not just donate the $20 million to the Food and Drug Administration whose job it is to police the dietary supplement industry? Contrary to popular belief, DSHEA absolutely grants FDA regulatory authority over the dietary supplement industry.

If MLB was really concerned about what products the FDA allows to come to market, they’d spend the $20 million to lobby Congress for a greater annual budget allocation for FDA.

Bravo. Illegal or undisclosed steroids in our dietary supplements is more important than the voluntary use of steroids by professional baseball players. It is time that Congress reevaluate their priorities. I like DSHEA. It just needs to be enforced. It is clear that the supplement industry can’t regulate itself as they are not even aware of any problems. Rather than waste money on steroids in baseball, federal money would be better spent enforcing a good law like DSHEA and making our dietary supplements safe.

Sen. George Mitchell’s 409-page report on performance-enhancing drugs in baseball describes a thriving underground market for steroids and human growth hormone. What began with just a few players and trainers expanded into a network of dozens, if not hundreds, of professional athletes. That network grew year by year as the players referred their friends and teammates.

Below, we present the findings of the Mitchell report as a social network. Players are connected to the person who first introduced them to the Mitchell report’s star witness, Mets batboy turned personal trainer Kirk Radomski. In some cases, players met Radomski directly; in other cases they are several degrees apart. The statistical and visual analysis that went into making this chart was done using SocialAction, a software tool developed by Adam Perer and Ben Shneiderman at the University of Maryland’s Human-Computer Interaction Lab.

How many degrees of separation between every baseball player in the steroid social network?

The customary practice for federal prosecutors is to prosecute dealers rather than users. In a reversal of this practice, Radomski was given leniency in exchange for his testimony against his clients (individual steroid users who happened to be professional athletes).

Frank Bowman, a former prosecutor and current law professor at the University of Missouri-Columbia, justifies this approach:

Federal prosecutors customarily prosecute dealers rather than users primarily because dealers are considered more culpable. Dealers are the rich, bad-guy beneficiaries of others’ weaknesses, while users are destitute victims or inconsequential saps. Dealers affect many people. Users affect only themselves.

The hierarchy of the performance-enhancing drug market for professional athletes is exactly the reverse. The balance of power, money, and culpability lies with the players in their relationships with guys like Roger Clemens’ trainer Brian McNamee or former Mets clubhouse attendant Kirk Radomski. McNamee’s and Radomski’s continued employment in and around the major leagues depended on the favor of players, particularly stars. The nobody suppliers made a few thousand in pin money for supplying the juice. But the real financial gainers were the players: Drugs allowed them to cheat their way into the majors or to enhance and prolong careers worth millions of dollars. If relative culpability is to determine who is prosecuted and who is allowed to go free, it’s the players who should be indicted.

The other reason federal prosecutors ordinarily go after dealers, not users, is to have a greater effect on drug markets. But if one really wanted to stop the use of steroids in baseball, which is likely to be more effective—cooperation deals with a few locker room enablers, or the spectacle of big leaguers in prison stripes rather than pinstripes?

The end result is the same for the government snitch as the Drug Law Blog points out:

[T]he person who flips on their colleagues and friends is richly rewarded in our criminal justice system.

Now, Kirk Radomski is free to exploit his steroid infamy and sign the million dollar book that he bragged would overshadow Jose Canseco’s Juiced.

In other news, a teenager is facing 20 years in prison for selling steroids.

The report also uses statistics to show that Clemens’ performance had unpredictable “ups and downs” or “peaks and valleys” over the course of his career. The report asserts that “straight trend lines in performance” simply do no exist in Major League Baseball.

It suggests that variations in Clemens’ performance were similar to other notable pitchers, including Curt Schilling, who had their best “qualitative performances” later in their career. Schilling has frequently prodded Roger Clemens to come forward and tell the truth (presumably about his steroid use).

The reports also notes that Clemens career after age 40 is not an aberration in Major League Baseball; dozens of Hall of Fame pitchers have pitched well into their 40s.

The clear intent of this report is to refute allegations of steroid use by Roger Clemens in the Mitchell Report. The Roger Clemens report does an excellent job of suggesting that their are many factors that contributed to Roger Clemens late career success. But even as much as the general public and media love single cause theories e.g. steroids were THE reason for Roger Clemens success, I find it hard to believe the public will embrace a competing single cause theory e.g. the split-finger fastball was THE reason for Roger Clemens late career success!

Frank Bowman, a former prosecutor and current law professor at the University of Missouri-Columbia, posted some interesting thoughts on the matter on Slate. The Justice Department’s behavior is problematic when it comes to “grand jury secrecy laws” and its policy on “uncharged third parties”:

A mere allegation of criminal wrongdoing coming from government sources can wreck a life or a career. If formal charges are filed, the defendant will at least have his day in court to admit or attempt to disprove the government’s case. But if the allegation comes in a report issued by the private sector, but engineered by the government, the reputational damage is done, and the defendant has no forum in which to contest it.

For precisely this reason, by law, federal grand jury proceedings are secret to protect the reputations of those who are investigated but never prosecuted. Historically, Department of Justice policy has been even more sensitive to these interests. In public filings and proceedings, the DoJ’s Principles of Federal Prosecution require prosecutors to “remain sensitive to the privacy and reputation interests of uncharged third-parties,” which “means that, in the absence of some significant justification, it is not appropriate to identify … or cause a defendant to identify, a third-party wrongdoer unless that party has been officially charged with the misconduct at issue.” (The italics are mine.)

Technically, the deals requiring McNamee and Radomski to cooperate with Mitchell probably don’t violate grand jury secrecy laws, because those laws bind prosecutors, agents, and grand jurors, but not witnesses like McNamee and Radomski. And technically, those deals might not have violated DoJ policy on uncharged third parties, inasmuch as Clemens and other players weren’t actually named in official filings or in a federal courtroom. But using plea bargaining leverage to require witnesses to divulge to Mitchell the names of people the Justice Department never intended to prosecute surely violated the purposes of both grand jury secrecy law and DoJ policy.

The requirement for Radomski and McNamee to cooperate with Mitchell was clearly outlined in their plea agreements: 

I will cooperate with non-governmental anti-doping agencies at the direction of the government. I understand that this cooperation may include interviews, statements, or other proceedings.

Frank Bowman goes on to suggest that this potential abuse of government powers is serious enough for Congress to call a formal investigation.

Now, if you think that Professor Bowman is somehow sympathetic to Major League Baseball players who have used anabolic steroids or growth hormone, think again. Bowman believes the “hierarchy of the performance-enhancing drug market for professional athletes” is such that federal prosecutors should primarily target the “athletes” and not the “dealers” which is contrary to the customary prosecutorial practice of pursuing dealers instead of users.

Even if you agree with government involvement in anti-doping efforts of private sporting leagues, there should always be limitations on government behavior to prevent abuses of power.

Source: Slate

The purpose of these pages is to methodically dissect those claims and assumptions and compare each with what is actually known about it.

He analyzes several steroid assertions and supports each analysis with several scholarly and scientific citations. Some of his conclusions:

• Steroids and Home Runs: “No evidence” that steroids have affected home-run hitting.
• Steroid Side Effects: The side effects of anabolic steroids have been “grossly exaggerated.”
• Kids and Role Models: Adolescents who self-identify with a role model are no more likely to use drugs than those without a role model.
• Kids and Sports Heroes: Teenagers, overwhelming male, who self-identify with a sports role model are slightly less likely to use drugs.

Source: Reason blog; Eric Walker’s Steroid website

Gary Gaffney, M.D., from the University of Iowa College of Medicine, offers a defense of TUEs in his blog:

If we support the idea of medical disabilities, then those disabilities should be treated.  A fine line may be drawn between those who would correct medical problems: vision, ADHD, and legitimate endocrine problems v. those who abuse the treatments.  The same medications to treat these conditions could be used as  PEDs; however, a proper diagnosis and prescription would prevent the TUE rule gamed to ‘cheat within the rules’.

There is a critical difference between treating a disease, and using a drug in a healthy athlete for a competitive advantage.  If well documented, an athlete deserves treatment for a medical condition, even with a banned drug.

I generally agree with Dr. Gaffney. I have always had a problem with “banned substances lists” that prevented athletes from medical treatments and medical comforts afforded to the rest of the non-drug-tested population. This is the reason for the existence of therapeutic use exemptions.

But any use of performance-enhancement drugs is problematic for anti-doping organizations:

(1) Even a therapeutic dosage of a performance-enhancing drug (or any other corrective medical procedure) for a legitimate medical condition can improve the athlete’s performance above and beyond mere correction of any disorder. Even a 1-2% improvement in performance can be significant for an elite athlete.

(2) Legitimizing performance-enhancing drug use for athletes with therapeutic use exemptions may not result in a desired outcome of “returning to normal” but a desired outcome of “being better than normal”.

(3) Also, this is all premised on the belief that the athlete is at a competitive disadvantage without the corrective (pharmaceutical) treatment.

A good example of the aforementioned potential problems can be seen in discussions of other corrective medical procedures used by athletes, namely laser eye surgery or LASIK (Laser-Assisted In Situ Keratomileusis).

Tiger Woods was hardly at a competitive disadvantage with less than perfect vision. He apparently won 5 majors golf titles before correcting his vision. And with the procedure he returned to the course with better than normal vision, 20/15. Numerous other athletes have taken advantage of a corrective medical procedure for a legitimate medical condition to obtain a clear competitive advantage.

Golfers Scott Hoch, Hale Irwin, Tom Kite, and Mike Weir have hit the 20/15 mark. So have baseball players Jeff Bagwell, Jeff Cirillo, Jeff Conine, Jose Cruz Jr., Wally Joyner, Greg Maddux, Mark Redman, and Larry Walker. Amare Stoudemire and Rip Hamilton of the NBA have done it, along with NFL players Troy Aikman, Ray Buchanan, Tiki Barber, Wayne Chrebet, and Danny Kanell. These are just some of the athletes who have disclosed their results in the last five years. Nobody knows how many others have gotten the same result.

And then there’s the widely accepted Tommy Johns surgery. The therapeutic use exemptions for performance-enhancing drugs and permissible corrective medical procedures complicate the ethical discussion. If the patient were anyone other than a drug-tested athlete, there would be no hesitation on the part of the doctor or patient to make them as healthy and strong as medically possible – not just normal.

Three and half weeks after he quit using steroids “cold turkey” my son took his own life – a victim of the deep depression that accompanies withdrawal from these drugs.

This type of emotional testimony really has a strong effect on me as I’m sure it does on many others. Unfortunately, such emotional testimony is useless when it comes to scientifically, logically and rationally informed public policy.

Despite the testimony of grieving parents and so-called experts, it is not possible to show that anabolics steroids cause suicide. The role of anabolic steroids in depression and suicide is unclear.  Professor Jack Darkes, PhD of the University of South Florida explains why it is important for scientific experts and researchers to remain objective when evaluating such emotional testimony.

Suicide is a devastating and tragic event and the more that is known about the individual characteristics that signal increased risk for suicide, especially in adolescents, the better equipped we will be to intervene in time to save innocent lives like those mentioned herein. Suicide is an event where false-positive identification carries with it little harm at the personal level (certainly much less than the act, especially if handled correctly to avoid any stigma), but great benefit in some cases. Efforts to educate adolescents, families, physicians and others to the warning signs, be they drug use or other risky behaviors or psychopathologies, should be applauded. Efforts to ascribe such events to a single cause can distract attention from other important indicators that need to be noted. Ascribing blame can be comforting at times of devastation when one desperately needs to make sense of events and “do something”. But, from a scientific perspective, such efforts must be looked at skeptically and dispassionately. In this scientists must strive to remain ethically neutral and objective. They must attempt to ensure that they communicate clearly, not adjusting their message for a public seeking confirming statements and value judgments. Science has limitations, as do its research methods. Scientists do their best service when they remember this when reporting on their work to the public.

Our country and the health of our adolescent who face steroid use would be best served if Congressional policymakers would also remain ethically neutral and objective.

Congressman John Tierney (D-MA) revealed that Major League Baseball has granted over 100 therapeutic use exemptions to athletes for amphetamines and related stimulant drugs to treat ADHD. Of course, since the focus of the Mitchell report and the Congressional hearings are on the evils of steroids, the continuing problem of amphetamines in baseball will likely not be seriously investigated at this point.

http://oversight.house.gov/story.asp?ID=1685