The Drugs Won: The Case for Ending the Sports War on Doping
The fight against performance-enhancing drugs has long been framed as a moral crusade. But some heretics like retired investigator Don Catlin and former USATF exec Doug Logan now contend that the battle is a quagmire, and doing more harm than good.
Doug Logan had seen enough. For years, he had served on the front line of the sports war on performance-enhancing drugs, first as the commissioner of Major League Soccer, and later as the chief executive officer of USA Track and Field. For years, he believed in the fight.
Logan was a professional mentee of Peter Ueberroth—the man who organized the 1984 Los Angeles Olympics and helped fund the country's first anti-doping laboratory—and a lifelong runner himself. Two days after he took the top job at USATF, in the summer of 2008, news broke that former Olympian Marion Jones had asked President George W. Bush to commute her prison sentence for lying to federal investigators about her PED use. Logan responded with a harsh open letter to the White House, calling Jones a liar, a cheat, and a fraud. In 2010, when sprinter LaShawn Merritt blamed a failed doping test on his use of a sexual enhancement supplement purchased at a 7-11 store—an explanation an arbitrator later found credible—Logan nevertheless blasted him publicly, stating he was "disgusted" and that Merritt had brought "shame" to himself and his teammates.
Logan believed it was his job to protect his sport. Back when he established MLS's first drug-testing program, he insisted that front-office executives be tested, too, just like players, and that his urine be the first sample collected in a cup. "I took my responsibility seriously," says Logan, now 73 and living in Sarasota, Florida. "I kind of followed the tribe on this for a long period of time."
During that same span, however, Logan didn't witness any real progress. He would walk the infield at track meets, observe the superhuman physiques all around him—men and women—and know they were crafted with chemical help. He would overhear coaches talking about using asthma inhalers with their athletes, none of whom were actually sick. For all of the strong words and tamper-proof sample bottles, nothing much was changing. Nothing ever had. "My first year in MLS, we had only one positive test," he says. "That was for marijuana. And it was for an off-the-field employee!"
This was a war, Logan began to realize, with few victories. In 2010, he was fired by USATF, reportedly in part for his outspoken style (a subsequent wrongful termination suit was settled). The split gave Logan time to think, and by the summer of 2013 he was ready to share. In an online column titled "May the Best Meds Win," he called the sports war on drugs hypocritical and unwinnable. A quagmire. Dismantle the constabulary, he wrote, starting with the World and U.S. Anti-Doping Agencies, WADA and USADA. Put Barry Bonds in the Baseball Hall of Fame. If athletes break criminal laws, then let them face the consequences; otherwise, let them decide what's best for their bodies. Comparing PED prohibition to the Vietnam War, Logan concluded that it was time to declare victory, give up the fight, and bring the troops home.
"This is a war we have not won, cannot win, and should not be involved with," he says today.
When the Rio Olympics begin on August 5th, thousands of athletes from around the world will march into Maracanã Stadium, smiling and waving national flags. Many will go on to run fast, jump high, and otherwise push the limits of human performance. Some almost certainly will be doping. For decades, the sports world's response to PED use has been the same as Logan's letter to the Oval Office: zero tolerance. Police and punish. No retreat, and certainly no surrender. USADA executive Travis Tygart called Russia's recently revealed state-supported doping program a "violation of the very essence of sport." As is the case with the larger war on drugs, Just Say No is the athletic status quo, with the battle against banned substances ranging from testosterone to cold medicine framed as a moral crusade.
However, a small group of heretics—academics, mostly, but also people like Logan—have started to challenge that view. The war on doping, they contend, has done far more harm than good: wasting money, retarding medicine, fostering corruption, and trampling on athletes' rights and dignity while failing to protect their health. The ongoing Russian scandal—which features bribes, extortion, and state security agents infiltrating a Moscow anti-doping laboratory to slip doctored urine samples through a secret hole in an office wall, all resulting in at least 111 Russian athletes being banned from Rio—is not, to them, a meaningful victory. Rather, it's a sign of ongoing defeat. Sports keep fighting. Drugs keep winning. Wouldn't it be safer, rational, and arguably more honest to end PED prohibition? To permit, study, and regulate the drug use that already happens regardless of the rules?
At the very least, Logan believes, it's time for a rethink.
"The importance is to have the conversation," he says. "From the standpoint of the sports industry, the question shouldn't be, 'Did WADA screw up in Russia, and how can we arm them with more tools to make sure a Russia doesn't happen again?' No, the question should be, 'Should we be involved in this thing at all?'"
Don Catlin never intended to become America's top doping detective. He just wanted some new laboratory equipment. In 1981, Catlin—a University of California, Los Angeles medical school professor and former U.S. Army officer who had cut his scientific teeth researching drug abuse by American soldiers during the Vietnam War—was asked by the International Olympic Committee to run a drug testing program for the 1984 Summer Games in Los Angeles.
Catlin said no. Cocaine and heroin? Sure. Addiction was a serious social problem. But doping? Catlin had grown up rooting for Ted Williams and the Boston Red Sox. He considered himself a sports fan, but PEDs weren't on his radar. At the time, that wasn't unusual. For most of history, doping has been viewed more as something athletes did than something they shouldn't be doing; only recently has it become a matter of widespread concern.
The history of sports doping goes all the way back to the ancient Olympics, where athletes chewed on raw testicles in the hopes of enhancing their performances. In the modern era, 1904 Olympic marathon runner Thomas Hicks downed a concoction of egg whites and strychnine—a rat poison that also acts as a stimulant in small doses—en route to victory. Tour de France riders during the 1920s relied on the same drug, and also nitroglycerine, the primary ingredient in dynamite. Following World War II, amphetamine use spread from fighter pilots to professional baseball. In the 1950s, American and Soviet weightlifters were gobbling steroids; by the next decade, the same anabolic muscle-building drugs had spread to college and professional football.
Following the death of a Danish cyclist Knut Jensen at the 1960 Rome Games—he passed out during a race, cracked his skull, and ultimately died of heatstroke, a series of events blamed on amphetamines he may or may not have been using—sports officials began to view doping as dangerous. Nine years later, Sports Illustrated published an influential three-part cover story titled "Drugs: A Threat to Sport." The frame was set. When East German female swimmers fortified by a systematic, state-sponsored drug program crushed their American rivals at the 1976 Montreal Games, the notion that PED use equaled cheating was given a Cold War boost. No wonder those dirty, underhanded Commies beat our girls. By the early 1980s, the sports doping war was beginning to take shape, right alongside the larger War on Drugs. Each was informed by the cultural and political conflicts of the late 1960s, and a burgeoning sense that drug use of all kinds was both symptom and cause of moral decay.
None of that crossed Catlin's mind when the IOC reached out. However, the analytical chemist had a problem—he needed a gas chromatograph and a mass spectrometer, sophisticated machines used to analyze chemical compounds. Together, they would cost about $500,000. "The IOC offered to pay for it," Catlin says. "So I said yes. It was a good deal for me. All I had to do was test the athletes at the Olympics, and I'd get to keep the equipment. I didn't see what all of this would become."
Over the next three decades, Catlin oversaw drug testing at the 1996 Atlanta Games and the 2002 Salt Lake City Games. He helped develop tests for an artificial version of the male sex hormone testosterone, the blood-booster erythropoietin (EPO), and tetrahydrogestrinone (THG), otherwise known as "the clear," the performance-enhancer at the heart of the BALCO scandal that involved Jones, Bonds, and a number of other athletes across multiple sports. His UCLA Olympic Analytical Lab became one of the world's top anti-doping facilities, staffed by dozens of scientists and conducting tens of thousands of tests a year for clients including the National Football League, the National Collegiate Athletic Association, minor league baseball, and USADA.
Catlin saw the doping battle expand from the Olympics to international chess, and from a handful of labs to dozens scattered across the globe. By the late 1980s, after congressional hearings led by Joe Biden, America's punitive drug laws were lumping in steroids with narcotics. At the turn of the 21st century, agencies like WADA and USADA were formed to fight the scourge; soon they were spending hundreds of thousands of dollars on testing and investigations of athletes. For much of that time, Catlin relished the fight. The work was intellectually challenging; better still, it was making a real difference.
Or so Catlin believed. Over time, he began to have second thoughts. A pattern emerged. Scientists like Catlin would discover a drug and develop a test. A few athletes would be caught. The rest would figure out ways to beat the test, or move on to another substance. There were always new compounds, or new ways to mask old ones; there was an entire underground industry of labs and chemists working to evade and confound Catlin's best efforts. Sports organizations talked a good game, but didn't quite put their money where their mouths were: in 2015, WADA's total budget was approximately $30 million—only $8 million more than professional baseball player and repeat PED user Alex Rodriguez's salary in the same year.
By the time Catlin retired from his UCLA lab in 2007, his confidence had eroded. "I left with a sense of this isn't working the way I thought it would," says Catlin, 78, who now runs the Los Angeles-based nonprofit Anti-Doping Research. "You had to do testing, but it wasn't going to fix the problem of drugs in sports. In some ways, what I was doing felt futile."
Since the IOC first instituted limited drug testing for amphetamines at the 1968 Mexico City Games, the doping war has been fought with two goals in mind. Reduce and prevent use. Catch and punish users. Is the battle being won? Committed warriors like USADA's Tygart argue that testing acts as an effective deterrent. That it protects athletes who don't dope from having to compete against, and lose to, athletes who do.
Others disagree. John Hoberman, a University of Texas professor and sports-doping historian, calls current anti-doping measures "a charade." Former WADA chief Dick Pound has told reporters that he questions "everything I see" in sports, from cycling to tennis. BALCO mastermind Victor Conte told VICE Sports that he thinks the number of track and field athletes using PEDs in Rio will be about the same as at the 2004 Athens Games; meanwhile, World Swimming Coaches Association head John Leonard has said that the upcoming Games will be a "nightmare of doping," with more use among athletes in his sport than ever before.
Catlin used to enjoy following the Olympics. Not anymore. "I lost my taste," he says. "I saw everybody that doped."
Examples of failed deterrence abound. Earlier this year, New York Mets pitcher Jerry Mejia was banned for life by MLB after failing three steroid tests over two years. (Mejia's lawyer has accused the league of "mob-like corruption" and intends to sue.) In 2009, Rodriguez admitted to using steroids, apologized, said he no longer needed the drugs, endured public scorn, and then told federal agents that he continued to take PEDs between 2010 and 2012. When a federal investigation definitively uncovered cyclist Lance Armstrong's doping, Tygart and others hailed it as major victory, proof that the doping war was working—never mind that almost all of Armstrong's major Tour de France rivals already had been fingered as PED users, and that their exposure didn't stop Armstrong and his teammates from doping.
In late July, IOC officials announced that 45 athletes from the London and Beijing Olympics—including 23 medalists from the latter—had failed drug tests after their stored urine and blood samples had been reanalyzed using newer techniques, bringing the total number of retroactive doping busts from both events to 98. That's almost 100 athletes who competed at the Games knowing their samples would be retested in the future and doped anyway.
And why not? The odds are decidedly in their favor. In 2012, WADA-accredited laboratories worldwide conducted approximately 270,000 doping tests; just over one percent revealed the use of banned substances. Testing done by the London and Beijing Olympics, MLB, the NCAA, and high school sports officials in New Jersey and Texas reveal a similar rate of positives. Nobody believes the true incidence of sports doping is anywhere near that low. A 2013 WADA study that anonymously surveyed more than 2,000 track and field athletes found that an estimated 29 percent of participants at the 2011 world championships and 45 percent of participants at the Pan-Arab Games had doped during the previous year. A 2015 study published in Sports Medicine estimated that as many as 39 percent of elite international athletes used PEDs. One witness interviewed for a Cycling Independent Reform Commission report released last year claimed that 90 percent of cyclists use drugs, despite some of the toughest testing in sports.
"Low rates of positive tests look good," says Lisa Milot, a former high-level junior cyclist and University of Georgia law school professor who studies sports and the human body. "But when you look behind the numbers, it's highly unsuccessful." Milot ticks off a list of high-profile doping scandals: BALCO; the Biogenesis case involving Rodriguez; the Tour de France in the late 1990s; Armstrong's fall; credible allegations that American distance running coach Alberto Salazar is doping his athletes; the current Russian affair. What do they have in common? Each was exposed by a whistleblower, law enforcement, investigative reporting, or some combination of the three.
"None of those are testing results," Milot says. "They are things that show our testing regime has failed."
A former professional cyclist who spoke to VICE Sports on the condition of anonymity is more blunt. "If you look at [USADA's] overall success rate, they are astoundingly ineffective," the cyclist says. "They spend more than $10 million a year, millions of that coming from the [federal] government, and they are fucking useless."
Anti-doping agencies worldwide generally lack subpoena, seizure, and other evidence-collection powers, and rely on actual police to share information. Conte argues that current programs are riddled with loopholes. For example, users can evade detection by taking smaller amounts of a particular PED in order to remain below test thresholds, a technique called "microdosing." Catlin believes that testing efforts are badly underfunded; on his blog, he once estimated that the total worldwide anti-doping budget was between $250 and $400 million—about the same as that of a small pharmaceutical company, and far less that the billions of dollars made by the athletes, teams, and organizations that have nothing to gain from positive tests. Where Logan wants a troop withdrawal, Catlin wants a financial surge.
Charles Yesalis, a Penn State University emeritus professor and longtime sports-doping researcher, says that more money for testing probably won't yield better results. Not when athletes are simply too motivated, clever, and willing to push the envelope in order to win. To wit: a year-long professional sports PED investigation by the Australian Crime Commission found that athletes were using a series of drugs that weren't on WADA's banned list, including pig-brain and calf-blood extracts and an anti-obesity drug that was still going through human clinical trials.
Four years ago, Pound co-authored a report for WADA's executive committee titled Lack of Effectiveness of Testing Programs. Over 26 pages, he acknowledged that "testing has not proven to be particularly effective in detecting dopers/cheats," and blamed the futility on the lack of a "general appetite to undertake the effort and expense of ... doping-free sport." Here was a committed general in the doping war admitting that the drugs had won.
Hoberman, the University of Texas professor, wasn't surprised. The history of sports anti-doping, he says, can in part be read as a history of public relations: the real aim of testing is to catch a few users, but not too many. After all, enhanced performances are good for the bottom line; scandals, not so much.
"You're dealing with a global sports-entertainment industry with a gross turnover of about $400 billion per year," he says. "It's a Goliath that is interested in staying in business. Given what we know about the behavior of elite athletes, you simply cannot have effective anti-doping within that business model."
If the current anti-doping apparatus mostly fails to identify athletes who are trying to break the rules, then what about the athletes who aren't? The 2015 documentary Doped: The Dirty Side of Sports tells the story of Phil DeRosier, an American sprinter who served a six-month suspension for flunking a doping test. (Full disclosure: I also appear in an interview for the film, but not about DeRosier.) During that time, DeRosier couldn't race. Couldn't land sponsorships. He essentially lost a half-year's worth of income. Still, he would have been OK with that—if he had actually done something wrong.
DeRosier had taken a legal nutritional supplement containing a stimulant, methylhexanamine, that was neither on the supplement's label nor on WADA's banned substance list. No matter. WADA rules allow athletes to be sanctioned not only for using specific banned substances but also for using "any and all similar substances." If that doesn't seem fair, well, it was enough for USADA.
"In my opinion, I was a quota," DeRosier says in the film. "Somebody to show that they're doing their job."
Other athletes have been punished under similarly dubious circumstances. LaShawn Merritt—the aforementioned American sprinter who ingested a sexual enhancement supplement containing a steroid hormone, ExtenZe, purchased at a convenience store after a night of dancing with his girlfriend—lost nearly two years of his career to the subsequent suspension, and had to fight a protracted legal battle in order to compete in the London Games. A decade earlier, tennis journeyman Martin Rodriguez was busted for having excess levels of—no, really—caffeine in his urine during a tournament in Switzerland.
During his legal appeal, Rodriguez laid out his defense. He had been hanging out in the tournament's players' lounge, waiting to take the court. He was bored. A tournament sponsor was offering free espressos, which were being served by an "attractive female." Rodriguez usually drank three or four cups of coffee before his matches; on this particular day, he may have enjoyed a few extra. He wasn't counting. Oh, and he also ingested "one or two" colas during his match, which was absolutely fine with the chair umpire.
In short, Rodriguez wasn't doping. He was thirsty. He still lost his appeal, and was forced to forfeit $6,725 in prize money. (WADA removed caffeine from its banned list in 2004.) After finishing Doped, filmmaker Andrew Muscato concluded that the sports war on drugs both underperforms and overreaches. "WADA's policies and conduct seem as if they treat all athletes as guilty athletes," he says. "Olympic athletes have to forfeit their privacy rights in order to compete. Is that fair if the system doesn't actually work?"
Under WADA rules, athletes not only have to put up with piss police inspecting their sex organs during sample collection; they also must follow a "Whereabouts Rule"—that is, they are required to regularly report their current and planned locations to those same testers, who can then show up and demand blood and urine from them at any time, day or night. A decade ago, cyclist Kevin van Impe found himself giving a urine sample at a crematorium, where he was arranging the funeral of his son, Jayden, who died six hours after being born; more recently, skier Lindsey Vonn was pulled off the red carpet by USADA testers while attending a New York fashion gala.
Despite these shortcomings, the doping war shows no signs of slowing down. To the contrary, WADA announced last year that its investigations will not be limited by national laws or restrictions placed on law enforcement. The organization keeps a blacklist of people—mostly trainers and coaches associated with PEDs—with whom athletes are not allowed to associate. The standard Olympic sport suspension for major drug violations used to be two years; today, it's a career-killing four, and if an athlete believes they're being railroaded, like DeRosier or Merritt, they can expect to spend tens of thousands of dollars challenging anti-doping authorities in arbitration. All of this leaves Logan, the former USATF executive, asking a simple question: To what end?
"The fact is that we have not made much in the way of inroads in enforcement of the myriad of regulated substances in the world," he says. "We're wasting enormous financial resources, human resources. Why not get rid of the drug cops, the laboratories, the silly lists of banned substances? Why inhumanely test athletes, waking them up in four in the morning and making them tell us 180 days in advance where they will spend the night, and with whom? All that stupid shit should stop."
Andy Miah has a modest proposal. If you're a sports fan, it may sound radical, even unfathomable. But hear him out. A professor and bioethicist at the University of Salford, Manchester (U.K.), Miah studies technology and biological enhancement, grappling with questions such as In an era of genetic modification, what does it mean to be natural? Or human? You know, simple stuff.
Like Logan, Miah sees a doping war gone awry. A retrograde fight, out of step with both modern medicine and society, where we eagerly develop and deploy new technology to improve our collective lot. In sports, athletes are told to stay away from testosterone, which is a terrible, no-good shortcut to hollow, tainted glory; at home, middle-aged sports television viewers are encouraged to ask their doctors about AndroGel, a cream containing the same hormone, which could help them live richer, better lives.
As such, Miah suggests, it's time to retire WADA—and replace the organization with a World Pro-Doping Agency.
"The ethical concerns associated with doping are largely about the worries of medical professionals with the expanded use of therapeutic technologies for non-therapeutic ends," Miah wrote in an email interview with VICE Sports. "They are not keen on this era of human enhancement, and yet they want athletes to break new records. How can they do this without technology?
"If records and results don't matter, then let's get rid of timing and medals. That would have my vote, but I suspect not many others, since elite sport is interested in the limits of humanity and our capacity to transcend them."
Miah has been making his case for nearly a decade. At public debates on the topic, he says, he's usually the guy "people love to hate." The arguments against doping are well worn and widely accepted. Prohibition, supporters claim, ensures that athletes who don't want to use drugs won't be forced to do so simply to keep up with their chemically powered peers. It preserves the sanctity of records—like career home run totals, and the fastest 100-meter dash time—across eras. It discourages children—who, medical experts agree, cannot safely use PEDs—from doping in a misguided effort to emulate their athletic heroes.
Miah admits that ending PED prohibition in sports wouldn't be perfect. Athletes still would be able to hurt themselves by abusing drugs, the same way patients can hurt themselves by abusing painkillers. But swap the current cops-and-robbers approach for a medical model that permits open, consensual doping under careful, responsible supervision, Miah says, and the odds of harm would go down.
"There are lots of problems associated with taking drugs, so if we can find better alternatives, this is where we should focus efforts," he writes. "An athlete's health should still be monitored—and perhaps monitored even more closely—but that need not preclude them from using performance-enhancing technologies. We can decide what is an acceptable level of risk and then test for [that], but a starting point is to ensure that athletes can use substances that are generally accepted in society."
While Miah's position is unusual, it's hardly sui generis. Milot, the former junior cyclist and law professor, made a similar argument in the Harvard Law School's Journal of Sport and Entertainment Law. So have University of Oxford bioethicist Julian Savulescu and the Drug Policy Alliance, a nonprofit devoted to reforming the larger War on Drugs. Nearly two decades ago, former NFL lineman and admitted steroid user Steve Courson argued in the pages of Sports Illustrated that doping was inevitable, and that pretending otherwise produced nothing but hypocrisy. Did fans and coaches really believe that athletes like him could weigh 295 pounds and bench-press 600 pounds without chemical help? Were league officials serious when they warned players about the physical risks of steroids, as if football itself wasn't chock-full of bodily danger? Sounding a lot like Miah, Courson concluded that it would be better to have doctors monitor PED use and side effects than to have athletes getting their health information from "some guy on the street or at the gym."
"It would be great if sports were pure and steroids weren't a factor," Courson wrote. "It would be great also if we lived in a world without nuclear weapons."
What would a sports world that accepted doping, or even embraced it, look like? According to Logan, there would be far fewer scandals. Less corruption, too. The ongoing Russian affair is a morass of bribery and deceit: top Russian sports, anti-doping, and state security officials lying to WADA about some positive drug tests, and breaking into supposedly tamper-proof bottles to cover up others; senior officials from the governing bodies of world and Russian track and field extorting hush money from athletes to cover up PED use; French police investigating the head of track and field's world governing body, Lamine Diack, his advisor, and the organization's former doping chief on suspicion of accepting more than one million euros to do the same; and a report that Diack's organization, the IOC, and even WADA all either ignored or declined to act on evidence of systemic Russian doping presented to them in 2013.
The common thread? If PEDs were permitted, Logan says, none of this arguably would have happened. No secrets to keep, no payoffs to make. No subterfuge required. "Crime begets crime," he says. "Make something criminal, and there will be offshoots."
Scrap prohibition, he adds, and fans won't have to worry about attaching asterisks to sprint times and home run totals. Athletes such as Armstrong won't have to submit to humiliating genital checks, or lie about what it really takes to ride up the side of a mountain faster than anyone ever has before. They won't have to live in a state of constant paranoia about what they put in their bodies, either—scanning energy-drink and supplement bottle labels, cross-checking banned substance lists, forever aware that today's perfectly legal compound is tomorrow's career-derailer.
Earlier this year, tennis star Maria Sharapova received a two-year competitive ban after testing positive for meldonium, a heart medication she had been taking since a Moscow doctor prescribed it as an immune system booster in 2006. Hundreds of other athletes also have tested positive for the drug, which WADA added to its banned list at the beginning of 2016—even though there's no scientific evidence that it enhances athletic performance. Is that fair? Does it solve an actual problem? The anonymous former pro cyclist is skeptical.
"You have these WADA people completely crucifying a whole bunch of athletes for this," he says. "Show me one study that proves it's performance-enhancing. Show me. Because if you can't, it shouldn't be on the list. And they just fucked hundreds of athletes."
Like meldonium, most drugs with established performance-enhancing effects are first and foremost medicines. Human Growth Hormone is prescribed to treat growth deficit in children and pituitary gland problems in adults. Anabolic steroids are used to counteract muscle wasting from HIV/AIDS. EPO is given to treat anemia in cancer patients. As an American Medical Association doctor told Congress during a 1989 steroid hearing, patients under supervision can use the drugs safely, but medical monitoring is crucial. As is the case with other medicines, PEDs can produce dangerous side effects, including severe acne, liver damage, heart disease, and increased risk of stroke. Yet as Miah and Courson point out, prohibition pushes PED use underground. It drives athletes away from competent doctors, and toward the likes of BALCO's Conte—a self-taught nutritionist who didn't attend medical school, but did play bass in the 1970s R&B group Tower of Power—or Biogenesis's Tony Bosch, a medical school dropout who once drew blood from the baseball player Rodriguez in the bathroom of a Miami nightclub.
The anonymous professional cyclist was part of a team that doped. The cyclist says they did so carefully, both to avoid detection and to protect their health. Among the drugs they used was the red-blood-cell-booster EPO. The average person's proportion of red blood cells, or hematocrit number, is around 44 percent. According to a 2004 article in the British Journal of Sports Medicine, a hematocrit reading of 51 percent or more increases the risk of stroke and heart attack. The anonymous cyclist's team kept their levels around 47 percent, roughly the same range that can be achieved through high-altitude training. "Sitting here [now], I have zero side effects from EPO," says the cyclist. "The system we had in place was completely conservative."
The cyclist explains that the doctor overseeing his team's PED program "believed that, yes, you have to do this, because everyone was doing this. But we were not going to be reckless or crazy. If one [injection] gets you to the finish line, one is enough. We're not going to do ten. We had a situation with a drug that was ten percent beneficial [to performance], completely undetectable, and if taken under a doctor's care, completely safe. I was cool with that. No problem.
"But there was other stuff out there. Synthetic hemoglobin. PFC [a dangerous drug invented to treat severe battlefield blood loss]. Veterinary stuff. Clinical trials stuff. Crazy stuff. You see that, and you're like, 'I don't even care if it's cheating or not, somebody is going to croak here.' You can get into some pretty bad shit, pretty quick."
The cyclist isn't exaggerating. The sports doping war doesn't just leave athletes relying on sketchy doctors. It leaves them relying on sketchy drugs—whatever substances are available over the internet or from illicit channels, or unusual enough to have not yet drawn attention from testers.
Barry Bonds reportedly took trenbolone, a steroid created to improve the muscle quality of cattle. The CIRC doping report suggested that cyclists are experimenting with GW1516—a substance that burns fat, increases muscle mass, and sends more oxygen to the muscles but also "was not given clinical approval because it was thought to cause cancer." In a 1994 Loyola of Los Angeles Entertainment Law Review article on steroid regulation, author John Burge writes that imported or clandestinely manufactured steroids may be "far more dangerous" than those produced by American companies regulated by the Food and Drug Administration. For example, a former NFL drug adviser said he had seen people develop "everything from gangrene of the arm to an abscess on the hip" from using black-market drugs, while in an unrelated case, a user injected an entire vial of penicillin that had been mislabeled as a steroid.
In her own article, Milot cites a 2009 study in which researchers found that between 21 and 53 percent of the black-market steroids they examined were counterfeit, and that some contained harmful bacteria. "What happens is that in order to circumvent testing, people shift from relatively safe drugs to ones we know nothing about," she says. "Or they take oral steroids instead of injectable ones—because the orals clear your system faster. Well, they also cause organ damage. From a health perspective, that is a disaster."
Would above-board PED use always be responsible? Probably not. East Germany's secretive, state-sponsored sports doping program was a medical and ethical nightmare, with unscrupulous scientists causing lasting harm to unwitting athletes. In a famous biannual survey of elite athletes in the 1980s, more than half of the respondents said they would take a drug that guaranteed them a gold medal but would also kill them within five years.
Even with sound medical advice and responsible limits on what kind of doping is permitted, some competitors will be willing to take foolish risks—and if the excessively liberal use of painkillers in the NFL is any indication, some ethically flexible doctors will be willing to enable them. That's part of the athletic mindset: if one pill works, gobble a handful; if high-octane gas makes the engine run better, then add some nitro. Back when Milot was a high-level junior cyclist, she says, she received a phone call in the middle of a night. It was a friend, a fellow racer. Her tone was urgent: When you get up in the morning, go to GNC, and buy as much of product X as you can.
Milot was bleary-eyed, still half-asleep. She asked why.
They just banned product X. It must work!
"It didn't matter that the stated reason for the ban was that the product caused hallucinations, and caused people to jump out of windows and injure themselves," Milot says. "Athletes are risk-takers. There's no way to get to the international level of sports without being willing to put your body on the line on a regular basis."
Nevertheless, Milot argues, athletes would be better off knowing exactly what's going in their bodies, and what that might mean for their long-term health. So would society at large. Most of what the medical community currently understands about the benefits and drawbacks of PED use comes from studying sick people. As for healthy athletes? According to Charles Yesalis, the Penn State epidemiologist, most of what we presume to know comes from surveys of bodybuilders, who generally are taking massive quantities of drugs of dubious composition and origin. Talk to scientists, and they'll tell you that the sports doping war, and its accompanying moral hysteria, makes it almost impossible to study doping with any real rigor.
"It's hard to tell someone don't take this thing because it's bad for you, but we don't have data showing that," Milot says. "What we should be doing now is gathering information in order to understand how these substances work on healthy bodies. Focusing on that, rather than punishment."
Regarding punishment, Logan has a question: If an athlete can safely use a particular drug to run faster or jump higher, why is that wrong? Moreover, what if the substance in question enables performance, either by helping aging athletes extend their careers or by allowing injured athletes to return to play? These aren't hypotheticals: near the end of his time in the NFL, retired running back Abdul-Karim al-Jabbar had human growth hormone injected into his battered knee to stimulate the creation of cartilage; last year, Dallas Mavericks owner Mark Cuban helped fund a University of Michigan clinical trial studying whether the same drug can aid recovery from anterior cruciate ligament surgery. ESPN's Tom Farrey reports that researchers have found high rates of hormonal deficiency—specifically, HGH and testosterone—among victims of head trauma, likely due to damage to the pituitary gland, a pea-sized organ that sits at the base of the brain. Given the hard-hitting nature of sports like football, is it ethical to deny football players PEDs? Rather than protecting athletes, it's possible that prohibition is hurting some of them.
"The lines between enhancement and therapy are not clear," Milot says. "We like to pretend they are."
Andrew Tilin doped. And frankly, he enjoyed it. For almost a year in the early 2000s, the Austin, Texas-based writer and amateur cyclist took testosterone, the same hormone used by athletes from Armstrong to Bonds, and also available at anti-aging clinics across America.
At the time, Tilin was in his early 40s. Testosterone—or, as he calls it, "the T"—increasingly was being peddled to middle-aged men as a pharmaceutical fountain of youth. On his bike, Tilin found that the drug worked as advertised. Long rides used to leave him feeling "ruined"; now he could train even harder the next day. And off the bike? "It was if I had eight cups of coffee in me," says Tilin, who wrote about his experience in The Doper Next Door: My Strange and Scandalous Year on Performance-Enhancing Drugs. "I wanted my wife like I was 18. I'd go to a restaurant, check out a waitress, and not even feel bad about it. That sounds crass. But it was sometimes fun."
After quitting the drug, Tilin fretted about possible side effects. Would he never enjoy another erection? Would he end up with gynecomastia, the hormone-induced breast tissue growth colloquially known as "bitch tits?" Nothing materialized. Instead, he was left with newfound empathy. A longtime cycling fan, he used to watch the Tour de France with a hypercritical eye. They're all out of their minds on EPO. Cheaters!
"Now when people are busted, it doesn't move my needle," he says. "Of course they're on drugs. It's what these guys do for a living."
Tilin spins a hypothetical: "Imagine you're best writer at a magazine, you've basically been given all the best feature stories for years, and then one day Joe Smith comes in—who has always been mediocre—and suddenly and inexplicably, he's getting all the good work and adulation," he says. "Then his dealer pulls you aside and says, 'Here are the green pills I've been giving Joe.' What would you do?"
Tilin grasps the hypocrisy of the sports doping war. He acknowledges the arbitrary rules—how does LASIK surgery that corrects a golfer or baseball player's vision to better than 20/20 not qualify as unlawful enhancement again?—and ineffective enforcement. He feels for the athletes caught in the crosshairs. Like Logan and others, he thinks the fight can't be won. And yet, at book signings, Tilin says, amateur bike racers would show up to heckle him. Cheater! His current girlfriend is a hardcore triathlete. She hates his book. Calls it "a corruption."
There is a deep moralistic vein in athletics, a near-mystical preoccupation with notions of clean and dirty, of natural and unnatural. In the early 1980s, former IOC president Michael Morris said that the "creation of artificial man is something that will kill sport"; roughly a decade earlier, Sports Illustrated's Gilbert concluded his three-part doping series by proclaiming that drug use strikes at the fundamental nature of our games—namely, competition between equals.
"If you legalize drugs, my fear is that it becomes an arms race as to who can get the most in their veins, the choicest in their veins," Tilin says. "As much as we keep losing, I think we should keep fighting. Because the other side is actually darker."
Max Mehlman, a bioethics and law professor at Case Western Reserve University in Cleveland, Ohio, has been arguing against PED prohibition since the 1990s. At the time, the Human Genome Project was underway, and Mehlman was grappling with the ethics of genetic enhancement for the National Institutes of Health. A professional colleague mentioned doping, and how it ran contrary to "the spirit of sports."
"I asked what that meant," says Mehlman, who also has studied stimulant use in the military. "The more I probed, the more no one could really explain it in a convincing way."
Mehlman has debated athletes, sportswriters, other academics, even Dick Pound, the former WADA head. Doping is wrong, he was told, because it's against the rules. OK, but no one makes a high-minded crusade out of preventing handballs in soccer. Wrong because it's risky. Sure, but so is juvenile gymnastics. Wrong because, well, drugs. So how do you explain pain-numbing cortisone shots?
"I had one sportswriter tell me that the difference between steroids and something like a carbon fiber vaulting pole is that you swallow steroids," he says. "And that makes them bad."
Eventually, Mehlman concluded that the sports doping war had less to do with protecting athletes—people still boxed and played football, didn't they?—than with protecting an idea: the level playing field. Sports as a meritocracy, with on-field results rewarding hard work and desire.
And that, in turn, makes Mehlman wonder: Do sports have things backwards? "With doping bans, we're not just comparing effort [in competitions]," he says. "We're comparing luck. Having the good luck to inherit good genes, and to be born into a wealthy, sports-oriented family. Having access to the best coaches. An enormous amount of accomplishment is due to those factors. Doping could be seen as a way of leveling this playing field. Why not let people who are not so lucky in the game of genetic roulette dope?"
Earlier this year, Scottish academic Paul Dimeo gave an interview to The Times of London in which he said that the ideal of the natural athlete is an anachronism, that some drugs can be safely used for recovery and performance, and that maybe, just maybe, sports doping policies deserve some careful reexamination. He promptly was removed from his position as chair of USA Cycling's anti-doping committee. Like Logan, he was simply calling for a conversation—and like Tilin, he was met with puritanical scorn.
"Drugs are really hard to manage," says Hoberman, the University of Texas historian. "You have to admit that. But our society has a very hard time dealing with them in a rational way."
Can anything change? Last year, the Drug Enforcement Agency announced that it had busted 16 underground steroid labs and seized hundreds of thousands of PED doses in an undercover operation spanning 20 states and four foreign countries. Investigative journalist and author David Epstein noted the obvious—that's a lot of juice—before pointing out the subtext: That's a lot of juicing. Far more than can be pinned on high-level athletes.
To wit: between 2005 and 2011, inflation-adjusted sales of HGH reportedly rose 69 percent; by contrast, sales of the average prescription drug rose 12 percent over the same span. Ours is a doping culture, Hoberman says, one in which military pilots rely on amphetamines and Modafinil to stay awake, students and professors alike pop Adderall to study, Hollywood actors and producers use PEDs to get buff, and the rest of us guzzle energy drinks and double-shot cappuccinos to power through our workdays.
In 2012, researchers had 1,200 college students fill out a questionnaire describing two scenarios: a runner who used steroids to win a race, and a student who used stimulants to ace an exam. Respondents judged the runner to be a bigger cheater, with one telling caveat: respondents who previously had used stimulants without a prescription were more forgiving of the fictional test-taker. Familiarity breeds understanding. Understanding spawns acceptance. As society at large follows Tilin's lead, smearing testosterone cream into our collective armpits, will we continue to demand that athletes do as we say, and not as we do?
"This is all bullshit," Logan says. "I happen to live in a retirement community. Ladies with blue hair go down to strip malls and get injections of HGH on a daily basis. No one says they should be ineligible to go to dinner and have the 4:30 blue plate special. We have a pill for everything."
In many ways, Hoberman says, the war on doping is simply a branch of the larger War on Drugs: born during the Nixon Administration, intensified under President Ronald Reagan, and increasingly viewed as a wasteful, harmful, self-perpetuating failure by everyone involved—a losing battle not against any particular substance, but rather human nature. Mandatory minimums are on the way out. Marijuana is on the way in. Someday, perhaps, the sports world will take a hint.
After all, we've been here before. In 1973, the United States Senate held hearings to investigate drug use by athletes. Among the experts testifying was Lawrence Golding, a Kent State University doctor who had studied the effects of PEDs on sports performance—particularly amphetamines, one of the first drugs banned by the IOC. Athletes dope, Golding said, because they're trying to win. In a subsequent interview, he was asked how to curb use. Testing? Punishment? Golding shrugged. "Prohibition," he said, "never worked in keeping us from drinking whiskey."
Want to read more stories like this from VICE Sports? Subscribe to our daily newsletter.