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Cooperstown and the 'Roids

By Bill James
July 16, 2009

            For the last ten years or so people have been asking me to comment on the issue of steroids and the Hall of Fame.  To this point I have resisted addressing these questions, arguing—as I do with the Hall of Fame status of active players—that there is nothing to be gained by trying to guess where objects still in motion will eventually land.

With the passage of time the dust will settle, and we will see the issue more clearly.

After ten years, however, the dust does not seem to be settling very rapidly.   There seem to be as many different and contradictory opinions on the issue now as there were five or eight years ago.   We are all tired of arguing about it, but we still don’t agree. In any case, I am finally ready to say what I have to say about it.   It is my opinion that, in time, the use of steroids or other Performance Enhancing Drugs will mean virtually nothing in the debate about who gets into the Hall of Fame and who does not.

The process of arriving at this conclusion began when I was studying aging patterns in the post-steroid era.    One of the characteristics of the steroid era was that we had several dozen players who continued to improve beyond the normal aging time frame, so that many of them had their best seasons past the age of 32.   This is historically not normal. In the post-steroid era we are returning to the historic norm in which players hit a wall sometime in their early thirties.   But what does this mean?

            It means that steroids keep you young.  You may not like to hear it stated that way, because steroids are evil, wicked, mean and nasty and youth is a good thing, but. …that’s what it means.    Steroids help the athlete resist the effects of aging.  

            Well, if steroids help keep you young, what’s wrong with that?  

What’s wrong with that is that steroids may help keep players “young” at some risk to their health, and the use of steroids by athletes may lead non-athletes to risk their health as well.    But the fact is that, with time, the use of drugs like steroids will not disappear from our culture.   It will, in fact, grow, eventually becoming so common that it might almost be said to be ubiquitous.   Everybody wants to stay young.   As we move forward in time, more and more people are GOING to use more and more drugs in an effort to stay young.    Many of these drugs are going to be steroids or the descendants of steroids.

If we look into the future, then, we can reliably foresee a time in which everybody is going to be using steroids or their pharmaceutical descendants.  We will learn to control the health risks of these drugs, or we will develop alternatives to them.  Once that happens, people will start living to age 200 or 300 or 1,000, and doctors will begin routinely prescribing drugs to help you live to be 200 or 300 or 1,000.  If you look into the future 40 or 50 years, I think it is quite likely that every citizen will routinely take anti-aging pills every day.

How, then, are those people of the future—who are taking steroids every day—going to look back on baseball players who used steroids?    They’re going to look back on them as pioneers.   They’re going to look back at it and say “So what?”

The argument for discriminating against PED users rests upon the assumption of the moral superiority of non-drug users.   But in a culture in which everyone routinely uses steroids, that argument cannot possibly prevail.   You can like it or you can dislike it, but your grandchildren are going to be steroid users.   Therefore, they are very likely to be people who do not regard the use of steroids as a moral failing.   They are more likely to regard the banning of steroids as a bizarre artifice of the past.

Let us suppose that I am entirely wrong about all of that; let us suppose that our grandchildren do not wind up regularly ingesting chemicals to extend their youth. I would still argue that, in the long run, the use of steroids will eventually become a non-issue in who gets into the Hall of Fame.

My second argument is this:

1)  Eventually, some players who have been associated with steroids are going to get into the Hall of Fame.   This is no longer at issue.   One cannot keep Barry Bonds, Roger Clemens, A-Rod, Manny Ramirez, Mark McGwire, Sammy Sosa and all of the others out of the Hall of Fame forever.    Some of them have to get in.   If nothing else, somebody will eventually get in and then acknowledge that he used steroids.

2)  Once some players who have been associated with steroids are in the Hall of Fame, the argument against the others will become un-sustainable.

When the time comes at which two or three or four players are in the Hall of Fame who have acknowledged some steroid use, the barrier to other steroid users rests upon some sort of balancing test.    Did this player use too many steroids to be considered legitimate?  Is his career a creation of the steroids?   Would he have been a Hall of Fame player without the steroids?

I am not suggesting that it is inappropriate for any one sportswriter or any one Hall of Fame voter to balance these considerations as best he can.   But one does not build a house upon a well-balanced rock.    The way that each sportswriters looks at these issues is going to be different from the way that each other looks at them.   There can only be a consensus on one of two positions:

a)  That steroid users should not be in the Hall of Fame, or

b)  That steroid use is not an issue in the debate.

Between the two extreme positions, it becomes a fluid discussion.    Once we move away from the one extreme, in my view, we will begin to drift inevitably toward the other.

I would liken this to attitudes about sexuality and television.   At one point there was a firm consensus that there was no place for sex on TV.   Married couples, on TV, slept in twin beds.   The first departures from this firm position were small and insignificant. . ..PBS specials on prostitution, chewing gum and soft drink commercials that pushed the boundaries of “taste”, and edited-for-TV movies that were not quite as edited as they would have been a few years ago.   Once there was no longer a firm consensus at an extreme position, there was a fluid standard that moved inevitably toward more and more openness about sexuality.

I will note that this happened without the consent and without the approval of most of the American public.   It was never true that most people wanted to see more sex on TV.   Probably it was generally true that most Americans disliked what they regarded as the erosion of standards of decency.   But it was always true that some people wanted to see more sex on TV, and that was all that mattered, because that created a market for shows that pushed the envelope, and thus eroded the barriers.  It was like a battle line that disintegrated once the firing started.   The importance of holding the battle line, in old-style military conflict, was that once the line was breached, there was no longer an organized point of resistance.    Once the consensus against any sexual references on TV was gone, there was no longer any consensus about what the standards should be—thus, a constant moving of the standards.

I think the same thing will happen here:  Once there is no longer a firm consensus against steroid users in the Hall of Fame, there will be a fluid situation which moves inevitably in the direction of more and more inclusiveness.   It is not necessary that people approve of this movement in principle.  It is only necessary that there be advocates for those who are still on the outside looking in. . ..for Sammy Sosa, let’s say, and Manny Ramirez.  And there is no question that there will be those advocates. 

Third argument.   History is forgiving.  Statistics endure.

At the time that Dick Allen left the major leagues, virtually no one thought of him as a Hall of Fame player.  In his first year of eligibility for the Hall of Fame, he received the support of a little less than 4% of the voters.  In his fifteen years of eligibility for BBWAA selection, he never reached 20% in the voting.

Dick Allen did not have imaginary sins or imaginary failings as a player.   He had very real offenses.   But as time passes, the details of these incidents (and eventually the incidents themselves) are forgotten, and it becomes easier for Allen’s advocates to re-interpret them as situations in which Allen was the victim, rather than the aggressor or offender.   The people who were there die off.   A certain number of people want to play the role of Dick Allen’s advocate.  No one—including me--wants to play the role of persistently denigrating Dick Allen; in fact, I’m pretty sure you can go to hell for that.   People who were friends of Dick Allen speak up; the dozens or hundreds of ex-teammates who despised Dick Allen keep silent, or speak of him as well as they can manage.

For very good reasons, we do not nurture hatred.   We let things pass.   This leads history to be forgiving.   Perhaps it is right, perhaps it is wrong, but that is the way it is.   Sometime between 2020 and 2030, Dick Allen will be elected to the Hall of Fame.

The same thing has happened, more slowly, with the Black Sox.   In 1950 no one thought Joe Jackson should be in the Hall of Fame.   Now it is a common opinion—perhaps a majority opinion—that he should.  People question whether he “really” did the things that he clearly admitted doing.   His virtues are celebrated; his sins are minimized.   Perhaps this is right; perhaps it is wrong.  It is the way of history.

History will rally on the side of the steroid users in the same way that it has rallied on the side of Dick Allen, Joe Jackson, Orlando Cepeda, Hack Wilson and many others.   But with the steroid users, we are not talking about a single isolated “offender”, but about a large group of them, representing the bulk of the dominant players of their generation.   The forces that push for their acceptance will get organized much more quickly and will move with much greater force.    This, in my view, will make the use of steroids a non-factor in Hall of Fame discussions within 30 to 40 years.

 

Fourth argument.   Old players play a key role in the Hall of Fame debate.  It seems unlikely to me that aging ballplayers will divide their ex-teammates neatly into classes of “steroid users” and “non-steroid users.”

One of the key reasons that Dick Allen will eventually be in the Hall of Fame is that one of his ex-teammates—Goose Gossage—feels strongly that he should be, and is outspoken on this issue.    Goose Gossage is now a Hall of Famer.   His voice carries weight.

Eventually, younger players who were teammates with Mark McGwire, Sammy Sosa, A-Rod and Roger Clemens are going to be in the Hall of Fame.   Andy Pettitte is probably going to be in the Hall of Fame.   When he is in the Hall of Fame—if he gets there before Roger—he is going to speak up for Roger Clemens.   Hell, somebody might even speak up for Barry Bonds.

Once this happens, it will erode the prejudice against steroid users in the Hall of Fame, to the extent that that prejudice might otherwise exist.  YOU might choose to divide the world of baseball players into steroid users and non-steroid users, but this is not a division that makes intuitive sense when you know the people involved.   Therefore, this is not the division that will ultimately endure, once the long historical sorting-out process that makes Goose Gossage relevant and Lindy McDaniel irrelevant has run its course.

 

I have a fifth argument here, but before I get to that, let me speak for a moment on the other side of the issue.  Let us adopt, for the face of the non-steroid user, Will Clark.   Will Clark and Rafael Palmeiro were college teammates, and apparently were not the best of friends.    As players they were rivals.    Texas had Palmeiro (1989-1993) and then had Clark (1994-1998), while Palmeiro went to Baltimore.  After the 1998 season the Orioles—then a strong franchise—signed Clark, while Palmeiro went back to the Rangers.   Later on Palmeiro went back to the Orioles, so that both the Rangers and the Orioles had Palmeiro, then Clark, then Palmeiro.    There was always a debate about which was the better player.

I’ve always been a great admirer of Will Clark, who I think was a great player and is a historically under-rated player in part because his numbers are dimmed by comparison to the steroid-inflated numbers that came just after him.  Will Clark, in the pre-steroid era, was a much better player than Palmeiro, although Palmeiro was good.  Palmeiro, as we entered the steroid era, gradually pulled ahead of Clark.   I have no idea whether Will Clark ever used steroids or not, but let us use Will Clark as the face of the player who chose NOT to use steroids in order to stay in the game, the player who chose the natural route and suffered the consequences of that.

Is it fair to Will Clark to compare him to players who chose to cheat in order to move beyond that level?  No, it is not.   Absolutely, it is not. But the critical issue is, Is this cheating?  If you choose to regard it as cheating, if you choose not to support the Hall of Fame candidacy of a steroid user because you regard it as cheating, I would not argue with you.   I think that Will Clark has a perfect right to feel that he was cheated out of a fair chance to compete for honors in his time, and, if you choose to look at it from the standpoint of Will Clark, I don’t think that you are wrong to do so.

            But at the same time, I do not believe that history will look at this issue from the standpoint of Will Clark.   I don’t see how it can.  What it seems to me that the Will Clark defenders have not come to terms with is the breadth and depth of the PED problem, which began in the 1960s and expanded without resistance for almost 40 years, eventually involving generations of players.   It seems to me that the Will Clark defenders are still looking at the issue as one of “some” players gaining an advantage by using Performance Enhancing Drugs.   But it wasn’t really an issue of some players gaining an advantage by the use of Performance Enhancing Drugs; it is an issue of many players using Performance Enhancing drugs in competition with one another.    Nobody knows how many.  It would be my estimate that it was somewhere between 40 and 80%.  

            The discrimination against PED users in Hall of Fame voting rests upon the perception that this was cheating.   But is it cheating if one violates a rule that nobody is enforcing, and which one may legitimately see as being widely ignored by those within the competition?

            It seems to me that, at some point, this becomes an impossible argument to sustain—that all of these players were “cheating”, in a climate in which most everybody was doing the same things, and in which there was either no rule against doing these things or zero enforcement of those rules.   If one player is using a corked bat, like Babe Ruth, clearly, he’s cheating.   But if 80% of the players are using corked bats and no one is enforcing any rules against it, are they all cheating?    One better:  if 80% of the players are using corked bats and it is unclear whether there is or is not there is any rules against it, is that cheating? 

            And. ..was there really a rule against the use of Performance Enhancing Drugs?  At best, it is a debatable point.  The Commissioner issued edicts banning the use of Performance Enhancing Drugs.  People who were raised on the image of an all-powerful commissioner whose every word was law are thus inclined to believe that there was a rule against it.

            But “rules”, in civilized society, have certain characteristics.  They are agreed to by a process in which all of the interested parties participate.    They are included in the rule book.  There is a process for enforcing them.    Someone is assigned to enforce the rule, and that authority is given the powers necessary to enforce the rule.  There are specified and reasonable punishments for violation of the rules.

            The “rule” against Performance Enhancing Drugs, if there was such a rule before 2002, by-passed all of these gates.   It was never agreed to by the players, who clearly and absolutely have a right to participate in the process of changing any and all rules to which they are subject.  It was not included in any of the various rule books that define the conduct of the game from various perspectives.   There was no process for enforcing such a rule.  The punishments were draconian in theory and non-existent in fact.

            It seems to me that, with the passage of time, more people will come to understand that the commissioner’s periodic spasms of self-righteousness do not constitute baseball law.   It seems to me that the argument that it is cheating must ultimately collapse under the weight of carrying this great contradiction—that 80% of the players are cheating against the other 20% by violating some “rule” to which they never consented, which was never included in the rule books, and which for which there was no enforcement procedure. History is simply NOT going to see it that way.

            The end of the day here is about the year 2040, perhaps 2050.   It will come upon us in a flash.   And, at the end of the day, Mark McGwire is going to be in the Hall of Fame, and Roger Clemens, and Sammy Sosa, and Rafael Palmeiro, and probably even Barry Bonds.   I am not especially advocating this; I simply think that is the way it is.   I only hope that, when all of these players are enshrined, they will extend a hand up to a few players from the Will Clark division of the game.

​
 
 

COMMENTS (70 Comments, most recent shown first)

jblatham
The steroids era was brought to us not so much by greedy and desperate baseball players as by those who own them. The idea that some day the average person will have the option of pharmaceutically extending their lives to "200, 300...1000 years" is pretty naive.
6:12 PM Jan 17th
 
burtshulman
I do have one question, though, Bill. I know you can't stand Barry Bonds, but why are you unable to separate your personal dislike from the man's genius as a baseball player? If steroids are (or will be) a non-issue, and I agree with that perspective, then there's no argument against Bonds as one of the top 3 overall players of all time. He won 7 MVP's and as you said somewhere probably should have won more. That's way beyond anyone else. He was a great fielder in his prime with a great arm. He stole over 500 bases and was one of the fastest, best baserunners. He hit for average. He had massive power. In natural gifts he was pretty much the equal even of Mickey Mantle. On top of which he had incredible plate discipline, and walked more than anyone -- which gave him astounding on base percentages, especially in the steroid years. And even given the steroids, his performances against peers who were also using steroids were so outlandishly better that he dominated baseball for a few years the same way Babe Ruth did back in the early '20's. So why are you so grudging in giving the man his due? In my view, there's Ruth, Mays, Wagner, Cobb, Joe Jackson and Bonds. Mantle faded too quickly, Ted Williams couldn't match the others in the field, DiMaggio while great wasn't as great for as long. Aaron was amazing, as was Musial, but again not as amazing. I'd probably say Ruth, Bonds, Mays, Wagner, Cobb and Jackson in that order. How about you?
9:13 PM Aug 12th
 
burtshulman
I agree with you, Bill, and as usual you've put the argument in a remarkably clear context. Some may say that there's a clear line between steroids and amphetamines (remember Bouton's "greenies"?); I think that's absurd. Professional competitors always look for an edge -- in this country, where we celebrate winning above all else, we're trained to revere people who always look for an edge. The hypocrisy of a Frank Robinson (great player that he was) in his holier-than-thou stance is irritating because I'm certain that if you studied how he played the game you'll find that he (like all top competitors) did plenty of "unsportsmanlike" things to win. Baseball, in fact, winks at cheaters if they get away with it. Is the old hidden ball trick sportsmanlike? Is deliberate head-hunting sportsmanlike (Bob Gibson, Don Drysdale, Roger Clemens, et al)? Is spiking someone in a slide at second base sportsmanlike? Some -- many -- players in their desperation to be at the top took the risk of cancer and other ailments to ingest substances that enhanced their performance. Others did not -- but I submit they didn't more because they were sensible about the long-term health impact, not because they were concerned that taking steroids was "cheating". Are food supplements -- vitamin B complex, Omega-3 fish oil products, etc. -- banned? What about food itself? Steak was once considered crucial to building muscle; ballplayers ate steak if they could afford it. Were they cheating? I'm sure there are ways to draw lines, but there are also ways to cross those lines and the sharper the lines the clearer the target will be regarding ways of crossing them. It's like Wall Street. I believe in much tighter regulation, but I also know without doubt that armies of computer geeks will always be out there working out ways to "honor" the letter of the regulation while violating the spirit. We're a nation, a culture, built on winning. All these men were doing was what they and the rest of us have been taught to do: looking for an edge. It is the worst kind of hypocrisy to condemn them for that when the only real damage they've done is to their own bodies. And as you suggest, once bodies are no longer being damaged because better substances have been created, the rest of us will be lining up at the pharmacies too. By the way, if a vegetable were to be found that had the same properties as steroids but only certain players knew about it and secretly ate it every day, should their stats be nullified -- should they be called "cheaters"? If a player finds an unknown strength coach who has a great new theory about weight training that confers enormous benefits, and other players don't know about it, should his stats be nullified? Guess what: those kinds of things happen all the time.
9:02 PM Aug 12th
 
RonDV
I think as long as the Selig regime continues to put short term results ahead of long term gains by essentially trying to ignore steroids, the argument that it is not cheating to break a rule not enforced will hold true. Over time this will diminish the deep hold the game has on fans (see poll on how many people watch the NBA LESS than they did 20 years ago).

On the other hand, if someone gets some sense and pulls the collective management's head out of its proverbial ass (including player's union management) and provides some straight talking transparency to the issue, the history James sees may not come to pass in baseball.
11:52 AM Aug 2nd
 
schoolshrink
Ventboys, neither or I, nor a lot of people care about steroids, or want to punish anyone. Bill wrote a piece on this site, "Mr. Pederson's Legacy," where it was pointed out to me that the story was about steroids. I did not get steroids in the story at all because I never think about steroids when watching baseball ... I just don't. Typical fans watch games for our entertainment and do not want to be bothered by side issues. And there is another reasonable argument not to care about steroids: the guys on all teams are drugged up anyway, they just take meds that received societal approval. What meds are those? They have Parke-Davis, Johnson & Johnson, Bayer, Amgen, et. al., logos attached on their pills and capsules. And they won't get rid of those drugs because of the money involved. Baseball players and their teams are guys who really can "ask their doctors" if taking a drug is right for them because the drugs are expensive and seven-figure athletes and teams can afford them. To me, steroids are the marijuana of baseball: steroids have represented all of what is wrong with the drug culture in the sport, just as in society in general marijuana is banned for its evils, even when more deaths annually can be attributed from prescriptions of drugs made by Parke-Davis, Johnson & Johnson, Bayer, Amgen, et. al.

Steroids are not all that is wrong with baseball, but the performance impact of steroids is pretty hard to deny. I am glad that baseball is addressing steroids because, and I could be wrong, the sport's competitive balance has since improved. Banning steroids has helped, along with strides taken by poorer teams to be competitive against the rich teams. Those factors are what have brought me back to baseball as a fan; I basically tuned the sport out from 1997-2004 and got interested again after reading Game of Shadows. I think a lot of fans are that way. What we really care about is thinking our teams have a reasonable chance of being competitive. It breaks my heart that the Mariners are not going to catch up this year after putting up with them a year ago, and during several 100 loss seasons. But the trades they have made make a lot of sense, for next year if not for this year. The Rangers and Angels are better than Seattle this year, but at least the M's will have a shot in a year. Even when the M's were a playoff team I never thought they were going to beat the Yankees. I don't think there was anything they could have done to beat them. Even making the playoffs and winning 116 games did not help to make watching baseball fun, as the Yankees were financially a mountain above all other teams in the league.

To me, the steroids issue is nothing but another money issue. If steroids were developed by Parke-Davis, Johnson & Johnson, Bayer, Amgen, et. al. and not BALCO, it probably would not be an issue at all. Similar to cannabis, marijuana would not be an issue as it is today if it were just controlled by American Brands, Phillip Morris, R.J. Reynolds, et. al.
12:49 PM Jul 31st
 
kcale
If this is the path baseball takes it will be it ultimate demise, effectively a license to cheat and be rewarded for it. Rafeal Palmeiro in the Hall of Fame? He should be in jail for lying to congress, not in the Hall. We have become a society of whimps... what we really need is another Judge Landis as the commissioner.
9:32 PM Jul 28th
 
ventboys
I personally don't care about the steroid issue that much. I doubt that any of us do, other than a few that have some real information to add. I am only bugged that so much misinformation is out there, and that the harbingers of sports "truth", the ones with the bully pulpit, are so lax in getting to at least some of the truth.

I sit here on my computer, in the backwoods of the country, and I feel sometimes like I know more than the national media about what has happened, despite not caring about it.

-I know that Palmiero's statement that he received a B-12 shot is true, while Rhome squawks twice a month that it's total bull, laughing and smirking into the camera, telling America that anyone that believes that crap is a moron.

- I know that Pete Rose was best friends with Paul Janszen, a convicted steroid dealer who he met in a gym in the act of selling. Janszen was in the circle, running his bets and living in his house.

- I know that Reggie Jackson also was living with a convicted steroid dealer while he was an active player. Reggie was Jose Canseco's teammate in 1987, which might or might not have anything to do with anything.

- I know that Eric Davis and Darryl Strawberry both contracted Colon cancer, which has been listed as a side effect of steroid abuse in something that I read. I can't assume that this is true, others are more qualified to judge this.

- I know that Mickey Mantle had a bleeding abcess in his leg, attributed to getting a bad b-12 shot. I read (again, I am only reporting this) that a b-12 shot won't cause an abcess.

- I know that several players accused of of steroid use in the 1990's (Sosa, Bonds, McGwire come to mind, I am missing someone) have usage timelines that coincide with recovery from a serious injury.

The top 3 (Palmiero, Rose and Reggie) are proveably true in the public domain. The bottom 3 are also true, but there is no proveable tie to steroid usage that I know of.

Again, I don't care about the usage, and I have no interest in punishing anyone. I would just like to know why the mainstream media is so lax and lazy about reporting the whole story, not just what pops up in front of them. I see a good story here, but it would take an investigative reporter that is willing to take on something that might not be well received.
1:22 AM Jul 28th
 
ventboys
I guess I can point this out one more time:

Pete Rose is in the news, as you all know. Colin Cowherd, on his show today, said that he has rethought his position on Pete Rose because of the steroid scandal. I just can't believe that a guy in his position doesn't know that Rose not only knew a steroid dealer, but lived with a steroid dealer for 3 years, and called him his BEST FRIEND. This dealer (Paul Janszen) was the guy that tossed Rose under the bus in the Dowd Report.

I don't care about Rose, or really care what he did or didn't do. I do care, and care a great deal, why the four letter network flatly refuses to say, on the air, that Rose had such strong connections to a convicted steroid dealer while he was still an active player and manager of a major league franchise. They have to know, don't they? I personally have emailed dozens of them over the years, and it's common, public knowledge. I don't get it.
1:02 AM Jul 28th
 
evanecurb
In Yaz's biography that was published shortly after the 1967 season, he described in detail the offseason workout program in which he engaged. He used a personal trainer who had previously trained other types of athletes (boxers maybe? It's been a long time since I read it). In any event, the profram was very rigorous, involving lots of calisthenics, medicine ball, sprints, etc. I don't remember if free weights were involved, but this type of program was unusual for its time.
10:11 AM Jul 26th
 
ventboys
This is a terrific discussion. I have nowhere near the medical background to understand much of it, but it's interesting to see some educated input. One thing that I want to point out: Is there hard evidence that Yaz did NOT do anything? I read more than once that he attributed his power surge in 1967 to working out, and maybe that's the simple truth.

Can we assume it? I am not accusing him, not at all. I am not accusing anyone, but lets not just assume, as the media does, that steroid used began with the first positive test. It's not fair the the ones that got caught.
11:59 PM Jul 25th
 
Paulroche1
Bill thanks for a very thoughtful article on the subject. I do agree that ultimately it will become too difficult to exclude all the known and suspected steroid users from the Hall of Fame, but I find that point very troubling. Our standards for the personal conduct of athletes has become so low that we are willing to ignore the criminal and ethical behavior of these individuals all because of loop holes in the collective bargaining agreement and the pervasive actions of the group.



10:10 AM Jul 25th
 
Kev
Bill; Your article is presented on 2 levels: Baseball, with emphasis on HOF considerations, and a present and forward-looking glance at society and PED.

>IN time the use of steroids or other Performance Enhancing Drugs will mean virtually nothing in the debate about who gets into the HOF or who does not.
I AGREE, and I don't have to like it. It will happen.

>It means that steroids keep you young.
UNTRUE. The fact that some people suffer adverse and even lethal effects does
not support "steroids keep you young."

> If we look into the future, then, we can reliably foresee a time when everybody is going to be using steroids or their pharmaceutical descendants. We will learn to control the health risks of these drugs, or we will develop alternatives to them. Once that happens, people will start living to age 200,or 300, or 1,000, and doctors will begin routinely prescribing drugs to help you live to be 200 300 or 1,000.
THIS is almost incredibly presunptuous and assumptive. The optimistic picture of a Forever Young society happily aging while remaining young is preposterous.
Reliably? There is nothing in existence to suggest such a chemical/biological order is approaching, and, on a practical level, your vision assumes the moral perfectability of man, in that it assumes such anti-aging agents will not fall prey to the control or attempted control of all sorts of characters motivated by profit. And at what age do we begin to decline, and what has been the quality of life for, say, the past 300 yrs.? Do we remain a youthful, immutable 50, and then decline rapidly, or do we decline as we do now, but at a slower, more pleasant, less erosive pace as is the case now?

>The argument for discriminating against PED users rests on the assumption of the moral superiority of non-drug users.
UNTRUE. The majority of retired athletes assert that they would have used PED had they been available when they played. The second objection of non-users (though it should be first) is the potential for serious bodily harm. High-schoolers are using PED today in order to be able to compete. Do PED accelerate or stunt a teen-ager's growth? Whichever, they are interfering with the natural development of the subject. And there will likely be a price to pay. Actually, I don't see it as a moral issue at all, unless deception or coercion is involved. To me, it's more like the flu--you can chance it and not take the shot, or take the shot. And the use of "discriminating" dilutes a fair debate.

> Steroids help athletes resist the effects of aging.
PARTIALLY true, certainly. But there is no evidence to suggest a categorical imperative regarding all athletes and their resistance to the effects of aging.

>History is forgiving.
WELL, you have a pawn covering two pieces here. History, as you use it, coupled with "statistics endure" is certainly true. But history is not forgiving in the cases of Hitler, Stalin, or the neighborhood predator. But speaking of stats, I regret that another layer of incomparability has entered the forest. It is ever more difficult to compare players under the veil of suspicion, to your Will Clark
reference. I think that Clark was probably born too early, if current ex-athletes are to be believed. Or maybe he would have stood firm against PED. We'll never know. But eventually he would be overwhelmed, his stand proudly recalled, or regretted? Again, we'll never know.

>the discrimination against PED users in Hall of Fame voting rests upon the perception that this was cheating.
THAT is certainly true--and hypocritical. Gaylord Perry laughed his way to the HOF with his did I or didn't I routine; Whitey Ford and Elston Howard performed surgery on the ball when circumstances required them to. Did those players cheat?
Yes, absolutely. And if there is a rule against anything, even if "everybody does it", and it is not even enforced, it's still cheating.

>The Commisioner's periodic spasms of self-righteousness do not constitute baseball law.
"PERIODIC spasms" is excellent.

And so too, is your concluding paragraph, with especial hosannas to your last sentence.


5:16 PM Jul 24th
 
hotstatrat
Thanks, Bill, for another refreshing well thought out well articulated point of view.

Thank you, Gary, for your well researched shocking point of view and for so patiently responding to all those questioning your assertions. Obviously it is hard to shake our well gelled notions of the dangers of steroids. My mind conjures up reports of shrunken testicles, Ken Caminiti, Lance Armstrong, and the guy who runs the gym facility I go to who also survived a cancer scare. However, I have not read any scientific journals on the subject.

Thank you, Chris DeRosa, for your insightful criticisms of this article. I would like to bring more attention to them and hopefully a response from Bill James himself:

1. Is there strong evidence the PED or steroid era is over? Can we see players more consistently going down hill in their early 30s already? Andruw Jones, Magglio Ordonez, etc. - and not recovering from injuries as strongly as they used to - Pedro Martinez, BJ Ryan, Julio Lugo, etc.? By the way, Bill James supposed most players will be using some form of steroid in the future. Perhaps, we are already in an era of better masked steroids?

2. Just how performance enhancing are performance enhancers is another area of huge controversy, which has been debated extensively elsewhere. Again, I have no scientific study to back me up except the gigantic incidental knowledge of Bonds, Sosa, and McGwire, etc. doing the previously impossible at advanced stages of their career. It does seem to be much more than a fountain of youth. However, no need to debate this further, unless someone has a specific legitimate scientific study to share. I remain ignorantly in the camp of it sure as heck helped some guys perform beyond their un-enhanced capabilities enormously.

3. How much of a rule it was is another area that has already been debated and debated elsewhere. I think Bill acknowledged this appropriately. Besides, don't we all exceed speed limits?

4. That BJ kept referring only to his high estimate of PED use (80%) is not being objective. Chris raised a very good point here and demonstrated what a difference that stat makes in the discussion. Bill, is there a justification for this other than shading reality to fit your point? (Nobody's perfect. We love you nonetheless.)

12:35 PM Jul 24th
 
CharlesSaeger
Martin: the rule for fixing ballgames was on the books at that time, and had been on the books since the founding of the National League. See Jim Devlin for an extremely early enforcement of that rule.
3:46 PM Jul 23rd
 
BigDaddyG
Martin- I think the reason throwing games is in a different category is because it means that the player is not trying to win the game, which ultimately hurts the fan. As a fan, what I care most about is that the contest is, in fact, a contest. The other forms of "cheating" (scuffing, corking, Lasik, lacquered bats with thin handles, Tommy John surgery, uppers, anabolics, etc) are used with intention of trying to win, which at least doesn't cheat the fan.
8:27 PM Jul 22nd
 
wovenstrap
I buy this argument almost completely, but I think he stretches one particular argument to the breaking point. So:

Question: Bill cites Joe Jackson in support of his argument, that public opinion will gravitate in favor of the perpetrators over time. Surely there is some truth to this. But doesn't the Black Sox example actually cut in opposition to Bill's argument? Bill thinks that the PED users will be exonerated over time because they will be perceived as "violating some 'rule' to which they never consented, which was never included in the rule books, and which for which there was no enforcement procedure." But wasn't the same thing largely true of fixing baseball games? Was there an enforcement procedure in place to cover the Black Sox? Did the players vote on the rules covering fixing games? I would suspect no, in both cases -- and yet, Joe Jackson's popularity notwithstanding, surely Landis and the enforcers had much, much greater public acceptance for many decades and decades -- and still enjoy great acceptance. Is there anything wrong with this interpretation? Is the parallel so far off?
4:20 PM Jul 22nd
 
oldehippy
It's nice to see someone who has studied the game and is respected has virtually the same opinion as I do. Steroids? Coke? Greenies? Cocktails? I don't care what the players take. If it's illegal, then they have the law to answer to. All I care about is seeing the best possible baseball as often as I can. What the players want to and are willing to do to their bodies is all right with me. I just want to see the best possible baseball as often as I can.
1:06 PM Jul 22nd
 
cderosa
Hi Charles,

If I mischaracterized you as an advocate of premise 1 above, apologies. These aren't straw men though. There were folks on SABR-L who used to argue premise 1. Premise 2 is Bill's, in his Hey Bill comments. Premise 3 has been advanced on this thread. Premises 4 & 5 are implicit and explicit, respectively, in Bill's piece, which was the point of my original post. Premises 2 & 5 I believe are novel to Bill, and in my opinion, the least workable. Premise 1 is also a reach, in my opinion. Premise 4 has lots of fans, and come to think of it, was also part of a memorable Steve Goldman column a few years ago. I could see that one (so much use as to level the playing field) being believable, once enough memoirs about the culture of 1990s clubhouses are available to make a tentative judgment.

Cheers,
11:29 AM Jul 22nd
 
CharlesSaeger
Ritchie: From your last response, it is very clear to me that you have had no intention of debating or even understanding the issues. There are other voices on this thread with whom I've disagreed -- Kevin, evan, Chris -- but they've contributed something positive to the argument.

(Nota bene: a "straw man" is a hypothetical argument that no one has actually made posited for the sake of debunking it. I can't help but think that because I used the word, you used it, even though it was an inapplicable word. Anyways, what you want to say is that aspirin deaths are irrelevant, then prove how this is so.)
10:28 AM Jul 22nd
 
Richie
Were some of you guys tobacco-company spokesmen back in the 70s? At least they put food on the table doing it.

Aspirin. Missing long-term studies of a substance whose long-term use by normal people is illegal. Ascribing all their bad medical outcomes to variably-present other substances. You apologists are trotting out one straw man after another.

But goodness knows the 'Steroids are the Plague!' folks have plenty of their own forums. So I suppose you guys ought to have yours', too. I leave it to you. Till we meet again on another thread.
4:00 PM Jul 21st
 
CharlesSaeger
Chris: Who is making that assumption that those questions do not exist? You're attacking a straw man here.
12:52 PM Jul 21st
 
cderosa
Hi Charles,

Your question was how I knew IPEDs in fact improved anyone's performance. It isn't about what *I* know. I know next to nothing. To understand what IPEDs did to baseball over the last 30 or so years, I have only a small smattering of the galaxy of data points I need. My point is, in the absence of robust data, why should we buy into assumptions that seem designed to minimize the issue?

In Bill's article, the thread, and the Hey Bill comments, we've seen the following premises advanced:

1) Performace enhacing drugs either don't enhance performance or cancel each other out.

2) Drugs that are obtained illegally are not really illegal, because there are other contexts in which they are legal.

3) The health risks which are the basis of IPEDs' illegality are largely illusory.

4) "Everybody" was using, so it was a level playing field after all.

5) We are now safely in the "post-steroid era."

If any of these five premises turns out to be true, I'll be very happy about it. In the meantime, they bear a burden of proof. I'm not going to use them as operating assumptions, because they strike me desperate and illogical attempts to minimize the issue and get on with believing in the essential fairness of the game in which all of us as students and fans of baseball have invested so much of ourselves.

Because let's say that it was 50% of the players using, rather than 80%. Let's say there was a large group of players who were squeamish about breaking the law. Then we have to ask, was there, in say, 1996, such thing as a "steroid heavy" team and a "steroid light" team? What happened when they played each other? Which type of team won more championships? What about in 1986? What about in 2006? We don't have answers to those questions and maybe won't get them. I don't think it is intellectually honest to assume those questions don't exist.
11:32 AM Jul 21st
 
schoolshrink
"Exactly as Dr. Gary has reported, the evidence to support that adverse impact of steroids on kids is sketchy at best, non-existent at worst." Redacting the phrase "on kids." I should have written that the long term adverse impact of steroid use is sketchy at best, non-existent at worst. Would be helpful to be able to screen what I write before posting; maybe it will happen at this site one day.
11:32 AM Jul 21st
 
schoolshrink
Armen Keteyian of Real Sports, the HBO series, has provided reports on steroids as well as Tommy John surgery. In discussing the long-term impact of steroids usage, he was unable to find compelling evidence to support the conclusion that there was any long-term adverse impact. But in a separate story, Tommy John surgery was discussed. Ethical or not, Tommy John surgery has been conducted on kids as young as age 12, and concern that long-term ligament damage as a result of the surgery was reported.

Exactly as Dr. Gary has reported, the evidence to support that adverse impact of steroids on kids is sketchy at best, non-existent at worst. I suspect that blaming steroids as the be-all and end-all of drug problems in baseball has simply served as a shield for other medical problems in the sport, including Tommy John surgery and maybe LASIK. I never hear anyone wanting to talk about the artificial competitive advantage provided by Tommy John surgery, because we want to see John Smoltz and others pitch again. This is where I think Bill's article is spot on: In fifty years we will regard it silly to ascertain the negative consequences of steroids as we do today in the same way as we simply accept Tommy John surgery as a regular part of treatment to allow pitchers to work again. And maybe we will report real long-term damage as a result of Tommy John surgery that we cannot report today because we need a large enough sample size to draw a real conclusion about its damaging effects, if any.

Since Bill's article addresses induction to Cooperstown, I have to think Smoltz's surgery allowed him to cross the barrier to being included. He was close but not close enough before the surgery, but afterward he clearly crossed the Rubicon. As for Will Clark, I cannot think of any surgery that would have been helpful in the same way as Smoltz's -- well, maybe LASIK. Should I feel bad for him that LASIK was not popular enough for Will to consider it, or good for him that considered LASIK but chose to avoid it. Maybe it did not even cross his mind. Maybe Will Clark did not care to use it to enhance his career; some guys do burn out at some point. As for his career and HOF credentials, it seems to me that he is at a similar tipping point as Smoltz before surgery. Like Mark Grace, good but not good enough.

Bill, consider Gary as one of your correspondents for this site. His responses have been fantastic and he offers a point of view unavailable from those of us without medical backgrounds. Gary, your responses are most appreciated.
11:19 AM Jul 21st
 
evanecurb
Gary:

Thanks for bringing up corticosteroids and their harmful effects. We are told about these intermittently, but for some reason, nothing is ever done.
11:15 AM Jul 21st
 
Richie
Our disagreement is actually pretty narrow, Mike. Either it's A), not a rule; or B), a rule from a superseding legal authority that the local regulatory one (MLB) chose not to (could not?) enforce. Not that much difference there.

MLB isn't trying to retroactively punish any users, are they? Legally they can't, can they? Just because some Squawk Radio guys suggest they do so, who cares?

HOF voters can vote however their brains and consciences instruct them. Myself, Clemens/Bonds/Sosa et.cet., furtively and in contravention of US law, grabbed themselves an advantage over their non-using, US law-abiding peers. For what I feel are understandable though not excusing competitive reasons.

I suppose I'd split the middle (and so catch flak from both sides). Deny them 1st-ballot status, then mentally downgrade their performance some in guesstimate that half of their opponents were using and half weren't. Then vote or not vote for them on that basis.

Not that anyone should care how I'd vote. But I figured I ought to put my position out there, so people know where I'm coming from.
11:14 AM Jul 21st
 
evanecurb
The PED era (referring here to anabolic steroids and other strength training drugs, not to amphetamines) has happened (or is still happening, if you prefer), and lasted from 1986 +/- to ???. Nothing can be done about changing what happened in the past. The discussion about steroids has turned into a debate about who should be in the Hall of Fame or who is entitled to hold records. This focus on only the history and the record books has always struck me as being the wrong approach, and I have been trying to figure why I feel this way. Here are some thoughts:

1. The focus on Bonds, McGwire, Clemens, et al. in the HOF voting keeps them in the spotlight, much as Rose and Shoeless Joe remain in the spotlight. Shoeless Joe is remembered because of Eight Men Out, Field of Dreams, and Say it Ain't so, Joe! Rose is, to this day, a popular topic on talk radio because of his HOF status. Every sports fan knows who he is. Eddie Collins has his plaque in Cooperstown and is largely forgotten today. Same thing is true for Carl Yastrzemski.

The same thing is going to be true of the steroid era guys, as long as we keep them out of the Hall. Clemens will remain a polarizing figure who is known to millions; Maddux and Glavine will fade from memory. Barry Bonds, like Clemens, has committed the triumvirate of sins: used PEDs, continues to lie about it, and acts like a jack ass generally. Bonds will remain in the spotlight to some extent as long as he is kept out of the Hall. His contemporary, Rickey Henderson, will fade in memory. (Look, I know Rickey had his best years ten years before Barry's, but for this comparison, I was looking for someone who played in the same era, has not been accused of PED use, and has broken a major record. Trust me. There aren't that many.)

2. Hundreds of guys were using PEDs, and many of their names are public knowledge. The lesser players have not been punished and won't be. To punish the stars while ignoring the lesser players seems wrong to me.

3. Andy Pettitte and Brian Roberts confessed to using steroids on a single occasion and are left alone afterward. The difference between Pettitte/Roberts and Clemens/Bonds is humility and tone. Both pairs of players committed the same offense, and both pairs are lying to the public. One pair is much more polite about it.

I don't like it that PEDs became a major part of the game in the 1990s and '00s. I won't lose any sleep if Bonds and Clemens never make it into the Hall of Fame, and I won't be upset if they do. What is important to me is that the adverse effects of PEDs (sorry, Gary; I continue to believe they are dangerous) are made to be common knowledge to all players, that the current testing and enforcement policy be maintained, and that MLB continue to improve and refine its drug testing methodology.

It's not that I "don't want to talk about the past" (to the contrary, I love the past; I was young then. It was great.). I believe the focus on past behaviors to the exclusion of correcting and improving the present situation is counterproductive.

What should the PED users do? I personally believe that baseball fans would be well served if each PED user were to make a statement detailing their use of substances and any positive effects and adverse effects which they experienced. This won't happen but wouldn't it be great if they did?

What should the commissioner do? He could try to ban all retired PED users from baseball for life. (I don't think they belong to the union after retirement, but not sure and don't know). This would have the effect of keeping them and the issue in the spotlight, and I see it as a bold but in the end a senseless gesture. So the commissioner should keep doing what he is doing, which is enforcing the current policy.

What should the union do? Lots of things, all aimed at protecting the players by taking away their ability to use PEDs without consequences. Research the issue and find out what the harmful effects are. Educate the players. Demand more thorough drug testing. And, most importantly, ostracize the cheaters as you ostracized the scabs in 1995. These guys are trying to take your jobs away and are putting you in position where you feel pressured to do something that jeopardizes your health and your livelihood. Don't let them do it.
10:49 AM Jul 21st
 
mikeclaw
Richie -
I realize the commissioner issued some sort of statement about steroids, but it wasn't a *rule* because the commissioner can't unilaterally establish rules. As Bill points out in this article, it was never approved, it was never entered into the rule book, etc.

But let's put that aside and call it a rule. If MLB established a rule, but made it clear that it had no intention of enforcing it, no intention of punishing anyone, and no intention of investigating even after it became apparent that hudreds of players were openly violating it ... well, is that really a rule? And if your answer is "yes," then isn't it well beyond hypocritical for baseball to want to retroactively punish people who did so?

As for the Hall of Fame ... the idea that we should take some sort of misguided moral stance and refuse to consider the biggest stars in the game because they played in an era when baseball turned a blind eye to steroid use, that's silly. There was no "unfair advantage," because every player in baseball knew he was free to use steroids without fear of consequences.

Should we also launch an investigation, maybe involving Congress, to determine which players from the 1960s and '70s used amphetamines so that we can then removed those players from the Hall of Fame? Because I'm unclear on how those two situations are drastically different.
7:30 AM Jul 21st
 
Richie
Gary, you address the one part of the aspirin objection while pretending that the other 2 parts aren't there. Where do you get off comparing the short-term effects of aspirin vs. the short-term effects of steroids when the clear dangers of steroids are long-term? Where do you get off comparing the medical outcomes of aspirin use vs. the medical outcomes of steroid use when aspirin use is indeed something like 100,000/1,000,000 more common than steroid use?

If you're into bodybuilding, you ought to know of Schwarzenegger's pal who wrote on the medical effects of steroids. He became a doctor of some sort, I believe. Nutritional, perhaps.

My father couldn't take aspirin later in life due to bleeding (stemming from massive overconsumption earlier in life, we figure). He was also put on steroids in old age. But you're not proposing medical use of steroids on this forum. You're defending professional use. By (18-year-olds? 21-year-olds?) 20-somethings rather than 80-somethings. And ongoing, cumulative use by 20-somethings I presume, as steroid use must be ongoing for the benefits to be ongoing, certainly at the level of professional athletics.
10:36 PM Jul 20th
 
BigDaddyG
> Cause me to re-submit to you my unansweed question: Would you advise a teen-
age son of yours to use steroids in his athletic pursuits.

This a question of large scope. First, it is unlikely that any child of mine is going to be athletically gifted enough to be a pro in anything, so my priorities would be to help promote a healthy lifestyle that includes proper diet, sleep, and encourage them to play multiple sports.

I think the concern I have (and perhaps you do, too) is the malignant culture of always striving to be the best, damn the consequences. I think that is an unhealthy attitude in general. I don't know that I will have to specifically single out steroids, since it more likely that he would get involved in other drugs, like uppers to help him to stay up late to study, or beta-blockers to help him play an instrument at the highest level (both of which are probably more pervasive drug's of abuse in youth, and neither of which are entirely benign).

But, no, I would not want my son to use anabolic steroids. I mentioned this before, but it bears repeating- one of the groups that should not be taking anabolic steroids are boys who have not finished growing, because it can close off their growth plates and stunt their growing.

I will tell you, though, who I would encourage to consider the use of anabolic agents- the older men in my life, whether they be my father, grandfather, uncles, etc. The incidence of low testosterone levels are actually very, very high, and this may in fact be part of the spectrum of the largest medical problem in the US (metabolic syndrome). Low testosterone levels are part of the endocrine response to stress, and helps explains why a lot of medical conditions are unresponsive to what otherwise seems like appropriate care.

It's something to think about if you know someone (whether it is yourself or someone you care about) who has a nagging injury that can't recover. And one of the reasons I have an "agenda" about testosterone is that I sometimes have to spend several visits to open up patients to even consider the use of testosterone because of the paranoia that has been created by the media.

An aside- this is not unique testosterone. I know friends of mine who are pediatricians, for example, who are extremely frustrated by how much time they have to spend in convincing parents to vaccinate their children because of the media talking about the possibilities of vaccines causing autism, even though the data is pretty unequivocal that they do not. There are many other examples of this. The media coverage of medical issues is, in my opinion, quite poor.


> And what would be a sensible reply to one's problem that he cannot compete with others who use steroids unless he does. Would you advise him to begin to use steroids to level the playing field?

I think a sensible reply (if this was my son or someone with whom I could speak candidly) is to ask them to honestly assess their true talent level. It is a rare athlete who is talented enough that the use of anabolic steroids or any other ergogenic aid is going to help them cross the threshold to playing at a professional level.

> Gary, it troubles me that you present intriguing but unconvincing arguments, and my experience, remarkable for nothing more than daily observation and "hearsay" (itself at times a valuable source, with no imprimaturs or pedigrees)

Daily observation is helpful. But as we know from the analysis of baseball, it is hard to observe with an honest eye (e.g., one could be led to conclude that Derek Jeter is an oustanding outfielder). Here is my challenge to you- from now on, every time you see an article talking about the dangers of steroids, make a mental note to yourself if they reference anything. I think you will find over time that they do not- it is just assumed that they are harmful as the premise of the discussion.
9:44 PM Jul 20th
 
BigDaddyG
Chuck- I don't any literature to support the use of testosterone for eyesight. Anecdotally, I've heard this claimed for HGH, but I don't know enough to comment one way or another.
9:24 PM Jul 20th
 
BigDaddyG
Richie- my only agenda is the best interest of my patients. As a layperson, before I ever researched the issue, I always assumed, like most people do, that there must be some great harm in the use of anabolic agents.

As I started to read the literature, my experience was not unlike Bill James's experience in the essays on reserve clause and free agency- I was shocked at how little there was to support the claims of negative side-effects.

My experience with fellow physicians is that they are initially skeptical, but I have not yet met one physician who has read the literature who considers anabolic agents to be especially harmful. This was highlighted to me at this year's American College of Sports Medicine meeting, when they had a pro- and con- lecture on the benefits of screening for doping. They were unable to find a physician to speak on the dangers of anabolic agents- they used a philosopher instead.

As for the dangers of aspirin and tylenol, there are clear dangers of both that don't require other explanations. Tylenol is one of the most common causes of liver toxicity, and aspirin is associated with thousands of bleeding events every year. I was just listing the deaths. As for the deaths associated with anabolic agents, I wasn't cherry picking. Even if you assume that all the deaths associated with anabolic agents are just from the anabolic agents, that still puts the death toll at a pretty low number - significantly below, for example, the background death total associated with travel.

As for why testosterone is illegal- first of all, it's not. It is perfectly legal to prescribe it, as I and many other physicians do regularly. It is a scheduled drug, meaning it requires a script with special protection, similar to what would be required for Percocet or other pain medications. The choice for testosterone to be a scheduled drug is primarily a political, and not a medical decision.

I am somewhat surprised by the vehemence and anger in the discussion of this topic, particularly in this forum. I know that I am a Bill James fan largely because I am interested in questioning underlying assumptions to determine the truth that lies beneath.

I don't think any of you should take my word on this. However, if you have an interest in steroids and baseball (and apparently you do, since you are reading the comments to a post about it), I think it is a worthwhile investment in your time to read, even just a little bit, to see if the assumption about the harm of anabolic agents is based on anything.

In my opinion, having read extensively on the issue and in treating both youth and senior athletes, that assumption is false. And if that assumption is false, that the entire discussion needs to be reframed.
8:31 PM Jul 20th
 
Kev
Bravo, Richie, all posts.
6:38 PM Jul 20th
 
Kev
Mike,

If what Richie says is correct, that steroids were againt the U.S. Code, then they were illegal. Your argument saying that if MLB didn't enforce the rule, that somehow it therefore didn't exist is ridiculous. If the rule existed.they were illegal. If not, not.
6:37 PM Jul 20th
 
Richie
Mike, there was a rule against steroids. Which MLB itself didn't enforce. But the rule was there, and some players honored it. And every last player who didn't kept his mouth shut about what he was using. Because if he 'fessed up, he faced a possibility of US law coming after him. If 20%-60% (BillJ's guesstimate) of people observe a rule, that rule is in place, nevermind that the infringers are getting off scot-free.

Charles, steroids indisputably really really helps you build strength. And strength is indisputably really really a good thing in baseball. Nevermind that I'm sure you can find a good player or two who's built like Don Knotts.
6:09 PM Jul 20th
 
schoolshrink
Charles, I would suspect that the owners care about managing steroids now because it is better for MLB to do so. It was not better for baseball to intervene ten years ago when McGwire and Sosa were hitting 70 and 66 HRs. They were SI's sportsmen of the year for good reason: that is what the public wanted. Chicks did dig the long ball, but for a limited time, and the steroids era helped to mask the ridiculous lack of competitive balance in the sport. Today, baseball needs competitive balance, particularly because players and owners alike embarrassed themselves in Congress and in managing the problem with the leaks of the secret research on player involvement.

To me, it was more ridiculous for the Yankees to go 120-50 and for the Marlins to go from World Series champs to losing more than 100 games after a fire sale of their players than for McGwire and Sosa to have hit that many home runs without chemical assistance. And the Yankees had the likes of Chuck Knoblauch on their team anyway, who, for me, was about the worst offender of the whole lot of em. I can only suspect Knoblauch had minor league talent absent the roids, and we had to suffer through his routine of checking his equipment before every pitch.


By the way, the player stats during the steroids era absolutely should stand without asterisks. I know it is off topic from the reasons why players are taking steroids, but you would have to question the Yankees 120-50 record because of Knoblauch and anyone else on that team who may have participated or was implicated if you were to eradicate the individual statistics of any one player. And guys who participate on this web site and in baseball are certainly able enough to read through the validity of those statistics.
6:07 PM Jul 20th
 
schoolshrink
Charles, I would suspect that the owners care about managing steroids now because it is better for MLB to do so. It was not better for baseball to intervene ten years ago when McGwire and Sosa were hitting 70 and 66 HRs. They were SI's sportsmen of the year for good reason: that is what the public wanted. Chicks did dig the long ball, but for a limited time, and the steroids era helped to mask the ridiculous lack of competitive balance in the sport. Today, baseball needs competitive balance, particularly because players and owners alike embarrassed themselves in Congress and in managing the problem with the leaks of the secret research on player involvement.

To me, it was more ridiculous for the Yankees to go 120-50 and for the Marlins to go from World Series champs to losing more than 100 games after a fire sale of their players than for McGwire and Sosa to have hit that many home runs without chemical assistance. And the Yankees had the likes of Chuck Knoblauch on their team anyway, who, for me, was about the worst offender of the whole lot of em. I can only suspect Knoblauch had minor league talent absent the roids, and we had to suffer through his routine of checking his equipment before every pitch.


By the way, the player stats during the steroids era absolutely should stand without asterisks. I know it is off topic from the reasons why players are taking steroids, but you would have to question the Yankees 120-50 record because of Knoblauch and anyone else on that team who may have participated or was implicated if you were to eradicate the individual statistics of any one player. And guys who participate on this web site and in baseball are certainly able enough to read through the validity of those statistics.
5:52 PM Jul 20th
 
CharlesSaeger
An unrelated note: the sides of this fight have never made any sense. Let's use the commonly held assumptions: steroids make you play better, steroids are bad for your health. (Again, we don't know for certain that either assumption is true. I took corking the bat to be a boost for years until I watched Mythbusters try it. But I think most people, including the players and the owners, believe both assumptions.)

Now, the concern. The owners have the players for a few years, and want to win with them and their large contracts. Wouldn't the owners want the players to be as doped up as possible, and wouldn't the players, who want have a life after baseball, want someone like a commissioner to step in and keep the owners from sucking away their later years?

However, it has been the owners who have been calling for testing, and using it as a plank in labor negotiations. What I don't understand is why the owners care. Bringing this up publically just diminishes the appeal of their product. Granted, the owners have been trashing their own product for over 30 years as a negotiating tactic, but it keeps me from taking this whole argument from being anything other than a sad diversion.
5:14 PM Jul 20th
 
CharlesSaeger
Chris: that doesn't answer the question. (Indeed, the extra bulk might slow down the bat speed, since there is now need to move even more muscle.) I've seen exactly one study showing any sort of effect, and it isn't large even there (a 5-10% boost in Runs Created), and the usual issues apply -- nobody knows for sure who was using what when (it used the Mitchell Report players over a whole period), it doesn't look at the pitchers. Point me to one study showing your conclusion. If you can't, there's a correct answer to the question, the one I gave: I don't know, and you don't know either.
4:45 PM Jul 20th
 
mikeclaw
Richie -
Your logic is mistaken. It now comes out that steroid use was rampant for more than a decade, and pretty much everyone within the game knew it. It was being rumored. It was being accused. It was being written about. Baseball did nothing. Every other sport on the planet was banning steroids, testing for them, punishing offenders. Baseball did nothing. If players were carrying shivs onto the field and threatening opponents (using your example), baseball would have put a stop to it. If knife attacks had become so commonplace that other sports were taking harsh action to stop them, baseball would follow suit. But that didn't happen with steroids. Baseball knew steroids were a widespread issue in sports, but nothing was done. People at every level of MLB knew that they had become widespread, that major stars were using. No one did anything to stop them.

Trying to argue that steroids were illegal in MLB in the 1990s is silly. We now have come to find out that the majority of the players were most likely using, and everyone within the game knew about it. And did nothing. You can like that or you can hate it, but it's a fact. And it's impossible to say that something is illegal if there's no rule against it, or if the authorities make it clear to everyone involved that they have no interest in enforcing the rule that is in place.

MLB players who used steroids in the 1990s were not cheating.
4:14 PM Jul 20th
 
Richie
Baseball's written rulebook does not prohibit Jacoby Ellsbury from bringing a sharp surgical instrument onto the field, showing it to Robinson Cano and telling him "you don't want to be applying no tag on me at 2nd base today." It is nevertheless against baseball's rules by contravening the US legal code, and so cannot be done.

It is not against baseball's written rules for Dustin Pedroia to phone the Yankee clubhouse prior to the game, and tell that day's starting Yankee pitcher Andy Pettitte his wife's died in an auto accident so quick go home and see to the kids. But it's again against the US legal code which subsumes all enterprises within it, baseball and everything else. It is also therefore against baseball rules.

By being illegal within the overarching set of legal rules within which baseball operates, yes, steroids were against baseball rules too. In that way, no different than any other kind of criminal act.

Now the rule being unenforced, and widely ignored, that does have legal ramifications. In my opinion, raises moral qualifications too, then. But steroids were against the rules.
2:37 PM Jul 20th
 
mikeclaw
Two thoughts, upon reading these comments:

1.) I'm still amazed at how many people angrily refer to these people as "cheaters" when it is clear that there was no rule against steroid use, no attempt to stop it, and extraordinarily widespread use. Baseball's "policy" throughout the '90s was: "We wish you wouldn't, but we're not going to test you or punish you, and if steroid use becomes epidemic, we will look the other way." You don't have to like that fact, but the truth is, it wasn't against the rules, and if it's not against the rules, it's not cheating. The idea that these guys need to be punished retroactively, since baseball refused to test or punish them at the time, is silly. The idea that they should be denied entry into the Hall of Fame until after they are dead is juvenile beyond words.

2.) I'm not a doctor, but what Gary says here makes complete sense. Steroids, in and of themselves, are tremendously beneficial. I've taken them as part of the recovery process following surgery. I would guess that most of us on this site have used steroids at one point or another. They are beneficial. What is harmful isn't steroids themselves, but irresponsible use of steroids -- acquiring them from a disreputable source, using them without consultation of a physician or trainer, using them in large doses without knowing the effects. Using steroids in that way would be irresponsible and dangerous. Using any medicine that way would be irresponsible and dangerous.
11:59 AM Jul 20th
 
Richie
Schwarzenegger had a pal, name something like Curulescu/Cusculescu (can't find it now), a world class bodybuilder, who researched the deleterious health effects of steroids. He confirmed the conventional wisdom that of course they have them, without making them out to be the Black Plague or anything.

Some of Gary's comparisons are laughable. Saying '1100 people die per year from aspirin/tylenol consumption', without accounting for whatever extra abuse those people did, while any steroid-related deaths are of course instead attributable to that other abuse. Comparing aspirin and steroids in the first place, when aspirin reaction death is immediate while steroid damage is medium- and long-term. Comparing aspirin and steroid death rates when for every steroid injection there's 100,000/1,000,000/10,000,000 aspirin popped.

Gary has an agenda, to justify steroid use rather than impartially examine it. Nothing wrong with taking the unpopular side of an issue, and goodness knows he's outnumbered about 1100-to-1 by the agendeers on the other side. But he's not being the impartial physician here.
11:14 AM Jul 20th
 
Kev
Gary, my keyboard has faild near the conclusion of my reply. I cannnot undo it, and apologize for its incohrenecy.

3:12 AM Jul 20th
 
Kev
Gary,

Your rebuttal, lengthy and thorough, leads me to conclude that you:
1. Believe that the prevailing thought on steroids as harmful is,
for whatever reason, almost 10% false, since it is unsupported by medical
research, and regard those deaths you referenced attributable to other causes.
And regard the possibility of steroid use rendering bodies so vulner-
able to complications as not even worth discussing.

2. Declare, in effect, that there is no reason to regard steroids as harmful.

3. Ignore "non-medical" accounts of steroid-related tragedies in media reports
regularly, as well those discussed in normal social intercourse as not worthy
of consideration

4. Lead me to believe that steroids, far from harmful, are beneficial to the body
despite the fact that they must be obtained illegally since rhey are regarded
as a menace, and also make me wonder why they are not freely dispensed to
athletes, depressives and others who would benefit from them.

5. And I are living in diffwerent environments, and one of them is out of touch
with daily life and its pitfalls.

6. Cause me to re-submit to you my unansweed question: Would you advise a teen-
age son of yours to use steroids in his athletic pursuits. And what would be
a sensible reply to one's problem that he cannot compete with others who use
steroids unless he does. Would you advise him to begin to use steroids to
level the playing field?

Gary, it troubles me that you present intriguing but unconvincing arguments, and my experience, remarkable for nothing more than daily observation and "hearsay" (itself at times a valuable source, with no imprimaturs or pedigrees), describes a position so countsr to yours. If I am wrong, it has no importance, but if you are uninformed, then because of the wide-ranging significance of your profession, an unappreciated danger exists.





3:05 AM Jul 20th
 
chuck
Gary,
I recall a story I heard on the radio on steroid use, in which the journalist tried using a particular steroid to be able to talk firsthand about the effects it had. One of these was that he felt he had better eyesight after using it. Does this jibe with anything you know about particular steroids (I can't remember the one in the story) or with HGH?
Obviously such a side effect would be a boon to a baseball player. I thought Mac's comment on Bonds a bit ago in the Hey Bill section of the site was a fine one- that: if taking these substances essentially arrested the aging process, that he would then be in a position to utilize all that baseball knowledge gained over his long career. But I wonder if it's also possible that he might simply have gained better eyesight as well.
1:47 AM Jul 20th
 
BigDaddyG
Kevin,

In short, what I am saying is the traditional orthodoxy- the assumption that anabolic steroid use is harmful- is not based on fact. This parallels many of the concepts Bill James has brought up in traditional baseball analysis- there are many assumptions that old school baseball fans still adhere to (the best measure of a pitcher's skill is their win total, that batters can protect other batters in the batting order, that batting average is the best measure of a players offensive contribution, etc). The assumption that anabolic steroids are harmful is similar- this assumption is taken as a truth when there is no real basis for it.

Why would such an assumption be so pervasive? For the same reasons erroneous beliefs take hold in any field- nobody has bothered to check, or too much weight is given to outlying episodes.

In the specific case of steroids, there are a whole bunch of factors that have probably contributed to the assumption that steroids are harmful:
1. Lyle Alzado. He is the one athlete everybody points to. If you go back and read his interview in Sports Illustrated, no physician corroborated his assumption that steroids were responsible for his brain tumor. The fact that Alzado is the one athlete that is the poster child for the dangers of steroids is in large part because there aren't other great examples.

2. Deaths of pro-wrestlers. This is unfortunate, and they have an incredibly high death rate. On the other hand, almost all of these deaths have other factors that are more likely contributors. Eddie Guerrero had an enlarged heart, which is more likely related to his well-documented decades of alcohol abuse. Chris Benoit had severe brain damage that is likely linked to the hundreds (if not thousands) of concussions he had from diving headbutts and chair shots. Louie Spicolli was found with huge doses of Soma and alcohol, etc. There are a few that are probably traceable to steroid use- Rick Rude comes to mind. Again, a useful control group is professional bodybuilders, who use more anabolic agents, but are considerably healthier. It's probably the other substances and bad habits that contribute to their health risks.

3. The are many variations of the polls that ask athletes "if you could take a pill that would guarantee you a gold medal, but would cause you to live 10 less years than you would have otherwise," for which a high % of athletes say they would take the pill. The implication in the question is that such a pill exists, and for many people, they assume the magic pill is steroids. This type of linkage has led many to assume that there is some body of data to support the conclusion that steroids are harmful, when no such data exists.

4. Inappropriate use of steroids in the wrong populations. Many of us are familiar with the mass-doping that was used with female Chinese and East German athletes, who suffered permanent damage from the androgenizing side effects of anabolic steroids. Similarly, use of anabolic steroids in prepubescent males can cause growth plates to fuse and stunt growth, and use of steroids without monitoring could exacerbate prostate cancer.

5. Lack of due diligence by sports media. Mike Greenburg, from Mike & Mike in the morning on ESPN, has a journalism degree from Northwestern, and has been discussing steroids for well over 5 years on the radio. He frequently notes that he has done no research into the dangers of anabolic steroids, but talks about it endlessly on the radio. I have never heard them have a physician or researcher on the radio to discuss the risk/safety of steroids, which seems like an obvious thing to do. Mike and the Mad Dog (formally on in the NY market) did have an endocrinologist on once that I heard, who confirmed that anabolic steroids are relatively safe. These are just anecdotal examples, but as a whole, I think it fair to say that the sports media has been lazy in doing their own research.

6. Professional sports not wanting to address more serious issues. Most professional sports leagues do have drug issues, but they don't want to address them. Uppers are routinely used in some form, whether it be coffee, cocaine, or amphetamines, part of which is purely for performance, part of which is because teams have grueling travel schedules. These are not innocent medications- many of the deaths from heat-related illness were exacerbated because of use of uppers. If you look at football players from the 1970s, many of them are cripples (e.g., Earl Campbell). The frequent use of pain killers and corticosteroid injections have been linked to exacerbating degeneration of the joints, whereas anabolic steroids have data to support their use in aiding healing.

There are other factors at play here, too, but they all have contributed to a narrative that anabolic steroids are some great health risk, but is little supported by data.

So, Kevin, to address your question of "Do you believe that there is no scientific evidence linking anabolic steroid use with harmful side effects?"- I think there is some evidence of harmful side-effects of anabolic steroids, but these risks are similar in effect size to the use of inhalers for asthmatics or caffeine, probably less than the use of birth control pills, almost certainly less than the use of corticosteroids and other anti-inflammatory medications, and orders of magnitude less significant than the risks of poor landing techniques, overuse injuries in youth althletes, and disruptive travel schedules.

I see several youth athletes a month who have injuries traceable to them playing only one sport at a young age. I have not yet seen an athlete with ill health related to anabolic steroid use. I am not saying that it doesn't exist, but there is nothing in the medical literature or in my observations as a sports fan that suggests to me otherwise.

Furthermore, I see probably 3-4 patients per week who have chronic health problems related to low testosterone, which is a true medical epidemic. All of the attention on the dangers of anabolic steroid abuse has made it difficult to treat the very real issue of low testosterone, since it has created a sense of paranoia about the dangers of testosterone.
3:02 PM Jul 19th
 
Kev
To Gary, re: Gary to Kevin,

Thank you for the prompt response. If I understand you correctly, there seems to be an epidemic of steroid phobia abroad in the land, quite akin to that once associated with fallout shelters, and just as bogus.
Also frequent travel and disruptive sleep schedules pose greater dangers to athletes than anabolic steroids.
And thank you for the article reference.
Do you believe that there is no scientific evidence linking anabolic steroid use with harmful side effects? The seedy obtaining of the steroid (e.g., the back of the gym) you dismiss from the subject; you also claim impure paraphernalia contributes to the problem, thus presumably subtracting that segment as well from steroid side effects. They exist, as you say, but you claim 5%, though hard to pin down, to be a fair morbidity estimate. Properly administered steroids by qualified medical personnel to combat disease is not the topic. We are interested in the harmful effects of steroids upon athletes, regardless of source. (And incidentally, without a suitable time period to monitor this over many years into later life among widely dispersed former athletes is an incomplete study.) Difficult as well is gathering information from athletes who swear they have never used steroids. Your conclusions are made from neat and clean premises--they do not address the problem. How could they when we are told the problem no longer exists? Newspeak by the Commissioner of Basball proclaimed the Steroid Age to be over-- just prior to the admissions of PED usage by baseball mega-stars. This suggests how intensely bseball itself is tracking its problem, and how successfully...
I thank you again for your research, but I find it unsatisfactory, or rather feel that it does not agree with other opinion on the matter. I brought up NEJM and am properly skewered on it--but am I? Does that excerpt prove or suggest that the use of steroids by athletes poses no threat, and has no or mininaml side effects?
I confess chagrin at what you seem to be saying in disputing the prevailing (to me, anyway) thought on steroid usage and its evils, absent the professional utilization previously referenced. The fact is athletes cannot obtain the steroids from qualified medical personnel without resorting to falsification of their need for it. Why is that? The dangers of which we speak are the reason. No doctor in good conscience will prescribe those steroids. Why? They are harmful. NEJM appears to be segregating steroids,or at least not discussing what we are discussing. But the drugs exist, and are easily obtained--they must be included in your survey and its conclusions regarding "no evidence". Those athletes who hold the key are not about to permit themselves to be studied. The question which
remains begged is stillout there.
And the greater question, paramount over all, is what do our highly competitive high-school and college athletes believe: there is little to no danger in using steroids, or they can kill you. and everything in between.



12:58 PM Jul 19th
 
BigDaddyG
In response to Kevin:

>Physician Gary:
Just how many people must die before you will amend your otherworldly statement that the health risk incurred by using anabolic steroids is "dramatically over-stated"? Was Lyle Alzado an actuarial improbability?

There is no reason to think that Lyle Alzado died from anabolic steroid usage. He died from a brain tumor, and even the harshest steroids critics don't consider brain tumors a side effect of anabolic agents.

> And if you don't mind, what does "that assumption is untrue, on balance,"? mean?

It means that there is very little evidence that anabolic steroids have harmful side-effects, period, but certainly in comparison to other things that athletes routinely do. There is far more medical literature showing the harmful effects of frequent travel and disruptive sleep schedules- things that seem relatively innocent, but are far more detrimental to the health of the athletes.

> I've long noticed that those employing "on balance" in debate use those words to attempt to strengthen their argument by blur or vaguenes

I used "on balance" as a shorthand so as not to go through a long list of side-effects of different medications and their probability of causing morbidity and mortality.

But, since you did not want me to be vague ...
In a typical year, 1000 people in the US die from aspirin consumption, and probably another 100 from tylenol. The estimates from anabolic steroid usage is hard to pin down, but it's probably less than 5 people a year, and those are related to incidental issues like infection from needles.

Furthermore, many of the health risks from anabolic steroid usage is artificially created by driving the distribution of the medication into an underground economy. Routine safety measures like liver function tests, PSA levels, and quality control are not possible if the mechanism for obtaining the medication is from a dealer at the back of the gym.

> Your argument conveniently avoids the volume factor in steroid use by athletes. They will, once they see favorable results, consume whatever is required to keep rhe machine running.

Athletes tend to look for what works, not what is maximized. If you look at professional bodybuilding, they don't use bigger and bigger doses- they cycle. And if you look at professional bodybuilders as a whole, they tend to be pretty healthy.

> And I seriously doubt that an article supporting your opinion that steroid use is "dramatically over-stated" will ever appear in the New England Journal of Medicine.

You don't have to take my word for this- others within the medical community have pointed out that the assumptions of harmful side effects of anabolic agents are not based on any scientific evidence. A good review on the topic is the article "MEDICAL ISSUES ASSOCIATED WITH ANABOLIC STEROID USE: ARE THEY EXAGGERATED?" by Jay R. Hoffman and Nicholas A. Ratamess in the Journal of Sports Science and Medicine in 2006.

There is no particular reason to view NEJM as the ultimate arbiter of medical knowledge, but since you asked- there are 211 articles in the NEJM about the use of testosterone. Looking through the abstracts, they all appear to be related to the health benefits of testosterone, and there are in fact articles about using testosterone in populations that used to be considered unsafe- including women and men with prostate cancer.

In the article "Risks of Testosterone-Replacement Therapy and Recommendations for Monitoring" by Rhoden & Morgentaler from the NEJM in 2004, they note the following:
- "Studies of testosterone-replacement therapy have not demonstrated an increased incidence of cardiovascular disease or events such as myocardial infarction, stroke, or angina."
- "Thus, the present data, taken together, suggest that testosterone-replacement therapy within the physiologic range is not associated with worsening of the lipid profile."
- "It is reassuring that as far as we can determine, no testosterone-associated thromboembolic events have been reported to date."
- "In our opinion, proper monitoring with measurement of PSA and digital rectal examination should promote the early diagnosis, and thus potential cure, of most "unmasked" prostate cancers identified during testosterone treatment"

> And tell me, would you advise a son of yours to ignore those arguments, to use steroids to shine in his athletic pursuits?

Of the many things that athletes do to their bodies, warning against anabolic steroid usage would be relatively low on my list of priorities. For the greatest risk/benefit ratio, I would emphasize those things that I know are important- a good sleep schedule, a healthy diet, not smoking, always look at what you are tackling to avoid spine injuries, learning proper landing techniques to prevent ACL injuries, etc.

There are many legitimate medical epidemics that affect youth athletes- concussions, spine injuries, ACL injuries, poor sleep, use of corticosteroids and pain killers, playing only one sport in high volume at a young age, etc. If the goal is to protect our children, the emphasis on anabolic steroids is a very curious place to start.
9:30 PM Jul 18th
 
BigDaddyG
In response to Kevin:

>Physician Gary:
Just how many people must die before you will amend your otherworldly statement that the health risk incurred by using anabolic steroids is "dramatically over-stated"? Was Lyle Alzado an actuarial improbability?

There is no reason to think that Lyle Alzado died from anabolic steroid usage. He died from a brain tumor, and even the harshest steroids critics don't consider brain tumors a side effect of anabolic agents.

> And if you don't mind, what does "that assumption is untrue, on balance,"? mean?

It means that there is very little evidence that anabolic steroids have harmful side-effects, period, but certainly in comparison to other things that athletes routinely do. There is far more medical literature showing the harmful effects of frequent travel and disruptive sleep schedules- things that seem relatively innocent, but are far more detrimental to the health of the athletes.

> I've long noticed that those employing "on balance" in debate use those words to attempt to strengthen their argument by blur or vaguenes

I used "on balance" as a shorthand so as not to go through a long list of side-effects of different medications and their probability of causing morbidity and mortality.

But, since you did not want me to be vague ...
In a typical year, 1000 people in the US die from aspirin consumption, and probably another 100 from tylenol. The estimates from anabolic steroid usage is hard to pin down, but it's probably less than 5 people a year, and those are related to incidental issues like infection from needles.

Furthermore, many of the health risks from anabolic steroid usage is artificially created by driving the distribution of the medication into an underground economy. Routine safety measures like liver function tests, PSA levels, and quality control are not possible if the mechanism for obtaining the medication is from a dealer at the back of the gym.

> Your argument conveniently avoids the volume factor in steroid use by athletes. They will, once they see favorable results, consume whatever is required to keep rhe machine running.

Athletes tend to look for what works, not what is maximized. If you look at professional bodybuilding, they don't use bigger and bigger doses- they cycle. And if you look at professional bodybuilders as a whole, they tend to be pretty healthy.

> And I seriously doubt that an article supporting your opinion that steroid use is "dramatically over-stated" will ever appear in the New England Journal of Medicine.

You don't have to take my word for this- others within the medical community have pointed out that the assumptions of harmful side effects of anabolic agents are not based on any scientific evidence. A good review on the topic is the article "MEDICAL ISSUES ASSOCIATED WITH ANABOLIC STEROID USE: ARE THEY EXAGGERATED?" by Jay R. Hoffman and Nicholas A. Ratamess in the Journal of Sports Science and Medicine in 2006.

There is no particular reason to view NEJM as the ultimate arbiter of medical knowledge, but since you asked- there are 211 articles in the NEJM about the use of testosterone. Looking through the abstracts, they all appear to be related to the health benefits of testosterone, and there are in fact articles about using testosterone in populations that used to be considered unsafe- including women and men with prostate cancer.

In the article "Risks of Testosterone-Replacement Therapy and Recommendations for Monitoring" by Rhoden & Morgentaler from the NEJM in 2004, they note the following:
- "Studies of testosterone-replacement therapy have not demonstrated an increased incidence of cardiovascular disease or events such as myocardial infarction, stroke, or angina."
- "Thus, the present data, taken together, suggest that testosterone-replacement therapy within the physiologic range is not associated with worsening of the lipid profile."
- "It is reassuring that as far as we can determine, no testosterone-associated thromboembolic events have been reported to date."
- "In our opinion, proper monitoring with measurement of PSA and digital rectal examination should promote the early diagnosis, and thus potential cure, of most "unmasked" prostate cancers identified during testosterone treatment"

> And tell me, would you advise a son of yours to ignore those arguments, to use steroids to shine in his athletic pursuits?

Of the many things that athletes do to their bodies, warning against anabolic steroid usage would be relatively low on my list of priorities. For the greatest risk/benefit ratio, I would emphasize those things that I know are important- a good sleep schedule, a healthy diet, not smoking, always look at what you are tackling to avoid spine injuries, learning proper landing techniques to prevent ACL injuries, etc.

There are many legitimate medical epidemics that affect youth athletes- concussions, spine injuries, ACL injuries, poor sleep, use of corticosteroids and pain killers, playing only one sport in high volume at a young age, etc. If the goal is to protect our children, the emphasis on anabolic steroids is a very curious place to start.
8:51 PM Jul 18th
 
cderosa
Hi Charles, steroids help you train with weights. There are those in the sabermetric community who are still in denial that physical strength helps you play baseball (as to which players, or group of players, benefits more, we could not guess), but I don't think that's a realistic operating assumption. Again, it would be convenient if we could wish away the imapct of IPEDs by assuming that they cancel each other out, and I really wish they did somehow, but I think to understand baseball history, we need to be more skeptical of these convenient arguments.

Yours,
Chris
5:40 PM Jul 18th
 
Kev
Bill, this won't be long-winded, I promise. Period. But isn't the most important issue in the steroid issue itself the harm and legacy we leave for our kids?

1:17 PM Jul 18th
 
Kev
Physician Gary:

Just how many people must die before you will amend your otherworldly statement that the health risk incurred by using anabolic steroids is "dramatically over-stated"? Was Lyle Alzado an actuarial improbability? And if you don't mind, what does "that assumption is untrue, on balance,"? mean? I've long noticed that those employing "on balance" in debate use those words to attempt to strengthen their argument by blur or vaguenes; try to attach to it a kind of universal blessing, one which is not only not theirs to give, but also not supported by fact. Or, put another way, what the hell does "on balance" mean?--balancing the benefits of steroids against their danger (a danger that shows up later when it's too late to remedy its effects? Your argument conveniently avoids the volume factor in steroid use by athletes. They will, once they see favorable results, consume whatever is required to keep rhe machine running. And OK, I'm impressed by "physician", but "doctor" would impress me no less. And I seriously doubt that an article supporting your opinion that steroid use is "dramatically over-stated" will ever appear in the New England Journal of Medicine. And didn't you mean "moral", instead of "morale"?
Please don't consider me ungrateful for your sharing your ahead of the curve wisdom with the rest of us, as well as with other physicians/doctors, indeed, the entire medical profession: ("I think the public (and medicine) will come to realize the public assumption of health risks with steroids is bogus in the next 10 years, after which the morale posturing about steroid use will cease to hold weight."
And tell me, would you advise a son of yours to ignore those arguments, to use steroids to shine in his athletic pursuits?

1:07 PM Jul 18th
 
BigDaddyG
In response to Trailbzr's question/comment: of the many harmful things that people do to their bodies, use of anabolic agents is one of the least damaging, and it is questionable as to whether they are damaging at all. In regards to the Pittsburgh Steelers of the 70s and their drug use- testosterone is not all they were using, and they were not living a healthy lifestyle. If you were to compare three professions of large framed men who used anabolic agents- football players, professional wrestlers, and bodybuilders- clearly, the bodybuilders are the ones who have had the healthiest long term outcomes, and without any data in front of me, they seem to be as healthy as any other male population. The bodybuilders serve as a control group demonstrating what happens if steroids and anabolic agents are the only thing you use, but still live a healthy lifestyle with good nutrition, adequate sleep, and resisting other drug use. This, to me, highly suggests that the health consequences seen in professional football players and professional wrestlers is related to the other things they are doing except for use of anabolic agents. As another control- compare stand-up comedians to professional football players and professional wrestlers. Stand-up comedians have many of the same vices (particularly bad sleep schedules, but secondarily other drug use) EXCEPT for the use of anabolic agents, and as a group they have many of the health issues that football players and pro-wrestlers do, but that bodybuilders are spared. This suggests to me that, again, the use of anabolic agents is not particularly linked to ill health consequences. Beyond these anecdotal observations, though, the medical literature has not provided evidence of significant health consequences in users of anabolic agents except in the case or prepubertal males (where it can stunt growth) and females (where it can masculinize), at least relative to other medications that are used routinely. I think it is reasonable to say that the risk/benefit ratio of testosterone compares very favorably to common agents like aspirin and cortisone.
12:35 AM Jul 18th
 
BigDaddyG
In response to Trailbzr's question/comment: of the many harmful things that people do to their bodies, use of anabolic agents is one of the least damaging, and it is questionable as to whether they are damaging at all. In regards to the Pittsburgh Steelers of the 70s and their drug use- testosterone is not all they were using, and they were not living a healthy lifestyle. If you were to compare three professions of large framed men who used anabolic agents- football players, professional wrestlers, and bodybuilders- clearly, the bodybuilders are the ones who have had the healthiest long term outcomes, and without any data in front of me, they seem to be as healthy as any other male population. The bodybuilders serve as a control group demonstrating what happens if steroids and anabolic agents are the only thing you use, but still live a healthy lifestyle with good nutrition, adequate sleep, and resisting other drug use. This, to me, highly suggests that the health consequences seen in professional football players and professional wrestlers is related to the other things they are doing except for use of anabolic agents. As another control- compare stand-up comedians to professional football players and professional wrestlers. Stand-up comedians have many of the same vices (particularly bad sleep schedules, but secondarily other drug use) EXCEPT for the use of anabolic agents, and as a group they have many of the health issues that football players and pro-wrestlers do, but that bodybuilders are spared. This suggests to me that, again, the use of anabolic agents is not particularly linked to ill health consequences. Beyond these anecdotal observations, though, the medical literature has not provided evidence of significant health consequences in users of anabolic agents except in the case or prepubertal males (where it can stunt growth) and females (where it can masculinize), at least relative to other medications that are used routinely. I think it is reasonable to say that the risk/benefit ratio of testosterone compares very favorably to common agents like aspirin and cortisone.
12:08 AM Jul 18th
 
evanecurb
Why is Hall of Fame voting the flash point in the steroids debate? "Rollo" gives the best answer to this question I have read, anywhere. I maintain that focusing the debate on the elite players and the Hall of Fame is a diversion that takes focus away from the greater issue - the fact that at least 103 major league players were using in 2003, and the fact that they knew they would be tested leads me to believe the actual number of users was much greater. Directing all of the outrage at Bonds, Clemens, McGwire, et al not only lets Jay Gibbons, Ryan Franklin, and Brian Roberts off the hook, but more importantly, it diverts our attention away from a much more important pursuit - trying to determine how widespread steroid usage was then and is now.
8:43 PM Jul 17th
 
CharlesSaeger
Oh, I wish I'd said it earlier, but this is one of the best damn baseball articles I've read, period, and easily the best on the topic at hand, which seems to attract more idiocy than other topics.
6:02 PM Jul 17th
 
kranepool
Excelent article. I've been asking the same question when people mention the "cheating" aspect of the Steriod Era Cheating at what? What rule was broken? Is taking a Cotisone shot cheating? Or Lasix surgery? they both help in recovery and performance enhancing? It seems the only people with thier panties in a bunch over this is the BBWAA.
2:28 PM Jul 17th
 
rcberlo
Rollo's comment about delaying a 'roider's entry into the HOF as a punishment is a good idea. The worst punishment would be to wait until after they die. BUT - this assumes we're quite sure who the 'roiders were and who weren't. Hate to deny the wrong person entry into the HOF during their lifetime.
1:44 PM Jul 17th
 
ventboys
Just about everyone is doing it, rules are either nonexistent of not enforced. The numbers are hopelessly skewed out of porportion, and anyone that doesn't play along is left with a competitive disadvantage. Steroids? Or the spitball? I don't see them as the same, but there are some important similarities. By the time the Hall opened the spitball era was 20 years in the rear view mirror.
12:36 PM Jul 17th
 
rollo131
I think the Hall of Fame/Steroids issue isn't about KEEPING players out of the Hall of Fame permanently, but about meting out some form of punishment to the cheaters. It's possibly the only form of punishment the cheaters can ever really receive. Hall of Fame voters withholding their votes for Barry Bonds five years from now won't necessarily feel that Bonds should never be elected, although some may feel that way, they may simply be using their positions to bring the perpetrators to justice. I believe Bill is right, that these players will all eventually get in, and ultimately the only punishment they'll receive for cheating will have been waiting a few extra years to get into the Hall of Fame.

Kind of like the way another well-known cheater is still waiting to get in.
11:27 AM Jul 17th
 
mikeclaw
Here is the best sentence I have read in the context of logical discourse in quite a while: "It seems to me that the argument that it is cheating must ultimately collapse under the weight of carrying this great contradiction—that 80% of the players are cheating against the other 20% by violating some “rule” to which they never consented, which was never included in the rule books, and which for which there was no enforcement procedure."

Great article.

10:38 AM Jul 17th
 
CharlesSaeger
Chris: How do you know that PEDs can be a "route to improvement over established levels of performance"? I still have yet to see a consensus on what steroids actually boost, and, if the pitchers are also on them, whether this is negated.
10:36 AM Jul 17th
 
cderosa
Bill offers a plausible vision of how this question will resolve itself, and I basically agree that it isn't right to penalize the users when we all had a part in letting this get out of hand. I don't want to ban anyone from the Hall of Fame.

But I think there are some faulty assumptions in Bill's piece worth pointing out. The first is that we are in the "post-steroid" era. I think that is quite a premature conclusion, for some of the very reasons to which Bill alludes, including the pervasiveness of chemical enhancement in society in general, and the universal appeal of a fountain of youth.

The second questionable assumption is to characterize illegal PEDs as being essentially about hanging on to youth. They can also be a route to improvement over established levels of performance.

The third questionable suggestion is the idea that there was no rule against illegal drugs in baseball prior to 2002. Implicitly, something that is illegal in general is also illegal in the subset of society such as a professional sport. This is not just a semantic issue. The fact that players feel pressured to do something illegal is the just about the worst aspect of this to me.

Finally, Bill notes that we don't know if 40% or 80% were cheating, and then proceeds to argue as if it were 80%. It makes a big difference to our understanding of baseball history if it was 40% or 80%. At 80%, we're on nearly a level playing field. At 40%, we're looking at the possibility that steroids moved through the game in cliques and spurts, affecting some teams far more than others, and altering pennant races and championships.

All these assumptions tend toward the convenient, and I wish I could believe in some of them, but I can't see my way to it.


8:12 AM Jul 17th
 
Trailbzr
Gary, considering your profession and locale, I assume you've heard that 20% of ex-NFL players from the 70s who've died before 60 were Steelers, and some people have suggested they were more advanced or aggressive about using steroids than other teams at their time. Do steroids essentially "use up your youth," meaning they keep you performing as a young person longer than normal, at the expense of rapidly ageing later in life?
5:52 AM Jul 17th
 
BigDaddyG
Great article. One point- speaking as a physician, the risks of steroids on health have been dramatically over-stated. The underlying assumption against the use of steroids has been that players are putting themselves at health risks by taking steroids. However, that assumption is not true- on balance, the use of steroids tends to confer more health benefits than harm. As Bill noted, the steroids help keep people young. There are many things athletes do that are not banned but are far more harmful to their bodies- repeated cortisone injections, disruptive sleep and travel schedules, tieing down their peroneal tendons to pitch in the world series. I think the public (and medicine) will come to realize the public assumption of health risks with steroids is bogus in the next 10 years, after which the morale posturing about steroid use will cease to hold weight.
9:31 PM Jul 16th
 
rgregory1956
I'll be curious to see how the voting goes when Tony LaRussa and Joe Torre retire. If we discount certain player's home runs totals, shouldn't we discount the facilitator's wins too? How many wins did Canseco and McGwire contribute to LaRussa's total? How many wins did Clemens add to Torre's total? I am not by any means a baseball insider, but I knew from what I read in magazines that a lot of players were juicing long before 1994. And if I, as an outsider knew, those inside had to know. Are the managers and general managers and commissioners not also accountable?
8:34 PM Jul 16th
 
jonkroll
The best piece on steroids I've ever read. Thanks, Bill.

Baseball is filled with vagaries. Throwing at someone's head, a direct act of aggression against another player, seems more onerous than steroids. The phantom tag, stealing signs, scuffing the ball - Gaylord Perry is in the Hall and cheated on countless important pitches. The outrage over steroids is grossly overblown by the same parents who want others to raise their kids and want little league games to be played without keeping score so feelings aren't hurt. Raise your own kids, and let ballplayers be the wonderfully talented and flawed creatures that they are.
6:48 PM Jul 16th
 
shaneyfelt
You are supporting my original thoughts that this is indeed is going to be a question that will be answered with the voter’s perception of the issue, whatever that maybe. And then you can couple that with the simple fact that steroids were (are) illegal under federal law (with clear exceptions), does not exactly make the issue any easier.

And then couple this with the fact that baseball banned this in 1991 http://sports.espn.go.com/espn/eticket/story?page=steroidsExc&num=19 adds even further confusion what to do with those who violated the rules of the game or baseball executives who knowingly allowed the rules to be violated.

For me the clock stopped, but to kids 50 years from now they will not be a product of my environment, so I do agree, why will they care and most of the players in question will be either dead or 90+ years old hanging on by taking more Roids?!

It is a nightmare, in my humble opinion.

6:13 PM Jul 16th
 
PHjort
All great points. And I agree.
5:05 PM Jul 16th
 
 
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