Pumped-Up Hysteria

Forget the hype. Steroids aren't wrecking professional baseball.

Had Ken Caminiti been a less famous ballplayer, or had he merely confessed his own sins, then it would have been a transient controversy. But it wasn't. Last May, Caminiti, in a cathartic sit-down with Tom Verducci of Sports Illustrated, became the first major league baseball player, current or retired, to admit to using anabolic steroids during his playing days. Specifically, he said he used them during the 1996 season, when he was named the National League's Most Valuable Player. And his truth session didn't stop there.

"It's no secret what's going on in baseball. At least half the guys are using [steroids]," Caminiti told SI. "They talk about it. They joke about it with each other....I don't want to hurt fellow teammates or fellow friends. But I've got nothing to hide."

The suggestion that steroids are a systemic problem in professional athletics is hardly shocking, but such candor from players -- particularly baseball players, who until recently weren't subject to league-mandated drug testing -- was virtually unheard of. Before the Caminiti flap had time to grow stale, Jose Canseco, another high-profile ex-ballplayer, upped the ante, declaring that a whopping 85 percent of current major league players were "juicing."

The estimates were unfounded, the sources unreliable, and the implications unclear. But a media orgy had begun. The questions that are being asked of the players -- Do you think it's worth it? How many are using? Why did the players union wait so long to adopt random testing? Why won't you take a test right now? -- are mostly of the "Have you stopped beating your wife?" variety. The accusation is ensconced in the question.

This approach may be satisfying to the self-appointed guardians of baseball's virtue, but it leaves important questions unexplored. Indeed, before the sport can solve its steroid problem, it must determine whether it even has one.

From those sounding the clarion call for everything from stricter league policies to federal intervention, you'll hear the same two-pronged concern repeated time and again: Ballplayers are endangering their health and tarnishing baseball's competitive integrity. These are defensible, if dogmatic, positions, but the sporting media's fealty to them obscures the fact that both points are dubious.

A more objective survey of steroids' role in sports shows that their health risks, while real, have been grossly exaggerated; that the political response to steroids has been driven more by a moral panic over drug use than by the actual effects of the chemicals; and that the worst problems associated with steroids result from their black-market status rather than their inherent qualities. As for baseball's competitive integrity, steroids pose no greater threat than did other historically contingent "enhancements," ranging from batting helmets to the color line. It is possible, in fact, that many players who use steroids are not noticeably improving their performance as a result.

There are more than 600 different types of steroids, but it's testosterone, the male sex hormone, that's most relevant to athletics. Testosterone has an androgenic, or masculinizing, function and an anabolic, or tissue-building, function. It's the second set of effects that attracts athletes, who take testosterone to increase their muscle mass and strength and decrease their body fat. When testosterone is combined with a rigorous weight-training regimen, spectacular gains in size and power can result. The allure is obvious, but there are risks as well.

Health Effects

Anecdotal accounts of harrowing side effects are not hard to find -- everything from "'roid rage" to sketchy rumors of a female East German swimmer forced to undergo a sex change operation because of the irreversible effects of excess testosterone. But there are problems with the research that undergirds many of these claims. The media give the impression that there's something inevitably Faustian about taking anabolics -- that gains in the present will undoubtedly exact a price in the future. Christopher Caldwell, writing recently in The Wall Street Journal, proclaimed, "Doctors are unanimous that [anabolic steroids] increase the risk of heart disease, and of liver, kidney, prostate and testicular cancer."

This is false. "We know steroids can be used with a reasonable measure of safety," says Charles Yesalis, a Penn State epidemiologist, steroid researcher for more than 25 years, and author of the 1998 book The Steroids Game. "We know this because they're used in medicine all the time, just not to enhance body image or improve athletic performance." Yesalis notes that steroids were first used for medical purposes in the 1930s, some three decades before the current exacting standards of the Food and Drug Administration (FDA) were in place.

Even so, anabolic steroids or their derivatives are commonly used to treat breast cancer and androgen deficiencies and to promote red blood cell production. They are also used in emerging anti-aging therapies and to treat surgical or cancer patients with damaged muscle tissue.

Caldwell cites one of the most common fears: that anabolics cause liver cancer. There is dubious evidence linking oral anabolics to liver tumors, but athletes rarely take steroids in liquid suspension form. Users almost uniformly opt for the injectable or topical alternatives, which have chemical structures that aren't noxious to the liver. And as Yesalis observes, even oral steroids aren't causally linked to cancer; instead, some evidence associates them with benign liver tumors.

More specifically, it's C-17 alkylated oral steroids that are perhaps detrimental to liver function. But the evidence is equivocal at best. A 1990 computer-assisted study of all existing medical literature found but three cases of steroid-associated liver tumors. Of those three cases, one subject had been taking outrageously large doses of C-17 oral anabolics without cessation for five years, and a second case was more indicative of classic liver malignancy. It's also C-17 orals, and not other forms of steroids, that are associated with decreased levels of HDL, or "good" cholesterol. But, again, C-17s are almost never used for athletic or cosmetic purposes.

Another commonly held belief is that steroid use causes aggressive or enraged behavior. Consider the case of San Francisco Giants outfielder Barry Bonds, whose impressive late-career home run hitting and built-up physique have long raised observers' eyebrows. Last season, Bonds, long known for being irascible, had a dugout shoving match with teammate Jeff Kent. A few columnists, including Bill Lankhof of The Toronto Sun and Jacob Longan of the Stillwater News-Press, obliquely diagnosed "'roid rage" from afar. "There's very inconsistent data on whether 'roid rage even exists," says Yesalis. "I'm more open to the possibility than I used to be, but its incidence is rare, and the studies that concluded it does exist largely haven't accounted for underlying factors or the placebo effect."

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