Interesting unbiased media article
Thanks to Rick Collins
http://www.longislandpress.com/v01/...erstoryb_01.asp
Strong Island: Big Sports, Big Business and The Truth Behind the Criminalization of Steroids
By Beth Aldrich
THE MEETING
Jack sits across from me in a booth at the Massapequa Diner. He's dressed in a tight, nondescript short-sleeved shirt that hugs every peak and valley of his exaggerated 250-pound, 5-foot-8, 29-year-old frame.
He's eating an omelette, home fries and a bunless burger, and is gulping down several pills. Pills that make him look like the Incredible Hulk. Jack sure likes those pills. And despite the fact they're illegal, he sees nothing wrong with them.
Jack represents a significant subculture of men living on Long Island whose bodies, like his, appear to be developed well beyond the banks of the natural gene pool. Anyone who has ever had occasion to visit one of our countless gyms or nightclubs, or ventured onto any of our sandy beaches, knows what these individuals look like. The steroids they use are illegal and a much-maligned topic of sports media, so I regard lunch with Jack as a rare opportunity to listen without prejudice to a user who makes no excuses.
Despite the cry to ban anabolic steroids, there are volumes of legal and medical data—largely and intentionally ignored by the mainstream media—that show the potential benefits of these drugs. There is an obvious and indispensable relationship in this country between the billions of dollars that organized sports earn every year and the public's demand for sports. So it follows that the sports establishment would work hard at keeping performance-enhancing drugs out of the professional arena, since chemical enhancement compromises the basic tenets of professional sportsmanship. But the establishment's unceasing public condemnation of steroids, together with the success of its push to have them scheduled as controlled substances, have sown the seeds for a virulent black market by prohibiting normal adults from safely acquiring and using steroids for their many documented benefits.
IT STARTS WITH A FRIEND
"My friend got me started," says Jack, who has been weight training since he was 12. "You plateau," he explains. "There comes a point where you naturally just can't grow anymore. Naturally, I think I hit about 200 pounds. And I saw everybody in the gym growing, and I'd been training so much longer than everyone else, and they were making faster gains than me."
The year was 1996 and Jack knew without asking that all the guys who were growing faster than him were using anabolic steroids, or "juice," synthetic derivatives of the male hormone testosterone that are taken to promote the growth of muscle. At the time, Jack was also aware that anabolic steroids were a controlled substance and only prescribed in the U.S. to treat a handful of medical conditions: testosterone deficiencies in men, abnormally delayed sexual development in young men, some types of impotence, and to gain and maintain muscle mass and reduce the bodily wasting that occurs with HIV. Since Jack had none of those medical conditions, he had no choice but to resort to the black market.
Jack conducted some initial research, had numerous discussions with acquaintances at the gym, and watched the progress of other users, but most of his knowledge of steroid use came through his personal experience—from trial and error. He insists that what works for one person in terms of pharmaceuticals and dosages may not work for someone else. He stresses the importance of starting off with low dosages and adhering to serious training and diet strictures. Only then can people determine what they need to reach their particular goals without doing themselves harm.
THE SOURCE
There are several ways to obtain steroids. Jack and his large crew of bodybuilding friends get some from their doctors and some from the black market.
"The way it works," Jack explains, "is it's cash-and-carry.
"My doctor is a family practitioner/life extensionist, or whatever they want to call it. I've found [him] through other people at the gym. But my doctor can't get everything I need, so some of what I buy comes from the black market."
Despite the illegality of dispensing these drugs for non-medical reasons, Jack's doctor seems more than willing to provide Jack with what he requests.
"There's no clinical need for some of the stuff that I use," says Jack. "A lot of the stuff is not human grade. They're animal steroids, used to make the cattle grow."
Well then, does his doctor advise him against using animal-grade substances?
"No," Jack says, "because he's using them himself."
Jack says the two speak openly about their steroid use and bodybuilding regimens, which helps Jack ascertain the safest and most effective regimen. But Jack is quick to point out that most recreational users, as a result of the substance's illegality, never have the opportunity to obtain or discuss their steroid use with a doctor.
FUELING THE BLACK MARKET
According to Nassau County-based attorney Rick Collins, author of Legal Muscle: Anabolics in America, the criminalization of anabolic steroids has created a lucrative market for foreign manufacturers to exploit that's estimated at $400 million annually. Today's black market is all but exclusively foreign products—a statement that every user I contacted confirmed—and oftentimes the products are manufactured and labeled as veterinary substances, which are much easier to export to the U.S.
Collins says in his book, "[Steroid] labs all over the world are putting pictures of horses and dogs on the labels of their products, even as they churn out volumes that would be too much to juice up every horse, cow, goat, pig, dog and house cat in America." Furthermore, Collins notes that in the 1980s, prior to the legislation making steroids a controlled substance, it was estimated that only about one third of the steroid black market consisted of foreign products unlawfully smuggled into the country.
Despite the potential health risks of experimenting with these substances without the supervision of a physician, the black market that has proliferated in this country and the criminalization of the drugs pose yet another serious set of risk factors. Jack explains, "As far as the street [steroids], what's in them, what you hope is in them is sterile oil. A lot of the time there's contaminants in it. And then, as far as the water-based substances, the problem is anytime you have something that's water-based, and it gets a little bit of bacteria, it breeds the bacteria. And counterfeiting is a huge problem in the black market. I would estimate about 90 percent of the black market stuff is counterfeit. Not long ago, there was a ton of [steroids] going around that was actually made with Armor All." Armor All is a scouring powder like Ajax or Comet.
The pervasive problem of counterfeit steroids is well documented both in medical and trade journals. By Jack's account, he has witnessed many friends who have developed large abscesses from administering bogus substances, leading to surgery, scarring and, ironically, the removal of muscle tissue.
But Jack insists he's been in the game long enough to spot a fake. "I wouldn't buy anything [black market] from the United States. Most of the stuff I do is European, a lot from Greece," he says. He claims that he made these overseas connections "from other people in the community." And in speaking about Long Island's black market specifically, Jack says the majority of products coming here are from Mexico (a statement echoed in many trade journals), a country considered by people in the know to be the least safe and least accurate. The European products, he says, are the most accurate in terms of dosage and authenticity, though they are much more expensive.
QUESTIONING THE OPPOSITION
Collins offers volumes of evidence demonstrating that the criminalization of anabolic steroids was a result of pressure from the organized sports establishment rather than physicians, pharmacologists and medical experts. He points out that when the bill to schedule the drugs as a controlled substance was before Congress, after evaluation, it was opposed by the AMA (American Medical Association), the DEA (Drug Enforcement Agency), the secretary of Health and Human Services and several of the country's foremost experts on the subject.
After scouring more than 500 pages of transcribed testimony from hearings before Congress to classify steroids as controlled substances, Collins discovered there were only a few pages that addressed potential health risks associated with the drugs. The vast majority of witnesses, it seems, were athletes, coaches, trainers and sports officials, mostly from professional and college football.
Furthermore, he found that there were only two primary issues to typify the overwhelming majority of testimony throughout the voluminous transcript. One recurring issue was "the unfair advantage that steroid-enhanced professional top-level athletes have over those who don't use steroids," he notes, with words like "cheating" and "unequal playing field" used repeatedly by witnesses and legislators alike. The secondary issue raised repeatedly was "the message that steroid use in high-level sports sends to our youth."
Collins suggests the "save the children" rhetoric used on Capitol Hill was simply a maneuver to garner public support for the bill. Now, looking back, he tells the Press, "Instead of protecting our children from the risks associated with steroids, the legislation has put the children at greater risk. The issue of anabolic steroids for non-competing mature adults should be where it belongs: the physician's office. It certainly shouldn't be going on in parking lots or gym locker rooms. There are risks involved in using steroids under any circumstances. But those risks are greatly escalated when doctors are isolated out of the equation."
JUICE IN THE BIGS
The compelling evidence that steroids were indeed scheduled as a controlled substance at the behest of the big business of organized sports begs the question: Has the legislation resolved the steroid problem in pro sports?
Jack insists that the vast majority of professional athletes are using steroids, despite the legislation and unrelenting negative press surrounding these drugs, particularly in professional bodybuilding.
"All these natural bodybuilders, they're still doing it—because I've talked to all of them—they're just doing faster-acting [ones], it gets out of their system quicker, to beat the drug tests," Jack says.
And, of course, we have the ever-present pro athlete's fall from grace. Only last year, Major League Baseball's Ken Caminiti revealed publicly that he was using steroids when he won the National League's MVP Award in 1996. And, according to a May 28, 2002 article in Sports Illustrated, Caminiti disclosed his support for the use of steroids, saying that the practice is now so rampant in baseball that he would not discourage others from doing the same. The fact remains, there are hundreds of pro athletes who are either discovered using steroids through testing or who come out of the closet of their own volition; invariably they reveal the drug's prevalence in pro sports.
Dr. Elliot Pellman, who serves as the medical director for three professional sports teams, is the medical liaison for the NFL and is the medical advisor for MLB. He considers Jack's contention of rampant steroid use to be ludicrous.
"I do not believe that it is prevalent, nor do I believe that every single athlete does not do them," Pellman says. "I believe that sports, regardless of the level, is often a cross-section of the country, so you're going to have some people who are alcoholics, some who have marital problems, and just because they're in sports, these things are exposed in the media." Pellman adds that the issue of steroids is taken very seriously in professional sports, and there are myriad preventative measures in place to help curtail its incidence.
THE FOUNTAIN OF YOUTH?
Jack's doctor, a board-certified D.O. (Doctor of Osteopathic Medicine) and family practitioner with a special interest in anti-aging, asks to remain anonymous for obvious reasons. He denies dispensing and administering anabolic steroids to Jack, and denies his own use of anabolics as well. He will only go on record as using and prescribing HGH (human growth hormone), a synthetic substance often used in combination with anabolic steroids for bodybuilding purposes, as well as a pricey anti-aging magic bullet. Currently, the law does not prohibit HGH from being prescribed off-label for anti-aging purposes. And, like steroids, there are potential side effects associated with the use of the synthetic growth hormone; however, at present, there is a critical shortage of research into the long-term effects.
Despite dispensing these drugs, he sees potential problems. "It is concerning," he replies. "But I still believe it's safe. This is how all drugs start—you won't know unless you use it for a length of time." Though the doctor initially says he feels it's unethical to use anabolic steroids recreationally, he later argues for the benefit of steroids: "If you're taking a patient who's 6-foot, 150 pounds, and you're turning him into a 220-pound pile of muscle, I mean, what's wrong with that? As long as he's monitored and he's not experiencing any side effects. It's healthy for the patients who aren't experiencing side effects."
The general assumptions on the side effects of steroids, even in the medical community, are as diverse as the medical literature is limited. One is not hard-pressed to find a physician or medical expert who will claim that the side effects are primarily temporary if the drugs are not being abused; while there are those who claim the side effects are potentially dangerous. Dr. Pellman points out that within the medical community, it is commonplace to have an incongruity of opinions, particularly in the absence of solid long-term research (as is the case with anabolic steroids). He says, however, that in his experience, opposition to the use of anabolic steroids for non-medical purposes is nearly unanimous among physicians.
But there is a sizable population of physicians, mostly specialists in anti-aging or longevity, who oppose the criminalization of steroids by the government and the demonization of their use by the media. Dr. Richard Cohen, a physician recognized for his knowledge and use of dietary supplements, hormones and natural hormone precursors with respect to the aging male, holds the position that the media's constant dramatizations of "killing our youth" is unfair, as it overlooks the enormous body of literature demonstrating the benefits of the proper use of steroids in enhancing wellness and treating disease in the growing number of aging Americans.
"[Steroids] have been proven to have a very positive effect on lean body mass in mature men," Cohen says. He asserts that maintaining or gaining muscle mass with the use of exogenous hormones has been shown to improve vitality and reduce the risk of heart disease and diabetes. Cohen adds that he has never had a patient or heard of a patient suffering from complications resulting from steroid use.
WEIGHING THE CONSEQUENCES
Users, however, like Jack, have a slightly different take on the side effects. "It's more dangerous to [take steroids orally] because it goes through your liver twice. But adverse effects are acne, hair loss—they're mostly cosmetic. Another side effect can be an enlarged prostate. That's why you should do this under a physician's care and get checked as much as you possibly can. It also makes your testicles shrink, because they stop producing testosterone," Jack explains. One side effect he recently experienced was enlarged, calcified nipples (gynecomastia, or growth of male breasts), for which he needed immediate medical attention.
As for behavioral changes attributed to steroids, Jack insists it's a fallacy. "If you're an asshole when you start, then you're probably gonna be a bigger asshole when you're on juice," he says. "But you still know the difference between right and wrong."
While anabolic steroids are not believed to be physically addictive, many users complain of psychological addiction and depression upon coming off of a cycle of steroids.
Richie, a 40-year-old Suffolk County car salesman who's been taking steroids for cosmetic purposes for 20 years, speaks openly regarding his experience.
"I would say I'm a believer in steroids, but the only way I am is in a responsible, mature kind of way," he says, admitting that this revelation comes to him only now, with maturity and 20 years of hindsight. "Otherwise, it can be a very big mental trip. It can be very dangerous for younger people. I know, because I fell into it myself, and almost everyone I know fell into it. You fall into that zone where you want to get bigger and bigger, and when you go off, people start saying, 'Hey, you got smaller,' so then you stop going off-cycle."
Richie adds that since he started using, his life has been a mental roller coaster of highs when he's using and reaping the benefits, and lows when he's off-cycle and his body is fighting to revert back to its natural state. He expresses a genuine concern for less mature users getting caught up in the same kind of difficult emotional attachment to the amount of gains they may or may not be achieving as a result of the steroids.
THE UNKNOWN
It seems there are a handful of well-documented unintended effects that crop up in every text on steroids, such as testicular shrinkage, hair loss, acne, prostate enlargement and gynecomastia. But more to the point, the discrepancies that exist within the available body of data, it seems, are representative of a lack of attention from the medical community, which is indeed another regrettable upshot of criminalizing these substances.
"If it was good for you, we'd be handing it out. Why wouldnt we?" asks Jeff Corben, director of sports medicine for Garden City-based Central Sports Care and Rehabilitation. "But the whole thing is we see the deterioration and bad effects of it, so no, anybody who's in the sports medicine area would not [recommend] it. You're only gonna hurt yourself. It is not gonna help. You could die."
Dr. Steve Hollander, associate professor of health education at Long Island University, C.W. Post Campus, references a 1998 study published in the Journal of the American Medical Association (JAMA) which reports that perhaps as many as 106,000 people died in 1998 due to adverse reactions to various prescription drugs in the controlled environment of hospitals alone. He notes that the study was published by doctors, and one can only surmise to what scrutiny the study was subjected, since these doctors were in essence publishing their own mistakes.
"Death by adverse reaction is one of the leading causes of death in America. It may be the sixth leading cause of death in America. That is scary," Hollander explains. "Steroids have many documented side effects, and there is no one who has 30- or 40-year studies on the stuff. We know that prostate cancer is the number-one cancer for men each year and it's related to a man's own testosterone. So by exposing men to exogenous steroids, which are mimics of testosterone, are we going to have a growing army of prostate cancer [patients] in 10 or 20 years?"
According to the Mayo Foundation for Medical Education and Research, though, there is no known cause for prostate cancer, researchers theorize that testosterone speeds the development of prostate cancer cells.
Hollander also discusses his discontent with doctors prescribing any substance off-label, as is the case with steroids. "I think it should be illegal for doctors to go off-label. Doctors are not drug experts; they never have been and never will be," quips Hollander, citing that they could not possibly dedicate the amount of time or funding necessary to achieve an expert knowledge of all prescription drugs.
"Drugs are for people who have no other choice. And isn't it a doctor's goal to maintain or improve his patients' health? All medications have the potential for adverse effects. When doctors prescribe substances to a person for vanity, they're playing a role in adding health risks to that person's life."
A STRANGE DOUBLE STANDARD
Cigarettes, martinis, liposuction, hair transplantation, even a diet high in hydrogenated oils, are all lawful and socially acceptable activities we undertake each day to look younger, look better, feel relaxed or simply for the good old-fashioned purpose of satiation. But many of these activities involve potentially grave risks to the individual and all of them are riddled with a laundry list of perilous adverse effects. Charles Yesalis, a professor of health and human development at Penn State University, touched upon this peculiar double standard when testifying before a Congressional subcommittee about the actual health dangers and the idea of scheduling steroids: "Steroids do have a medical use. From an epidemiologic point of view of the health dangers, I am much more concerned about heroin; I am much more concerned about cocaine; I am much more concerned about cigarettes than anabolic steroids. This is not to say steroids are not potentially dangerous. Rather, from what we know currently, I am more concerned about the other drugs—and you could likely add the abuse of alcohol to that list—than anabolic steroids."
If the public's health were, in fact, Congress' paramount concern, then anabolic steroids would likely be an afterthought in comparison to the host of dangerous yet legally and medically sanctioned activities taking place daily in this country and without so much as a murmur from legislators or mainstream media.
It's clear that no matter where one stands, all agree that legislation has not reduced the trafficking of these substances; instead it has rerouted the traffic to foreign origins and is thus being produced under foreign safety and quality control standards. "What Department of Justice officials estimated in 1990 to be a $300-million black market has grown tremendously, to colossal proportions about which we can only speculate," Collins says. "In January 2001, federal law enforcement officials announced that they seized more than 3.25 million anabolic steroid tablets in the single largest steroid seizure in U.S. history."
That there are potential risks involved in taking anabolic steroids is well established, but there is no law against an adult choosing to accept the calculated risks involved in using a substance that is not medically necessary. If a substance such as Viagra has found favor with our legislators and in the medical community, how is it plausible that a mature man can be prohibited from consulting a physician about using a substance that can improve his physical condition?
The anabolic steroid naysayers are a powerful force, and their need to keep steroids out of organized sports is reasonable. But their aggressive tactics have resulted in unwarranted legislation with far-reaching and sometimes negative consequences for the public at large and, as an unfortunate corollary, effectively stalled the medical community from conducting extensive research into steroids' benefits.
