A clarification is in order.

In my column last Sunday, I wrote about the lure and price of glory, noting the irony of the BALCO steroids case. The athletes' apparent willingness to pay any price for greatness is what, in the end, is ruining their reputations and perhaps their careers. Some readers interpreted the column to mean I had joined the chorus of those who believe performance- enhancing drugs are inherently evil and should be banished from professional sports.

On the contrary, as I have written in the past, I believe we should have a serious discussion about legalizing steroid use for professional athletes and any other adults who, under a doctor's care, seek to improve their athletic performance.

But because steroid use without a prescription is not legal -- and even with a prescription, against the rules of baseball and most other sports -- the price Barry Bonds, Jason Giambi and others implicated in the BALCO case are paying is a real one. Athletes who take steroids have no one to blame but themselves because they know what the fallout will be if they are discovered.

For athletes caught up in the BALCO scandal, their characters have been impugned, their accomplishments denigrated. There have been screaming headlines, righteous trashing on the talk shows and, come spring, there surely will be boos and catcalls in every ballpark across North America.

But here's the question not being asked: Why is this the response to the revelations? Why is there such reefer-madness hysteria about steroids? The use of performance-enhancing drugs in sports is considered so abhorrent that, in the midst of war last January, President Bush highlighted its evils in his State of the Union address. And the U.S. Congress has threatened to take time from military budgets and intelligence reform to crack down on steroids in professional baseball if the owners and union fail to do so.

Norm Fost, pediatrics professor and medical-ethics expert at the University of Wisconsin Medical School, is confounded by the paroxysms over steroids in sports .

"There's mass hysteria because of sheer misinformation,'' he says.

He has been studying and writing about steroids in sports for more than 20 years. He has yet to find research that conclusively attributes a single death to steroid use. Former Raiders player Lyle Alzado believed steroids caused the brain tumor that eventually killed him, but there is no medical evidence to back up his claim -- or any claim that steroid use causes cancer.

Former Tampa Bay Buccaneers player Steve Courson believed steroids caused his heart degeneration. But by his own admission, he took steroids in such large quantities over such a long period of time, and in combination with other drugs, that his heart failure likely was caused by the extraordinary abuse of the drug rather than the drug itself. Ingesting massive quantities of almost any drug, even over-the-counter painkillers, can cause serious damage.

A teenager's suicide in Texas was also blamed on steroids, prompting his father to mount a national campaign. Again, there is no conclusive evidence of a connection.

"How many teenagers commit suicide every year? Lots. And how many took steroids the day before? How many more drank Cokes or ate Big Macs?'' Fost says.

The life-threatening health risks most of us have accepted as fact are anecdotal and largely speculative. (In last Sunday's column, I wrote that Giambi's pituitary tumor was a known side effect of steroids. I since have learned it is not.) This isn't to say taking steroids or other performance- enhancing substances is risk-free. All drugs carry risk, which is why they should be prescribed and managed by a doctor, rather than a muscle-man peddling them out of the trunk of his car.

In truth, a football player is more likely to suffer permanent disability by simply playing the game than by taking steroids. There is more risk in taking painkillers and cortisone shots to play while injured -- a common practice in football -- than in using steroids. Yet we allow adults to decide for themselves whether to throw their bodies in front of charging 350- pound linemen or pop pills to hurry back out on the field. Why are we so paternalistic about steroids?

Critics might answer this way: Even if steroids were made legal, they would give athletes willing to take them an unfair advantage over those who are unwilling, thus undermining the imperative of a level playing field. The fact is the level playing field is a myth and always has been.

Some athletes and teams have always had advantages over others, whether in funding, equipment, access to nutrition, training methods, coaching, even ease of transportation. Yet somehow, great athletes still manage to emerge as winners despite the inequities -- the Kenyan long-distance runners, for example.

"If baseball is so concerned about level playing fields, then why is George Steinbrenner's (New York Yankees) payroll six times bigger than my Milwaukee Brewers'?'' Fost asks.

He remembers watching the 1988 Olympics on television. While Canadian sprinter Ben Johnson was fleeing in disgrace after testing positive for steroids, U.S. gold-medal swimmer Janet Evans was regaling a news conference with details about a new kind of swimsuit that had helped her cut through the water faster. It was a technological breakthrough, she noted, that had been kept secret from the East Germans, the Americans' swimming rivals.

Yet no one accused Evans or the U.S. of undermining the level playing field, much less cheating.

"The hypocrisy is remarkable,'' Fost says.

And no more so than in Major League Baseball's argument that steroids must be eradicated because the sport needs to serve as a healthy example for the young folks. If baseball gives its stamp of approval to steroids, the thinking goes, then teenagers will think it's OK for them to use them, too.

One wonders, then, about all the beer ads at baseball parks. What kind of message does baseball's celebration of beer send to teenagers? Unlike steroids, alcohol kills 75,000 people a year in the United States.

"Not only are players not screened for alcohol, it's embraced and advertised,'' Fost says. "Baseball is delighted to be in cahoots with the alcohol industry.''

The recent steroids stories are big news because baseball's greatest player has been branded a cheater. But he is considered a cheater in large part because we have turned steroids into some evil potion that threatens to destroy not only sports, but, if President Bush is to be believed, the well- being and moral fiber of our youth. I wonder how he and others reconcile this viewpoint with their admiration for Arnold Schwarzenegger, whose chemically created body launched the storied career that has landed him in the California governor's office.

I lean toward allowing steroids in professional sports. I understand why others disagree and am braced for the deluge of contrary e-mails. But in making the decision to ban steroids, baseball and other sports at least ought to take a few deep breaths and examine the issue with some clarity and neutrality, recognizing steroids as the pharmaceuticals they are, not the wicked plague of immorality they have come to represent.

E-mail Joan Ryan at joanryan@sfchronicle.com.

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