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PUMPED:

A Truth-Enhancing Seminar on
Steroid Use and the Law
By Rick Collins, Esq.
Collins, McDonald & Gann, PC
One Old Country Road
Carle Place, NY 11514
516-294-0300
www.cmgesq.com; www.steroidlaw.com
© Rick Collins, 2006. All rights reserved.
Who am I?
z Hundreds of steroid matters have
crossed my desk, affording me a unique
view of the intersection of non-medical
steroid use and the criminal justice system
z Expert witness before U.S.
Sentencing Commission on
steroid legalities
z Practicing law since 1984
z Former prosecutor
www.rickcollinsonline.com

z Counsel to
the Int’l Federation of BodyBuilders
and the Int’l Society of Sports Nutrition
z Authored Legal Muscle (2002) to bridge
the information gap between users and
medical/legal authorities
(www.legalmusclebooks.com)
z Editor of wwwSteroidLaw.com
Where am I coming from?
¾ 30 years in the gym culture and my
interactions with steroid users conflicted
with information being presented by
mainstream sources.
¾ Researched law, science and policy in a
search for the truth. The results,
combined with my professional
experiences in steroid cases, became the
book, Legal Muscle.
Where am I taking you tonight?

¾ We will go further and deeper into this


topic than has ever been presented by
mainstream sources of information.
¾ We will examine law, science and policy
and the areas in which they overlap.
¾ We will search for the “truths” about
steroids.
You may be surprised
¾ You will be presented with data and views which may fly
in the face of conventional thinking on this topic.
¾ In such conflicts, you will be free to decide for yourself
which information is credible and reliable. I will,
wherever possible, offer the views of qualified experts in
the discipline relevant to a particular topic. I will offer my
two cents from time to time.
¾ This is not a lecture that steroids are good (or bad),
absent context. Rather, it is a multi-dimensional
presentation about a subject that has received extremely
one-dimensional exposure.
Keep your eyes open
As we journey along, pay attention to where
the general public’s information about
anabolic steroids comes from:
1. Claims of “experts” or other interested
parties, as filtered through the media;
2. “Authorities” (elected politicians and
representatives of social control
agencies), as filtered through the media;
3. Journalists, and mostly sports journalists
(i.e., the media).
Consider motives … and bias.
The Media Double
Standard of Proof
• Sensationalistic and negative?
– Dubious or unsubstantiated claim is reported
– Evolves into established truth

• Positive?
– Requires absolute certainty to be reported
(1996 NEJM study and others)
Fair and Balanced?
Steroids, Objectivity and Tabloid Television
Our Culture of Fear
¾ The hook for most media reports:
z The children are in peril from a “growing
epidemic”
¾ The three forces behind the propaganda:
z Special interests (e.g., social control
institutions, “claims makers” and professional
alarmists)
z Pandering politicians
z Sensationalistic media
What do we know about steroids?
(a partial but representative list)

ƒ They are only used by athletes and


teenagers.
ƒ They are cheating.
ƒ They killed Lyle Alzado.
ƒ They either cause ‘roid rage
or drive users to suicide.
ƒ They cause cancer, strokes
and heart attacks.
How much of that is true…?

z We’ll examine all that.


z We’ll also explore areas which are never
revealed via mainstream channels, such as
how the criminal justice deals with illicit
steroid use, who’s being targeted, and how
our laws and policy have had unforeseen
consequences.
z Ready?
Steroids 101
Steroids

z Steroids are chemicals that share a basic four-ring


carbon structure.
z There are many kinds of steroids, including
estrogens and birth control pills. When the doctors
put your Uncle Cosmo on steroids, it almost always
means corticosteroids, a catabolic form of steroids.
Even cholesterol is a steroid.
z Testosterone, the primary male sex hormone, is a
steroid. It is endogenously produced and present in
the bodies of every man, woman and child. It is an
anabolic steroid.
Anabolic steroids

z Build tissue up (“anabolic”) by increasing protein


synthesis and nitrogen retention (e.g., stimulate
healing in burn victims). Treat some forms of
anemia.
z Synthetic variations on the testosterone molecule,
these are “androgens” and thus have masculinizing
effects (“androgenic”) as well as anabolic.
z More properly called “anabolic-androgenic steroids”
(or AAS).
Endogenous Testosterone

z The average man produces about 4 to 7mgs


(milligrams) of testosterone every day. The normal
range for total testosterone levels in adult males is
278 to 1,000 ng/dl (nanograms per deciliter of
blood).
z Physicians typically prescribe 100mg weekly for
“hypogonadism” (to maintain normal levels).
z The literature routinely states that non-medical
steroid users administer between 10 and 100 times
replacement doses.
Oral steroids
z Plain testosterone is ineffective if taken orally because it must
proceed through the gastrointestinal tract to the liver. The liver
quickly breaks its structure down on its first pass, before it has
time to enter the blood to be distributed to the muscles.
z To withstand this rapid breakdown, oral anabolic steroids were
purposely modified. One type of modification is a process
called “alkylation” -- the addition of a carbon atom or atoms at
the alpha position of the number 17 carbon atom. Steroids
altered in this way are called C-17 alpha alkylated steroids.
They are more difficult for the liver to break down and make the
liver work really hard, especially if administered for a prolonged
period of time. That’s where the connection of steroids to liver
(hepatic) problems comes from. Technically, don’t blame
“steroids,” blame C-17 alkylation!
Injectable steroids

z Go into the muscle and are absorbed directly into the blood
stream, avoiding a first pass through the liver. The liver thus
experiences a much lower concentration than with orals.
z Intramuscular, not intravenous.
z Most injectable steroids have little effect upon liver function.
z Most injectable steroids undergo a process called esterification
to slow their release into circulation. Esterification is the
addition of carboxylic acids to the 17-beta hydroxyl group of the
testosterone molecule. An ester of testosterone will release
more gradually into the bloodstream from the site of injection
than unesterfied testosterone will.
Cycling steroids
z Legal restrictions and current medical ethics prevent physicians from
prescribing steroids non-medically. Consequently, a black market has
grown.
z To maximize the anabolic effects and minimize the potential adverse
effects, most AAS users will cycle their self-administration – often
called juice or gear – by alternating periods of use with periods of
steroid-free training. Cycling seems safer than staying on steroids all
the time. Cycle lengths vary considerably. The cycles of many novice
to intermediate cosmetic steroid takers last from 4 to 12 weeks,
followed by a steroid-free period of the same duration, but cycles
lasting from 12 to 16 weeks are also quite common.
z Steroid veterans and elite bodybuilding competitors may remain on
extended cycles of steroids, occasionally employing reduced dosages
or ancillary medications (i.e., HCG and/or Clomid) to bridge from one
cycle to the next.
Stacking steroids
z Testosterone esters, such as enanthate and cypionate, are extremely popular,
as they are reported to produce gains in size and strength with little or no liver
toxicity. Testosterone esters, however, are highly androgenic, meaning there is
the potential for unwanted effects at the dosages preferred to promote muscle
growth.
z So, users combine testosterone esters with less androgenic, more anabolic
compounds like nandrolone decanoate, popularly referred to by the brand
name Deca-durabolin® or simply “Deca.” This stacking technique is
intended to provide for the substantial overall dosages required for
growth in a way that minimizes side effects. Deca is not sufficiently similar
to testosterone to fully duplicate it. When used alone, it suppresses natural
testosterone production without fully supporting testosterone’s more androgenic
effects. This characteristic of nandrolone, which metabolizes into a weak
metabolite called DHN, is reported to explain the sexual functioning problems of
those who use nandrolone without a testosterone “base.” By combining both
drugs, favorable results may be obtained with minimal side effects.
z Most users stack multiple compounds.
The “Magic Bullet” Myth

z Steroids are no magic bullet, although they clearly


help build muscle and, to a lesser extent, lose fat.
z The popularized notion that steroids foster laziness
and “slacking” in the gym is incorrect in most cases.
Steroid users typically handle more demanding
training regimens than non-steroid users. Whatever
their risks and down sides may be, and there are
some, steroids undeniably foster harder training by
speeding up recovery and making training more
effective.
The Credibility Gap

z The hallmark of the relationship between the users


and the medical/social control establishment:
distrust.
z For too many years, the party line was “steroids
don’t work.” Virtually all steroid experts agree that
the credibility damage done has never been rectified.
z Today, legitimate health warnings may be
disregarded, and “experts” mocked (the “Chicken
Little” effect).
Law
“To retain respect for sausages and laws,
one must not watch them in the making.”
-- Otto von Bismarck (1815-1898)
Flashback to the ‘80s

z In the United States in the


1980s, testosterone, including
a variety of esterified injectable
versions, and human growth
hormone (hGH) were
prescription medicines like any
others, available upon the
script of a licensed physician.

z But then ...


The “Doping” Connection

z … Media reports began to


associate the use of
testosterone and, to a
lesser extent at that time,
human growth hormone
with performance
enhancement efforts in the
context of competitive
sports.
Teenage Users

z Concern over the use of


anabolic steroids in sports
grew, and public alarm was
furthered when media reports
began warning that “[s]teroid
abuse … has trickled down to
high school boys …”
-- Baltimore Sun,
June 8, 1987
Then came Ben …

z Canadian sprinter Ben Johnson was


stripped of his Olympic gold medal for
testing positive for the steroid stanozolol
in 1988.
z Steroids were decried as cheating to gain
an unfair advantage.
z Elite athletics seemed less about
discipline, training, and innate gifts and
more about who’s got the better drugs.
“Fairness” and “purity” in sports became
of national concern.
Pressure on Washington

z Congress began exploring the ways that it


might curtail the use of performance-
enhancing drugs in sports.
z Both the House and Senate drafted bills
and scheduled hearings to tackle the issue.
z Health risk issues were addressed, but the
unfair advantage issue took center stage.
z The State of California had already added
anabolic steroids to its schedule of
controlled substances.
The Experts say NO

z Not many people know or remember that the


American Medical Association, Drug Enforcement
Administration, Food and Drug Administration, and
National Institute on Drug Abuse – the four
regulatory agencies or organizations that ought to
know best about scheduling drugs — all sent
representatives to Capitol Hill to testify against
making steroids a controlled substance, maintaining
that abuse of these hormones does not lead to the
physical or psychological dependence required for
scheduling under the Controlled Substances Act.
That Didn’t Stop the Politicians (my 2 cents)

z They had their minds made up and moved forward anyway.


z Congress’ main concern focused less on protecting the public
health than on solving an athletic “cheating” problem.
z Congress wanted steroids out of sports and classified steroids
as Schedule III controlled substances.
z As a result, these sex hormones stand out as a strange
anomaly among the codeine derivatives, central nervous
system depressants, and stimulants that form the rest of
Schedule III.
Anabolic Steroid Control Act of 1990

z Added steroids to the federal Controlled Substances


Act [21 U.S.C. § 802(41)(A)].
z Simple unlawful possession became punishable by
up to one year in prison.
z Unlawful distribution and possession with intent to
distribute became punishable by up to 5 years in
prison.
z Unlawful distribution and possession with intent to
distribute to an individual under 21 years of age
became punishable by up to 10 years in prison for a
first offense and up to 30 years for a second.
The BALCO Scandal
ƒ In February 2004 then-Attorney General John Ashcroft announced the
steroid-related indictment of four men in San Francisco. Barry Bonds was
reportedly the impetus for the underlying investigation.
ƒ The investigation that followed targeted a company known as BALCO
(Bay Area Lab Co-Operative) and the elite athletes who were its clients.
Combining federal, state and local authorities, it involved late night trash
searches, undercover agents, extensive surveillance, a variety of
subpoenas and search warrants, and untold expenditures of money and
man hours. It led to the most notorious doping scandal in American
history, even prompting President Bush to dedicate part of his 2004 State
of the Union Address to a denunciation of anabolic steroids in sports.
ƒ It prompted Congressional hearings at which some of the biggest names
in MLB were scolded on national television, spurred the passage of
additional federal anti-steroid legislation, and has provided sports
journalists with endless opportunities for sermonizing and sensationalism.
The New
“Anabolic Steroid Control Act of 2004”

z Adds many new steroids and formerly over-the-


counter “prohormone” dietary supplements to the
Controlled Substances Act.
z Does include androstenedione, androstenediol, and
many others, such as THG.
z Does not include DHEA.
z Took effect on January 20, 2005.
“Anabolic Steroid” as Defined as of
January 20, 2005

z Any drug or hormonal substance,


chemically and pharmacologically
related to testosterone (other than
estrogens, progestins,
corticosteroids, and DHEA)
regardless of its ability to promote
muscle growth and includes a list of
49 compounds and some isomers.
State Laws on Androgens

z Vary, as does the definition of “anabolic steroid.”


z Some states have specifically legislated that
bodybuilding, athletic improvement and muscle
enhancement in healthy patients are not valid or
legitimate medical purposes, and have established
criminal penalties to discourage physicians.
z Human chorionic gonadotropin (HCG) is classified
as an “anabolic steroid” and a controlled substance
(illegal distribution is a felony) in:
– California, Colorado, Connecticut, Idaho, Indiana,
Louisiana, Nevada, New York, North Carolina,
Pennsylvania and Rhode Island.
States’ Regulation of Steroids

z Each state has the right to enact its own laws


to regulate drugs that are deemed
dangerous.
z Congress and many states have listed
anabolic steroids under Schedule III, but
there are exceptions. Examples: New York
listed steroids in Schedule II and Vermont
and Alaska (yet) didn’t schedule them at all!
States’ Definitions of Steroids
z Each state is also free to define anabolic steroids as it pleases,
typically by setting forth a laundry list of included compounds.
z Regrettably, state and federal lawmakers appear to have
received limited guidance from experts. As in the old federal
law, Connecticut lists D-bol twice – as "methandienone" and as
"methandrostenolone" – and lists the potent androgen DHT as
both "dihydrotestosterone" and "stanolone." In some states,
such as Rhode Island, both anabolic steroids and human
growth hormone are controlled substances. Pennsylvania, on
the other hand, has gone out of its way to say that growth
hormone "shall not be included as an anabolic steroid." And
Delaware inexplicably legislated the term "human growth
hormone" to be "synonymous with the term ‘human chorionic
gonadotropin.’" Huh? What a mess!
States’ Quantification of Steroids

z How much is a felony and how much is a


misdemeanor? In some states, simple possession is
a misdemeanor and possession with intent is a
felony. In others, simple possession alone is a
felony.
z In Ohio, up to 200 tablets or 16 ml. is a
misdemeanor, but more is a felony.
z In North Carolina, it’s up to 100 tabs.
z In Hawaii, it’s up to only 25 tabs!
z In Alabama, simple possession has a statutory
maximum sentence of ten years!
Human Growth Hormone

z The 1990 law inserted growth hormone into


21 U.S.C. § 333, the Steroid Trafficking
Act, replacing anabolic steroids.
z Technically, not a controlled substance
(federal).
z But, … federal law criminalizes whoever
knowingly distributes, or possesses with
intent to distribute, human growth hormone
for any use in humans other than the
treatment of a disease or other recognized
medical condition.
Illegal HGH Distribution Penalties

z Violations may be punishable by


imprisonment of up to 5 years (10 years if to
a person under 18 years).
z Any conviction is considered a felony
violation of the Controlled Substances Act for
the purposes of forfeiture.
z As used in this subsection the term ''human
growth hormone'' means somatrem,
somatropin, or an analogue of either of them.
DEA Authorized to Investigate

z Since testosterone is a controlled substance,


the Drug Enforcement Administration (DEA)
has jurisdiction to investigate.

z By federal law, the DEA is authorized to


investigate HGH offenses (even though in
practice, FDA has typically spearheaded
investigations). So, while not federally
controlled, pretty darn close.
HGH and State Laws

z Unlike federal law, the following


individual states have explicitly
scheduled human growth
hormone as a controlled
substance (illegal distribution
is a felony):
– Colorado, Idaho, Illinois
(unscheduled but non-medical
distribution is criminalized),
Minnesota, Oregon, Rhode Island
and West Virginia.
Legitimate Medical Purpose

z Under federal regulations, a controlled substance


can only be prescribed or dispensed for a “legitimate
medical purpose” in the “usual course” of
professional practice [21 CFR §1306.04(a)].
z A prescription written for an illegitimate purpose or
outside of the usual course of practice is an invalid
prescription.
z But what’s a legitimate medical purpose?
No Hormones for Muscle Building
z Steroids (e.g., testosterone) are permissible to treat
disease symptoms, even those associated with the
aging process, including hypogonadism (“andropause”),
erectile dysfunction and libido decline.

z But hormonal therapy to enhance athletic performance


or cosmetic muscularity in healthy people is a violation
of law and of current-day medical ethics.

z Currently, any mature healthy adult seeking to obtain


testosterone or hGH exclusively for muscle building
must resort to the black market, with all of the attendant
risks.
Federal Steroid Punishments

z In creating the federal guidelines for anabolic


steroids in 1991, the U.S. Sentencing Commission
acknowledged a “distinction” between steroids and
other Schedule III drugs because of “the variety of
substances involved” and defined one unit of
steroids as a 10 cc vial of injectable steroids or fifty
oral tablets.
z All vials of injectable steroids were to be converted
on the basis of their volume to the equivalent
number of 10 cc vials (e.g., one 50 cc vial is to be
counted as five 10 cc vials).
The NEW Steroid Guidelines
ƒ The Anabolic Steroid Control Act of 2004 directed the U.S.
Sentencing Commission to consider amending federal guidelines
to increase the penalties for steroid offenses “in a manner that
reflects the seriousness of such offenses and the need to deter
anabolic steroid trafficking and use…”
ƒ On April 5th, the Commission voted to promulgate as permanent
the “emergency” amendments to the guidelines which had taken
effect on March 27, 2006. Injectable and oral steroids will now be
quantified for punishment in a 1:1 ratio to other Schedule III drugs,
resulting in a twenty-fold measurement increase for injectable
steroid units and a fifty-fold increase for oral steroid
units. One “unit” of an oral steroid is now one pill, tablet or
capsule. One unit of a liquid steroid is now 0.5ml. Steroids in
other forms (“e.g., patch, topical cream, aerosol”) will be
reasonably estimated based on a consideration of 25mg as one
unit.
More Steroid Prosecutions
Coming…
ƒ The reasonably anticipated effect of the new law and increased
punishments will be an increase in steroid prosecutions and
investigations. Even before the enactment of the new legislation
or the increase in the sentencing guidelines, DEA officials had
announced that a newly invigorated anti-steroid enforcement
crusade had begun. DEA Deputy Administrator Michele Leonhart
warned at a steroids summit in Los Angeles on October 12, 2004,
“We are now focused on steroid trafficking and abuse as
never before.”
ƒ Since the expansion of the list of steroid substances and the
removal of the disincentive of too lenient punishment guidelines,
administrative rhetoric has escalated. Scott Burns, a deputy
director of the White House Office of National Drug Control Policy,
has declared that senior law enforcement officials have now
“made the trafficking of steroids a priority.”
Steroid operations have
already started.
ƒ DEA announced last December the
arrests of individuals involved with eight
“major steroid manufacturing companies”
as part of what DEA claims is “the largest
steroid enforcement operation in U.S.
history.” “Operation Gear Grinder” is
described by DEA as a 21-month task
force investigation that targeted Mexican
veterinary steroid manufacturers whose
products are claimed to have been
illegally sold to U.S. consumers via the
Internet.
But mostly…

ƒ We’ll probably see higher numbers of


arrests and prosecutions in both state
and federal courts of the same folks
who’ve been getting arrested and
prosecuted up to now. They are the folks
who are most commonly using steroids.
ƒ We’ll get to who they are … later.
Science
Health Risks for Adult Males

z Writer Dayn Perry, in “Pumped-up Hysteria”


http://www.reason.com/0301/fe.dp.pumped.shtml says (quote):
– “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 … ‘We
know this because they’re used in medicine all the time, just not to
enhance body image or improve athletic performance.’”
Commonly Reported Adverse Effects
in Adult Males

z Testicular Atrophy
z Sterility
z Acne
z Baldness
z Cholesterol Changes
z Hypertension
z Prostate
z Tissue Injuries
What is “truth”?

z The whole truth … and nothing but


z A case in point: steroids and the liver
z C-17 alkylation and liver stress
z Studies show damage is dose related in sick patients
z But one 30 week study showed no effects at 1,000mg
oxymetholone weekly on HIV+ patients
z Med lit. shows only 3 cases of steroid-associated liver
tumors in athletes (again, dose related)
z Injectable steroids have virtually NO effect on the liver
Steroids and Adolescent Suicide

„ Three highly publicized and tragic suicides


involving late adolescent males have been
attributed to steroids as the cause.

„ Can suicide be blamed on a single


causative factor?
Steroid Expert: Dr. Jack Darkes
„ In a comprehensive examination of the subject (available at
www.steroidlaw.com, Jack Darkes points out:
“Many individual difference factors, including long-term and current use
of a range of substances, characterize the history of suicide completers.
[N]umerous factors known to be associated with teen suicide were present
in these cases - several others were likely present as well. … AAS
researcher Harrison Pope is noted as suggesting that ‘…a steroid user who
was also taking antidepressants for an existing depressive illness might be
more susceptible to suicide risk’. The characteristics present in these cases
might be causes, effects of other causes, or correlates … [T]he factors that
might motivate AAS use (e.g., low self-esteem, body dissatisfaction) might
also ‘predict’ suicide, and at best, the temporal relationship to AAS use
might suggest that they exert a ‘permissive effect rather than a causal one,
which, in the example of testosterone-related aggression, suggests that
‘…testosterone is not causing aggression, it’s exaggerating the aggression
that’s already there’.” (Citations omitted)
Dr. Darkes quotes cont’d
z “In addition, the link between AAS use/withdrawal and suicide in both
the larger literature and in these cases is predicated on the idea that
depression is associated with AAS withdrawal and that suicide is a
consequence of that depression (whether such post AAS use
depression is solely caused by AAS withdrawal is hardly a proven
fact). This association is noted as proof that these suicides were
caused by AAS use.
z “However, researchers have also suggested that, in adolescents,
suicide might also be considered as part of the constellation of risky
and problem behaviors that appear in adolescence, which also
includes drug use.
z “Can or should these cases inform policy on adult use of AAS? [I]t is
already well established that use of any drug by adolescents is a risky
proposition and is associated with an increased risk of suicide. This
has little to do with the question of AAS use or withdrawal as a cause
of suicide among adult AAS users.”
My two cents

z Human nature favors simple answers and single causes to


explain the complexities of human behavior. Such reductions
are also good press.
z The depression which in some cases leads to suicide is likely
the result of a matrix of factors (e.g., environmental, hormonal,
genetic, situational, etc.) incapable of definitive causal review.
z For many and varied reasons, suicide is the 3rd leading cause
of death among 15 to 24 year olds, unrelated to steroids.
z Regardless, teenagers shouldn’t be using steroids non-
medically.
z Our hearts go out to the families of all suicide victims
regardless of age or motivations.
Steroids and Aggressive Rage
z Steroid aggression – so-called “roid rage” – is far less common than the public
is led to believe. It is even conceded by anti-steroid authorities that “[i]f this
phenomenon is real, it is relatively rare (probably less than 1%) among users.
Even among those affected, the impact of previous mental illness or abuse of
other drugs is still unclear.”[1] “Some long-time steroid users have never
suffered any emotional instability, or anything more than transient physical
effects” and many steroid users describe non-violent feelings of euphoria, well-
being and enhanced self-confidence as common effects.[2] Indeed, the
relationship between anabolic steroids and aggressive behavior is far more
complex than the press has reported, and the most exhaustive review of the
medical literature did not find consistent evidence for a direct causal
relationship between steroid use and aggression even in those affected.[3]

[1] C.E. Yesalis & V.S. Cowart, The Steroids Game (Champaign, IL; Human Kinetics, 1998), 60.
[2] J.E. Wright & V.S. Cowart, Anabolic Steroids: Altered States (Carmel, IN: Benchmark Press, 1990), 51.
[3] J. Darkes, The Psychological Effects of Anabolic/Androgenic Steroids, Parts I through IV, MUSCLE
MONTHLY, [http://www.musclemonthly.com/author/jack-darkes.htm].
Steroid expert:
Harrison Pope, M.D.

z “With regard to the ‘roid rage’ issue, my first reaction


as a scientist, obviously, is that ‘roid rage’ is a
meaningless term that simply arose in popular
parlance” to describe manic symptoms.
z Citing a 1994 paper which is “the closest thing to a
quantitative answer” on prevalence, Dr. Pope points
out that less than 5% experienced manic symptoms -
- and all of them were taking >1,000mg per week.
Of those consuming less, 0% (zero) experienced
manic symptoms.
z Dose, dose, dose. (As in most things.)
Steroid Expert: Mauro DiPasquale, M.D.

z Two-time world-champion power-lifter, eight-time Canadian champ,


two-time Pan-American and two-time North American champion.
Physician and one of our foremost authorities on performance-
enhancing drugs; written eight books on the topic
z “As used by most people, including athletes, the adverse effects
of anabolic steroids appear to be minimal,” says Di Pasquale.
“Steroids do not cause cancer. They don’t cause kidney failure. There
have been thousands of steroid studies and about a hundred of those
point out bad side effects. But if you look at those studies carefully,
there’s no one-to-one correlation, and a one-to-one correlation is the
hallmark of good science. Do anabolics produce ’roid rage? They
produce an incredible amount of energy, but you need to think about
the kind of people taking steroids. If really competitive and aggressive
people start taking drugs that give them more energy, then common
sense says that sooner or later you’re going to have some problems,
but are steroids the problem or the fact that this person didn’t know
how to control their anger long before the steroids came along?”
Steroid expert:
Nick Evans, M.D.
ƒ UCLA orthopedic surgeon and sports-medicine specialist
ƒ In 1996 published his first paper, “Gym and Tonic: A Profile of
100 Steroid Users,” in the British Journal of Sports Medicine.
ƒ Followed by an even more rigorous look at 500 long-time
juicers that was published this year. “Evans found no
concrete links between steroids and the deadly panoply
with which they are often associated, though at the extreme-
bodybuilding end of the spectrum, he has some serious
concerns about the heart. ‘The heart is a muscle and steroids
increase muscle size. If the heart starts getting bigger, it
becomes less efficient at doing its job, and over time that can
cause big problems.’ Evans also feels that if users had access
to proper medical advice, many of these problems could be
avoided.” http://www.laweekly.com/general/features/sympathy-
for-the-devil/417/
Are Steroids Devoid of Risk?
„ No way. Nothing is.

„ How do the risks compare?


„ Tobacco (over 440,000 deaths annually)
„ Adverse Reactions to FDA-approved medicines
(108,000 deaths annually, 7,000 of which are
medication errors)
„ Alcohol (approximately 85,000 deaths
annually from excessive or risky drinking)
„ NSAIDS and aspirin (estimated 7,600 deaths
and 76,000 hospitalizations annually)
Common Sense & Steroid Dosages
(i.e., “too much of anything…”)

z Compare two glasses of wine per night …


with two bottles of Scotch.
z The Michael Jackson Syndrome
(other than the pajama parties)
Hmmmm…

zGynecomastia

zMore isn’t better

zBut when is it right to


protect adult people from
themselves?
Don’t believe everything
you hear…

„ The average American likely believes that steroids are highly


dangerous, responsible for countless deaths including the demise of
Los Angeles Raider Lyle Alzado. In a 1991 Sports Illustrated
interview, Alzado blamed steroids for his brain cancer. Actually, the
T-cell lymphoma that killed Alzado has never once been associated
in the medical literature with steroids despite use by millions over
five decades.
Steroids for Health
„ If a young boy’s body doesn’t produce its own testosterone, he’ll
require testosterone administration in order to fully develop.

„ If an older man stops producing testosterone endogenously (by his


own body), or if his testosterone level becomes abnormally low, he’ll
need the exogenous testosterone administration to replace it. The
problem of insufficient testosterone is called hypogonadism, and the
age-related decline in testosterone levels experienced by most men
is sometimes called andropause.

„ Testosterone is the hormone that’s administered if a woman decides


to change her gender and become a man.
Steroids for Beauty in Aging?
z In an article entitled "Sympathy for the Devil: everything you thought
you knew about steroids is wrong," LA Weekly's Steven Kotler
separates fact from myth and fiction on the subject of anabolic steroids
as used by mature adult males (not teens, or women). An excerpt:
"What I found interesting ... is that when steroid-related complications
are compared to complications from other radical cosmetic practices
like liposuction or breast augmentation, the statistics show across
the board that elective surgeries produce far more problems, and
far more serious ones at that. What I found more interesting was that
unlike these cosmetic practices, steroids hold real promise. Plastic
surgery may hide wrinkles by cutting them out, but steroids might
actually make you feel younger from the inside out. All of which raises
the question: If steroids are not nearly as bad for us as we’ve been
led to believe, and if they show far more potential as anti-aging
medicine than anything else currently available, then what the
hell is the problem?"
Steroids and HIV Wasting
„ The crucial role that anabolic steroids can play in the
war against AIDS has recently begun garnering support
from the clinical community. The quality of life benefits
that steroids can offer those suffering from the muscle
wasting associated with the HIV virus are reportedly
wonderful.
„ For more information on the highly positive effects that
AAS therapy is having upon HIV+ and AIDS patients,
and about the relative safety of anabolic steroids in
general, see www.medibolics.com, the web site of
researcher Michael Mooney, an internationally
recognized expert in the field of AIDS survival strategies
and the co-author of Built to Survive: A Comprehensive
Guide to the Medical Use of Anabolic Steroids, Nutrition and
Exercise for HIV(+) Men and Women (PoWeR, 1999).
Steroid Education for Stupid People

ƒ STEROIDS = BAD
Steroid Education for Thinkers

z Steroids for Cheaters = BAD


z Steroids for Teenagers = BAD
z Steroids for Burn Victims = GOOD
z Steroids for AIDS Wasting = GOOD
z Steroids for Hypogonadism = GOOD
z Steroids for Certain Anemias = GOOD
z Steroids for Low Libido and E.D. = GOOD
z Steroids for “Anti-Aging” = Looks Promising?
z Steroids for Appearance = ?????
HBO Takes On … Steroids

z HBO Real Sports aired a segment recently entitled


"The Contrarian View" about anabolic steroids.
Armen Keteyian, who has been reporting on illegal
substances in sports for the past five years,
investigates the belief held by some scientists that
steroids, when properly administered, cause no
harm in mature adult males (the segment
emphasizes that the serious risks to teens and
women are higher). The proposition seems like
heresy in the current atmosphere of national steroid
hysteria…
Demographics
Who’s Using … and Why?
How many users are out there?

z Hard to say.
z Estimates have ranged from 3
million to as high as 6 million for
the total number of Americans to
have used steroids non-medically.
The growing disparity

z Years of contact with non-medical steroid users in


gym settings as well as in my law practice afforded
me the opportunity to come face to face with
hundreds and hundreds of non-medical steroid
users.
z Notwithstanding the portrait of steroid use presented
to the public, the overwhelming majority of users I
saw were neither teenagers nor cheating athletes.
This observation was a key point in Legal Muscle.
z But no relevant large scale studies existed.
Evans, N. and Parkinson, A. (2006)

z In the largest and most in-depth survey of its


kind to date, 500 steroid users were
surveyed anonymously via Internet.
z Finding: 80% of steroid respondents were
not competitive athletes. Rather, many of
them were recreational bodybuilders or
people using steroids as a means of
enhancing physical appearance.
Steroid use is primarily an
aesthetic or “cosmetic” effort for
males who want to look bigger
and stronger.
Mostly, steroid use is all about
appearance, not performance.
Unpublished data

z Between July 19, 2005 and November 19, 2005, an


anonymous, Web-based survey of adult non-medical
steroid use was conducted (researchers: Cohen, J.,
Collins, R., Darkes, J., and Gwartney, D.).
z The current sample (the largest ever) comprised
1,955 American males who self reported use of
anabolic-androgenic steroids for non-medical
purposes. The median age of the sample was 29-
years-old. [It was taken from a larger international
and mixed gender sample (n= 2663).]
Question: How many respondents (steroid users)
are currently competitive athletes?
So, if less than 11% of users
are currently competing in
sports, how many have ever
competed in sports since
beginning
steroid use?
So, for more than 4 out of 5
steroid users in this survey,
competitive sports were
completely unrelated
to either current or past
steroid use.
Even among the 1 in 5
respondents whose steroid use
occurred, at least in some part,
while competing in sports, the
connection may be largely
coincidental.
The top three motivations for
athlete-users are the very same
as for the overall user sample:
Increasing muscle mass
Increasing strength
Looking attractive
Confirmation of my observations
over many years.
Steroids and Cosmetic Appearance
„ Our society increasingly obsesses over
superficial appearance (too much, I think).
„ Widening acceptance of technology to
attain the perfection that is demanded.
„ Explosion of cosmetic surgery and
medical/dental procedures of varying
types and risks for people of all ages: e.g.,
liposuction, gastric bypass, breast
augmentation, breast reduction, prosthetic
implants in torso and limbs, Botox,
orthodontics, and on and on.
But if athletes aren’t the main
part of the steroid pie, it must
be our middle school and high
school students. Right?
Teen Steroid Use: the TRUTH

z Teenagers should not be using


anabolic steroids absent
medical reasons.
Period.
Any non-medical adolescent
steroid use is a problem.

z Health risks for teens are greater than those for


mature adults.
z Steroid use can close the growth plates of the long
bones and prevent the adolescent user from growing
to full height.
z In a black market riddled with foreign veterinary
steroids of questionable content, teens are more
likely to be scammed by shady dealers with
potentially dangerous products.
z Teens may be less inclined to admit their use to
disapproving physicians, leading to an increased risk
of health consequences for failing to monitor liver
and cardiovascular health markers.
Abuse potential

z Teens may be more likely to use steroids in


excessive dosages. Impatient, eager for fast results,
many teens are less focused on the distant future,
including possible health consequences. Typically,
maturity doesn’t come overnight. The teen years for
most of us are colored with recklessness, sporadic
irresponsibility, and a pervasive feeling of
invincibility, leading to some poor choices. That's
why we have a list of substances and activities which
are legal for adults but prohibited for minors.
Higher risks, lower benefits

z Although the risks for teen steroid users are


higher, the potential benefits are lower.
z Teenagers should note that their natural
testosterone levels are really high. Steroid
use shuts off natural testosterone production.
Studies have shown that testosterone levels
of teenaged boys can jump as high as 2,000
nanograms per deciliter of blood -- about two
to four times that of your typical adult male.
Steroid Use in High Schools and Middle
Schools 2005 University of Michigan Monitoring the Future studies

z 8th graders who reported using steroids at


least once in their lives: 2.5% in 2002 down
to 1.7% in 2005.
z Among 10th graders, 3.5% in 2002 down to
3.0% in 2003, then down to 2.4% in 2004,
and now down to 2.0% in 2005.
z Among 12th graders, the decrease was from
4.0% in 2002, to 3.5% in 2003, to 3.4% in
2004, and now dramatically down to 2.6% in
2005.
Missing statistics…

z Surveys have focused on the percentage of


high school students who use steroids.
z Little data on the percentage of steroid users
who are school-aged students.
z In other words, what portion of the pie chart
of American non-medical steroid users is
comprised of kids?
New Data Sheds Light…

z At least three large steroid use surveys have


shown that approximately 75% of steroid
users started their use at age 20 or older.
z Our unpublished data (a sample four times
as large as the previous largest)
corresponds, with over 94% starting use at
age 18 or older.
What about little girls?

z Read the papers and you’d think that there’s a massive army of
juiced-up prepubescent girls terrorizing the playgrounds of America.
z Credit the Associated Press for breaking the news in April 2005: “More
Girls Try Taking Steroids to Tone Up,” proclaiming a study supposedly
finding that an “alarming number of American girls, some as young as
9, are using bodybuilding steroids…”
z More journalists jumped on the “nine-year-old girls” story as
sensationalistic shorthand for the dangers of steroid abuse.
z Politicians started using the image in anti-steroid rhetoric.
z Even ubiquitous Canadian lawyer Dick Pound, ever eager to convince
American tax payers to commit more money to his World Anti-Doping
Agency, used it in a speech.
Steroid Expert: Dr. Harrison Pope
z Harvard psychiatrist and “roid rage” researcher has flat out
stated that “steroid use by girls is extremely rare.
z In his most recent appearance before Congress, he debunked
the idea that girls are injecting liquid steroids or downing oral
tablets like candy corn, stating that “even the 1% rate is still
probably a substantial overestimate” and that a 0.2% rate is the
most reliable estimate. “I would strongly question the assertion
that there is currently a widespread public health problem of
anabolic steroid use by teenage girls or young women in the
United States.”
z More recently, after further review: “Many anonymous surveys
appear to have greatly overestimated the lifetime prevalence of
AAS use among teenage girls; the true rate may be as low as
0.1%” (personal correspondence).
Even the study’s own researcher…

z “I would certainly not say that there is an


epidemic of use among females,” stated Dr.
Lloyd Johnston, the head researcher of the
study upon which the Associated Press story
was based. “The story was hyped in an AP
story earlier this year, and it just keeps
playing on.”
z Hype, hype, hype.
My two cents
z Concluding my review of the subject in an article entitled “Girls
Gone Steroids” at www.steroidlaw.com:

“So, have our middle-school daughters ditched Coach


bags and bejeweled cell phones for Deca and D-bol? Are our
little fourth graders forking over their milk money to brace-faced
little dealers after chorus class? The truth is alarming indeed,
but not because there’s an epidemic of bearded, balding, acne-
scarred tweens tearing up the local Limited Too. There isn’t,
and we should all have known that. What’s scary is how easily
lazy reporters and self-serving opportunists can foment a wave
of national hysteria in the absence of facts, evidence and
common sense.”
Steroid Expert: Dr. Charles Yesalis

z In the 1980s Congressional hearings about whether


or not steroids should become a controlled
substance, among those who testified was Charles
Yesalis, PhD, a professor of health and human
development at Penn State and the world’s leading
steroid authority at the time.
z “Steroids do have a medical use,” he testified. “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 [and alcohol] than
anabolic steroids.”
Compare to steroids…

z More than twice as many 12th graders have used ecstasy


(5.4%), over three times as many have used cocaine (8.0%) or
hallucinogens (8.8%), over five times as many have used
amphetamines (13.1%), and a whopping 57.5% have been
drunk. Nearly 20% of our 8th graders have abused alcohol to
intoxication, and more than twice as many 8th graders have
used cocaine (3.7%, and an increase since last year) over
steroids.
z Nearly 6,000 teenagers die each year in alcohol-related car
accidents in the United States.
A problem? Yes. But…

z These statistics are not intended to minimize in any


way the societal problem presented by teen steroid
abuse!
z I devoted a chapter of Legal Muscle and wrote an
article to discourage teen steroid use with truth, not
scare tactics. See
http://www.dolfzine.com/page528.htm.
z However, it’s dishonest for self-serving professional
alarmists and sensationalistic journalists to create
unfounded hysteria.
Summing up the “WHO”
¾ According to our survey, the average American steroid
user is a single, Caucasian, highly educated, gainfully
employed white collar worker, earning an above average
salary, in his late twenties to early thirties.
¾ The high rates of self-reported drive, motivation, and
goal-directed behavior by the respondents serve to
validate and be validated by the aforementioned
characteristics. Seventy percent of sampled steroid
users felt they were perfectionists. The high functioning
nature of this group is inconsistent with expectations
based on previous researchers’ reports of high
psychopathology.
Policy
Sports Policy
ƒ Steroid use is viewed as cheating.
ƒ Most professional and amateur competitive
sports have banned anabolic steroids since
the 1980s. Among the substances banned
in the National Collegiate Athletic
Association (NCAA) list of banned-drug
classes are “anabolic agents.” [Bylaw
31.2.3.1]
NCAA Drug Testing
ƒ A positive test result is sufficient to impose punishment; no trial takes
place.
ƒ There is no mechanism by which an athlete can promptly admit his
guilt in conjunction with extenuating or mitigating circumstances in
return for leniency. Under the current system, neither plea nor
sentence bargaining is an option; it’s all or nothing for the athlete
accused of doping, regardless of the individual facts.
ƒ It is the athlete’s obligation to file an appeal if he or she desires. The
burden of proof is then upon the athlete to challenge the result, such as
by establishing collection or testing protocol breaches, chain of custody
flaws, lack of notice and the like.
ƒ The design is a reversal of the American criminal justice system, where
due process places the burden on prosecutors to prove guilt beyond a
reasonable doubt in an adversarial proceeding and where even
murderers are innocent until proven guilty.
N.J. School Steroid Testing
ƒ New Jersey would become the first state to institute a drug-
testing policy for all high school athletes under a plan set to
receive final approval next month. The policy, which
received preliminary approval last week from the executive
committee of the New Jersey Interscholastic Athletic
Association, would bar high school athletes from
competing unless they and their parents agree to random
tests.
ƒ A parent whose daughter is a pitcher for a high school
softball team, is for the testing, especially because of what
is going on in Major League Baseball. "I don't think it's a
bad idea at all … Kids have to be held to standards.”
ƒ The plan bans about 80 performance-enhancing drugs and
imposes a one-year suspension for any athlete who tests
positive or refuses to be tested.
Testing (New Jersey)
ƒ Any reasonable and effective means to discourage teen steroid
use makes sense, but…
ƒ Sports writer Stefan Bondy points out:
“… state-funded testing for steroids — and only steroids —
sends out at least three false messages to athletes and non-
athletes:
1. Steroids are the biggest drug problem in schools.
2. Student-athletes are the biggest drug users.
3. Fair athletic competition is more important than
classroom success.

ƒ Bondy points out 2004 U.S. Department of Justice stats that


70% of high school seniors drank alcohol the previous year;
34% smoked marijuana; only 2.5% used steroids. “That ranks
behind tranquilizer, sedative, hallucinogen, cocaine and
inhalant users.“
ƒ Not to mention costs!!!
Steroids in Elite Sports
„ The Beam in Your Eye: If steroids are cheating,
why isn't LASIK? By William Saletan
http://www.slate.com/id/2116858/
“…Mark McGwire was hauled before a
congressional hearing and lambasted as a cheater for
using a legal, performance-enhancing steroid precursor
when he broke baseball's single-season home run
record.
“…Tiger Woods was celebrated for winning golf's
biggest tournament, the Masters, with the help of
superior vision he acquired through laser surgery.
“What's the difference?”
„ McGwire decided eye surgery was too risky and went for
andro instead. Ended up with 70 homers and a rebuke
from Congress.
„ Woods, who had lost 16 straight tournaments before his
surgery, ended up with 20/15 vision and won seven of
his next 10 events.
„ Since then, scores of pro athletes have had laser eye
surgery, known as LASIK (Laser-Assisted In Situ
Keratomileusis). Many, like Woods, have upgraded their
vision to 20/15 or better.
„ Golfers Scott Hoch, Hale Irwin, Tom Kite, and Mike Weir have hit
the 20/15 mark. So have baseball players Jeff Bagwell, Jeff Cirillo,
Jeff Conine, Jose Cruz Jr., Wally Joyner, Greg Maddux, Mark
Redman, and Larry Walker. Amare Stoudemire and Rip Hamilton of
the NBA have done it, along with NFL players Troy Aikman, Ray
Buchanan, Tiki Barber, Wayne Chrebet, and Danny Kanell. These
are just some of the athletes who have disclosed their results in the
last five years. Nobody knows how many others have gotten the
same result.
You don't need bad vision to get
the surgery
„ Pro golfers seek "to optimize any competitive
advantage," a LASIK surgeon told the Los Angeles
Times. "They're already tuned in to the best clubs, the
best putter, the best ball. ... Clearly having great vision
is one of the best competitive advantages you can
have." Eyes are just another piece of equipment. If you
don't like 'em, change 'em.
„ Woods says he's "able to see slopes in greens a lot
clearer." Woods' eye surgeon told the Los Angeles
Times, "Golfers get a different three-dimensional view of
the green after LASIK." They "can see the grain" and
"small indentations. It's different. Lasik actually
produces, instead of a spherical cornea, an aspherical
cornea. It may be better than normal vision."
Isn’t enhancing your performance
what it’s all about…?
„ Ironically, anti-steroid Congressman Tom Davis opted for
LASIK! "I was in and out in less than one hour," he
reports in a testimonial for the Northern Virginia LASIK
practice. "I was reading and watching television that
evening. My reading was not impaired and my distance
vision was excellent."
„ Saletan chides: “Good for you, Tom. Now, about that
committee you've established for zero tolerance of
performance enhancement. Are you sure you're the right
guy to chair it?”
Steroid expert: Norman Fost, M.D.
ƒ In “Let's get real about sports and steroids,” San Fran
Chronicle reporter Joan Ryan asks: “Why is there such
reefer-madness hysteria about steroids? … Norm Fost,
pediatrics professor and medical-ethics expert at the
University of Wisconsin Medical School, is confounded.

‘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.”
(http://www.sfgate.com/cgi-bin/article.cgi?file=/c/a/2004/12/12/BAGJ0AAI981.DTL: bn):
Joan Ryan quote continues…
“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?”
More Fost (c/o Ryan) …
ƒ “ ‘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.”
Should steroids be allowed in
sports?
ƒ I don’t think so, and the public will never
accept such a policy any time soon.
ƒ But why should just asking the question be
so offensive to people?
ƒ Dr. Fost has made a career of comparing
the dangers of steroids to the dangers of
playing football itself.
ƒ Want more? Check out his interview at
www.steroidlaw.com.
Criminal Justice Policy
Since 1991, who’s HASN’T been
getting busted for steroids?

„ Million dollar sports stars

„ Dealers

„ Cheaters
Who IS getting busted?
Of the hundreds of people I’ve represented on
steroid-related criminal cases, the vast majority
were health-conscious, gainfully employed, non-
smoking males aged 25 to 45 who exercise
regularly and eat a high protein, moderate to low
carb diet.
Compare, U.S. epidemic of
obesity among couch potatoes

Personal users
American Steroid Enforcement

z Nearly 10 years of relative quiet


z Along came the Internet
z Along came 9/11/2002
z Customs and the Postal Inspector
z Border Seizures
z Controlled Deliveries
z For more about all of this, see Mike’s story in
Chapter 23 of Legal Muscle (available online)
The Possession “With Intent” Problem

z In most state courts, drug traffickers are


understandably viewed as deserving of much
harsher punishment than personal users.
z Possession of "large" quantity = basis to infer that
the possessor was a seller rather than a user.
z Steroid offenders are often prosecuted as dealers
based merely on the quantity recovered, without any
other evidence of distribution.
z I’ve seen charges of possession with intent to sell
based on less than 100 tabs or 30 amps.
ƒ In street drug cases, possessing 15 or 20 individually
packaged units of cocaine or heroin implies an intention to
sell it. The implication is based on the fact that narcotics
users tend to purchase and possess only enough for an
immediate high. For example, a crack addict goes out,
buys enough crack for an immediate high, smokes it,
and experiences the immediate intoxication of the
drug. When the effect wears off, he's off in search of more
crack.
ƒ Steroids are different. Purchased with long-range planning.
Uncertain about future supplies, steroid users will buy
enough gear to avoid running out of stock mid-cycle. Many
steroid “pack rats” stockpile. Unsurprisingly, police can
mistake a hardcore personal user’s home for a major
distribution warehouse.
Oral steroids
ƒ While oral steroids are less popular than injectables (liver
issues), they are sometimes used.
ƒ Methandrostenolone (called methandienone in Europe,
and once popularized under the brand name Dianabol®) is
now imported from countries such as Thailand, where it’s
called Anabol. Each pink, pentagon-shaped Anabol tablet
contains 5mg of methandrostenolone – a relatively small
amount of active product.
ƒ Compare it, for example, to its closest steroid cousin,
Anadrol-50 (oxymetholone), which provides 50mg per tab -
- 10 times the amount of an Anabol tablet. Because of the
low potency, users typically average 5 to 10 tablets daily,
although heavy users may consume double that amount or
even much more.
Anabol: a low dose oral steroid

¾ The medical literature [D.L.J. Freed, A.J. Banks, et al.,


British Medical Journal, 2, (1975), 471-473] noted that
doses up to 300mg per day (sixty tablets daily!) have
been reportedly used by some muscle building
enthusiasts for several years!
¾ But let’s postulate as an example a less outrageous but
still ambitious 3-month cycle (or two 6-week cycles) at 10
tablets (50mg) daily. A total of nine hundred (900)
Anabol tablets would be required for personal use. That
quantity would most likely be pre-purchased (and
possessed) as a single tub of 1,000 tablets (or
more), and it would likely be administered concurrently
(stacked) with one or more injectable steroids (also in
the user’s possession).
Remember Steroids for HIV Wasting?

„ Before 1990, steroids were a prescription drug available to anyone


with a note from their doctor. Since the 1960s, California doc
Walter Jekot had been writing scripts for some of his patients,
primarily athletes and bodybuilders.
„ When the AIDS virus was identified, some of Jekot’s patients turned
out to be HIV-positive, and a few of those patients were the same
athletes and bodybuilders who had been using steroids. By 1984,
Jekot noticed that his HIV-positive patients who had been taking
steroids were still alive, while everyone else seemed to be dying.
They weren’t succumbing to AIDS wasting syndrome, and many of
them looked downright healthy. In 1984, Walter Jekot became the
first doctor to begin prescribing anabolic steroids as a treatment for
AIDS.
Jekot Goes to Prison and People Die

„ Walter Jekot was arrested, convicted and sentenced to


five years in prison. The government claimed he was
distributing the drugs to athletes and bodybuilders.
Nowhere in the transcripts of his court case does it
mention that he was prescribing steroids illegally in
order to continue his treatment of HIV-positive patients.
„ AIDS reseacher Michael Mooney. “They chose Jekot.
Was it a bad choice? Well, they scared the shit out of a
lot of good doctors, and they spread a lot of bullshit
about steroids that bad doctors believed as truth. It
almost goes without saying that if things had gone
differently, there’d be a few million HIV-positive people
who’d still be alive today.”
Something’s rotten in
Denmark…
¾ If steroid users are generally neither
misguided teens nor cheating athletes, but
rather mature adults making a personal
health choice, however misinformed, is the
criminal justice system appropriate?
¾ If cheating athletes (and the “message”
they send to the kids) are the problem,
shouldn’t we target them?
Olympic Embarrassment:
The Steroid Double Standard
An article in the November 2, 2005 edition of The New York Times points out the hypocrisy of
Olympic and world anti-doping officials regarding the Italian anti-doping law. "Steroid Laws: Equal
Justice And Punishment for All," by Selena Roberts, offers much food for thought. [abridged
version at www.steroidlaw.com]
_______________

Steroid Laws: Equal Justice and Punishment for All


by Selena Roberts
Who is the role model for criminal behavior?

There is a 40-something health-club barfly who wakes up with mirrors over his
bed and sleeveless T-shirts in his closet. The guy owns a tackle-box full of steroids
that he purchased over the Internet in hopes of bulking up just enough to pick up the
ladies.
There is an elite athlete who wakes up with mirrors in his home gym and a closet
full of lucrative endorsement deals. The sports star has a paid trainer who
administers steroids so he can find an edge to shatter records and gain wealth.
Where does a police raid take place -- health club or clubhouse? Whose home is
ransacked by the police -- the gym rat's or the sports star's?
Selena Roberts Con’t
“The same I.O.C. leaders who trumpet zero tolerance for drug cheating
spent last week pleading in futility for Italian authorities to relax their
punitive antidoping laws, which send offenders to jail for three months
to three years. ''It is a question of sporting ethics,'' the I.O.C. president,
Jacques Rogge, said Friday, ''rather than a question of crime and
criminality.''
If true, then why did Dick Pound, I.O.C. member and chairman of
the World Anti-Doping Agency, rip into the light prison sentence Victor
Conte, steroid designer to the stars, received in the Balco case? In one
reference, Pound called Conte's plea deal a potential ''cop-out on a
cosmic scale.''
Pound has spent a career mocking cheating athletes for blaming
dastardly opponents and tainted supplements for the fly in their soup.
But now he is offering his ample breath to conspiracy theories, openly
fretting about potential setups by saboteurs who would lure police
officials to a competing athlete's steroid stash.”
Roberts Cont’d
“No one wants to see athletes forced to turn in their U.S.A.
berets at the police desk. No one wants to see a sports figure
working out in a prison yard. ... But shouldn't a doping violator --
whether he is in the N.F.L. or whether she is a figure skating star --
have to answer to authorities? How about answering one question:
Who is your supplier? This is not about the steroid law itself, but
about the equal application of it for everyone, from the anonymous
store clerk hooked on vanity to the visible sports star hooked on
glory. ''It's incredibly hypocritical,'' Collins said. ''It's a bait-and-
switch. The very people the laws were enacted to apply to are now
asking to be exempt. There is something wrong with that. The
antidoping officials pushed for tougher laws as long as the laws
didn't affect the athletes. ''I can't think of one elite athlete who has
been prosecuted on steroid possession. There is clearly a
disconnect." This disconnect is in the mirror of the steroid user. One
reveals an athlete, the other a criminal.”
Should Steroids be
in the War on Drugs?
Norm Fost, MD:

“Whatever the arguments about our regulatory system for


narcotics and marijuana and so on, they simply don’t apply to
steroids. This is not a source of violent criminal activity, school
dropouts and all the social problems of illicit drugs. So putting this in
that category strikes me as bizarre. If the government is really
concerned about safety, if that is really the issue, the steroid
situation screams for regulating the drugs through the FDA, and
facilitating supervision by doctors. By driving this behavior
underground, we have increased whatever risks exist by ensuring
that safety studies are not performed, either short or long term. We
have also lost control of manufacturing processes, so the user has
no way of knowing what, in fact, he is using. The policy of a ban,
coupled with criminal penalties, is even more incoherent if safety is
the argument.”
Fost on Personal Freedoms
(interview at www.steroidlaw.com)
ƒ RC: What are your thoughts about non-competing adult
bodybuilders who elect to use steroids purely for cosmetic
reasons?
ƒ NF: Whatever ethical issues there are in the use of steroids
in competitive sports, which, as I’ve said, I don’t think are
worth the attention they receive, they disappear with non-
competing personal use. We are not talking about unfair
competition, we’re not talking about coercion, and we’re
not talking about undermining the integrity of sport. This is
pure personal choice, right up there with smoking, drinking,
bungee jumping – that is, choices people make in life
which they should be free to make.
Fost on Unknown Risks
„ RC: What about critics who argue that the adverse
effects of steroids won’t be seen or known for years,
decades, or even generations?
„ NF: That’s an argument that can be made about any
drug, any food, or any device that uses a new
technology. It’s a reason why we have regulations; why
we have an FDA that requires careful testing, and NIH
funding for long-term studies. It’s a reason to do
continuous monitoring of drugs’ effects, for having an
adverse event reporting system, and for having people
using these drugs under medical supervision. Everything
has unknown risks. Steroids are no different. The mere
fact that there are unknown risks is not a reason to
prohibit something.
Steroid Expert: Dr. Nick Evans
„ Finds America’s current steroid policy slightly ridiculous,
not because he believes that people should be taking
steroids, but because of the reasons most people are
taking steroids. “There’s this idea out there that the only
people who use these drugs are professional athletes —
that regulating steroids will clean up professional sports
and make the problems go away, but that couldn’t be
farther from the truth. There are 3 million steroid users
in the United States. In both of my studies I found that
80 percent of them were using them for cosmetic
purposes.” http://www.laweekly.com/general/features/sympathy-
http://www.laweekly.com/general/features/sympathy-for-
for-the-
the-devil/417/
Goals of the Anabolic Steroid
Control Act
„ Protect teens

„ Preserve sports integrity

„ Stop the black market


Protect Teens

„ FAILED!
„ Teen use INCREASED for years after
controlled substance status.
„ Associated propaganda has backfired.
„ Products are now unsafe and unsanitary
(remember Prohibition?)
Stop Cheating in Sports

„ FAILED!
„ The law was never even applied to the
folks it was targeted to!
„ Anyone think there’s less drugs in sports
now than 15 years ago?
„ If sports cheating is the problem,
shouldn’t we make sports cheating laws?
Stop the Black Market

„ FAILED!
„ Predictably, taking steroids out of the
hands of doctors EXPLODED the black
market.
„ The steroid market now consists almost
entirely of foreign products, mostly
veterinary products from the Third World
or labs in other countries with
questionable quality control.
The Bad Stuff

„ What the Steroid Control Acts DID


accomplish:
„ Chilled doctors
„ Ended research

„ Got lots of folks arrested who were neither


teens nor athletes
How to fix the problems…
… and preserve personal adult liberties

„ Steroids should be dispensed by


competent doctors, not black market
dealers.
„ Public Health Model vs.
Criminal Justice Model for abuse.
„ U.S. “War on Drugs” should apply to
steroids LEAST of all drugs.
For more information:

Rick Collins, J.D.


Collins, McDonald & Gann, P.C.
One Old Country Road, Suite 250
Carle Place, N.Y. 11514
516-294-0300
www.cmgesq.com or www.steroidlaw.com
© Rick Collins, 2006. All rights reserved.

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