The official position on steroids is in: They're really bad for you. Lawmakers are patting themselves on the back for this epiphany, and so is Major League Baseball, which is a pretty bold thing to do, seeing as how for years MLB's policy consisted of denial and deceit, until it was threatened with an act of Congress. Still, baseball finally has tough standards on steroids and uppers, and for this we should be glad. But we shouldn't think for a minute the problem is truly solved.
Baseball's new drug policy will accomplish one thing, and one thing only: It will punish the handful of pro ballplayers dumb enough to get caught, a 50-game suspension for a first offense, 100 games for a second offense and a lifetime ban for a third. It's merely a deterrent — and a crude one, at that. The problem is, there's little evidence that deterrents consistently work on elite athletes, who tend to be risk-takers by definition, and whose outlook and habits are formed long before they sign contracts.
There have been severe penalties for drug use in the Olympics for years — and while some athletes have been deterred, others have only been spurred to find better chemists. So, while the stiff new penalties in baseball are welcome, they don't get at the real problem. The problem is that there are two conversations going on about steroids. One is the public conversation among spectators, congressmen and the media, who agree that performance-enhancing drugs are a scourge and those who use them are cheats. Then there is the intensely private conversation that athletes conduct with themselves, in which they balance the risks, deterrents, benefits and enormous inducements. The difference between a Class AAA player and a major leaguer — or a bronze medalist and a gold medalist — is very small, but the difference in income is very large.
The congressional hearings of the last few months didn't really expose much about the motives and thinking of pro athletes when they use steroids. They just exposed the extent to which athletes aren't willing to talk frankly about it.
In any war on drugs, understanding the source of usage is just as important as enforcement. While it's satisfying to punish and vilify drug cheats, and it sends a better message to the kids, it doesn't really get us anywhere in terms of solving the larger problem. A half-million to 850,000 American teenagers experiment with steroids, and the truth is, they won't stop just because they see a major leaguer suspended. If the people inclined to use steroids are risk-takers to begin with, it serves no use to tell them they might hurt themselves, personally or professionally. Try telling an Evel Knievel not to use steroids because they're harmful, or a quarterback who has had four concussions.
Enforcement by itself doesn't take into account the nuances, different circumstances and reasons for which athletes use -- and without curing the motivation, we won't have a chance of prevention. That's why Linn Goldberg, an expert on teen steroid usage who has testified twice before Congress, persuasively argues that peer programs are likely more effective in dissuading new steroid users than sanctions at the major league level.
"It's fine for the public image; that's good that they have more penalties if they want to clean up their act," he says. "But don't say it's for kids because it's not. The cat's out of the bag: Right now kids are using. So how do we reduce that? By making more penalties for pro basketball and baseball and football players? I don't think so. . . . Kids know that these substances work, and that high-profile, rich, famous athletes have used them."
Goldberg points out that high school male athletes tend to be risk-takers to begin with. They are more prone to binge drinking than their non-athletic peers; they get into more fights than non-athletes; they use their seat belts less than others, and they have more unprotected sex.
"You're starting with a type of person who is more of a risk-taker, and you can also call it 'sensation seeking,' " Goldberg says. "That's [a person] who's a risk for substance abuse anyway, any type of substance abuse."
Nor does MLB's policy do a thing to address the vastly different motive that girls have for using steroids, as body-shaping aids. The highest percentage of users among girls is found in the ninth grade, and they also abuse laxatives and diuretics. "Do they care what Major League Baseball does? I don't think so," Goldberg says.
Goldberg, a professor of sports medicine at Oregon Health and Science University, was called to testify before Congress on steroids because he has been a White House consultant on drug control, and he was a former officer for the U.S. Anti-Doping Agency, as well. He told Congress that while Major League Baseball is good for a splashy message, if we really want to make inroads against steroids, we should be funding two programs directed at high-schoolers, called ATLAS and ATHENA.
The National Institute on Drug Abuse devised the programs, which are evidence-based, empirically tested, and have shown enough real results that they were honored with the Model Program Award from the Department of Health and Human Services. ATLAS (Athletes Training and Learning to Avoid Steroids) is directed at boys, while ATHENA (Athletes Targeting Healthy Exercise and Nutrition Alternatives) is directed at girls. The programs work because they're frank and realistic.
For one thing, they're peer-delivered, which makes them effective, and gender specific. Peers discuss solid alternatives to steroids, and give specific training tips right down to how much protein to eat and calcium to take. They talk about everything from laxatives to diet pills to the dangers of needle-sharing — 25 percent of all steroid users share needles, a harrowing statistic.
ATLAS-ATHENA was initially funded by NIDA using 4,000 athletes in 12 cities. Goldberg says it reduced new use of steroids by 50 percent. Use of marijuana, amphetamines and sports supplements also declined. Drinking and driving fell by 24 percent.
Congress was so in love with the program, it even added it to the 2004 Anabolic Steroid Control Act. There's only one problem: "They didn't appropriate funds for it," Goldberg says.
So, while it's great that Major League Baseball is finally sending the message about getting tough on steroids, it's not the whole answer. If fame and money are inducements, then it's right to take away those things in proper measure for the crime. But in our determination to punish, we shouldn't stop doing hard and detailed thinking — or funding. We need to keep getting at what's being used, and how, and at the why of it, too. Congress has done its investigating, but we also need to keep investigating the soul of the athletes. What are the forces that act on them, what inner bargain are they making, what reckoning, what deal, in sorting out risks and deterrents?