Pharmacy and Baseball: Exploring the Uses of Known PEDs

Photo Credit: athleticbusiness.com

Photo Credit: athleticbusiness.com

BREAKING NEWS: Ryan Braun has been suspended by the MLB for the remainder of the 2013 season. He will accept the suspension and has released this statement  via @MLB, “I realize now that I have made some mistakes. I am willing to accept the consequences of those actions.”

Background

Being a fifth year pharmacy major at Butler University, my family and friends have been bugging me to write a piece on the role of pharmacy in baseball. Well, unfortunately there really is not a defined role of pharmacy in baseball. Sure, teams have their own doctors, but when it comes to prescription medicine, it is really up to each individual player to go pick up his medication(s) on his own.

Thus, I have decided to do a piece on some of the infamous performance-enhancing drugs (PEDs) that have been reportedly used in baseball over the years. The list is not exhaustive, but rather, I focused on seven drugs that I have learned about in some of my classes.

Before I get into the discussion, I want to lay out the purpose for the writing of this article. It is not meant to ridicule players for their offenses, but rather, I am looking to shed some light on the issue in a way that is not always made clear by the national media when reporting drug suspensions.

If a player is suspended for PEDs, it does not always necessarily mean that they are on steroids. There are other drugs out there that also fall under the PED classification by Major League Baseball. Another reason I am writing this piece is to show that most of these same drugs do in fact have a legitimate medical purpose outside of the “performance enhancing” realm.

Drug Analysis

1. Cocaine: aka “Coke”

Cocaine

Cocaine

Medical Use: It is the first known local anesthetic that is used to numb areas of the body for various types of surgeries. It is not widely used in practice anymore because research has shown that a related drug, lidocaine, has more reliable, less addictive results.

Baseball Use: It can provide a brief energy boost, but it also has various negative side effects such as increased blood pressure and heart rate. This was so popular in the 1980s that there is even a book (though it is not a very good one) out there about the “Cocaine Seven.” This is not really used for baseball performance anymore, but I figured it was still worthy to bring up given its past.

Reported Offenders: Joaquin Andujar (1986), Darryl Strawberry (1995, 1999, 2000)

2. Androstenedione: aka “Andro”

Androstenedione

Androstenedione

Medical Use: It has been shown to increase testosterone levels in patients that are testosterone deficient, but studies show that it does not produce the desired lasting effects.

Baseball Use: Studies show that it is possibly effective in muscle growth, but there is no real evidence to support this. Also, according to Micromedex, it states that there is “no real reliable evidence that Andro aids athletic performance.”

Reported Offender: Mark McGwire (1998)

3. Human Chorionic Gonadotropin: aka “hCG”

hCG

hCG

Medical Use: hCG is FDA-approved to treat infertility in women by triggering ovulation.

Baseball Use: This is mainly used in conjunction with anabolic steroids because it is believed to help maintain testosterone levels that decrease during steroid use. Thus, if a player tests positive for hCG, it is often seen as a sign that anabolic steroids may be present as well.

Reported Offender: Jose Canseco (this book says it all. Please don’t purchase it, though, because he does not need any support), Manny Ramirez (2009, suspended 50 games; some reports say he tested positive for hCG, others say that it was in fact testosterone)

4. Human Growth Hormone: aka “hGH” or Somatropin

OMNITROPE® (somatropin [rDNA origin] injection)  Structural Formula Illustration

Somatropin (rxlist.com)

Medical Use: hGH promotes the growth of cartilage, bone, and muscle mass. It leads to an increase in IGF-1 (Insulin-like Growth Factor) which aids in muscle protein synthesis. According to Micromedex, it may enhance fat loss in healthy adults as well as post-menopausal women. It is also possibly effective in treating osteoporosis due to its growth effect on bone. It can be used in children that have growth hormone deficiency to help aid their growth. Lastly, it has metabolic effects that can help with body wasting symptoms in AIDS patients.

Baseball Use: It is often used in speeding up the recovery/body healing process after an injury or surgery. Also, some players use it for its fat loss effects–replacing the fat lost with new muscle. However, its true value as a “performance enhancer” is unproven. Yet, this may be a growing trend in baseball for use after injuries. Because of this, the MLB is working diligently to develop an effective test for it.

Reported Offenders: Andy Pettitte (used in 2002 after injury, admitted in 2007), Jason Giambi (2001-2003)

5. Amphetamines: such as Adderall

Adderall chemical structure

Adderall

Medical Use: Amphetamines such as Adderall are often prescribed for patients with Attention Deficit Hyperactivity Disorder (ADHD). They stimulate the brain leading to a “decreased sense of fatigue, an increase in motor activity and mental alertness, and brighter spirits.” (source: Clinical Pharmacology) According to the FDA, it is also approved to treat narcolepsy.

Baseball Use: It provides players with an increased focus that stimulates them to work out harder and train longer. It can also be taken to give a player an energy boost.

Reported Offender: Barry Bonds (2006). He was suspended but was sent to drug counseling and subjected to increased testing.

6. Ephedrine: aka Ephedra

Ephedrine

Ephedrine

Medical Use: Ephedrine was proven effective in treating asthma as well as weight loss in adults. However, in 2004, the FDA banned its use in the US because it “presented an unreasonable risk of illness, injury, or even death.”

Baseball Use: Ephedrine is a stimulant that led to increased focus and energy (similar to amphetamines) while also leading to weight loss due to the speeding up of the body’s metabolic processes.

Reported Offender: Steve Belcher (2003): His cause of death was classified as heatstroke, but reports show that Ephedra played a large role in his death.

7. Testosterone

Testosterone

Testosterone

Medical Use: Testosterone is FDA-approved to treat hypogonadism in males 12 years and older. It is also sometimes used to treat osteoporosis in males and help provide weight gain if needed, though not FDA-approved for either instance.

Baseball Use: Like hGH, it is believed to help with building muscle and increasing bone density.

Reported Offenders: Ryan Braun (2012, won his appeal), Melky Cabrera (2012, suspended 50 games), Alex Rodriguez (2003-????)

Conclusion

These are just seven of the performance enhancing drugs that have been allegedly abused by professional baseball players as well as other athletes. Other notable drugs include “the Clear” and Winstrol (an oral steroid), but these were not covered in my classes so I did not feel comfortable writing about them. Also, I know that there are various other steroids out there, but I did not feel they were worth your time in this post–there are already plenty of publications on them already.

I hope that this piece has helped you get to know these drugs better while also learning that many of them do have useful roles in the medical field outside of baseball. If abused, especially when used for mere performance enhancement, PEDs pose a health risk to the players, especially in the long-term. This could be an entire article of its own.

If the Biogenesis Scandal ever materializes, I may have another topic to explore, but I figured this was enough drug knowledge for one post.

Until next time…

Joe

Follow me on Twitter: @stlCupOfJoe

If interested, follow this link to read the 36 pages that make up Major League Baseball’s Joint Drug Prevention and Treatment Program.

Credits

Special credit goes out to my Medical Chemistry professor, Dr. Kim Beck, for providing me with the majority of the drug structures shown above. Over the past few years, she has lectured my pharmacy class on the structures of drugs and above is some of what we have learned.

Also, special credit goes to the Micromedex 2.0 Drug Database for helping me with some of the drug indications when I needed to double-check. I hope my pharmacy teachers aren’t reading this since I should have known them all already!

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3 thoughts on “Pharmacy and Baseball: Exploring the Uses of Known PEDs

  1. Pingback: Pharmacy and baseball: Exploring the uses of known PEDs - StlSportsMinute.com : StlSportsMinute.com

  2. Wow – I’m a little surpised by, I’m not sure if it’s lack of knowledge or just naivete.
    So, with a background including legal, and athletic, let me update you on performance enhancers that you have here.
    “Andro” has long been used by athletes to COVER for testosterone or steroid use b/c it alters favorably the Epitestosterone to testosterone ratio that is the basis for all drug testing.
    Hcg is used CLINICALLY to help men regulate testosterone release, it is used as a performance enhancer b/c it causes you to release more of your own testosterone (thus passing the test that might be triggered by exogenous T).
    Hgh is a well known performance enhancer and has MASSIVE anabolic effect. It is used to build muscle and cut fat as it causes a tremendous increase in BMR. However, it is also extremely dangerous as it is hyperphilic and not hypertrophic. i.e. it causes cell growth indiscriminately and thus can cause any number of side effects (different size feet, ears, etc, to growth of internal organs and cancer).

    What is more important is that steroids and hgh are both generations old. Hcg is now the common replacement for steroids or testosterone and IGF1 for Hgh.

    There is NO test for Hgh (the test they are promoting is useful only within 24 hours of use and only detects the OTHER substances in exogenous Hgh and not the actual hormone).

    In most world class sports, the athletes have moved on to far more advanced stuff.

    As a note, the Olympic standard, used by all American professional sports that DO test, allows an epi to test ration of 1:4 which is 4 TIMES the normal ration. In other words before they even begin to test for what you are cheating with, you are allowed to cheat 400%.

    Finally, all of these tests are easily beaten with any # of different methods. From ammonia in the urine, excessive water or sodium intake, etc. Athletes have been doing it for decades.

    And until baseball and football engage in EXTENSIVE out of competition testing and WITHOUT ANY notice to the players, they will remain a joke.

  3. Just an addition to make clear. Hgh is NOT used to help heal injuries. That is a lie that, for example, Andy Pettite and others used. Like all performance enhancers they CAN aid in that (steroides, for example, like their cortico cousins have anti-inflammatory benefits), but that is not what these guys are using them for.

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