With Lance Armstrong admitting to doping in his interview with Oprah it seemed time to revisit the topic of performance-enhancing drugs and their use by athletes – amateurs as well as professionals, across many fields of competition. Anabolic steroids, EPO, blood transfusions, stimulants and even opioids and marijuana have been used in different sports through the years. We also discuss the evolution of testing, which as the Armstrong controversies have shown, can now be done years after the fact, and the role that designer drugs now play in trying to beat the testing.
Click here to play podcast
Transcript (edited):
HOWARD: Welcome to the CNS Podcast featuring Dr. Darryl Inaba, research director for CNS Productions I am Howard La Mere. Let’s start today with sports and drugs and doping, Lance Armstrong and his admission of doping has been so much in the news lately due to his interview with Oprah Winfrey (which aired after this podcast) so we can’t comment on what he said – but we can talk about the issue in general. This particular person (Lance Armstrong) really underscores the whole phenomena of what has been going on and the fact that we kind of turn a blind eye to it and let it go on to the point where athletes begin dying or experiencing other health complications. Brain injuries suffered by football players is another topic in the news lately. We’ve talked before about what steroid use does to the brain – can we expand on what we’ve already talked about on this topic?
DARRYL: Well, there’s some interesting aspects about what’s happening right now. The interview with Armstrong that everyone is talking about assumes that Lance is going to admit that he used steroids when he competed in the Tour de France and the Olympics. Yesterday the Olympic committee stripped him of his bronze medal in the 2000 Sydney Olympics and they are investigating his teammates and other athletes who won to possibly strip them of their medals as well, thinking that use was not isolated to Armstrong but to everybody he was associated with. Everybody is reacting to this before the program airs. His Tour de France medals have already been taken away and his Olympic medal has been already taken away – it’s admission after the fact sort of thing. The other aspect that’s interesting is that this unfortunately underscore the efficacy of performance enhancing drugs. I mean here’s a guy who was an icon in the cycle world, it’s kind of amazing what he was able to accomplish in all of his competitions and I can’t help but think that other athletes are going to look at this and say, oh my God, those things are really effective. They really work and then they must ask themselves if getting the fame and glory for a short period of time before all the awards are stripped from you and you are condemned by the sports world is worth it – and also is it worth all of the medical problems that athletes who have gone down this road are suffering from today. But if athletes believe it is so effective, I don’t know if it’s something we can ever control because chemists are smart enough to keep one step ahead of all of the drug testing situations.
HOWARD: Part of what’s weird about this is the time lag and the fact that they’re reexamining samples drawn many years ago and subjecting them to more sophisticated techniques and thus determining today that the drugs were in a person’s system way back when. There is an ethics question here I think.
DARRYL: Well, the thing is, it’s not so much of a technique as much as finding the right reagent . In chemical analysis terms, a specific chemical is first isolated then a specific antigen or reactant to it is developed in order to find it in the urine. Chemists are smart enough to restructure anabolic steroids or roids to present a different profile…so they would be unnoticed because the test is not looking for that particular configuration. Sometimes it takes several years for the labs to discover these modifications and develop a standard for it. So, that’s going to continue. We see that today with synthetic marijuanas, the bath salt stimulants, and a variety of drugs. Street chemists and street pharmacologists keep one step ahead of the law and keep manufacturing these substances even though we have designer drug laws and recognize performance enhancing drugs as a category.
There is another aspect of this that’s not being looked at, performance enhancing drugs won’t do very much if the athlete taking them doesn’t do the work. If there is no preparation, no training – no conditioning using the drugs isn’t going to win anyone a medal. You have to do the body building, the practice, the techniques and be at a world class level before these medications give you the extra edge. So here you have a world class athlete who has done a tremendous amount of preparation, has sacrificed a lot to get to where they are – and then risks everything because they cheat a little bit by using a performance enhancing drug. Is it worth really losing everything that you’ve worked so hard for just to get that extra edge? There’s one of those Harry Potter films where his best friend, Weasley was supposed to be a guard in Quiddich that funny game – soccer in the air – and he was all worried and Harry supposedly slipped him, or gave him, a performance enhancing spell potion and he went out and performed brilliantly and after was told that it was a placebo, it was water, but giving him the confidence enabled him to perform better. And I wonder if what athletes need is simply more confidence rather than exposing their body to something that can cause harm later on and may just tweak their performance a little bit today
HOWARD: Yes there has to be different options and a different approach.
DARRYL: We talked about this during the London games this summer, the Olympics, but it could be a matter of choice. An athlete can decide whether it’s worth it or not to do one of these things especially if there are no consequences. There are many studies that show that world class athletes are willing to take any chance. Some have stated that they would take something that would kill them 3 months after taking it if by taking it they would break a world record or something like that. So, they have a different psyche all together.
HOWARD: A different psychology, a different something.
DARRYL: Right. There was a comment made by somebody during the London Olympics regarding a situation where if these things are indeed effective and they are open for everyone to take them, then when the gold medals are awarded – do we rewarding the laboratory the chemists who made it possible – instead of the athlete. Lance is certainly bringing more focus to a situation that I think has grown worse, not better. It is all about better chemistry and better hiding techniques and concealment and maybe more athletes, especially at the world class level are using performance enhancing substances.
HOWARD: We will find out more because – as the old saying goes – it ain’t over ’til the fat lady sings. What else is in the news – there is something about brain shape that I thought was kind of interesting.
DARRYL: Oh, I thought it was fascinating and I think it validates what we’ve been talking about here at CNS in terms of the addiction pathway in the brain. Instead of just talking about the go switch or the reward/reinforcement nucleus accumbens, which is the powerful obsessive part of addiction we started looking at the fact that there had to be a difference between addicts and normies, or people who aren’t addicts….people who can use drugs recreationally and socially and never developed a compulsivity or addiction to them – we realized that there had to be something that was different about the control mechanisms in their brains and we found a lot of research showing that there was indeed a stop switch, an area in the orbital frontal cortex, predominantly the left ventral medial…or right behind the left eye…part of the frontal cortex that was involved with decision making and control. Studies show that addicts had a hyperactive, or overactive compulsion switch – go switch or reward switch – which when activated by an addictive drug, created a strong compulsion to use…almost at a survival level. In addition, they had a less reactive, or even an inactive stop area in their brain, their frontal cortex. A study that just came out conducted by Cambridge in England, examined cocaine users, some were controlled long time users who throughout their lifetime never developed compulsions, obsessions…never had any problems with it…never engaged in criminal behavior – except using cocaine, of course. There were other people who were addicted and had tremendous problems in their lives as a result of use. The brains of the non-addicts, the recreational social users had a much larger frontal part of their brain, frontal part of their skull, and a much more active frontal area which is the control area – this confirmed that the biology of an addict differs from a non-addict. I found that to be very validating and wonder why more studies aren’t doing more research on the orbital frontal cortex and looking for other physiological differences that can predict whether or not an addict will relapse and slip after they’ve been treated versus other addicts who managed to maintain their abstinence and stay in recovery after treatment, purely on how the brain is functioning, how the brain is working. All of this reinforces the whole medical/biological aspects of addiction and will hopefully help to erode and dissolve the stigma and the moral issue associated with addiction.
HOWARD: Is this related to genetics or simply the shape of the brain?
DARRYL: Well, the shape of the brain would be genetics…the number of gray matter and gray cells and the function of those gray matter brain cells is also part genetics, but is also part epigenetics, which has to do with responding to environmental situations, nutrition, toxins, and all the other things we talk about in terms of roots of addiction. But, it’s also a matter of what the exposure is. And what I’ve been trying help the addicts I’ve treated understand – and it’s a hard fight- is that nicotine is a specific toxin effecting the connectivity of connective neurons between the frontal control area or stop area of the brain and the compulsion, the go switch of the brain. A person may have a genetic predisposition to having a good control area and they reinforced that throughout their life. ..but but they start smoking…or they start using addictive drugs when they are young and …those substances erode the connective neurons between the stop area or control area of the brain and the go area of the brain.
HOWARD: The go and the stop switch discussion is always fascinating and it does deserve more research and I’m sure we’ll be talking about it more. It looks like we’re pretty much out of time today.
DARRYL: I did want to mention very briefly a couple of things that I’ve found in the news this week. The national survey on drug use and health is out and the 2010/2011 data shows our state – Oregon is now #1 per capita in abuse of prescription drugs – non-medical use of prescription drugs and prescription drugs for ages 12 and older. It has leveled off slightly but there is still a major abuse of prescription opiates going on in our society. The survey also noted that there was a slight, but steady decrease in underage drinking in America and daily drinking has decreased, but there was an increase in binge drinking. Binge drinking is defined as having 5 or more drinks within a 2 or 3 hour period for a male; for a female, having 4 or more drinks in a 2 or 3 hour period. Underage binge drinking is increasing in opposition to the overall decrease in drinking amongst adolescence. Binge drinking among adolescent females is very dangerous because we’ve known that for women…just having 1 drink a day can increase the risk of breast cancer 6% and binge drinking increases the risk to 20%. So somehow we’re not getting the information to that extremely vulnerable population. Women have less body mass…they have less body water…they have less body fat compared to males so the same amount of alcohol is more toxic for a woman than in a man. And finally, one non-related story, there’s some research from here in America and in Asia saying that there is a non-steroidal anti-inflammatory drug, a NSAID, …the classic one is ibuprofen that is proving to be effective in decreasing craving and lessening addiction to methamphetamines. I would be interested to follow that out in a future show.
HOWARD: By all means! Thanks as for listening and we invite your comments, questions, suggestions – write to us on our website cnsproductions.com.
Please check back soon for the next in the series.