Sports and doping returns again – this time its star Yankee Alex Rodriguez, receiving a 211 game suspension for being associated with a south Florida anti-aging clinic, known to dispense human growth hormone, among other things. Related, in terms of punishment for drugs, the administration has announced its plans to look at the currently harsh drug penalties in this country, which incarcerates more people per capita than any other country. And the application of the sentences appear to be unevenly applied, as a much great number of minorities receiving harsher sentences than anglos. Money is also a factor – the cost to the society in terms of the legal system, building and maintain prisons, and the cost of keeping someone in jail – (as opposed to treatment.) Other stories include news of Lindsay Lohan adopting a $5000/day shopping habit while in treatment – and a look at exchanging one addiction for another. And a study out of Australia highlighting to correspondence between medical experts on review panels for new drugs, etc., and the degree of remuneration that is appropriate.
Howard: Welcome to the CNS Podcast featuring Dr. Darryl Inaba, research director for CNS Productions, I am Howard La Mere. Let’s take a quick look at some of the stories in the news from the past week. The link between money and medical experts was examined in a study from Australia – the study found that a high percentage of professionals – doctors who participate in research activities receive something in exchange and as a result, diagnoses are expanded and that of course means more money for the pharmaceutical companies involved. Our favorite poster girl for celebrity addiction, Lindsey Lohan, has apparently shifted her drug and alcohol addiction to shopping – on the order of 5000 dollars a day. So, that’s a pretty significant addiction and something we might talk today or sometime in the future is the transference of addictions from one thing to another activity or another related or unrelated addiction and what the effects of that are and what it means to the whole process. The highest profile news this week involves punishment for drugs and doping. The administration is looking at their sentencing guidelines, noting the great disparity between minority persons and Anglo persons and that the laws are not being applied fairly. And more big news in the world of doping and sports comes with the suspension of A-Rod Alex Rodriguez and 12 others for doping and their relationship with an anti-aging clinic in South Florida that apparently prescribed human growth hormones. So, Darryl those 2 stories are most interesting. We can talk about the other things too, but I want to hear your opinion on sports and doping because that is once again big in the news. Also today or yesterday, a cyclist, Andrea Clear was charged with or received a sanction for doping . Where should we start?
Darryl: As always, Howard, you always have a wide range of topics to talk about in terms of drugs and addiction and abuse and they’re always fascinating to me and interesting to me so I wouldn’t mind talking about any one of them, but since you have identified the last 2 as the most important, I guess we should start with the monumental announcement by attorney general Eric Holder that he is going to change the sentencing guidelines for drug abuse. And I don’t know if he can actually do that legally, but what he is proposing is changing enforcement – have judges look differently on how they sentence people who are convicted of or are facing drug crimes. And, you know, I hate to say this but the common thread I think with all the things you mentioned is unfortunately the money piece. He appears to be talking about the disparities in punishment for minorities versus non-minorities for committing drug crimes – which has been looked at and acknowledged for a long time, but I think what really is going on here is that we have a criminal justice system that is non-sustainable. We cannot afford to keep putting our people in jail. The last statistic I heard on NPR, National Public Radio, was that the United States has 5% of the world’s population but 25% of all the prison population throughout the world ..
Howard: the highest percentage.
Darryl: And well, that’s amazing.
Howard: In the world.
Darryl: Yes, we just have 5% of the world’s population but we have 25% of the world’s prisoners. The other statistic that spans several decades shows the U.S. population has increased some 30% which is pretty big, but the prison population has increased 800% and that’s primarily due to the rough sentencing that people accused of possession and use and addiction are getting through the criminal justice system and it’s bankrupting our whole country. We can’t sustain that. We can’t afford to put people in jail. I’ve said many times when you do cost comparisons between prevention or treating drug addiction versus arresting and criminalizing people for drug addiction, it’s just an amazing difference. Outpatient treatment is still about 2000 dollars or less a year whereas incarceration is a minimum no matter what county, city, or state you’re in is about 30,000 a year.
Howard: Oh, at least.
Darryl: And then, if you consider prisoners who say they are suicidal or they’re feeling whacky or whatever, the need for mental health watch increase the costs of that prisoner to 100,000 dollars a year 150,000 dollars a year – that is unaffordable for our states, our counties, and our federal government. We have to do something so Holder announces policy based on this great disparity minorities get more prison time for the same drug offences than do non-minorities. Minorities have even a lower incidence per capital of drug abuse but they represent the highest percentage of people incarcerated for drug abuse but again it’s a smoke screen for the cost – we’ve got to do something or this country is going to go totally broke just trying to manage prisoners who are primarily addicts and alcoholics. And why we haven’t invested our money into something that works rather than prison is still baffling. Studies show that if we just put the money into treatment and into prevention, we’ll get a lot more bang for our buck than we do locking people up and expecting them to do well after they get out. But that’s my personal take on the topic. I’m glad to see something happening though. It’s a move for decriminalization of non-violent prisoners, prisoners who didn’t commit any other major crime but were caught possessing and using. The way the laws are now you’re going to have a minimum of a 20 year sentence if you possess a certain amount of a drug because that’s considered to be a trafficker’s amount and trafficker’s get a lot more severe penalties. This new direction eliminates mention any amount in possession during the proceedings and then determines later on how much time this person should get – the reality is we just can’t afford to keep these people in prison and that is where I think this announcement is coming from, but in either event, I’m really glad to see it. I hope other things happen like a larger investment in treatment or that more people realize that they have a chronic persistent medical disorder that we happen to codify and call addiction and therefore it’s a treatable condition and a manageable condition. It’s also probably a very preventable condition and if we just put a little stock in that, people’s lives can turn around as well as our society can turn around. Unfortunately they’re trying to skirt the issue by saying the penalties are too harsh so get people out of jail but they’re not talking about increased treatment or increased prevention dollars.
Howard: Well, you’ll recall a few weeks ago there was talk about that but we never see any money committed to it. There are still ongoing discussions about the budget deficits and the effects I was reading yesterday about how it’s affecting research facilities and some of the top level research is virtually shutting down because of sequestration. That is just a travesty, we need to spend more money on science, not less.
Darryl: That of piggybacks nicely on the other top story you started out with – that Australian study showing that all the research dollars and all the monies coming to scientists across the world, it was an Australian study, but I’m sure it’s happened in the United States ..comes from pharmaceutical companies who are paying top dollar for
Howard: Because they’re the only ones who have money now.
Darryl: Exactly. They have a lot of money and they can make a lot of money even though they’ve got a short patent on a drug like say Suboxone – which is the number 1 prescribed drug and still under patent soon to come off, but in the short time it was patented, it became the number 1 drug and that’s big dollars. It was a good investment and the ethical dilemma that catches even myself is that certainly you want to be paid for what you do. Everybody should be paid for what they do there’s no doubt about that. But do you want the pharmaceutical companies to do it? Or do you want the federal government to do it or the county or the university or whoever – but the ones who have the bucks and the companies who are not cutting expenses are the pharmaceutical companies.
Howard: The question is is it biased?
Darryl: Well, that’s the whole point.
Howard: Or biasing?
Darryl: I do a lot of workshops and speak at conferences and I’ve always believed and my colleagues have always believed that a company can pay for your travel, and even pay for you to present, but nobody can pay for what you’re going to say. And nobody can pay for what you’re going to do. It is important to disclose – saying on this particular trip the people who created this conference got funding from so and so to bring Dr. Inaba out here to present – and I always disclose that I’m here, thanks to the goodness of this pharmaceutical company or that company, but clearly, I’m disclosing this because they can’t tell me what I’m going to say and if I happen to say something that is positive toward their medication or what they’re trying to do it’s because I firmly believe it is. And if I don’t say anything, or if I say something negative, it’s because I believe that way not became somebody is paying me to be there and not because they’re a sponsor. And that’s the dilemma you find yourself in. We all know that there is a need to transfer information on the science of addiction technology transfer that there is a lack of people who can bring the information to the general public, to the medical communities, to the law enforcement communities, to the judges, and to clients themselves so that we can have healthier attitudes to move forward with. But unfortunately, there are not a lot of organizations who can afford to pay people to bring that transfer of technology to practice or technology to the communities. And although many communities and educational facilities like the University of Utah – they hold an annual conference I go to – they rely on their own funding, from registration fees and tuition for the University of Utah and the tuition for the summer conference to pay for the speakers’ expenses rather than from private companies and corporations. But as I go across the country, I see many schools folding. Many schools cannot afford to offer the summer schools on drugs and alcohol, – the costs are just too high. Budgets are being cut everywhere. Treatment facilities can’t afford to send their practitioners to these conferences and individual counselors, individual doctors, individual people working in this field are so under paid to begin with that they don’t have money for travel, accommodations, and expenses for a week or so to educate themselves and be exposed to knowledge. Few can afford these educational opportunities and so to fill the funding void – pharmaceutical companies will step in with the expectation that they’re going to get at least some notice for their product and generate some interest in it. But almost all of the professionals I know in this field would not sell their testimony. They’re not going to compromise what they’re going to say. If they’re called as an expert witness in a court proceeding, good luck to the person hired you because testimony can’t be bought. You’re going to say what you believe and hopefully they have screened you well enough to know what you might say, but if you go up there and they didn’t screen you, you’re going to say what you believe and it might actually hurt the case.
Howard: Let’s take a look at sports and doping because it just keeps coming around and coming around and coming around and in this case, Barry Bonds is the last person that had the homerun record and it’s A-Rod Alex Rodriguez who is definitely on track to meet and beat that homerun record. In addition to the injuries he has had in the last year, now he’s looking at an entire year suspension because of this doping charge which could be long enough to just ruin his career. So, this is the other side of what we were talking about regarding reducing penalties at the federal law level and as I may or may not have mentioned, there was actually no physical evidence in the A-Rod case to show that he was using human growth hormones or one of the other banned substances. The charge comes from simply his association with this clinic and I thought that that was quite interesting. But how do you see doping and sports be it baseball, be it cycling those appear to be the most common that we hear about, but I’m sure that all the sports are culpable as well.
Darryl: Well, I think it stems from where our society has raised sports and athletics to.
Howard: We talked about that before. It’s a different form of addiction.
Darryl: And these people have become icons. They are superstars who every kid wants to grow up to be and because of that legislatures, the general public and especially the media believes they have a responsibility to represent high morals and ethics and good character and things like that and so there’s this sort of a zero tolerance and witch hunt going on to catch athletes like A-Rod and Barry Bonds and put them in a difficult spot. Because A-Rod, as you said, claims he did test positive once but he hasn’t used any steroids or anything .
Howard: for 10 years.
Darryl: performance enhancing drugs for 10 years and there’s absolutely no proof that he did use anything or has violated any policy, but as you said, …they couldn’t accuse him of lying because that’s not lying. It is basically his association with this firm that has been promoting human growth hormones and other products and his association with about 10 or 12 other athletes as well. And so he is appealing his sentencing. It’s not quite a year, but it’s almost a total year in terms of all the games he would be unable to play and he looks at it as almost a death penalty – almost like a lifetime ban and so he’s appealing it and while he is appealing it, he can continue to play baseball and I think that’s his interest. He wants to complete this season and get into the playoffs and if he can and contribute when he can he will face it in the off season and see what happens. But it’s a scary thing when you look at it. One way you could look at it and say, yeah, you know, these athletes are cheating and they should be held accountable and because they’re looked up to by our youth and everybody else they especially shouldn’t cheat and lie about it and so they should be penalized. But it’s a different story when you look at it legally and wonder, are we in one of those totalitarian states, where there might not be a lot of evidence but because of the passions and because of the thinking of the times and what’s going on right now in society – think back to the Salem witch trials. I hate to make that reference, but it sort of is like a witch hunt during that time, everybody who seemed even slightly guilty was held to the maximum penalty as sort of a deterrent. So it is an interesting phenomenon. I think drugs have always been a part of sports and probably always will be. I remember reading a story once about the athletes in the original Athens Olympics, the original Olympics in Greece who got caught eating meat because eating meat was considered to be an unfair advantage at that time and so they were stripped of their laurel leaves. People will do anything to help them win if we’re going to hold them up to that iconic standard of a God if they are able to succeed. And maybe I don’t know if we can change that in society. Why do we pay our star baseball players a lot more than we pay our star counselors or anyone else who is making a difference in hundreds of people’s lives – making them healthy and productive. Why do we pay our star football players an outrageous sum of money to play for one season when somebody who spends their whole life doing a lot of good for a lot of people and benefiting a community and society and makes a pittance of what a football player makes in one season. I think until that changes or we start reconsidering who we want to elevate to icon status in our society, we’re always going to have the problem of people who want to be the absolute best and are going to do whatever they have to do to perform.
Howard: It’s interesting and it keeps coming up so I’m sure we’ll talk about it again soon. And one final aspect of this there was another story about a new kind of doping in sports that is related to a new drug that makes muscles huge. What it does is stop the enzyme or hormone that controls the growth of muscles so they just keep getting bigger and bigger. We’ll see how long it takes for that to show up in sports.
Darryl: You know, that is something that’s not new, Howard. Doping in animals and doping in body building has been around from the beginning. Athletes take a water pill, like Lasix, to take water out of certain parts of their body so that when they demonstrate their muscles, they appear to have a better physique. Muscles look more toned up. I’ve know body builders who are basically heavy on the anabolic steroids, the “roid” drugs to build up muscles in an accelerated period rather than the long workouts that it traditionally takes to build up that much muscle – those have been around for a long time – the Mr. Universe contests and competitions like that. And if you’ve watched the Mrs. Universe contests, you wonder a woman’s body can develop that kind of muscles without any help. Well, that’s my thinking. Throughout my career I’ve worked with jockeys – formerly top jockeys not because they could bond with the horses better and not because they can ride better, but because they can inject their horses better with the right kind of drugs to boost them up. Urinalysis testing occurs regularly in horse racing and other equine sports to make sure that no cheating happens – the horses are not being given an extra advantage from a boost up with opioids that make them run faster or cocaine or something like that. I’m sure they have to do that with dogs greyhound racing and all of that and so, it’s not limited to human beings. Once money is involved like betting – people are going to want to move the odds in their favor and that’s what doping does. Before we close though, you did mention Lindsey Lohan one thing that’s not seen by a lot of people but maybe seen by those of us in the recovery field, is Lindsey Lohan is a wonderful example of how difficult it is to deal with addictions. I mean, here’s a person with a silver spoon in her mouth and she has tremendous, what we call, “recovery capital.” She has a lot of money. She has a lot of fans. She has personality. She has all the earmarks of an addict, charisma, charm, intelligence, and she has the capital recovery capital of a loving family and a mother who supports her no matter what she does. A co-dependent enabling her and basically she models that it’s hard to maintain your sobriety when you’ve got all this going for you so she relapses over and over, basically proving to me anyway and hopefully to others, that it’s a biological condition. It’s not what somebody wants. I don’t think she wants to be known for the junkie and the addict that she is. I think it’s something she cannot control. And one of the interesting things is having relapsed several times; points to the fact that addiction is a relapsing disease and a number of failures are to be expected. The shopping thing that she is experiencing could be the result of controlling her addiction to some drugs, and moving on to process addictions like shopping actually the condition is buying disorder. She has an uncontrollable need to spend 5000 dollars a week or a day or something like that and buy things that, if she has this disorder, she absolutely does not need. She has garages and closets full of stuff that she has probably never taken the price tag off of and never will wear or use, but she just has to have it when she sees it. And she gets off on doing it. It’s all about that unconscious dopamine area in the brain that controls ultraistic behaviors. It’s activated by gambling. It’s activated by shopping. It’s activated by heroin. It’s activated by cocaine and if you’re sensitive there, then you’re going to have a survival need and your go switch is going to run so bright that you just can’t prevent yourself from doing these things. I hope they continue to follow her and I hope she finally embraces recovery, and finally learns the tools, or finds the tools that will help her or maybe even the right medication that will put to sleep those centers of the brain long enough to give her a chance of having some clean time that she will fully embrace. Now here’s the interesting thing about addictions in saying all of this, I think a lot of addicts become addicted to recovery! They get on into being clean and sober and attending 12 step meetings and attending their fellowship groups and that becomes the most important thing in their life and maybe it should be, but it is that compulsive nature that’s not of their making or of their desire, but rather of a biological process that has to be quelled or satisfied.
Howard: We’ve spent a lot of time today talking about a lot of interesting things and we are out of time. Thanks for listening. Your comments, questions, suggestions are always welcome. You can stop by the website, cnsproductions.com and drop us a note. You will also find an archive of podcasts with transcripts on topics you might find interesting. Darryl, as ever, thank you and we’ll talk again soon.
Darryl: Hey great, Howard, thank you very much.
Howard: That wraps our pod for today. Thanks for visiting the CNS Podcast. Please check back soon for the next in the series and visit our website, www.cnsproductions.com