San Francisco Chronicle

Athletes and steroids: Will tomorrow's game involve drug advisers?

Sunday, October 7, 2007

The use of performance-enhancing drugs - appropriately called doping - has spread like a pandemic through sports. Bicycle racing, sprinting and baseball are only a few examples, with tennis seemingly the least tainted. But even that may be only a question of time.

Increasingly, just as they did with conventional social drug abuse, serious observers are now urging that performance-enhancing drugs in sports be tolerated if not actually legalized.

Yet as a longtime steroid chemist, I believe that we are heading down a slippery slope.

The latest argument in favor of tolerating doping comes from Hans Ulrich Gumbrecht, one of Stanford's most distinguished cultural and comparative literature scholars and the most prominent literary proponent of sports. In a recent column in the Frankfurter Allgemeine Sonntagszeitung, the professor suggested appointing drug advisers in competitive sports to ensure the least harm to the doped athlete.

Such ideas are based on the not unreasonable premise that huge resources are expended in what are essentially Sisyphean efforts to criminalize drug (mis)use by athletes. Why spend vast sums of money on attempting to prevent what cannot be controlled? Let us accept the fact that these novel performance enhancers will continue to be developed in a perpetual technological race between improvements in pharmaceutical efficacy and improvements in detection limits.

Proponents of such tolerance might well argue that legalization of drug use by athletes will happen through societal acceptance, as has occurred with the misuse of potency-enhancing agents such as Viagra. Although originally designed for treating clinical erectile dysfunction (for instance, in certain diabetics or post-prostatectomy patients), these drugs are now widely used recreationally by men who do not suffer from physiological erectile dysfunction.

But why be surprised? Drug-promoted performance enhancement actually started through the misuse of anabolic (muscle-building) steroids that chemically were closely related to the male hormone testosterone.

Since this is a field in which I was active for decades, I can recall that such anabolic drugs were intended for treating physically debilitated patients after serious operations. The drugs had to pass the muster of the FDA and other regulatory agencies and could be used only with a prescription and supervision, for limited periods of time.

The misuse by athletes of such drugs decades later has stimulated illegal research in which other closely related steroids have been synthesized - and are much more difficult to detect. These drugs were then consumed, in the absence of regulatory approval, by athletes who paid little attention to potential side effects - including, ironically enough, impotence - because the athletes' focus was on short-term competitions.

This brings me back to Gumbrecht's arguments about a safe use of performance-enhancing drugs to satisfy the desires of athletes to exceed the natural limit of their athletic capability. This, he suggests, could be done by establishing a new professional category: accredited drug advisers who will point athletes to the most efficacious performance-enhancement drugs with the least side effects.

Though logical, such acceptance or legalization of performance-enhancing aids has serious ramifications. I predict that a new subset of drugs - for which I propose the term "lusuceuticals" (after the Latin lusus for play or sports) - will arise. These new drugs will follow the model of commercially successful products labeled "nutraceuticals" and "cosmeceuticals" that have already crossed the sharply defined boundaries of standard pharmaceuticals designed to treat diseases.

One might argue that aside from the obvious economic potential, the new specialty of "lusuceutics" will have the virtue of being regulated for safety and efficacy. Market pressures would then drive how such research would be channeled.

But will lusu-chemists (another new discipline!) limit themselves to much safer anabolic drugs, now that detectability will be of no concern? Or will they head into much more questionable directions, such as growth hormone analogs that will lead to 71/2-foot-tall pole vaulters or basketball players?

Whatever the case, such chemical efforts would be trivial once genetic manipulators entered the new field, which would almost certainly be unavoidable, given the all-too-frequent ambitions of certain parents to sacrifice their children's upbringing on the altar of super-athletic performances.

How early in life would parents be allowed to make such decisions: ex utero, in utero, or at the pre-implantation stage of an embryo? And once drug-induced performance enhancement becomes de rigueur, should national health services pay for the use of such drugs so as not to discriminate against the poor?

Whatever we do in terms of legalizing drug abuse in athletics, we are heading in the direction of changing the Olympics from a competition of athletes to one of chemists, where the emphasis will shift abruptly from body to mind. Will new sport records then be recognized with double gold medals: one to the athlete and the other to the chemist who really made the newest record possible?

As a chemist, I ought to welcome such a prospect, because the mind does not deteriorate as rapidly as the body. Nevertheless, I dread such a future.

Carl Djerassi, a professor emeritus at Stanford University, was awarded the National Medal of Science (for the first synthesis of a steroid oral contraceptive) and the National Medal of Technology. In recent years, he has shifted to literary and theatrical writing. His newest work, "Four Jews on Parnassus: A Conversation," will be published by Columbia University Press in 2008. Contact us at insight@sfchronicle.com.

This article appeared on page E - 1 of the San Francisco Chronicle