Why Athletes Dope

Yet again, revelations about doping in sports are in the news: Manny Ramirez and David Ortiz took steroids while playing for the world champion Boston Red Sox (is that how they finally broke the curse of the Bambino and beat the Yankees?) and the 2009 Tour de France stage 16 winner Mikel Astarloza was busted for the blood booster drug EPO (long the drug of choice among professional cyclists). When that list of juicing baseball players is eventually revealed (as it will be, despite it's alleged secrecy) there's a good chance it will contain a veritable who's who in the sport.

Like most sports fans, I don't want to believe that any of these stellar athletes are guilty, and of course, each individual is innocent until proven otherwise. However, the overwhelming evidence leads me to conclude that many, perhaps most, professional athletes dope. It is time to move beyond if and ask why. The reason is threefold: (1) the drugs work, (2) the arms race between drug takers and drug testers is consistently won by the dopers, and (3) the athletes believe they have to dope to compete. Examining each of the three shows how the game matrix of sports changed from doping as cheating to doping as a rational choice.

The Drugs. Scientific studies on the effects of Performance Enhancing Drugs (PEDs) are few in number and usually conducted on non- or recreational athletes. For obvious reasons, elite athletes who dope are disinclined to disclose their data to curious scientists, but the consensus among sports physiologists I interviewed for an extensive study I conducted for Scientific American is that using EPO and other blood doping products (including injecting your own blood drawn earlier) boosts performance a minimum of 5% to 10%, and in conjunction with the brew of other PEDs (e.g., Human Growth Hormone) an additional 5% to 10% can be squeezed out of the human engine. In events decided by less than one percent differences, this is colossal.

The drug of choice for endurance athletes is recombinant Erythropoietin (r-EPO). In its natural state EPO is a glycoprotein hormone produced by the kidneys that when released into the bloodstream binds to receptors in the bone marrow to stimulate the production of red blood cells. More red blood cells translates to more oxygen carried to the muscles. r-EPO is just as effective as blood transfusions, but instead of hassling with storing bags of blood and poking long needles into a vein, the athlete can store the tiny ampoules of the drug on ice in a thermos bottle or hotel mini fridge and simply inject it subcutaneously through a tiny needle.

The Australian sports physiologist Michael Ashenden, founder of the group Science and Industry Against Blood Doping, co-authored a 2002 study on recreational athletes in which they gave them r-EPO (or a placebo) over a 12-week span, using VO2max (maximal aerobic power) as the performance measure. The r-EPO group experienced 7.7%, 9.7%, and 4.7% improvements at weeks 4, 8, and 12, significantly better than the controls. A 2007 study on non-athletes found even more spectacular results for the miracle drug, with a 12.5% and 11.6% increase in VO2max at weeks 4 and 11, again significantly better than the placebo controls. If any of the top athletes in a sport are on the juice, their erstwhile competitors cannot afford to give away such margins. This is where the game matrix kicks into defection mode.

The Arms Race. In evolution there is an arms race between predators and prey that drives both to greater levels of fitness. In sports there is an arms race between the drug takers and the drug testers, leading to more sophisticated drugs and drug tests. In my opinion, the drug testers are five years away from catching the drug takers...and always will be. The reason is threefold: (1) it takes a long time to develop tests for new drugs (the test for r-EPO is not full proof and there is no test for Human Growth Hormone or for homologous blood doping, where you withdraw your own blood and then inject it later just before competition), (2) athletes' countermeasures are as sophisticated as the drugs (using masking agents or thinning your blood after r-EPO use), (3) the takers have a much greater financial incentive to stay ahead of the testers, and in the case of Major League Baseball, they have a powerful union on their side that protects them from too much intrusion on the part of drug testers.

The Athletes. Game theory explains the psychology of doping. Game theory is the study of how players in a game choose strategies they hope will maximize their return in anticipation of the strategies chosen by the other players in the game. Research shows that when the game is played just once, or over a fixed number of rounds without the players being allowed to communicate, cheating becomes common. But when the game is played over an unknown number of rounds the most common strategy is "tit-for-tat," where you begin by cooperating and then do whatever the other player does. Even more cooperation can be induced when players are allowed to accumulate experience with the other players in order to establish trust. But once defection builds momentum there is a cascading sequence of cheating throughout the system.

In sports, the rules clearly prohibit the use of PEDs. But because the drugs are extremely effective and the payoffs for success are so high, and because most of the drugs are difficult, if not impossible, to detect, or the tests can be beat with countermeasures, or the governing body of the sport itself (as in the case of Major League Baseball) doesn't fully support a comprehensive anti-doping testing program, the incentive to dope is powerful. Once a few elite athletes in a sport defect to gain an advantage over their cooperating competitors, they too must defect (even if they only think others are cheating), leading to a cascade of defection down through the ranks. Because the rules are clear, however, a code of silence prevents any open communication and cooperation between competitors and teams in order to reverse the defection trend (and thus the "secret" list of doping baseball players must be released to break the code of silence).

Solutions. The only hope of salvaging professional sports is to change the game matrix. To that end I have five recommendations:

1. Immunity for all athletes pre-2009. Since the entire system is corrupt and most competitors have been doping, it accomplishes nothing to strip the winner of his title after the fact when it is almost certain that the runners' up were also doping. Immunity will enable retired athletes to work with governing bodies and anti-doping agencies for improving the anti-doping system.

2. Increase the number of competitors tested, in competition, out-of-competition, and especially immediately before or after a race to prevent counter-measures from being employed. Sport sanctioning bodies should create a biological baseline profile on each athlete before the season begins to allow for proper comparison of unusual spikes in performance in competition.

3. An X-Prize type reward to increase the incentive of anti-doping scientists to develop new tests for presently undetectable doping agents, in order to equalize the incentive for drug testers to that of drug takers. Money is a universal incentive.

4. Increase substantially the penalty for getting caught. A 50-game ban on Manny Ramirez is a joke. No Major League player will take that seriously as a deterrent. Professional cycling has a two-year ban, which is a good start. And yet still some cyclists are doping. So, with immunity for pre-2009 sporting events, implement starting today a new policy of one strike and you're out, forever. To protect the athlete from false positives or inept drug testers (both exist), the apparatus for arbitration and appeals must be fair and trusted by both sanctioning bodies and athletes, but once a decision is made it must be substantive and final.

5. A return of all salary paid and prize monies earned by the convicted athlete to the team and/or its sponsors and investors, and extensive team testing of their own athletes.

These recommendations may sound draconian, or perhaps utopian, but something must be done to prevent professional sports from turning into a pharmaceutical competition.

Michael Shermer is an adjunct professor at Claremont Graduate University, the publisher of Skeptic magazine and a monthly columnist for Scientific American. His latest book is The Mind of the Market. mshermer@skeptic.com