Performance Enhancing Drugs and Substances
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One of the biggest controversies in the world of sports over the last several decades has been the use of performance-enhancing drugs and substances, or PEDs. It seems as if there hasn't been a single sport that hasn't been touched in some way by the use of PEDs. But what exactly are PEDs and how do they give athletes an advantage? Do they really work? And if they do, just how big of an advantage do they give?

Learn more about performance-enhancing drugs and how they've impacted the world of sports on this episode of Everything Everywhere Daily. This episode is sponsored by Mint Mobile. One of the things I've noticed traveling around the world is how much more expensive American mobile phone plans are. In most countries I've visited, data and phone plans were very affordable. In the U.S., they tend to be really expensive.

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Most of you are probably aware of the many famous cases surrounding performance-enhancing drugs, or PEDs. At the 1988 Olympics, sprinter Ben Johnson had his gold medal in the 100 meters revoked due to being caught using PEDs. Cyclist Lance Armstrong had his seven Tour de France wins from 1999 to 2005 nullified for the use of blood doping and PEDs.

Barry Bonds, Mark McGuire, Sammy Sosa, and Roger Clemens have been denied entrance to the Baseball Hall of Fame because of their PED use. In 2016, the entire country of Russia was banned from the Olympics because of their state-sponsored use of PEDs. These cases are only some of the highest profile examples. There have been cases of PED usage in almost every sport at every level going down to high school. So what exactly are performance-enhancing drugs? How do they work? And when did all of this start?

Taking substances to enhance performance, or substances that were believed to enhance performance, goes back at least 2,700 years. At the ancient Olympics in Greece, athletes consumed substances like hallucinogenic mushrooms, herbal tonics, and wine potions believed to enhance strength and endurance. Perhaps the most popular items that were consumed were raw animal testicles.

The consumption of animal testicles was something that was found in most cultures, as most cultures realized that eunuchs lacked many masculine traits. Roman gladiators used stimulants and herbal concoctions to fight fatigue and increase aggression in the arena. Needless to say, these things didn't do much to improve performance. It was mostly the placebo effect. With the reintroduction of the Olympics in the 19th century, once again, athletes tried to find an edge.

Many of these early uses of performance-enhancing substances were stimulants like caffeine, alcohol, strychnine, and cocaine to improve stamina and suppress fatigue. If you remember way back to my episode on the 1904 Olympic Marathon, the winner, the American Thomas Hicks, was given strychnine, which is used as a rat poison, as well as brandy during the race. However, the early 20th century saw an explosion in our understanding of human biology and chemistry.

In 1935, the German biochemist Adolf Butenant independently isolated and purified testosterone from animal testicles. Later that year, Butenant and his team identified testosterone's molecular structure, confirming it as the primary male sex hormone. That same year, the Croatian-Swiss researcher Leopold Ruzicka synthesized the male hormones endosterone and testosterone. Butenant and Ruzicka were awarded the 1939 Nobel Prize in Chemistry for their work.

Once testosterone structure was understood, scientists began producing synthetic versions with improved potency. And here is as good a time as any to define some important terms. Steroids are a class of organic compounds that include hormones, vitamins, and other biologically active molecules. They're naturally produced in the body and play essential roles in metabolism, immune function, and development.

So steroids themselves are not necessarily bad. They're completely natural and all of us have some steroids in our body. Anabolic steroids, specifically anabolic androgenic steroids, are synthetic derivatives of testosterone designed to promote muscle growth, aka anabolic effects, and enhance male characteristics, aka androgenic effects.

They increased protein synthesis, nitrogen retention, and red blood cell production, improving muscle mass, strength, and recovery. After the Second World War, the first performance-enhancing drugs that went into common usage were actually amphetamines. Amphetamines are central nervous system stimulants that increase dopamine and norepinephrine levels, enhancing alertness, energy, and focus while reducing fatigue.

Amphetamines were given to US troops during the war and began being used in both team and individual sports during the 50s and 60s. These drugs were commonly available and were totally legal. Nobody was concerned about their use at the time. Doctors on baseball teams in the 1960s openly had veritable pharmacies that they provided the players, and it was all mostly out in the open. The one thing that wasn't commonly prescribed at this point were anabolic steroids.

The 1950s also saw the rise of the Cold War and the rise of sports as a proxy for armed conflict. The Soviet Union began using anabolic steroids in weightlifting and wrestling, achieving unprecedented success. In 1958, Dianabol, the first oral anabolic steroid, was developed by Dr. John Ziegler in the United States for American athletes to compete with Soviet strength.

The 1960s saw the first deaths of athletes due to taking PEDs. Cyclist Knud Jensen died after using amphetamines, bringing public attention to the dangers of PEDs. And in 1967, British cyclist Tom Simpson died during the Tour de France due to amphetamine use combined with dehydration.

The rise in PED usage led the International Olympic Committee to ban performance-enhancing drugs, primarily amphetamines, in 1967, and to introduce drug testing at the 1968 Winter Olympics in Grenoble and later at the 1968 Summer Olympics in Mexico City.

The 70s saw an explosion in steroid usage. Steroids became widespread in bodybuilding. Arnold Schwarzenegger admitted steroid use was part of the game, and if you didn't use them, then you'd have no chance of competing. The country that really leaned into steroid usage was East Germany.

The East Germany Steroid Program, known as State Plan 1425, was a state-sponsored doping operation initiated in the 1960s to dominate international sports, particularly the Olympics. After witnessing the Soviet Union's success with anabolic steroids, East Germany sought to create elite athletes as a means of showcasing communist superiority on the world stage.

Under the direction of the East German Secret Police and the Sport Science Research Institute, the government secretly administered anabolic steroids, primarily oral Turnabal, to thousands of athletes, many of them teenagers, without their consent. Throughout the 1970s and 1980s, East German athletes, particularly in swimming, track and field, and weightlifting, dominated global competitions, setting world records and winning hundreds of Olympic medals.

After the fall of the Berlin Wall in 1989, secret documents were uncovered exposing the full scale of the doping program. While the East Germans had the most organized system, every East Bloc country was doing it. Athletes were also using steroids in Western countries. It's just that it wasn't quite as organized of a campaign. The IOC and steroid users were playing a game of cat and mouse for years, trying to create new ways of taking PEDs without getting caught.

At the 1983 Pan American Games, several athletes withdrew after being tested for steroids, hinting at widespread use. At the 1988 Seoul Olympics, Canadian sprinter Ben Johnson tested positive for stanazolo after winning the 100-meter gold medal, one of the most infamous doping cases. The 1980s also saw the rise of a new technique known as blood doping.

Blood doping is an illegal performance-enhancing technique used to increase the oxygen-carrying capacity of blood, improve endurance, and aerobic performance. It's commonly associated with endurance sports like cycling, long-distance running, and cross-country skiing. Blood doping enhances an athlete's performance by increasing the number of red blood cells in circulation. More red blood cells means more oxygen delivery to muscles, allowing athletes to perform at higher intensities for longer durations.

Blood doping can be done via transfusions of the athlete's own blood, taking erythropoietin or EPO, which is a naturally occurring hormone produced by the kidneys that stimulates red blood cell production, or by taking synthetic oxygen carriers. The 80s also saw the first use of human growth hormone or HGH. HGH is a naturally occurring hormone produced by the pituitary gland that plays a critical role in growth metabolism and cell regeneration.

Unlike anabolic steroids, HGH does not drastically increase muscle mass, making it harder to detect in drug tests. By the 1990s, the problem had become so great that even greater measures were taken to stop it. In 1990, the United States passed the Anabolic Steroid Control Act, making steroids a controlled substance. And in 1999, the World Anti-Doping Agency was founded to combat doping globally. Despite the efforts to crack down on PEDs, they continued to be used.

In 2002, the Belko scandal revealed a widespread doping operation in the United States involving athletes like Marion Jones and Barry Bonds. From 2007 to 2012, Lance Armstrong faced accusations and eventually admitted to using EPO, blood doping, and steroids after years of denial.

When his Tour de France victories were vacated, no one was declared the winner, mainly because doping was so prevalent that they would have had to have probably vacated the results of the next several finishers as well. Despite the high-profile cases, PED use hasn't stopped. Whistleblowers revealed a state-sponsored doping program in Russia, and in 2016, the entire nation of Russia was banned from the Rio Olympics after a World Anti-Doping Agency investigation.

PEDs have actually expanded beyond the obvious sports that involve strength, speed, and endurance. Shooting and archery have had PED scandals with athletes taking beta blockers which reduced hand tremors and anxiety and stimulants for focus. A North Korean shooter, Kim Jong-soo was stripped of two medals for using propranolol at the 2008 Olympics. Competitors in esports, aka video gaming, have begun using cognitive enhancers like Adderall.

There's even been rumors of drugs such as Adderall being used by chess players, even though there have been no high-profile cases of anyone getting caught. One question I've always personally had is just how effective are performance-enhancing drugs? If an average person were to take steroids, would it turn you into a muscle-bound athlete? The answer is no. If an average person took steroids and then did nothing and just sat on a couch, it would do very little for you.

They can increase your muscle growth, but it would require you to do something to encourage muscle growth in the first place, like work out. Assuming you took anabolic steroids as part of a training regimen, the results, however, can be quite dramatic. Studies show that anabolic steroids can lead to an increase of 4-7 kg or 9-15 lbs of lean muscle mass in just 10-12 weeks when combined with proper training and diet.

In one famous 1996 study, testosterone and antheid increased bench press strength by 20% and squat strength by 38% in just 10 weeks. Blood doping has been found to increase red blood cell count, improving oxygen delivery by 5-15%. VO2 max, which is a measure of aerobic capacity, can improve by 10-15% as well, leading to a 5-10% increase in endurance performance.

Cyclists and long-distance runners using EPO have been shown to gain 3-5% improvement in race times, which is the difference between winning and finishing outside of the top 10. And that's the thing to remember. At the very elite end of athletic performance, the benefits of PED might be smaller than they would be for lesser athletes, but when the difference between winning and losing is just a tenth of a second, that would be more than enough.

One example of how small improvements can lead to dramatic results is in baseball. One estimate says that a professional baseball player might be able to increase muscle mass by 10% using steroids, which might result in a 4% increase in bat speed. However, kinetic energy is determined by the square of velocity, so a 4% increase in bat speed has a bigger impact than you'd think.

Furthermore, home runs are determined on the margin. A great home run hitter may only hit a home run in 8% of his plate appearances. If just a few percent of long fly balls now turn into home runs, that can result in an enormous increase in home run totals. A 20 home run hitter might now be hitting 30 or 40 in a season. One thing I haven't touched on so far are the health risks of using PEDs.

Using PEDs carries serious short-term and long-term health risks that vary depending on the substance. Anabolic steroids can cause liver damage, heart disease, high blood pressure, infertility, and psychological effects like aggression, aka roid rage, and depression. Human growth hormone may lead to organ enlargement, joint pain, and insulin resistance, increasing the risk of diabetes.

EPO and blood doping can dangerously thicken the blood, increasing the likelihood of heart attacks, strokes, and blood clots. Stimulates like amphetamines and modafinil can cause insomnia, anxiety, high blood pressure, and addiction, while diuretics used for cutting weight can lead to dehydration and kidney failure. Performance-enhancing drugs are probably going to be with us forever. Right now, there's some biochemist somewhere trying to develop a new way to improve performance without getting caught.

and there's some other biochemists working on new ways to catch them. So long as there are huge incentives for athletic performance, there will always be people who will do whatever they can to get an advantage, however small the advantage and however risky. The executive producer of Everything Everywhere Daily is Charles Daniel. The associate producers are Benji Long and Cameron Kiefer.

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