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July 14, 2008

The Doping Dilemma: Scientific American contributer, and Skeptics Society Founder, Michael Shermer uses Game Theory to explain why doping has become rampant in cycling and other sports. He also uses the theory to outline some actions that can be taken to remedy the problem.

posted by sic to culture at 01:42 PM - 15 comments

And don't forget to check out the further reading: Gaming Baseball: Why Players Dope

posted by sic at 01:56 PM on July 14

Thanks, sic. Interesting stuff.

posted by 86 at 03:53 PM on July 14

In the article, on page 5, part of his suggestion solution is this:

4. Increase substantially the penalty for getting caught: one strike and you’re out—forever. To protect the athlete from false positive results or inept drug testers (both exist), the system of arbitration and appeals must be fair and trusted. Once a decision is made, however, it must be substantive and final.
That is such flawed thinking, classic Drug War mentality, and it will never work. Especially in cycling, it sounds like everyone's already doping, and no one is going to either rat out their peers or give up the chance for success if you can- as the author notes earlier- stay "5 years ahead of the testers" in terms of the technology. And if you are risking a lifetime ban but with the possibility of sports immortality... well, you weren't going to cycle forever anyway, so you only get a few shots at immortality. The penalty is pointlessly harsh as it doesn't change behavior. Doping: Why do we even care? The doping issue boils down to this: anti-doping folk always start with an unchallenged premise, that "Doping is inherently bad", and then springboard into how pervasive it is and how to stop it with increasingly punitive measures. Yet when people get Lasik to improve their already great vision, or use carbon-fiber composites to create bicycles that are almost impossibly light, or use kinetic monitoring and training, high-altitude training, or wind tunnel testing to scrape every last km/h out of their body or every last foot out of their homerun swing or every last muscle fiber twitch out of their sprinting... well, that's also a form of "doping" in that it is an artificial, scientific aide to make an athlete more successful. So then, why is doping "bad" whereas countless hours in a full personal gym and with PhD holding staff monitoring your every heartbeat and O2 % in every breath "perfectly okay"? I can think of only two reasons why doping has a negative veneer: 1) There are with newer, less-tested, technologies, potential risks in use due to it being secretive. As noted, some cyclists did r-EPO doping and had a heart attack because of how dosage can affect blood thickness. 2) The game theory aspect that all athletes, especially in sports like cycling where it's simply "How fast can you go?" will then be pressured to join the silent majority of dopers simply because they can no longer compete. Alright, so let's look at this, rationally. Like the drug war in general, to me the biggest problems with these drugs is largely a result of banning them! With #1, the problem is- as with prostitution or drug use in general- not the doping itself, but that the doping is in an underworld of technology and thus not well monitored or controlled. The athletes may not be fully aware of all the risks, or be properly taken care of in their use of either a well known or experimental technology. If you hand someone an ampule and say "This will make you faster", they could incorrectly dose- with potential lethal results. If you legalize these efforts, athletes will be able to choose from better tested drugs, with full and proper doctor supervision, so that the risk of taking these drugs is as little as the risk any average person might have from their own medications for asthma, hair loss, or heart disease: a theoretical and empirical risk that can be largely minimized by looking for warning signs and consulting with a doctor should that particular drug or dosage be probematic for you. With #2, the problem is again the banning/shunting of the drugs. Athletes dope because they feel they can't compete, but who is doping, and with what, is also underground information that not everyone has. Then again, no one forces a player to do off-season weight and cardio training, but the players who don't will probably find they get injured more, and don't have the stamina, of the players who do. The Hincandenza Solution My proposition is that game theory, specifically the prisoner's dilemma, is exactly the wrong way to approach the problem. What is left unsaid about the Prisoner's Dilemma is that the structure- payoff and penalty- are artificial, and invented by the puzzle creator. These rules can be change. Maybe it's time we change the structure of the payoff and penalty, not by unilaterally stiffening the penalty but surprisingly by weakening the penalty! I'd argue the solution to the doping "problem", such that is even a problem, is to make doping perfectly acceptable, but request that players and facilities simply let the sport's organizing bodies- the IOC, MLB, NBA, NFL, the UCI- know what drug cocktails are available, and their medical effects. In this way, the player's lives are less at-risk, since they can choose from many available doping options- or none at all- and be properly informed about the benefits and the risks, the effects on different parts of the body, etc. Yes, doping would then still occur but the players are able to make, with their doctor, a better choice about which drugs might benefit them without a significant risk to their own health. And given a choice between two drugs, one highly experimental with not terribly well-known benefit or risk, and one that's been around for a few years, well tested, and larger user base who aren't suffering adverse effects... well, what athlete would choose to be a human guinea pig? Which- when you remove the unexplained knee-jerk of "But... but... drugs are bad, mmm-kay?!"- is what's most important: that these athletes are not risking their lives for a few extra homeruns or a few seconds on the peloton. Okay, you might say, but what about #2, the case of the athlete who says "I want to be clean of all drugs" and then can't compete? Well, controversial as it might sound, I'd suggest that at the most elite level where millions of dollars in salaries are offered, that athlete might be wrong to want to not try some available drugs. Athletes already get cortisone shots for stiff muscles, or have asthma inhalers, or even vitamin supplements. The genie is out of the bottle- so long as you recognize that not all drugs are bad, not all drugs are PCP or heroin. Maybe, if done healthily, doping is okay for the elite level of sport- just as the average person wouldn't spend tens of thousands of dollars out of his own pocket to have scientists test their body, blood, oxygen intake capacity, etc, or have personal chefs/trainers cook them a perfectly balanced macrobiotic diet free of drugs, or build a full-featured gym in their own home. All of those things are perfectly legal, but confer significant advantage and are at this point probably necessary to succeed at the highest levels. So why not some drugs? But I'll concede that does seem unfair to a point, and there will be a desire to avoid the game theory effect, and this is where my "weakening the penalty" suggestion comes in. Rather than hide the drugs, and then lifetime ban the caught dopers, not only would we open the lab doors and let people make safer choices, but as the drugs are understood better in this new open environment, we might in those sports like cycling or track and field even add in a weak penalty not unlike the "wind-aided 100m dash". So-and-so set a world record in the 1500m, but was penalized 10 seconds due to his use of r-EPO; thus the final standings reflect accomplishment with adjustments for the use of drugs. In sports like baseball, well I'd argue the presence of players like Ichiro Suzuki suggests you don't need to dope at all to succeed, or if you do dope it should be nothing more shocking or controversial than what is already done like cortisone shots, Tommy John surgery, et al. But if the drugs were safer, more public, then yes you'd know that the 50-HR second baseman was probably on a particular drug- but wasn't risking his body greatly, and those drugs aren't making him scoop up singles and turn them into outs. We are long past the days of ABC Afterschool Special horror shows about teenagers shooting raw horse testosterone into their neck. The 21st century of doping is vastly more advanced, and potentially far more safer if we take it out of the closet and allow our morals to catch up with our technology.

posted by hincandenza at 05:26 PM on July 14

I'm not sure that I agree with your contention that the steroid cocktails that are being used currently are being used incorrectly simply because they are illegal. I think some of the athletes increase dosages while being fully aware of the potential consequences. As you stated it's their one shot at sports immortality. People misuse legal drugs on a daily basis. we might in those sports like cycling or track and field even add in a weak penalty not unlike the "wind-aided 100m dash". So-and-so set a world record in the 1500m, but was penalized 10 seconds due to his use of r-EPO; thus the final standings reflect accomplishment with adjustments for the use of drugs. To add 10 seconds on to a runner's time is tantamount to banning them for life. Steroids offer a marginal benefit, so to add time would negate that. We could discuss forever what would constitute a "fair" penalty without reaching a consensus. Maybe, if done healthily, doping is okay for the elite level of sport- just as the average person wouldn't spend tens of thousands of dollars out of his own pocket to have scientists test their body, blood, oxygen intake capacity, etc, or have personal chefs/trainers cook them a perfectly balanced macrobiotic diet free of drugs, or build a full-featured gym in their own home. All of those things are perfectly legal, but confer significant advantage and are at this point probably necessary to succeed at the highest levels. So why not some drugs? So, who is to decide where the elite level starts? The problem with steroids is that we have high school kids taking them to better their odds of making the school team and/or hoping to better their odds of obtaining a college scholarship. I totally understand your point that perhaps the elite olympian probably has the knowledge and medical team to "properly" take steroids. I just don't see how you make it legal for some and not others. At what level of baseball is it okay? College, A, AA, AAA, the Majors? In my mind it boils down to either banning them, or allowing them. At this point I'm in favor of banning them.

posted by dviking at 11:18 PM on July 14

Hal, I respectfully disagree with your solution. On the one hand, encouraging drug use is not only dangerous to the elite athletes and the validity of sports but it would also have an even greater trickle down effect on amateur sports, those that try to emulate the elite athletes without the aid of "doctors" - including children. Surely that's not a good thing? On the other hand, I don't think that the stigma of taking dope would be wiped away just because the penalty is lower; in other words, the illusion that somebody is a great natural athlete, who achieves greatness through natural ability and hard work is what makes them popular, so if a player is doping there are reasons beyond legal penalties for them to keep it hidden. For instance, if Lance Armstrong would have admitted he had been doping, he never would have had huge sponsorship deals and his consecutive Tour streak would have been unimpressive because people would have assumed (correctly) that it was the dope that won it for him. In your dystopia (and to me that's what it is) it would be the dope pushers, the "doctors", who would be the real stars, because they would be competing with one another to concoct the most effective drug cocktails to push the athletes over the edge. But really they wouldn't be stars because, at least in a sport like cycling, no one would care anymore if the drugs became the most important aspect. The winner of the tour this year is r-EPO! Who could get excited by something like that? Cycling fans? Corporate Sponsors? Would little kids dream of being the next vehicle for a break through drug in Tour De France 2020? One part of the solution that Shermer came up with (and in reality all of the things he mentions would have to be implemented in conjunction, so you have to look at all of them not just one or two) is that to break the "code of silence" the teams and all teammates should be punished along with the cyclist who is caught. This would reverse the pressure to be silent on (and take) drugs as everybody's career would be in jeopardy. This would create a "reverse cascade" of drug rejection and the speed of the peloton would slow down and in his words their would be a collective "woosh" of relief as the cyclists no longer felt forced to dope to be competitive. I think he is on the right track.

posted by sic at 02:10 AM on July 15

dviking: To add 10 seconds on to a runner's time is tantamount to banning them for life. Steroids offer a marginal benefit, so to add time would negate that. We could discuss forever what would constitute a "fair" penalty without reaching a consensus.
See, I don't even know how to react to that- you seemed to have made my point. First, if it is tantamount to banning them... well then, it's just as good as banning them! Since so many of you are stiffly anti-doping, then surely you'd support my suggestion, which would have the effect of penalizing athletes to the point that more would choose not to dope at all. However, the linked article has a doctor discussing this very concept:
Italian sports physiologist Michele Ferrari, as knowledgeable on doping as he is controversial (because of his close affiliation with elite athletes who have tested positive for doping or been accused of same), explains it this way: “If the volume of [red blood cells] increases by 10 percent, performance [the rider’s net gain in output of useful kinetic energy] improves by approximately 5 percent. This means a gain of about 1.5 seconds per kilometer for a cyclist pedaling at 50 kilometers per hour in a time trial, or about eight seconds per kilometer for a cyclist climbing at 10 kph on a 10 percent ascent.”
So there you go; in the case of cycling, you could make r-EPO have a time penalty or percentage penalty, and also make any drugs that haven't been fully tested and analyzed to get specific numbers equal to the maximum penalty. Now, in the TdF, you'd have a block of riders way up front, and a block behind- but in the TdF especially, it'd be easy to adjust total times and suddenly those r-EPO aided riders aren't actually leading when the penalty is assessed; they are in the middle of the pack, or fighting for first. And that as a result would make the drugs less attractive: you bust your ass, get penalized 5% of your time, and suddenly you're not even competitive. Might as well not risk your health and do it natural (although it's worth noting that the TdF is the very definition of "risking your health", in terms of how hard these people push their bodies for days on end). My argument is, after all, that by opening it this way, edge players and performers could choose to dope... but they'd have a penalty in doing so that might remove the incentive! Again, that penalty is only in racing sports; the penalty is such that a player will have far less reason to do drugs, although I guess the untestable drug would still be desirable; it'd allow you to claim cleanliness while still performing beyond the "natural" level.

posted by hincandenza at 09:46 PM on July 15

I'd also like to point that neither of you addressed my key concept: which is "Why exactly is it so bad?" As I understand it, the biggest use of PEDs is to aid in the recovery of the body, whether it's in pedaling up a mountain for days on end, or pitching 35 starts over 6 months, or slamming into 300 pound linemen 16 games in a season. The players aren't looking to risk their health; quite to the contrary, they're trying to improve it! As such, a well-tested drug that helps improve the recovery time from damage- either in lifting weights, resulting in larger muscle mass, or in repairing the normal wear and tear of muscles from high-level sports activity- is a boon to athletes. Again, I think you all have this ABC Afterschool Special notion of all PEDs as some wonder elixir that makes 98-pound weaklings into homerun champions, and turns them all into melon-headed roid-raging freaks. Here's a steroid that many athletes have taken; cortisone. Cortisone is a steroid, with amazing properties; it can be found in arthritis medicine and asthma medicine, and countless times every season baseball players will get "cortisone shots" to help with elbow or shoulder joint problems. It's discoverer won the Nobel Prize in 1950 because these steroid drugs have been a boon to modern medicine. And this is hardly a new technology; Sandy Koufax played the last years of his career in pain, and as noted in Wikipedia:

On April 22 [1964], however, against the St. Louis Cardinals, during the first inning of Koufax's third start, he felt something "let go" in his arm. Koufax ended up getting three cortisone shots for his sore elbow, and he missed three starts. ... He was diagnosed by Dodgers' team physician Robert Kerlan with traumatic arthritis. Koufax finished the year with an impressive 19–5 record. ... To get himself through the games he pitched in, Koufax resorted to Empirin with codeine for the pain (which he took every night and sometimes during the fifth inning) and Butazolidin for inflammation. He also applied capsaicin-based Capsolin ointment (called "atomic balm" by baseball players) before each game, and then soaked his arm in a tub of ice.
Those last 3 years of his career, Koufax was really only able to pitch with medical help from... wait for it... wait for it... "performance enhancing drugs". The natural state of things was for his arm and arthritis to end his career after 9 seasons- where he wouldn't have been eligible for the Hall of Fame, btw- and rob him of those last three years where he won 19, 26, and 27 games for an incredible 72-22 record. But I guess we'll just have to put a biiiig ol' asterisk next to those career marks, and take his plaque down from the Hall of Fame. Damn cheater!

posted by hincandenza at 10:04 PM on July 15

I think you missed my point entirely. Since there is not an exact way to measure how steroids are going to affect a particular athlete, there is no way to establish a fair penalty for taking them. Your reference to Ferrari's comments are quite vague, in that we don't know for sure if a certain dose of whatever drug we're talking about will in fact raise rider A's red blood count 10%, or 11%, or maybe just 8%. We'd have to test every rider continuously to determine specific punishments. To state this another way, let's take a rider named Frank. Frank says he takes r-EPO (whatever, you pick the drug), and he claims to take a certain dose that is said to raise blood counts by 10%. Unless we test Frank every day, we don't know if his count indeed went up by only 10%, nor do we know if he just took the dose he said he did. He could in fact be cheating on the drugs even though the drugs are legal. So, once again we'd have dopers getting an unfair advantage. And, that's if we could really determine how much of an advantage drugs would give each rider. Keep in mind that if you and I each take the exact same dose of the exact same drug, we will react differently. Body size and chemistry will cause differences, thus my point that we really can't set fair penalties. Add that to the harm steroids do to younger riders, and I see no reason to allow them. I know, just let elite cyclists use them....of course that leads to the discussion of what constitutes an elite cyclist.

posted by dviking at 10:20 PM on July 15

I'd also like to point that neither of you addressed my key concept: which is "Why exactly is it so bad?" Okay, let's start with this reference from a medical study done at the University of Nebraska. Hypertension is believed to be related to the viscosity of the blood which increases along with hematocrit. As hematocrit rises the thicker blood perfuses organs at a slower rate and is more prone to clotting. This increases the risk for heart attack and stroke. Although never conclusively linked to rEPO, eighteen world-class Dutch and Belgium cyclists have suffered deaths of cardiac origin. One who died was Johannes Draaijer of Holland, who seven months earlier had finished 20th in the Tour de France. Whether these deaths were related to rEPO may never be known. Despite that, athletes who inject the drug put themselves at considerable risk for cardiac and cerebrovascular side effects. When rEPO is given to patients with kidney disease the doses are controlled to result in a hematocrit of 30-33 percent. An athlete has a much higher baseline hematocrit (usually 40-48% for men and 36-42% for women). Athletes using rEPO may raise their hematocrit levels as high as 60 percent. During competition the hematocrit may rise even higher due to fluid loss. The effects of rEPO on hematocrit can continue for up to ten days following injection which can put the athlete at risk well after the competition is over. This inability to limit the increase in hematocrit makes rEPO potentially more dangerous than blood doping. The fact is, every drug one takes has side effects. Aspirin, r-EPO, all of them. And while I understand your argument that since we allow some drugs, why not all? My thinking is that we don't need to allow ones that have proven dangerous. Again, if we could restrict them to only cyclists in the Tour de France, I'd say fine. However, we both know that is not possible.

posted by dviking at 10:36 PM on July 15

The medical facts aren't really what concerns most people. For many it's about creating a fair playing field. If one person dopes and the other doesn't, the doper has an unfair advantage. Of course if you took too athletes and used two equaly effective training regimes, the winner would be decided by genetics. Which I guess leads me to a question I'm not educated enough to know not to ask. Is sport as a whole just a form of a mating ritual? If you think about it in that light, doping is bad because it masks who has the best genes. It means the doper isn't just a cheater, they are a liar, a liar about how good their genetics are. People hate liars.

posted by apoch at 03:02 AM on July 16

Hal, I admit your argument is clever, but it doesn't convince. Although the line may be blurry, there is a difference between taking a drug to help heal an injury and quite another to take drugs purely as a way to enhance performance. Yes, I understand the semantic argument that in both cases performance is "enhanced". But it would be disingenuous to say that there is no difference between one scenario and the other. You blithely say that nowadays it's "safe", but as you know all athletes, dopers or not, push the envelope as to what their bodies will withstand - so if everyone were taking r-EPO, new, more powerful and riskier techniques would be employed to achieve an "edge". We would have a doping arms race on our hands. Therefore, as I stated earlier, if we were to simply make everything legal, the sporting world would be taken over by chemists and their performance enhancing cocktails. That would become the only story, or at least the primary story to all professional sports. I also think it would be impossible to monitor what the doctors were putting in the athletes as these would be closely guarded secrets (like the recipe to Coca Cola, these performance enhancing cocktails would become intellectual property of say US Postal) and once doping is made legal very little effort (even less than today) would be made in improving testing methods. Is this really what we want professional sports to become?

posted by sic at 12:33 PM on July 16

Honestly? I don't care if it does. These people are already pushing their bodies to unhealthy levels; in retirement, there are pitchers can barely raise their arms above their heads. Plenty of football players have permanent neurological damage from taking hits or weakened bodies from constant pounding. But that's their choice- my only concern is that they were pushed, like football players, to do things they didn't fully understand. So long as they understand the consequences, I say "have at 'em". dviking makes the point that r-EPO can be dangerous because of its affect on the blood. But if you look at the cortisone link, if overdosed or used improperly that "wonder drug" can have severe side effects. When used safely and with good medical supervision, it's pretty much all reward/no risk. My claim is that if the r-EPO usage and dosage is wide open and well known, that one competitor who uses too much to get to the 60% hematocrit level might win this year, but his fellow competitors pushing themselves to 50% might know this number and say "Yeah... not worth it." Then again, if they think it's worth it even with 18 Dutch and Belgian world-class athletes already dying of heart issues... but that still may be due to not knowing how much their fellow competitor is really doping, and thus pushing themselves further than they needed. This is again an area where openness would be a benefit. They are genetic freaks to begin with to even be close to top-level competition. When it comes to pure racing sports- where the doping is probably the most common such as track and field and cycling- I really, truly don't care if they finish in AA:BB:CC time or XX:YY:ZZ time; the sports viewing is enjoyable for the competitiveness the group. It's simply not fun if only one player is leading by such a huge margin the rest shouldn't show up. And in sports where there is a diversity of skills- I'm thinking baseball here- I don't care either. If PEDs mean that pitchers can go the full season with less labrum tears and sore elbows because their bodies heal faster... yay! Baseball's great because a guy like Ichiro can be a batting champion the same year (2004) as Barry Bonds. The idea that the game is "violated" simply because of PEDs seems alarmist and uninformed. Baseball players aren't doing the same kind of PEDs as cyclists or T&F athletes; the PEDs as I understand it are almost uniformly "quicker recovery" drugs. This helps prevent injury or fatigue over the course of the season, but presumably also allows for faster muscle gain in off-season workouts. What is allowable, if PEDs are not? Lasik surgery? Contact lenses? Elbow armor for hitters? How about this story, being discussed over at Metafilter today? Runner with prosthetic legs is now running basically competitive in the 400m (although I guess he doesn't have qualifying times for the individual). Should he be "allowed" into the Olympics on the relay team? If not, why not?

posted by hincandenza at 04:12 PM on July 16

The law is rife with arbitrary lines in the sand. If you are going to legislate the use of drugs in sports you have to put that line somewhere, because as you rightly point out there are tolerable exceptions (such cortisone shots, anti-inflammatory medication etc.). The problem with allowing say r-EPO to be legal and thus safer (somewhat debatable) would create a situation where r-EPO would then become the baseline, that is, all cyclists would have to be using it just to stay in the peloton; at the same time the superstars, the Lance Armstrong's that have to carry teams would then be obliged to take greater risks by using more radical techniques to keep ahead of the pack. That's the danger. Maybe it's great that baseball pitchers can prolong their careers by using drugs, but perhaps those drugs are going to have serious long-term health consequences. Should that be a factor in this debate? Anyhow, judging from the conversation, Shermer's game theory proposition hasn't impressed, and that's what I really wanted to talk about.

posted by sic at 06:30 PM on July 16

Well, it was a good post sic- certainly led to an interesting conversation. I think my base point regarding the article was not so much that game theory can't help, it's that game theory is only useful if you remember that game theory takes place in the context of a game, with rules that are arbitrary. Game theory helps you solve the prisoner's dilemma for one iteration as well as many iterations; but if you alter the terms of the prisoner's dilemma, you may alter the right choices for individual players. Hence my lengthy screed saying that we could tweak the rules of the game by changing how we judge PED use, and allowing for both increased safety as well as increased openness in their use- to me, that's a more desirable thing. While people might still take risks, they- and we- would be well aware of them. One last thought, since I've certainly bled enough electronic ink on this issue: does anyone recall the Gatorade commercials from last year, where it recounted the history of Gatorade? Namely, that in 1965 a research team at the request of head coach Ray Graves of the University of Florida formulated a drink with a variety of nutrients and electrolytes to increase performance in the hot Florida sun. The Florida Gators went on to win the Orange Bowl in 1967. Even the opposing coach of Georgia Tech chalked up losing to "We didn't have Gatorade". It's a performance enhancing drug in every sense of the phrase, and you have been able to buy it on store shelves for 4 decades.

posted by hincandenza at 09:17 PM on July 16

Ha! So let's draw the line at gatorade then! ;-) But seriously, electrolytes can only be considered a drug in the very broadest sense of the word (check out the wikis for "drug", "electrolyte" and "chemical substance"). Still your point has been well made, at least I understand what you have been trying to get at in your posts. But I think it comes down to what you want professional sports to be. If it is purely entertainment, spectacle, then I guess it makes sense to let consenting adults knowingly do what they want to their bodies to earn money (a dangerous proposition, as cynical exploitation is already common in sports like cycling and especially boxing). However, in my case, I want sports to serve a nobler purpose as well; you know, old fashion stuff like setting an example for youngsters of certain values that we want to promote in our societies, and that's why I just can't get behind dangerous PEDs (notice the adjective, the first time I have used it). The obvious short term and potential long term health risks just turn me off. Have you seen the size of Barry Bonds' head? I wouldn't want a child of mine to be seduced by money and fame into deforming their body and cutting their life short. But hey, that's just me!

posted by sic at 02:18 AM on July 17

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