A scenario, from a 1995 poll of 198 sprinters, swimmers,
powerlifters and other assorted athletes, most of them U.S.
Olympians or aspiring Olympians: You are offered a banned
performance-enhancing substance, with two guarantees: 1) You
will not be caught. 2) You will win. Would you take the substance?
One hundred and ninety-five athletes said yes; three said no.
Scenario II: You are offered a banned performance-enhancing
substance that comes with two guarantees: 1) You will not be
caught. 2) You will win every competition you enter for the next
five years, and then you will die from the side effects of the
substance. Would you take it?
More than half the athletes said yes.
April 13, 1997
It is no secret that performance-enhancing drugs have been used
by Olympians for decades, or that athletes will do almost
anything to gain a competitive edge. (Chicago physician and
author Bob Goldman has conducted the above survey every two
years since 1982 and has gotten more or less the same response
each time.) What is surprising is that 25 years after the
introduction of supposedly rigorous drug testing of Olympic
athletes, the use of banned performance-enhancing substances has
apparently become more widespread, and effective, than ever.
"There may be some sportsmen who can win gold medals without
taking drugs, but there are very few," says Dutch physician
Michel Karsten, who claims to have prescribed anabolic steroids
to hundreds of world-class athletes from swimming, track and
field and the non-Olympic sport of powerlifting over the last 25
years. "If you are especially gifted, you may win once, but from
my experience you can't continue to win without drugs. The field
is just too filled with drug users."
The word steroids calls to mind 325-pound NFL linemen who not so
many years ago weighed 250 pounds, or weightlifters with
trapezius muscles that ascend like mountains from their
shoulders to their ears, or sprinters with quadriceps like steel
cables. But the use of steroids--and other, more exotic
substances, such as human growth hormone (hGH)--has spread to
almost every sport, from major league baseball to college
basketball to high school football. It is the dirty and
universal secret of sports, amateur and pro, as the millennium
Though what follows focuses in considerable detail on Olympic
sports, circumstantial evidence of performance-enhancing drug
use from a wide variety of sports, pro and amateur, abounds.
Even casual fans notice that NBA players sport biceps that a
Kevin McHale or even a Moses Malone never dreamed of; that Ivy
League colleges field football teams with linemen bigger than
All-Pro linemen were a few years ago; and that it's no longer
remarkable for veteran big league baseball players to show up at
spring training having put on 20 pounds of solid muscle since
the end of the previous season.
Most pro leagues don't test for performance-enhancing drugs. And
those athletic governing bodies that do, strike fear in the
hearts of few athletes. The International Olympic Committee
(IOC) sanctioned exactly two positive drug tests at last
summer's Atlanta Games out of a pool of 11,000 athletes, 2,000
of whom were tested for banned substances. No medals were
forfeited. From those numbers--down from five positives at the
1992 Olympics in Barcelona and the alltime high of 12 positives
at the '84 Games in Los Angeles--you might assume that the '96
Olympics were the cleanest since the beginning of full-scale
drug testing at the '72 Games. Don't kid yourself.
Dozens of athletes, coaches, administrators and steroid
traffickers interviewed by SI say that the Atlanta Olympics,
like other Games of the last half century, was a carnival of
sub-rosa experiments in the use of performance-enhancing drugs.
And few of those interviewed were surprised that only two users
were caught. "Athletes are a walking laboratory, and the
Olympics have become a proving ground for scientists, chemists
and unethical doctors," says Dr. Robert Voy, the director of
drug testing for the U.S. Olympic Committee (USOC) at the 1984
and '88 Games. "The testers know that the [drug] gurus are
smarter than they are. They know how to get in under the radar."
No less an authority than Dr. Donald Catlin, director of the
IOC-accredited drug-testing lab at UCLA, while noting that "I
don't think everyone in Atlanta was doped," makes a telling
admission: "The sophisticated athlete who wants to take drugs
has switched to things we can't test for."
The IOC itself has scheduled a summit to address the state of
drug testing in Lausanne, Switzerland, on April 22-23. Since the
Olympics, it has pointed to the testing results in Atlanta more
than once as evidence that testing discourages drug use. But
critics describe the IOC's testing program as crippled by
bureaucracy and politics, tolerance for the use of banned
substances and flawed testing methods. The $2.5 million
drug-testing effort in Atlanta was, in fact, almost comically
ineffective. To augment testing done with a gas chromatograph
mass spectrometer (the device that turned up the two positives),
the IOC brought in a vaunted new piece of equipment, the
high-resolution mass spectrometer (HRMS), that would supposedly
be able to catch athletes who had used steroids in the previous
two or three months. During the Games the HRMS revealed what
appeared to be five positive tests for anabolic steroids. But
the IOC threw the results out. Olympic officials, fearful of
expensive lawsuits--many an athlete who has tested positive for
steroids has sued an athletic federation, the IOC, a lab or a
meet sponsor--decided that the positive tests might not stand up
in court because the mass spectrometer was still relatively
Even if the IOC's equipment were both proven and technologically
cutting-edge, eliminating drug use from Olympic sports would be
no small challenge. The users range from weightlifters and
shot-putters and bobsledders to swimmers and marathoners and
gymnasts. (While male gymnasts might typically turn to steroids
to get stronger, some female gymnasts are said to intentionally
retard their growth by taking so-called brake drugs, such as
cyproterone acetate, a substance sometimes used to reduce the
sex drive in hyperlibidinous men.) Says Kees Kooman, the editor
of the Dutch edition of Runner's World magazine, "All athletes
someday have to choose: Do I want to compete at a world-class
level and take drugs, or do I want to compete at a club level
and be clean?"
Over the years athletes from the former Eastern-bloc countries,
the Netherlands and China have been known as heavy users of
performance-enhancing drugs, but American Olympians, at least in
the eyes of the U.S. public, never have been so stigmatized.
That is a misperception. "I've had American athletes tell me
they were doing performance-enhancing drugs," says Voy. "Most of
these athletes didn't really want to do drugs. But they would
come to me and say, 'Unless you stop the drug abuse in sport, I
have to do drugs. I'm not going to spend the next two years
training--away from my family, missing my college education--to
be an Olympian and then be cheated out of a medal by some guy
from Europe or Asia who is on drugs.'"
"I would say nearly every top-level athlete is on something,"
says Michael Mooney, a California bodybuilder and authority on
steroids who used to help athletes with questions on how to use
the drugs most effectively and now designs steroid regimens for
AIDS doctors to prescribe to their patients. "What bothers me
are the hypocrites, the athletes I've talked to who I later read
are talking about how bad steroids are. The number of these
supposed steroid-free athletes--very well-known athletes--who
have contacted me about how to pass [drug] tests in just the
last year blows my mind."
In 1993 the head of the IOC's medical commission, Prince
Alexandre de Merode of Belgium, told a British newspaper that he
believed that as many as 10% of all Olympic athletes were
regular users of performance-enhancing drugs. At the time, that
statement made headlines. Now the 10% estimate seems hopelessly
naive. In a rambling interview with SI on Monday, De Merode
said, "I am not unhappy about the situation. More and more,
high-level athletes have to be treated like normal workers. We
have to be able to face the courts. People don't realize that
our power is very weak. We have power only at the Olympic Games.
The federations and national governing bodies have ... more
power. Everybody is doing it. Nobody is taking note that an
actor, a singer, a politician or a truck driver is taking drugs.
They don't have tests. We have tests. We have made a lot of
Drug insiders see it differently. According to those interviewed
by SI, three distinct classes of top-level athletes have emerged
in many Olympic sports. One is a small group of athletes who are
not using any banned performance enhancers. The second is a
large, burgeoning group whose drug use goes undetected; these
athletes either take drugs that aren't tested for, use
tested-for drugs in amounts below the generous levels permitted
by the IOC or take substances that mask the presence of the
drugs in their system at testing time. The third group comprises
the smattering of athletes who use banned performance enhancers
and are actually caught. To be caught is not easy; it only
happens, says Emil Vrijman, director of the Netherlands' doping
control center, when an athlete is either incredibly sloppy,
incredibly stupid or both.
Of course, avoiding detection does require an effort. The days
of an athlete's simply turning in a bottle of somebody else's
urine are over. As degrading as it may sound, an official is now
required to watch the athlete urinate. Even that's not
foolproof: Cases have been reported of an athlete urinating
before an event, inserting a catheter up his or her urethra and
using the equivalent of a turkey baster to squeeze someone
else's urine into his or her bladder.
Of course, an athlete who refines his use of banned performance
enhancers need not worry about giving a urine sample. If an
athlete stops taking water-based steroids--the most common
kind--within two weeks, there is, typically, no detectable drug
left in his urine. And that's being cautious. Says Ben Johnson,
the Canadian sprinter who was stripped of his gold medal in the
100 meters after testing positive for anabolic steroids at the
1988 Olympics, "There are about six dozen drugs on the market,
as far as I know, and some, like water-based testosterone, leave
the system in a day," an assertion confirmed by several experts
on steroids and other performance-enhancing substances. Even
with the most commonly used water-based steroids, the two-week
period can be shortened. "Let's say I have a deal with a lab
under which I can send your urine to test your [steroid]
levels," says Voy, assuming the role of an illicit-drug adviser.
"Then I just play around. I adjust the doses. I know exactly
when to get you off to fall below the [drug-testing] radar. If I
can get you off nine days before your event, we've got it made,
because chances are you're not going to lose any of your
[strength and endurance] gains in that period. It's simple
"I know athletes who take their urine to a women's health center
in West Hollywood," says California-based steroid expert Jim
Brockman, a self-trained biochemist and trainer whom athletes
have contacted about steroid use and how to hide it. "The lab is
important. You have to constantly monitor your usage."
But what about the random, out-of-competition testing conducted
by some sports federations, including FINA, swimming's world
governing body (following story)? Doesn't that scare athletes?
Not much. There's a saying that to be a great athlete today you
need a great coach, a great chemist and a great lawyer. The
so-called chemists--who in fact are just as likely to be
trainers, doctors or simply self-taught drug experts--are known
in the athletic community as gurus. They specialize in buying
illicit performance-boosting substances and creating programs
that will give a client maximum benefit from those substances
while minimizing his chances of getting caught. "No athlete I've
ever helped has tested positive, and I've helped hundreds," says
a Dutch doctor who has been a guru. The athletes he has helped,
the guru-doctor says, come from "every sport you can imagine."
Gurus often buy or create so-called designer steroids for
athletes who can afford the price of a program (as much as
$3,000 a month). These drugs are steroids that have been
chemically altered to tailor them to an athlete's needs and
render them more difficult for testers to identify. Each type of
steroid has a unique signature that shows up in the urine of a
user. Because drug testers look only for the signatures of
commercially available steroids, a steroid whose signature has
been changed will be much more difficult to detect. For an
athlete using that altered steroid, passing a drug test becomes
Even an athlete with little money can have his steroids
doctored. Despite the many polysyllabic terms bandied about in
the steroid culture, the chemical components of steroids are so
simple to alter that virtually any graduate student in chemistry
has the ability to do it. SI took one guru's steroid-altering
instructions to a third-year college chemistry student, who in
the course of two days made the resultant designer drug. An
independent testing lab, which analyzed the altered drug, said
that its testers would be unable to find any identifiable trace
of steroids in the urine of any person who had taken the
Drug gurus are so easily found that an SI writer tracked down
three of them--one in Houston, another in Kingston, Jamaica, and
a third in Denver--by making a half-dozen telephone calls over
the course of a week. The guru in Houston, a chemist who once
worked for a pharmaceutical company, did not want the writer to
visit him. "There are too many people here you'd recognize," he
To procure drugs, American gurus go to local doctors, to
pharmacies in Tijuana, to dealers hanging out at bodybuilding
gyms all over the U.S., to track and field meets in Europe.
The gurus do all their business in cash; the cash is provided by
the athletes. A guru who is a doctor risks losing his license by
providing an athlete with any performance-enhancing substance,
such as an anabolic steroid, that by law can only be prescribed
for bona fide medical needs. But the doctor has incentives. A
kilogram of pure testosterone wholesales for $500 through
medical channels. It can be mixed with calcium, made into
tablets and produce about $100,000 in illicit steroid sales,
according to the U.S. Drug Enforcement Administration. (An
athlete caught possessing steroids without a prescription could
likewise face a felony rap, but that's just another risk many
athletes are more than willing to take.)
After the guru buys and perhaps alters a drug, his next job is
to make sure it is administered properly--that is, in a way that
will enhance performance without being detected. The trick is
for the athlete to receive just the right dosage at just the
The guru might tell a sprinter, "You should take 40 milligrams
of Winstrol [a steroid] three times a week for eight weeks, then
take nothing for eight weeks, then resume your schedule for six
weeks until three weeks before your competition." One of the
guru's most important roles is to hold the athlete back;
athletes, like junkies or alcoholics, often take the view that
if a little is good, more is better.
Actually, for sprinters and other strength athletes, the most
popular banned substance today is human growth hormone, not
steroids. (Some athletes jokingly referred to the Atlanta
Olympics as the Growth Hormone Games.) Growth hormone is used
primarily by pediatricians to treat dwarfism, but it also helps
an athlete's muscles recover speedily from intense workouts and
thereby enables him or her to train harder and more often. Urine
tests don't detect hGH, which is one reason so many athletes are
taking injections of it despite the $1,500-a-month cost.
While growth hormone is popular among strength athletes,
competitors who rely on endurance--long-distance runners,
cross-country skiers, distance swimmers and the like--prefer a
genetically engineered version of erythropoietin, or EPO, a
natural hormone that is effective in the treatment of kidney
disease, anemia and other disorders. It stimulates the formation
of red blood cells, which carry oxygen to the muscles, thus
fostering greater endurance for athletes. Urine testing cannot
detect EPO use. And though more than two dozen deaths have been
attributed to EPO--including the deaths of five Dutch cyclists
in 1987, the year the drug was introduced in Europe--its
popularity among athletes persists. "You have guys who will go
to the funeral of a friend who died from this stuff, come home
and inject it again," says an Olympic distance runner from
Europe who uses EPO himself. There is an ongoing effort to find
urine tests for both EPO and hGH, so far to no avail.
The frustration of drug-testers might be reduced with one bold
move: The IOC could require the testing of athletes' blood.
Blood testing can detect signs of illicit usage of both hGH and
EPO. Since March the UCI, cycling's worldwide governing body,
responding to riders' requests, has been testing the blood of
professional road racers for signs of EPO. Four cyclists found
to have thickened blood have been forced to sit out races as a
Catlin maintains that blood testing is not yet reliable enough
to be used at the Olympics. Other testing experts disagree but
see it as impractical. "Blood testing is invasive," says
Goldman, whose book, Death in the Locker Room, last updated in
1995, details the dangers of steroid use and abuse. "Blood's too
much of a pain. Blood spoils. Tubes break. It can clot if you
don't keep it cool when shipping. You're sticking holes in
athletes, and some people have religious problems with that.
People pass out. But blood testing would be more accurate.
There's no doubt about that."
So why no official push for blood testing? Says Voy, "It's very
difficult for sport organizations that depend on sponsorship
money" to have their athletes caught taking performance
enhancers. "The IOC fears exposing the high levels of drug use.
It turns off the public. The IOC is very nervous about testing."
Voy quit his Olympic position in 1989 because, he says, neither
the IOC nor the USOC was committed to eliminating the use of
illicit performance enhancers. Exposing star athletes would
create enough publicity to send sponsors packing, and it might
also disillusion a sports-watching public that assumes that the
overwhelming majority of Olympic athletes are clean.
Once scientists determine that the drug test of an Olympic
athlete is positive, two separate IOC committees must accept the
results. The committees meet in private and have been accused of
putting the interests of a particular sport or a particular
country ahead of the drug-testing rules. Ontario Supreme Court
judge Charles Dubin, who as head of the 1989 Canadian government
inquiry into drug use in sports heard months of testimony,
concluded that the IOC had by omission covered up more drug use
than it had uncovered. "The general public has long been led to
assume that if only one athlete tested positive, the others were
not also using drugs," wrote Dubin in his report. "We know now,
as the IOC ... has known for many years, that this assumption is
Nor is the testing itself as stringent as Olympic testers would
have the public believe. The IOC tolerates startlingly high
levels of testosterone in both male and female athletes. Olympic
testing guidelines established 15 years ago by the late German
biochemist Manfred Donike, who was the head of the IOC's doping
subcommittee from 1980 until his death in 1995, measure an
athlete's testosterone level as a ratio between the testosterone
and the epitestosterone (a natural hormone with no known
physiological benefit) found in his or her urine. Virtually all
men have a testosterone/epitestosterone (t/e) ratio of 1.3 to 1
or lower. A small fraction of men, far fewer than 10 in 1,000,
have a t/e ratio of more than 5 to 1. To cover these people and
to avoid lawsuits, Donike pegged the maximum acceptable ratio in
Olympic athletes at 6 to 1. Thus, a male athlete with a natural
t/e ratio of 1 to 1 can artificially increase his ratio to 6 to
1 and still have legal readings. A man with a natural 1-to-1
ratio could take 200 milligrams of testosterone three times a
week and remain below 6 to 1. Sports scientists say that a
run-of-the-mill male athlete with a 1-to-1 t/e ratio who raised
his ratio to 6 to 1 by injecting testosterone, in conjunction
with hGH, could improve his athletic performance by as much as
10% to 20%. That's a huge advantage in, say, a 100-meter sprint,
in which a few hundredths of a second can separate first place
from fourth, or in a throwing event, in which six feet can
separate a gold medalist from an also-ran.
Donike also established 6 to 1 as the legal ratio for women,
even though it is almost unheard of for a woman to have a ratio
greater than 2.5 to 1.
A woman who boosted her ratio to 6 to 1 would see even more
dramatic improvements in performance than a man who did so.
"Women require a lot less anabolic stimulation than men do in
order to build up their strength and endurance," says Voy. "It's
sometimes pretty hard to stimulate a lot of males with anabolic
steroids because a lot of their androgen receptor sites
[male-hormone receptors found in almost every muscle in the
body] for the anabolic steroids have been closed down because of
maturity. But in a woman those receptor sites are always open,
so just a little tweak here and you can get great gains."
Donike's guidelines have had the unintended effect of
encouraging female athletes to take more powerful
muscle-building substances. Before Donike established the 6-to-1
t/e ratio, says Mooney, "women preferred synthetically produced
steroids over straight testosterone because the synthetics had
fewer male side effects. Since then, it's been easier to get by
the tests with pure testosterone, so that's what they're using."
He adds, "You start feeding a woman testosterone, essentially
you're turning her physiology into a man."
That and other risks from banned performance-enhancing
substances are well-documented. Steroids can cause heart
disease, liver cancer and impotence. The hormone of the moment,
hGH, can cause disfigurement by encouraging growth not only of
muscles but also of bones, especially in the feet, hands and
face. Some hGH users develop jutting foreheads, prominent
cheekbones and an elongated jaw. (In Olympic circles an athlete
with a pronounced chin is sometimes said to have GH jaw.)
According to Walter Jekot, a Los Angeles pediatrician doing five
years in North Las Vegas Federal Prison following his 1992
conviction for trafficking in steroids, a track athlete had to
undergo a skin graft in the late 1980s because doses of hGH had
caused the bones to practically push through the skin, and the
athlete could no longer fully open his hands.
None of that has stopped athletes from using
performance-boosting drugs. They are skeptical not only of the
proposition that testing will catch them but also of the
proposition that it will catch their competition. "We've lost
the trust of the athlete," says Vrijman, the Netherlands'
testing official. Ironically, the IOC catalog of 200 banned
substances has come to serve as a shopping list. "The best
advertisement for athletes to find drugs is to put them on the
banned list," says Vrijman. The logic is impeccable: "That tells
the athlete that this drug improves performance, or we wouldn't
And every year there is new stuff to try. One
performance-boosting substance growing in popularity is Insulin
Growth Factor-1. Since it is naturally produced by the body, the
presence of IGF-1 in a urine sample can be explained away
easily. Insulin pulls nutrients into muscle tissue, thus
promoting muscle growth.
In Atlanta traces of a drug relatively new to testers appeared
in the urine samples of athletes from Russia and other Eastern
European countries. The stimulant was ultimately identified as
bromantan, and its use by athletes was so new--although it had
been used by the Russian military to keep troops alert and to
adapt quickly to extreme heat and cold--it was not yet on the
banned list. The drug's benefits were not fully understood, nor
its dangers. That hardly mattered. When the word that bromantan
had the potential to improve performances got around, the drug
A great silence enshrouds the world of covert drug use. What
athlete wants to confess to a practice that would taint the
authenticity of his performance--and to a felony to boot?
Retired athletes too have no incentive to tell a truth that
would bring shame to their careers. A British bobsledder, Mark
Tout, failed a drug test last year and openly discussed his
steroid use. That inspired exactly no one else to come forward.
The continuing pervasiveness of drugs in the Olympics and other
sports competitions has even spawned a small but vocal movement
that promotes legalizing the use of anabolic steroids and other
banned substances. One who has articulated this argument is Dr.
Norman Fost, a visiting professor of bioethics at Princeton, who
says in lectures and writings that steroids are not appreciably
different from certain legal foods and drugs that enhance
performance and that the health risks of steroids have been
seriously exaggerated. "The widespread use of anabolic steroids
by athletes is upsetting to many people, but it is not clear
why," Fost began a 1983 piece published by The New York Times.
"The objection that steroids provide an 'unnatural' assist to
performance is inchoate. Many of the means and ends which
athletes use and seek are unnatural. From Nautilus machines to
... Gatorade, their lives are filled with drugs and devices
whose aim is to maximize performance."
That's nuts, says Catlin. If drugs were permitted, he says,
"then we would just have a race among pharmacologists to find
better and stronger drugs. Now at least they [athletes] have to
worry about being detected."
Clearly, that race is already on, and drug testing is serving as
no deterrent. "People like to think that things are better since
Ben Johnson," says Dutch track coach Henk Kraayenhof, who has
trained world-class runners for 20 years. "I argue the opposite.
If anything, Ben Johnson's getting caught promoted drug use.