OUR DRUG-HAPPY ATHLETES
We've brought secret weapons nobody else has even thought about," boasted U.S. Davis Cup Captain David Freed as he arrived with his tennis team in Australia last week. "Why, we have more dope and pills than anyone on earth." When reporters' eyebrows rose, Captain Freed hastily explained that the pills he referred to were all harmless. Nevertheless, his boast sent reporters' memories back to last summer's Olympics, when a Danish cyclist named Knud Jensen collapsed, apparently of sunstroke, near the end of a 62-mile road race. Within a few hours he was dead. Subsequently, his trainer admitted giving him Roniacol, a form of nicotinic acid that is used by doctors to aid circulation in elderly people suffering from arteriosclerosis. Roniacol works, loosely speaking, by dilating the vessels that carry the blood through the body. "Assuming that a cyclist's muscle power depends on good circulation in the limbs," says a medical specialist, "Jensen's trainer may have felt the drug would enable him to pedal harder and faster. Unfortunately, the blood-vessel-dilating effect of the drug, added to the natural dilating effect of the exercise, probably overloaded the cyclist's heart so much that he went into shock—a state that can cause death."
Jensen's death was a sharp and tragic fact in a clouded pool of rumors concerning the use of drugs in sport. Those rumors have grown steadily more widespread since 1957, when Dr. Herbert Berger, then chairman of the New York State Medical Society's committee on narcotics, charged that many athletes were dosing themselves with amphetamine (a drug commonly trademarked under the names Benzedrine and Dexedrine) to improve their performance.
Predictably, the sports world reacted to this charge with angry denials. Nonetheless, as time passed, Dr. Berger's assertions began to receive considerable support. A former high school basketball coach in Ashland, Ohio declared he had been giving Dexedrine tablets to key players for years and that such pills were in common use in colleges and high schools throughout the country. (The coach had been forced to resign after one of his players suffered a nervous breakdown.) Bruno Banducci, a onetime all-league guard in the National Football League who switched to Canadian football, admitted he had taken Benzedrine. "I could play through the whole game," he said, "and not get tired." His teammate Tom Dublinski said he had taken Benzedrine, too, but not for several years. "They hopped me up too much," he said. "That's no good. A quarterback has to be steady." And in Australia, a former Olympic swimmer cheerfully announced that some of her country's top athletes told her they took such stimulants regularly.
Three years ago, under the aegis of the American Medical Association, Research Anesthesiologist Gene Smith and Dr. Henry Beecher, a physician, both of Harvard, undertook the task of clarifying this chaos of accusations, denials and admissions by conducting a series of controlled experiments. Completed last year, their investigation established one claim clearly as fact: athletic performances can be measurably improved by the use of amphetamines—the "pep pills" of the jazz musicians, the "bennies" of the kick-seeking beatniks, who sometimes eat them by the handful like popcorn or peanuts.
The Smith-Beecher study tested 57 swimmers, runners and weight throwers (athletes whose performances are easily measurable in terms of time and distance). Sometimes these men were given 14 mg. of amphetamine per 70 kg. (154 pounds) of body weight two to three hours before competing. At other times they were given placebos (harmless sugar pills) and sedatives (secobarbital) to discount the effect of autosuggestion. The results showed that, in about three-quarters of the cases tested, the athletes performed better under the influence of amphetamine than placebo. Predictably, the results also showed that secobarbital, in large enough doses, generally impaired their performance. The degree of improvement under amphetamine was as much as 4% for weightthrowers, 1½% for runners and 1.16% for swimmers—percentages, reported the AMA's special committee on amphetamines, equivalent to the improvement athletes might spend months in achieving without the drugs. In terms of records, these figures indicate that amphetamines could take 3.6 seconds off the time of a four-minute miler.
A few months later, in an amphetamine study of his own patterned on the Smith-Beecher experiments, Dr. Peter Karpovich, research professor of physiology at Springfield (Mass.) College, found that the results he obtained on swimmers and weight throwers substantiated the Harvard study, but those on runners generally did not. On one occasion Dr. Karpovich discovered the track men being tested actually ran slower on amphetamines. All of which would seem to indicate that while bennies are sometimes effective, they are not completely reliable as aids to performance.
The grab bag
But, one might ask, if pep pills do any good at all, why shouldn't everybody take them? The answer, of course, is that, like most specifically effective medicines, amphetamines, which work by stimulating the central nervous system to reduce the sense of fatigue and despair, can be highly dangerous unless their use is medically supervised.
"They are quite useful," says Dr. Berger, "in the treatment of persons who suffer from depression. But a normal person taking the drug without a doctor's advice can be elevated to a hyperexcited level. He doesn't get tired, he thinks he's witty and he feels, probably quite rightly, that he has a great deal of strength. If he tends to be a person who is hyperexcited to begin with, the drug can make him go berserk." There are other dangers as well. Since these drugs quicken the heart and raise the blood pressure, physicians must make certain the cardiovascular system is normal, or the subject may overstrain himself without knowing it, at the risk of serious illness or even death. "Also," Dr.Berger goes on, "amphetamines are an appetite depressant and, in the case of growing adolescents, there is the chance of malnutrition. Moreover, there is the possibility of habituation, of the subject feeling unable to function without the drug. Finally, after taking amphetamines for several days to 'keep going' there is the danger of complete collapse because the subject loses his awareness of normal fatigue and pushes his body beyond its capabilities."
In view of the peril inherent in their indiscriminate use, pep pills are absurdly easy to get. Although they are sold at retail only on prescription, any person (of any age) can write a pharmaceutical jobber or wholesale house, give a name that sounds like a legitimate drug store, include the cash and wait for the pills to arrive. "The law," says Dr. Berger, "provides safety measures only against the retail sale of drugs."
At the opposite end of the drug spectrum from the active amphetamines are the passive tranquilizers, the calming, relaxing drugs of which Miltown, that favorite of Hollywood gagmen, is far and away the best known. These are the high-powered executive's drugs, the ulcer-defeating palliatives of the high-tension age. They work by reducing the sensitivity of the nervous system, thus allowing the individual to withstand pressures that might otherwise emotionally incapacitate him. Obviously, their place in sports is limited—since most athletes need pepping up, not slowing down—but they have their advocates. Several seasons ago Reno Bertoia, then of the Detroit Tigers, who had hit a resounding .182 the year before, found himself leading both leagues after two months of play with a .397 average. Since he was taking tranquilizers for other reasons, he attributed his sudden success to the pills. A short time later, however, his batting average dropped toward .200 again. "Now," moaned Reno, "everyone says that I'm over-tranquilized."
Between the two extremes of amphetamines and tranquilizers is a whole physiological and psychological grab bag of artificial aids to athletic performance that includes everything from drugs, oxygen and vitamins to sugars, wheat-germ oil and hypnotic trances. The best that can be said for many of them is that they frequently inspire the athlete, as in the case of Reno Bertoia, to greater efforts through autosuggestion. "You can give a man a sugar pill," declares one doctor, "and tell him it will enable him to run faster, and if he runs a good race he swears by that pill from then on."
Some coaches and trainers are convinced of the winning ways of plain oxygen. The U.S. Olympic championship hockey team credited its victory at Squaw Valley in large part to the inhalation of pure oxygen. Doctors, for the most part, scoff at any such claims. "The body does not store up oxygen," the AMA Journal says, "and since the effect of oxygen-inhalation wears off in about three minutes, no benefits can be anticipated involving prolonged exertion. Inhalation immediately before short track sprints and short swimming races (in which breath-holding is a factor) may be of limited value, but these benefits probably can be obtained by forced deep-breathing of ordinary air." The reason why breath-holding is of value, points out Dr. Karpovich, is that "it tenses the athlete's muscles and allows him to exert more power."
For years the favorite drug of Europe's bike riders (called by many the most drug-ridden group in the world) has been cocaine. A powerful, quick-acting drug that is capable of producing an addiction as difficult to break as that of heroin, cocaine is derived from the coca leaf, a shrub indigenous to Bolivia and Peru. Unlike most narcotics (e.g., morphine, heroin), which act as sedatives tending to depress the spirit, a moderate dose of cocaine actually stimulates the central nervous system, accelerating the respiratory and circulatory rates. On taking it, either by "sniffing" or hypodermically, a cyclist feels he has great energy; he frequently sprints to the head of the pack just to show what a fine, strong fellow he is. The South American Indians who habitually chew the leaf are known for their tremendous feats of endurance—and, it should be noted, for their short life spans. Similarly, toreros fatigued by an afternoon of facing angry bulls find that cocaine restores their confidence when they depart in the evening to face an eager lady love. Doctors doubt that anybody is really the better in any way for the use of cocaine, but there is no doubt that many bicycle riders and bullfighters think they are.
Behind the belief of athletes in medications, most doctors believe, is a kind of wishful thinking that there must be a magical way of improving performance. Self-dosing athletes are, in short, like horseplayers in search of a system. "Many of our topflight people," comments Dr. Allan Ryan, chairman of the AMA's sports medicine committee, "tend, in a mild way, to be victims of compulsion neurosis. If a man wins a swimming race after rubbing a rabbit's foot for luck, he probably keeps on rubbing it. The rabbit's foot becomes a magic amulet. In a sense, this drug business is something out of our childhood. One of our youthful heroes was Popeye, who used to say, 'I am what I am,' but placed his reliance on spinach."
Such childlike faith was apparent in Rome last summer, for instance, when a drugstore in the Olympic Village, whose customers were some of the finest physical specimens in the world, managed to sell 14,000 bottles of vitamin pills in a single week. This despite the AMA's flat assertion that there is not an iota of reasonable evidence to indicate vitamins can help an athlete's performance.
The search for a magic amulet is an old story. Twenty years ago, one university physician recalls, an immobilized halfback, the star of the team, hobbled into his office and cajoled him into administering the pain-killing drug novocain to anesthetize a sprained ankle. The halfback played, but poorly. "My God," he said when he was removed from the game, "I didn't know whether my foot was on top of the ground, below the ground or in the ground!" What's more, the physician adds, the man aggravated the sprain so much he missed the next three games. Novocain has a counterpart for today's athlete in the pain-killing Butazolidin, an analgesic legally (in some states) administered to race horses to permit them to run on sore limbs.
The Texas A&M football team at one time was dosed with a vitamin capsule trademarked C.V.P., which was supposed to soften the effects of bumps and bruises. C.V.P., a bioflavonoid compound made from citrus peel and juices with vitamin C added, acts "to thicken the substance of capillary walls" and thus retard hemorrhaging. Similarly, at the Olympics last summer, boxers took Varidase tablets (a combination of two enzymes, streptokinase and streptodornase) to lessen blood clotting and hasten healing.
Just how widely drugs and stimulants are used in competitive sports is anybody's guess. In connection with the amphetamine study made by Smith and Beecher, the AMA's special committee on amphetamines sent out questionnaires to some 1,800 college and high school coaches asking whether they used the drug. Only 1% of those answering admitted that they did, and the AMA committee declared that "the actual use of amphetamine-type drugs in athletics is relatively rare." But Dr. Joseph Wolffe, vice-president of the International Federation of Sports Medicine, believes, like many other authorities, that the use of amphetamines is far more prevalent than the survey indicated. "It is only natural," he says, "that athletes, like most individuals, should look for ways to improve themselves." And who is to say what ways are ethical and what are not?
Caffein, Dr. Wolffe points out, is a stimulant that can be taken by any athlete without criticism in the form of a cup of coffee. Yet three cups of strong coffee contain at least 5 grains of caffein—a highly effective dose. And cola drinks, which contain both caffein and sugar, are not only permissible, but are frequently advocated by athletic coaches and trainers.
Amidst this continuing debate, Dr. Karpovich takes what is perhaps the most realistic approach. "The use of a substance or device which improves a man's physical performance without being injurious to his health," he says, "can hardly be called unethical. As for taking advantage of other contestants who do not use these aids, this should be regarded in the same light as the use of special diets, special exercises and so forth. All these means are available to everyone." But, he warns—and it is a significant but—"there are few, if any, pharmacological aids which can be used indiscriminately without incurring risk."
SIX ILLUSTRATIONS
JAMES FLORA