Performance Enhancing Drugs in Everyday Life

Whenever star athletes use performing enhancing chemical agents to “game” drug screening systems for a competitive edge, people are understandably appalled and angry. We've seen this in the Olympic Games and other major amateur competitions and in professional sports all over the world.

But are these critics as upset and outspoken when chemicals are used to enhance performance in other aspects of life?

Self-medication is so common that we often see headlines like the following, all beginning with “Widespread Use Of”:

"…Performance-Enhancing Drugs (PED’s) by Participants in Major Sports" (Athletics)

“…’Nootropics’ (Amphetamines, Ritalin, etc) as Study and Exam Aids in Colleges and Universities" (Education)

"…Anti-Depressants and Tranquilizers (SSRI’s, Benzodiazepines, etc) to get Through The Day" (Stress of Life)

"…Natural Marijuana and Synthetic Cannabinol Use" (Recreation and Relaxation)

“…Caffeine to kick start the day, stay awake, overcome fatigue (stimulation)

“…Alcohol by People of All Ages” (Stress, pleasure, performance, need)

“…’Self-Medication’…Prescription and Over-the-Counter Drugs” for myriad conditions: (Erectile Dysfunction); (Weight Loss); (Sleep-Aids); (Performance Anxiety in Public Speaking, Music, Acting, Dancing).

Here is a true story in which I'll substitute "you" for the father:

“You” are a respected leader in the business of organized sports who is outspokenly opposed on ethical and health grounds to any athlete using performance-enhancing agents. You’ve made offending athletes return their medals or awards.

When your son, Alan, was in law school, he was distressed by the relentless academic pressure. He had difficulty concentrating and studying and was increasingly frustrated and sad. His roommate offered him Adderal (an amphetamine) which he’d been prescribed for attention deficit disorder.

Knowing your strong feelings, Alan was initially reluctant but he was getting more upset and finally, he reached sufficient desperation to try the medication. He discovered that it helped his concentration during studying and taking exams and his mood improved.

Fast forward a couple of years; he continued to use this same stimulant to enhance his academic performance and he successfully passed his law school finals and the state bar examinations.

What do you think Alan’s father did when he learned of this well after Alan passed his bar exams? (I'll tell you, but perhaps you can ask yourself what you might have done in these circumstances). When his father learned about Alan’s use of PED’s, he said and did absolutely nothing. On the contrary, he was very pleased that Alan was now a lawyer and was to join a prestigious law firm.

Alan was lucky: He only used the drug for the specific purpose of studying, he had no detrimental side effects, and it proved to be effective. These were due to his self-control and luck, especially because he had no supervising physician.

Louise won the top prize in the piano competition after taking her usual tranquilizer before the trials. She beat other aspirants for the prestigious and ultimately lucrative prize. Michael ”slayed” the crowd with his stand-up comedy routine in the competition, after his regular double scotch before going onstage. He was awarded a major contract. Kathy uses synthetic cannabis oil to help her sleep each night so she can handle the daily pressures in the fashion industry where she is a major executive. Ken can only pursue his demanding dentistry practice when he uses hyper-caffeinated energy drinks every couple of hours throughout the day.

We make a distinction between how we look at chemically enhancing performances in sports competitions ('Terrible!') versus competition in other areas, like artistic, academic, business, or professional endeavors ('No problem.').

Is there anything to be done? I’m afraid that the “International Performance Enhancing Train” has already left the station and we are all passengers.

It seems we have two imperfect and opposing choices:

• Outright ban: We recognize that widespread self-medication is already upon us, and extend our ban on using PEDs beyond the sporting world. We screen everyone engaged in any competitive endeavors and punish all transgressors.
• Laissez-faire: We adopt a permissive attitude, enabling people to use whatever substance they feel enhances their creativity, productivity or sense of fulfillment.

Of course, neither of these two options solves this complex dilemma, and both are unworkable extremes. This is truly a social, medical, legal, health, psychological and philosophical conundrum. As in many complicated dilemmas in life, we are forced to deal with gray ambiguities, as much as we desire the simplicity of absolutes.

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The comment, 'it depends,' often provokes annoyance, and satisfies no one. Unfortunately, it does depend upon the competitive activity, the specific chemical, its purity and dosage, its side effects and dangers, the presence or absence of medical supervision, the 'prescriber’s' credentials and integrity, the prevalent laws in that jurisdiction, and the current and long-term health of the user.

Having said all that, it looks as if we shall be muddling along in this challenging arena for the foreseeable future. 'It depends,' indeed.