Ode Magazine piece misses the mark on doping

A piece in Ode Magazine starts off asking about the role of society vis a vis the Tour de France doping.  Unfortunately by the third paragraph the article drifted astray -- way astray.

If a conclusion is drawn it should be ascertained from the valid data preceding it.  Let's take a look:

I just read the news about the third doping case at this year's Tour de France: Italian rider Riccardo Ricco has tested positive for the banned blood-booster EPO. And of course, as it happens so often with sportsmen who are associated with artificial performance-enhancing measures, Ricco was "booed by spectators when he was taken off the Saunier-Duval team bus by police Thursday," the AP report said.

Poor Ricco! I don't think using drugs was such a great idea, but I do feel we need to ask ourselves some serious questions before we condemn him. After all, in the rest of society, performance-boosters have become increasingly commonplace.

OK, now here it comes, the litany of horrible pharmaceutics:

* People take Prozac so they can better manage psychological pressure. * Students take Ritalin to improve their grades. * Middle-aged men take Viagra to spice up their sex lives. * Shy people take Paxil so they can handle social situations. * Writers, musicians and other artists take other stimulants to stand out in their fields.

Cliche list.  Inaccurate information.

• Prozac is not prescribed 'to manage psychological pressure'.  Fluoxetine is prescribed for mood disorders, anxiety disorders like OCD, Autism, and other medical disorders. The key is 'disorder'. The diagnosis 'psychological pressure' will never be found in a medical record.
• Students do not take Ritalin to improve their grades.  Methylphenidate is prescribed for patients with ADHD to ameliorate inattention, impulsivity, and hyperactivity.  An improvement in grades may be a benefit with the appropriate work effort.
• Middle aged men do not take Viagra 'to spice up their sex lives'  (what an incredibly insensitive remark).  Viagra is used for impotence -- the inability to achieve an erection.  "Spice up".  Yeah, We suppose crutches are used by amputees to beat the airport rush.
• Shy people take Paxil so they can handle social situations.   There's an example of an egregious abuse of drugs. huh?  Patients with social anxiety are clearly cheating the system and should simply stay isolated at home.
• Writers etc. tale stimulants to stand out in their field.   Huh?  Ok, you lost us at 'stand'

Seems this writer distorts medicine, or twists medical treatments to support a illogical argument that EPO abusers like Manuel Beltran is paying for the sins of the Prozac Society.

And Marion Jones took insulin mimicking those horrible diabetes who inject insulin so they can eat pizza...

In modern society, athletes have become heroes. Sports stars aren’t so much role models for society as reflections of it, albeit reflections with exceptional talent. Athletes take performance-enhancing substances mainly as a consequence of our sky-high expectations and the huge commercial interests involved.

Ultimately they are part of the same achievement-oriented society we are, in which he use of stimulants has become normal. The appropriate response is not moral outrage, but a relaxing of the enormous pressure we put on them: Just do your best, kid. That’s all you can do.

OK, we understand the conclusions; however please present preceding arguments developed to support the conclusions rather than a roll call of popular press target medications.

PEDs, and medicines are simply molecules.  Molecules are not evil.  The use or abuse of the molecules is the issue.

Comments

[Me]

For sure people without ADHD abuse Ritalin to do well at school. I know several medical students that use a number of stimulants so they can work longer hours. I also know people who abuse viagra who are not impotent. You can abuse anything you like.

[Millard Baker]

Certainly, pharmaceutical drugs have recognized medical indications for which they are prescribed. But in actual practice, it seems that a large percentage of prescriptions for the mentioned drugs are given in the absence of a clinically significant medical/psychological disorder.

Most people (let me qualify that by saying most "professionals" in their 30s and 40s and beyond) can successfully go to their doctor and ask for Viagra or Cialis to "spice up their sex life" and not be turned down. Tell your doctor you need more energy and focus and ask for Provigil and you will often be given one. Tell your GP your dealing with extra anxiety due to work demands and successfully receive a prescription for Klonopin or Xanax.

The actual practice of medicine today does not meet the ideal medical practices.

[Millard Baker]

I want to add that ironically in the age of the doping hysteria, it seems that doctors are most willing to prescribe drugs like Adderall, Provigil, Ritalin, and Wellbuterin to professionals for whom the drugs will enhance their work-related productivity and on-the-job performance. IOW, performance enhancing purposes. This seems to be acceptable in the medical community (if not society at large).

[Migel Palota]

"In modern society, athletes have become heroes. Sports stars aren’t so much role models for society as reflections of it, albeit reflections with exceptional talent. Athletes take performance-enhancing substances mainly as a consequence of our sky-high expectations and the huge commercial interests involved.

Ultimately they are part of the same achievement-oriented society we are, in which he use of stimulants has become normal. The appropriate response is not moral outrage, but a relaxing of the enormous pressure we put on them: Just do your best, kid. That’s all you can do."

As much as we may wish the above was not a true statement, it is. The columnist is correct. This is the pharmacological age and there are countless, countless examples of PED use in the world outside sport.

As to the PED use, outside sports, of anti-depressants - SSRI's - it's far more common than people think. In the book "Listening to Prozac", the author writes about the ethics of what he called "pharmacological plastic surgery". Basically, business executives - who are healthy - are using ant-depressants and anti-anxiety drugs to help them through very tough business deals. I, personally, have seen this.

[Mahidhar Reddy]

Gaffney is stretching it now....I'm in med school and probably 50% of the people are using amphetamines to at least, in their mind, "do better and score higher"...It's easy to talk about sports but what about medicine, where doctors are responsible for the lives of others?

I guess there is no "black market" for viagra pills either....wrong again Gaffney.

Maybe the kids don't really have ADHD...after all, many can play video games everyday without problem....maybe it is BTD (boring teacher disorder)....Yes, yes, not a real medical diagnosis in DSM....Because of course, everything in DSM is a fact and there are no personal agendas involved in the "disease mongering" just to make a buck off of medicalizing people's suffering.

I've used weights for 17 years and I've never seen a steroid or used steroids, but some of your commentary is just ignorant....like your criticism of Chris Bell (BIGGER STRONGER FASTER). "whom the bell tolls"....that's very high on the sensitivity scale my friend.

And you basically defended Taylor Hooton's father in another post. Maybe you should watch the movie again regarding the part about Lexapro use and suicidal ideation. Blaming the steroids over the lexapro is questionable at best, which is what you are implicitly doing.

All of your so called cliche information is cliche when applied to large groups of people in a generalized manner. However, those stereotypes did develop for a reason: because for a large percentage of people IT IS ACTUALLY THE CASE. I know that's hard to grasp from the Ivory towers at Iowa.

You should spend more time criticizing your co-workers and expand on the lax ethics in medicine that allows for steroids to be used in an irresponsible and deleterious manner. It is more constructive than criticizing steroid use and steroid users. Steroid use, for better or worse, is here to stay. Ethics in medicine are far more relevant to a large percentage of people. Your comments about PEDs in medicine among medical professionals is largely dismissive in tone, typifying the arrogance I've seen with the numerous doctors in my own family (about 30 when including 1st 2nd and 3rd cousins).