Order Code RL32894
CRS Report for Congress
Received through the CRS Web
Anti-Doping Policies: The Olympics
and Selected Professional Sports
April 29, 2005
L. Elaine Halchin
Analyst in American National Government
Government and Finance Division
Congressional Research Service ˜ The Library of Congress

---

Anti-Doping Policies: The Olympics
and Selected Professional Sports
Summary
The use of performance-enhancing substances by athletes has a long history,
predating the ancient Greek Olympiads. Concern about this practice was manifested
in the 20th century by, in the case of the Olympics, the creation of anti-doping
organizations, and the adoption of anti-doping policies by these organizations and
professional sports leagues in the United States. Leading the way was the
International Olympic Committee (IOC), which implemented testing in 1968 at the
Olympic Games in Grenoble, France, and Mexico City, Mexico. The National
Basketball Association (NBA) and the National Football League (NFL) followed suit
in the 1980s. Major League Baseball implemented an anti-drug policy in 2003.
This report compares current anti-doping policies for performance enhancing
substances among the Olympic movement and three professional sports — Major
League Baseball, the NBA, and the NFL. Details associated with each of the selected
group’s policy are presented in Table 1. The report also presents elements of what
have been identified as model anti-doping policies and (in the appendix) provides a
comparison of Major League Baseball’s former and current anti-doping policies
(Table 2) and a glossary of related terms.
In general, the report indicates that the anti-doping policies for the Olympic
movement are more independent of the sports they regulate than are the policies of
Major League Baseball, the NBA, and the NFL, both in the manner in which they are
established and in the entities responsible for their implementation. For example, the
World Anti-Doping Agency (WADA) unilaterally established the anti-doping policy
for Olympic athletes, whereas the professional sports leagues’ policies are the result
of negotiations with their respective players associations. The Olympic movement
also maintains the most comprehensive list of prohibited substances and methods,
and provides sanctions that are more strict than in the professional sports. For
example, the Olympic standard provides a two-year ban for a first violation, whereas
Major League Baseball imposes a 10-day suspension without pay for a first violation.
Also, Olympic athletes and NFL players are responsible for what is in their bodies,
but neither Major League Baseball nor the NBA addresses this subject.
Direct comparison of these sports is sometimes difficult because the policies use
different terminology or make reference to other standards. The policies are also
constantly changing in response to the development of new substances that are
sometimes designed to avoid detection. In some cases, the policies prohibit certain
substances for which tests are not available in order to inform athletes about harmful
substances. However, in other cases, tests and sanctions are not provided for
substances for which tests are available. For example, except for “reasonable cause”
testing, Major League Baseball’s policy provides for testing and sanctions only with
regard to steroids — not other substances prohibited in the league’s policy.
This report will be updated as anti-doping policies change and elements of those
policies become clearer.

---

Contents
Anti-Doping Policies . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
Olympic Policies More Independent of Regulated Sports . . . . . . . . . . . . . . . 3
Issues in Comparing Anti-Doping Policies . . . . . . . . . . . . . . . . . . . . . . . . . . 4
Identifying prohibited substances/methods . . . . . . . . . . . . . . . . . . . . . . 4
Changing Nature of Policies . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5
No Tests or Sanctions for Some Prohibited Substances . . . . . . . . . . . . 6
Comparison of Olympic Movement, Major League Baseball, NBA, and
NFL Anti-Doping Policies . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8
Elements of Model Anti-Doping Policies . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17
Conclusion . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 18
Appendix . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19
Glossary . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 23
List of Tables
Table 1. Comparison of Selected Features of Anti-Doping Policies . . . . . . . . . . . 9
Table 2. Comparison of Selected Features of Major League Baseball’s
2003-2004 Policy and 2005 Policy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19

---

Anti-Doping Policies: The Olympics
and Selected Professional Sports
Anti-Doping Policies
While the use of drugs and other substances — such as alcohol, ether,
strychnine, anabolic steroids, stimulants, and hallucinogenic mushrooms — as a
means of improving athletic performance has a lengthy history, predating the ancient
Greek Olympiads, condemnation of the practice did not surface until the early 20th
century.1 In 1933, Dr. Otto Reiser commented that
[t]he use of artificial means [to improve performance] has long been considered
wholly incompatible with the spirit of sport and has therefore been condemned.
Nevertheless, we all know that this rule is continually being broken, and that
sportive competitions are often more a matter of doping than of training. It is
highly regrettable that those who are in charge of supervising sport seem to lack
the energy for the campaign against this evil, and that a lax, and fateful, attitude
is spreading.”2
Despite such concerns about the use of performance-enhancing substances
(PES) by athletes, anti-doping policies for the Olympic movement and major
professional sports leagues in the United States were not drafted until the latter part
of the 20th century.
! The International Olympic Committee (IOC) implemented testing
in 1968, at the Olympic Games in Grenoble, France, and Mexico
City, Mexico. Anabolic steroids were added by the IOC to its list of
prohibited substances in 1976.3
! The National Football League (NFL) followed suit, in 1982, when
it began to test players, although testing for anabolic steroids did not
1 Charles E. Yesalis, William A. Anderson, William E. Buckley, and James E. Wright,
Incidence of the Nonmedical Use of Anabolic-Androgenic Steroids, research monograph
102, U.S. Dept. of Health and Human Services, National Institute on Drug Abuse
(Washington: GPO, 1990), pp. 97-98; Charles E. Yesalis and Michael S. Bahrke, “History
of Doping in Sport,” in Performance-Enhancing Substances in Sport and Exercise, Michael
S. Bahrke and Charles E. Yesalis, eds. (Champaign, IL: Human Kinetics, 2002), pp. 1-2.
2 Yesalis and Bahrke, “History of Doping in Sport,” p. 1. (Italics in original.)
3 World Anti-Doping Agency, “A Brief History of Anti-Doping,” n.d., available online at
[http://www.wada-ama.org/en/dynamic.ch2?pageCategory_id=20].

---

CRS-2
begin until 1987.4 The NFL and the players association have
updated their anti-doping policy several times since then. In
testimony he presented at a congressional hearing in April 2005, the
Commissioner of the NFL stated that the league and the players
association recently had agreed to several changes to their policy and
that the changes will take effect in 2005.5 However, because these
changes have not been formally published yet, this report treats their
last public policy as the current policy.
! The National Basketball Association’s (NBA) first anti-doping
policy was issued in 1983, and it has been updated several times.6
! Major League Baseball implemented an anti-doping policy in 2003.
Apparently in response to public pressure, Major League Baseball
and the Major League Baseball Players Association (MLBPA)
reopened the collective bargaining agreement in 2005 and updated
the policy. Although the 2005 policy has not been ratified yet by the
players, it appears to be in effect and is treated in this report as the
current policy.
This report compares current anti-doping policies among the Olympic
movement and three professional sports — Major League Baseball, the NBA, and the
NFL.7 However, this issue clearly transcends these three leagues and the Olympics,
and affects other professional sports and amateur athletics. Details associated with
each of the selected group’s policy are presented in Table 1. Although the anti-
doping policies in this report sometimes include so-called “recreational” drugs such
as cocaine and marijuana, this report generally focuses on performance-enhancing
substances. Also, it is important to emphasize that the descriptions and comparisons
made here reflect the different sports’ anti-doping policies, not their implementation.
In addition, this report presents elements of what have been identified as model anti-
doping policies and, in the appendix, provides a comparison of Major League
Baseball’s former and current anti-doping policies (Table 2) and a glossary of related
terms.
4 Ibid., p. 2.
5 U.S. Congress, House Committee on Government Reform, statement of Paul Tagliabue,
Commissioner, National Football League, and Harold Henderson, Executive Vice President
— Labor Relations, National Football League, unpublished hearing, 109th Cong., 1st. sess.,
Apr. 28, 2005, p. 5.
6 Information provided by the NBA’s Basketball Communications Office to the author on
May 19, 2004.
7 Efforts to obtain a copy of the National Hockey League’s program, NHL/NHLPA [National
Hockey League Players Association] Substance Abuse and Behavioral Health Program
(SABHP) were unsuccessful. It is unclear whether this program includes performance-
enhancing substances. This program took effect in September 1996 and apparently expired
on September 15, 2004, when the collective bargaining agreement negotiated by the NHL
and the players association expired.

---

CRS-3
Olympic Policies More Independent of Regulated Sports
In general, this report indicates that the anti-doping policies for the Olympic
movement are more independent of the sports they regulate than are the policies of
Major League Baseball, the NBA, and the NFL, both in the manner in which they are
established and in the entities responsible for their implementation. For example, the
anti-doping policies of the professional sports leagues are established through a
collective bargaining process between a players association and the applicable league,
both of which benefit from professional players’ performances. These policies also
are administered by entities selected by the players associations and the leagues (for
example, the members of baseball’s Health Policy Advisory Committee are selected
by Major League Baseball and the Major League Baseball Players Association). By
contrast, in the Olympic movement, the World Anti-Doping Agency (WADA)
unilaterally established the anti-doping policy and has no vested interested in the
athletes’ performances. The organization which administers this policy for U.S.
Olympic athletes, the U.S. Anti-Doping Agency (USADA), also is independent of
athletes and the organization that supports these athletes, the USOC.8
A comparison of selected features of anti-doping policies shows, among other
things, that the Olympic movement maintains the most comprehensive list of
prohibited substances and methods. This may be due, at least in part, to the general
understanding that some substances or drugs benefit only athletes in certain sports.9
8 In 1999, the International Olympic Committee (IOC) convened a World Conference on
Doping in Sport, which produced the Lausanne Declaration on Doping in Sport. The World
Anti-Doping Agency (WADA) was established, pursuant to the Lausanne Declaration, on
Nov. 10, 1999. (World Anti-Doping Agency, “WADA History,” n.d., available at
[http://www.wada-ama.org/en/dynamic.ch2?pageCategory_id=12].) The U.S. Anti-Doping
Agency (USADA), which began operations Oct. 1, 2000, was created as a result of
recommendations made by the U.S. Olympic Committee’s Select Task Force on
Externalization. It is responsible for anti-doping efforts within the U.S. Olympic movement.
Specifically, USADA has the authority to test and educate U.S. Olympic, Paralympic, and
Pan American athletes, adjudicate appeals, and conduct research in support of its anti-
doping efforts. (U.S. Anti-Doping Agency, “USADA History,” n.d., available at
[http://www.usantidoping.org/who/history.html]; U.S. Anti-Doping Agency, “USADA
Mission,” available at [http://www.usantidoping.org/who/mission.html].) The Paralympics
“are a multi-sport, multi-disability competition of elite, world-class, disabled athletes.
Although similar in scope to the Olympic Games, the Paralympic Games provide an elite
competition opportunity to athletes with a functional disability, which precludes their
involvement in open competition of the Olympic Games.” (U.S. Olympic Committee,
“ P a r a l y m p i c O ve r vi e w , ” n . d . , a va i l a b l e a t [ h t t p : / / w w w . u s o c . o r g /
education/paralympic_overview/paralympicindex.htm].) The Pan American Sports
Organization (PAS) consists of 42 nations of Central, North, and South America, and the
Caribbean. “The Pan American Games are held every four years just like the Olympic
Games and precede the Games by a year. The Pan American Games consist of all summer
Olympic sports, plus some non-Olympic sports, and serve as an Olympic-qualifying event
for many of the participating sports.” (U.S. Olympic Committee, “Pan American Games
Overview,” n.d., available at [http://www.olympic-usa.org/education/ panamoverview/
panindex.htm].)
9 For example, the Olympic prohibition against beta-blockers applies to 18 sports (and only
(continued...)

---

CRS-4
For example, a drug that slows down heart rate and reduces fine motor tremors would
be more helpful to an archer than a basketball player. Another feature on which the
Olympic movement and most professional sports leagues differ is whether an athlete
is responsible for the substances discovered is in his or her body. In both the
Olympics and the NFL, an athlete is responsible, but neither Major League Baseball
nor the NBA addresses this subject in their written policies. Sanctions for testing
positive also vary. The Olympic movement imposes the most stringent penalties: the
first violation results in a two-year ban, and a second violation results in a lifetime
ban from competition, as defined by WADA.10 In contrast, according to Major
League Baseball’s current policy, a second violation results only in a 30-day
suspension without pay.
Issues in Comparing Anti-Doping Policies
The structure and content of these sports’ anti-doping policies vary in a number
of ways, including the subjects covered in those policies, the extent of detail
provided, and the language and terminology used to identify or describe prohibited
substances. As a result, direct comparison of the policies is extremely difficult, and
certain of their provisions may be subject to differing interpretations. Also, various
contextual factors need to be considered when comparing the different sports’ anti-
doping policies.
Identifying prohibited substances/methods. It is sometimes difficult to
determine which specific substances and methods are prohibited in an anti-doping
policy. As a result, it is difficult to compare those policies. These difficulties can
arise when different policies use different terminology, or when a policy refers to an
associated statute or standard. For example, Major League Baseball’s list of
prohibited substances incorporates, by reference, several of the federal government’s
9 (...continued)
during competitions) including archery, curling, and gymnastics. (World Anti-Doping
Agency, The 2005 Prohibited List, International Standard, n.d., available online at
[http://www.wada-ama.org/rtecontent/document/list_book_2005_en.pdf], p. 18.)
10 An athlete who has been banned under the WADA Code has been declared ineligible. An
athlete’s status during eligibility is as follows: “No Person who has been declared ineligible
may, during the period of ineligibility, participate in any capacity in a Competition or
activity (other than authorized anti-doping education or rehabilitation programs) authorized
or organized by a Signatory or Signatory’s member organization” (p. 35). Signatories are
those organizations that have signed and agreed to comply with the WADA Code and
include “the International Olympic Committee, International Federations, International
Paralympic Committee, National Olympic Committees, National Paralympic Committees,
Major Event Organizations, National Anti-Doping Organizations, and WADA.” (World
Anti-Doping Agency, World Anti-Doping Code, pp. 35, 75.) For example, the list of
organizations that have accepted the WADA Code includes the International Fencing
Federation, International Swimming Federation, International Tennis Federation, and the
International Wrestling Federation. (World Anti-Doping Agency, “List of Sports
Organizations Who Have Accepted the Code,” n.d., available at [http://www.wada-
ama.org/en/print.asp?p=42255].)

---

CRS-5
lists of controlled substances.11 Examples of substance names found on one of the
lists of controlled substances are clonitazene, etoxeridine, and the bacon. However,
it is not clear whether any of these substances are beta-2 agonists, agents with anti-
estrogenic activity, glucocorticosteroids, or beta-blockers — classes of substances
identified by WADA as performance-enhancing substances. Our efforts to obtain
clarification from Major League Baseball or the players association on this and other
matters are continuing.
Changing Nature of Policies. The nature of the problem of doping in
sports has implications for the creation of lists of prohibited substances and testing
policies. In some cases, performance enhancing substances being used by athletes
may not appear on the lists of prohibited substances because sports officials are not
aware of their existence or use. For example, in an effort to evade detection of
steroid use, some athletes use designer steroids, which are described as follows:
... a designer or “new” steroid [is a substance that] has been chemically produced
(synthesized in the laboratory)[and] that retains the anabolic properties desired
for such a drug. At the same time the molecular structure ... is chemically altered
so that the currently used steroid screening test will not ... [find the drug in an
athlete’s specimen] ....12
When it was created, tetrahydrogestrinone (THG) was a designer steroid. THG
became known after a then-anonymous track and field coach in the United States
provided a sample to USADA, which forwarded the sample to the UCLA Olympic
Analytic Laboratory. Using this sample, the laboratory was able to identify the
substance.13 Because designer steroids are developed specifically to avoid detection,
11 The federal government has established five schedules of controlled substances. The
following three criteria are used to determine on which schedule to place a substance or
drug: its potential for abuse, whether the item has a currently accepted medical use in the
United States, and the probability that abuse of the substance could lead to physical or
psychological dependence. Schedule I includes substances and drugs that have a high
potential for abuse, that currently have no accepted medical use in the United States, and
that lack accepted safety for use under medical supervision. Substances and drugs listed
on one of the remaining four schedules have currently accepted medical uses, and the
potential for abuse and the probability that abuse could lead to physical or psychological
dependence declines from Schedule II through Schedule IV. (21 U.S.C. § 812(a) and (b).)
12 R. Craig Kammerer, “Drug Testing in Sport and Exercise,” in Performance-Enhancing
Substances in Sport and Exercise, p. 330.
13 In early summer 2003, USADA received a syringe from an individual who claimed to be
a track and field coach. The then-anonymous coach also provided the names of American
and international athletes that he alleged had used an undetectable steroid. USADA
forwarded the contents of the syringe to the UCLA Olympic Analytic Laboratory, a WADA-
accredited laboratory, for analysis. Dr. Don Catlin, head of the laboratory, determined that
the substance was a designer steroid, meaning that it could not be detected by normal
laboratory testing. The UCLA laboratory determined that the substance was
tetrahydrogestrinone (THG) and developed a test for THG. (U.S. Anti-Doping Agency,
“U.S. Anti-Doping Statement on Doping Case with Designer Steroids,” press release, Oct.
16, 2003, available at [http://www.usantidoping.org/files/active/resources/press_releases/
PressRelease_10_16_2003.pdf].) USADA has alleged that the source of THG was the Bay
(continued...)

---

CRS-6
it is impossible for anti-doping organizations or sports leagues to include them on
their lists of prohibited substances. Therefore, as new doping methods become
known, anti-doping policies must be revisited from time to time to ensure they are
up to date.
Some of the professional sports included in this report have recently changed
their anti-doping policies. The NFL’s April 2005 change reportedly tripled the
number of times a player can be tested for steroids during the offseason, added to the
league’s list of prohibited substances, and allowed for retesting of a players’ urine
samples for designer steroids that may have been previously undetected.14 A
comparison of Major League Baseball’s former and current policies (Table 2 in the
appendix) also shows several significant differences. Under the former policy,
hormones may not have been prohibited; the list of sanctions allowed first-time
offenders to be placed in a treatment program and permitted the imposition of a fine
in lieu of a suspension without pay for second through fifth violations; and testing
was not conducted during the off-season. The current policy prohibits the use of
hormones, imposes a 10-day suspension without pay for a first violation and
progressively longer suspensions without pay for subsequent violations, and testing
is conducted during the off-season.
No Tests or Sanctions for Some Prohibited Substances. Anti-doping
policies may not provide tests or sanctions for certain prohibited substances. In some
cases, tests for those substances are available, but are not being used. For example,
Section 3.B. of Major League Baseball’s policy explicitly states that, except for
“reasonable cause” testing, “Players shall not be subject to testing for the use of any
Drug of Abuse.”15 Notably, included among the list of “drugs of abuse” is ephedra,
which the league banned in the wake of a player’s death in 2003. Therefore, although
13 (...continued)
Area Laboratory Co-Operative (BALCO), which is located in Burlingame, CA. Internal
Revenue Service agents raided BALCO in September 2003. (Mark Asher, “Bonds to Testify
on Supplement Supplier,” Washington Post, Oct. 22, 2003, p. D2.) As reported by the
Washington Post, the Department of Justice initiated an investigation of BALCO in 2003,
and the Senate Committee on Commerce requested and received information from the
department’s investigation. (Amy Shipley, “Olympic Officials to Request Federal Files,”
Washington Post, May 5, 2004, p. D9; Amy Shipley, “USADA Bans White for 2 Years,”
Washington Post, May 202, 2004, p. D5.)
14 Maske and Shapiro, “NFL Strengthens Steroid Policy,” p. D8.
15 Major League Baseball, Major League Baseball’s Joint Drug Prevention and Treatment
Program, n.d., pp. 3 and 6, available at [http://reform.house.gov/UploadedFiles/
031705%20MLB%20Policy.pdf]. See Table 1 for additional information. Major League
Baseball’s policy states: “In the event that any HPAC [Health Policy Advisory Committee]
member has information that gives him/her reasonable cause to believe that a Player has, in
the previous 12-month period, engaged in the use, possession, sale or distribution of a
Prohibited Substance, such member shall immediately request a meeting (or conference call)
to present such information to the other HPAC members. If HPAC agress bya majority vote
that such reasonable cause exists, the Player will be subejct to immediate testing ....” ( Major
League Baseball, Major League Baseball’s Joint Drug Prevention and Treatment Program,
n.d., p. 6, available at [http://reform.house.gov/UploadedFiles/031705%20MLB%20Policy
.pdf].)

---

CRS-7
a test for ephedra is available, it is not currently included in the list of substances for
which players are being tested. In fact, other than “reasonable cause” testing, Major
League Baseball’s policy does not provide for testing or sanctions for any prohibited
substance other than steroids.16
In other cases, though, lists of prohibited substances may include known
substances for which there are no laboratory tests, or, in the case of hormones and
other substances that occur naturally in the human body, for which there is an
insufficient amount of data to determine “what levels of ... hormones are abnormal
or indicative of abuse and what levels are normal.”17 For example, natural hormones
other than testosterone — such as human chorionic gonadotropin, insulin, and
erythropoietin — may be found on lists of prohibited substances, but laboratory tests
may not be available yet and what constitutes an abnormal level in the human body
may not yet have been determined.
Nevertheless, including substances for which laboratory tests do not exist on a
list of prohibited substances may serve an organization’s purposes. For example, an
organization may establish a list not only to alert athletes to doping tests but also to
inform them about harmful substances. One of the purposes of the World Anti-
Doping Program and the World Anti-Doping Code is “[t]o protect the Athletes’
fundamental right to participate in doping-free sport and thus promote health, fairness
and equality for Athletes worldwide ....”18 Certain elements of the rationale for the
Code may also have a bearing on the inclusion of substances for which tests are not
yet available. These include, for example, “ethics, fair play and honesty .... health ....
character and education .... respect for rules and laws .... respect for self and other
participants ....”19 The National Football League cites three reasons, including the
health of players, for its concern about the use of prohibited substances:
[They] threaten the fairness and integrity of the athletic competition on the
playing field .... [T]he League is concerned with the adverse health effects of
steroid use. Although research is continuing, steroid use has been linked to a
number of physiological, psychological, orthopedic, reproductive, and other
serious health problems .... [T]he use of Prohibited Substances by NFL players
sends the wrong message to young people who may be tempted to use them.20
Thus, it appears that these two organizations (WADA and the NFL), and possibly
others as well, recognize that the value of an anti-doping program or policy extends
16 Major League Baseball, Major League Baseball’s Joint Drug Prevention and Treatment
Program, n.d., pp. 11-12.
17 R. Craig Kammerer, “Drug Testing in Sport and Exercise,” in Performance-Enhancing
Substances in Sport and Exercise, pp. 330-331. As noted below (Table 1, footnote g.), a
blood-based test for human growth hormone has been developed.
18 World Anti-Doping Agency, World Anti-Doping Code, 2003, available online at
[http://www.wada-ama. org/ rtecontent/document/code_v3.pdf], p. 1.
19 Ibid., p. 3.
20 National Football League, National Football League Policy on Anabolic Steroids and
Related Substances, 2003 (as amended May 15, 2003), p. 1.

---

CRS-8
beyond testing to include messages about harmful substances and how they might
undermine other aspects of athletic competition.
Comparison of Olympic Movement, Major League Baseball,
NBA, and NFL Anti-Doping Policies
Table 1 below compares specific elements of the anti-doping policies of the
Olympic movement, Major League Baseball, the NBA, and the NFL. Those
elements include which organizations administer the policies, the substances and
methods prohibited, and the sanctions for testing positive for a prohibited substance.
In many cases, reference to an associated footnote is needed to understand particular
elements of a sport’s policy.

---

CRS-9
Table 1. Comparison of Selected Features of Anti-Doping Policies
Olympic Movement
Major League Baseball
National Basketball
National Football League
(MLB) and Major League
Association (NBA) and
(NFL) and National
Baseball Players
National Basketball Players
Football League Players
Association (MLBPA)
Association (NBPA)
Association (NFLPA)
(2005 policy)a
— What organization or
— U.S. Anti-Doping
— Health Policy Advisory
— Medical director.
— NFL Advisor on
individual is responsible for
Agency (for American
Committee (HPAC).
Anabolic Steroids and
administering the anti-doping
athletes).
Related Substances.
policy?
— Is the organization or
— Yes.
— No. MLB and MLBPA
— No. The medical director
— No. The program is
individual independent from
each select two members of
is selected jointly by the
conducted under the auspices
the sponsoring
the HPAC.
NBA and NBPA.
of the NFL Management
organization(s)?
Council, and it appears that
the Advisor is an employee
of the NFL.b
Is testing conducted off-
Yes.
Yes.
No, except possibly for
Yes.
season (or out of
“reasonable cause” testing.c
competition, for the
Olympics)?
Is an athlete responsible for
Yes.
Subject is not addressed in
Subject is not addressed in
Yes.
prohibited substances found
the policy.
the policy.
in his or her body?

---

CRS-10
Olympic Movement
Major League Baseball
National Basketball
National Football League
(MLB) and Major League
Association (NBA) and
(NFL) and National
Baseball Players
National Basketball Players
Football League Players
Association (MLBPA)
Association (NBPA)
Association (NFLPA)
(2005 policy)a
Does the responsible
No.f
No (steroids only).g
Yes.f
No.f
organization test athletes for

all prohibited substances?
Does the anti-doping policy
prohibit:d
— Steroidse
— Yes.
— Yes.
— Yes.
— Yes.
— Hormones and related
— Yes.
— Yes.h
— No.
— Yes.i
substances

— Beta-2 agonists
— Yes.
— Unclear.j
— No.
— Yes.
— Agents with anti-
— Yes.
— Unclear.k
— No.
— No.
estrogenic activity
— Diuretics and other
— Yes.
— Unclear.l
— Unclear.m
— Yes.
masking agents
— Enhancement of oxygen
— Yes.
— No.
— No.
— No.
transfer

---

CRS-11
Olympic Movement
Major League Baseball
National Basketball
National Football League
(MLB) and Major League
Association (NBA) and
(NFL) and National
Baseball Players
National Basketball Players
Football League Players
Association (MLBPA)
Association (NBPA)
Association (NFLPA)
(2005 policy)a
— Chemical and physical
— Yes.
— Unclear.l
— Unclear.m
— Yes.
manipulation
— Gene doping
— Yes.
— No.
— No.
— No.
— Stimulants
— Yes.
— Unknown, except for
— Yes, but only
— Yes.
ephedra, which is prohibited
amphetamine and its
but not tested.n
analogues.
— Glucocorticosteroids
— Yes, but only in
— Unclear.o
— No.
competition.
— No.
— Beta-blockers
— Yes, but only for certain
— Unclear.p
— No.
sports.
— No.
What laboratory tests the
WADA-accredited
Subject is not addressed in
Laboratories are selected by
Under the existing collective
samples?
laboratories or as otherwise
the policy, but MLB has
the medical director,
bargaining agreement,
approved by WADA.
indicated that testing is
approved by the NBA and
samples to be analyzed for
conducted at a WADA-
NBPA, and certified by the prohibited substances are to
accredited laboratory in
International Olympic
be submitted to the UCLA
Montreal.q
Committee and/or the
Olympic Analytical
College of American
Laboratory at the UCLA
Pathologists (for steroids), or
School of Medicine.s

---

CRS-12
Olympic Movement
Major League Baseball
National Basketball
National Football League
(MLB) and Major League
Association (NBA) and
(NFL) and National
Baseball Players
National Basketball Players
Football League Players
Association (MLBPA)
Association (NBPA)
Association (NFLPA)
(2005 policy)a
the Substance Abuse and
Mental Health Services
Administration (for
substances other than
steroids).r
Are sanctions applicable to
Yes.
No (steroids only).t
Yes.
Yes.u
all prohibited substances?
What are the sanctions for
testing positive?
— First violation
— Two-year banv
— Steroids: 10-day
— Steroids: Five-game
— Suspended without pay
suspension without pay.
suspension and required to
for a minimum of four
enter steroids program.
games.
Amphetamines: First-year
player is dismissed from the
NBA for one year and
required to enter treatment
program. A veteran player is
dismissed from the NBA for
a minimum of two years.w

---

CRS-13
Olympic Movement
Major League Baseball
National Basketball
National Football League
(MLB) and Major League
Association (NBA) and
(NFL) and National
Baseball Players
National Basketball Players
Football League Players
Association (MLBPA)
Association (NBPA)
Association (NFLPA)
(2005 policy)a
— Second violation
— Lifetime ban.
— 30-day suspension
— Steroids: 10-game
— Suspended without pay
without pay.
suspension and required to
for a minimum of six games.
enter steroids program.
— Third violation
— Not applicable.
— 60-day suspension
— Steroids: 25-game
— Suspended without pay
without pay.
suspension and required to
for at least 12 months.
enter steroids program.
— Fourth violation
— Not applicable.
— One-year suspension
— Steroids: Same as third
— Not addressed.
without pay.
violation.
— Subsequent violation(s)
— Not applicable.
— MLB Commissioner
— Steroids: Same as third
— Not addressed.
imposes further discipline.
violation.
What types of specimens are
Blood or urine.
Urine.
Urine. However, the medical
Urine.
collected and tested?
director has authority to
determine the use of blood,
breath, or other testing
techniques.
Sources: U.S. Anti-Doping Agency, United States Anti-Doping Agency Protocol for Olympic Movement Testing, revised Aug. 13, 2004, available at
[http ://www.usantidoping.org/files/active/what/p roto col.pdf]; U.S. Anti-Dopi ng Ag e n c y, “U SAD A P r e ss K i t , ” J a n. 2 0 0 5 , a vailab le at

---

CRS-14
[http://www.usantidoping.org/files/active/resources/press_kits/2005%20Fact%20Sheet.pdf]; World Anti-Doping Agency, World Anti-Doping Code, 2003, available at
[http://www.wada-ama.org/rtecontent/document/code_v3.pdf]; World Anti-Doping Agency, International Standard for Testing, June 2003, available at
[http://www.wada-ama.org/rtecontent/document/testing_v3_a.pdf]; World Anti-Doping Agency, International Standard for Therapeutic Use Exemptions, n.d., available at
[http://www.wada-ama.org/rtecontent/document/international_standard.pdf]; World Anti-Doping Agency, The 2005 Prohibited List, International Standard, n.d., available at
[http://www.wada-ama.org/rtecontent/document/list_book_2005_en.pdf]; Major League Baseball, Major League Baseball’s Joint Drug Prevention and Treatment Program, n.d.,
available at [http://reform.house.gov/UploadedFiles/031705%20MLB%20Policy.pdf]; National Basketball Players Association, NBPA Collective Bargaining Agreement, n.d., available
at [http://www.nbpa.com/cba]; National Football League, National Football League Policy on Anabolic Steroids and Related Substances, 2003 (as amended May 15, 2003).

Notes:
a. The policy negotiated by Major League Baseball and the players association that takes effect during the 2005 season has not yet been ratified by the players, but apparently it is in
effect. An article issued by MLB.com stated that an outfielder for the Tampa Bay Devil Rays tested positive for steroid use and, as a result, was suspended for the10 days. (Barry
M. Bloom, “Rays’ Sanchez Suspended for 10 Days,” MLB.com, Apr. 3, 2005, available at [http://mlb.mlb.com/NASApp/mlb/mlb/news/mlbsearcharchive.jsp].
b. The NFL Management Council oversees policies that relate to players, including the collective bargaining agreement. The council reports to the Commissioner of the National
Football League. (Information provided by telephone by the NFL Communications Department to the author on Apr. 18, 2005.)
c. Reasonable cause testing is conducted when the Independent Expert who has been selected by the NBA and the NBPA has determined “there is reasonable cause to believe that the
player in question has been engaged in the use, possession, or distribution of a Prohibited Substance.” (National Basketball Players Association, NBPA Collective Bargaining
Agreement, n.d., available at [http://www.nbpa.com/cba], Sec. 5(a).)
d. The detail and extent of an anti-doping policy’s list of prohibited substances and methods vary from organization to organization. One possible reason for variations among the
lists is that some substances may benefit only athletes in certain sports. For example, beta-blockers, which decrease the heart rate and may aid in decreasing tremors or shaking,
may be used by athletes who participate in sports that reward precision and accuracy, such as archery.
e. The use of the term “steroids” in this context refers to anabolic or anabolic androgenic steroids, substances which may help an athlete increase his or her muscle size and strength
and recover more quickly from injury. The class of substances known as “steroids” includes other types of substances. See “anabolic androgenic steroids” and “steroids” in the
glossary.
f. In some cases, accurate laboratory tests do not exist for certain prohibited substances or levels. In other cases, though (e.g., the NFL’s policy on human growth hormone), tests are
available to detect the prohibited substances but are not used. The NBA tests for all prohibited substances, but its list of such substances is shorter than the lists for the other sports.
g. The federal government has established five schedules of controlled substances. The following three criteria are used to determine on which schedule to place a substance or drug:
its potential for abuse, whether the item has a currently accepted medical use in the United States, and the probability that abuse of the substance could lead to physical or
psychological dependence. Schedule I includes substances and drugs that have a high potential for abuse, that currently have no accepted medical use in the United States, and
that lack accepted safety for use under medical supervision. Substances and drugs listed on one of the remaining four schedules have currently accepted medical uses, and the
potential for abuse and the probability that abuse could lead to physical or psychological dependence declines from Schedule II through Schedule IV. (21 U.S.C. § 812(a) and
(b).) Major League Baseball’s list of prohibited substances includes drugs of abuse (cocaine, LSD, marijuana, opiates, Ecstasy, GHB, PCP, ephedra, all drugs or substances listed

---

CRS-15
on Schedule II, and all Schedule I drugs listed on Addendum B of the league’s anti-doping policy) and all anabolic androgenic steroids listed on Schedule III. Section 3.B. of
this policy explicitly excludes drugs of abuse from the testing program: “Except as set forth in Section 3.C. [reasonable cause testing], Players shall not be subject to testing for
the use of any Drug of Abuse.” (Major League Baseball, Major League Baseball’s Joint Drug Prevention and Treatment Program, n.d., pp. 3 and 6, available at
[http://reform.house.gov/UploadedFiles/ 031705%20MLB%20Policy.pdf].)
h. Human growth hormone (hGH) is on the list of prohibited substances, under the heading “steroids,” but MLB does not test for it. In testimony offered during a House Committee
on Government Reform hearing, Robert D. Manfred Jr., Executive Vice President, MLB, and Elliot J. Pellman, M.D., Medical Advisor to the Commissioner of Baseball, indicated
that Major League Baseball does not test for human growth hormone (hGH). The rationale they offered was that no valid urine-based test exists. Mr. Manfred added: “Contrary
to published reports, there is not an available, verified test for HGH, even with a blood sample.” (U.S. Congress, House Committee on Government Reform, statements of Robert
D. Manfred Jr., Executive Vice President, Major League Baseball, and Elliot J. Pellman, M.D., Medical Advisor the Commissioner of Baseball, unpublished hearing, 109th Cong.,
1st sess., Mar. 17, 2005, available at [http://mlb.mlb.com/NASApp/mlb/news/press_releases/intro.jsp] and [http://reform.house.gov/Uploaded Files/Pellman%20Testimony.pdf].)
It should be noted that the World Anti-Doping Agency tested athletes for hGH at the 2004 Athens Olympics, using a blood test that had been developed and validated in
partnership with the IOC and USADA. (World Anti Doping Agency, “Minutes of the WADA Executive Committee Meeting,” Nov. 20, 2004, p. 20, available at
[http://www.wada-ama. org/en/dynamic.ch2?pageCategory_id=44].)
i. As an example of how the lists of prohibited substances vary from organization to organization, only human growth hormone, animal growth hormone, and human chorionic
gonadotropin are included on the NFL’s list of hormones. The WADA list includes several other hormones and related substances. (World Anti-Doping Agency, International
Standard for Testing, June 2003, available at [http://www.wada-ama.org/rtecontent/document/testing_v3_a.pdf].)
j. The list of prohibited substances includes all of Schedule II and an extensive list of substances from Schedule I. It is unclear whether any substances known as “beta-2 agonists” are
listed on either of these schedules. Efforts to obtain clarification o n this matter from Major League Baseball or the players association are continuing.
k. The list of prohibited substances includes all of Schedule II and an extensive list of substances from Schedule I. It is unclear whether any substances known as agents with anti-
estrogenic activity are listed on either of these schedules. Efforts to obtain clarification on this matter from Major League Baseball or the players association are continuing.
l. Masking substances (and methods) are not identified on the list of prohibited substances, but the policy states: “Attempts to substitute, dilute, mask, or adulterate a specimen sample
are considered a positive test result.” (Major League Baseball, Major League Baseball’s Joint Drug Prevention and Treatment Program, p. 6.)
m. Masking substances (and methods) are not identified on the list of prohibited substances. However, the policy states that “[if a player attempts to substitute, dilute, mask, or adulterate
a specimen sample or in any other manner [alter] a test result,” such activity or action will be considered a positive test. (National Basketball Players Association, NBPA Collective
Bargaining Agreement, Sec. 4(c)(iv).)
n. The list of prohibited substances includes all of Schedule II and an extensive list of substances from Schedule I. It is unclear whether any substances known as stimulants are listed
on either of these schedules. Efforts to obtain clarification on this matter from Major League Baseball or the players association are continuing. While ephedra is a prohibited
substance, it is found on the “Drugs of Abuse” list, which means it is not included in regular testing of players. (Major League Baseball, Major League Baseball’s Joint Drug
Prevention and Treatment Program, p. 3.)
o. The list of prohibited substances includes all of Schedule II and an extensive list of substances from Schedule I. It is unclear whether any substances known as glucocorticosteroids
are listed on either of these schedules. Efforts to obtain clarification on this matter from Major League Baseball or the players association are continuing.

---

CRS-16
p. The list of prohibited substances includes all of Schedule II and an extensive list of substances from Schedule I. It is unclear whether any substances known as beta-blockers are
listed on either of these schedules. Efforts to obtain clarification on this matter from Major League Baseball or the players association are continuing.
q. Major League Baseball and the players association agreed, in spring 2004, to have all drug testing conducted by the Doping Control Laboratory at the INES-Instituted Armand-Flapper
Research Center in Montreal. This is a WADA-accredited laboratory. (Major League Baseball, “MLB Drug-Testing Programs Move to Olympic-Certified Laboratories,” May
11, 2004, available at [http://mlb.mlb.com/NASApp/mlb/content/printerfriendly/Mb/y2004/m05/d11/c740823.jsp].)
r. The Substance Abuse and Mental Health Services Administration is an agency within the Department of Health and Human Services.
s. This is a WADA-accredited laboratory.
t. This sanction is specific to Articles 2.1 (presence of a prohibited substance in an athlete’s substance), 2.2 (use or attempted use of a prohibited substance or a prohibited method),
and 2.6 (possession of prohibited substances and methods) in the WADA Code. For the list of sanctions imposed for other violations, see the WADA Code, pp. 27-35. An athlete
who has been banned under the WADA Code has been declared ineligible. An athlete’s status during eligibility is as follows: “No Person who has been declared ineligible may,
during the period of ineligibility, participate in any capacity in a Competition or activity (other than authorized anti-doping education or rehabilitation programs) authorized or
organized by a Signatory or Signatory’s member organization” (p. 35). Signatories are those organizations that have signed and agreed to comply with the WADA Code and
include “the International Olympic Committee, International Federations, International Paralympic Committee, National Olympic Committees, National Paralympic Committees,
Major Event Organizations, National Anti-Doping Organizations, and WADA.” (World Anti-Doping Agency, World Anti-Doping Code, 2003, available at
[http://www.wada-ama.org/ rtecontent/document/code_ v3.pdf ], pp. 35, 75.) For example, the list of organizations that have accepted the WADA Code includes the International
Fencing Federation, International Swimming Federation, International Tennis Federation, and the International Wrestling Federation. (World Anti-Doping Agency, “List of Sports
Organizations Who Have Accepted the Code,” n.d., available at [http://www.wada-ama.org/en/print.asp?p=42255].)
u. It is unclear what sanction, if any, the NFL would impose on a player who uses masking agents or otherwise practices pharmacological, chemical or physical manipulation of a sample.
Both masking agents and doping methods (that is, manipulation) are included on the list of prohibited substances. However, the policy states that “Any effort to substitute, dilute,
or adulterate a specimen or to alter a test result may subject a player to more severe discipline than would have been imposed for a positive test.” (National Football League,
National Football League Policy on Anabolic Steroids and Related Substances, pp. 4, 11-12.) The use of the word “may” suggests that the NFL may exercise discretion when
dealing with a player who has attempted to alter, or has altered, a test. The phrase “than would have been imposed for a positive test” suggests that the NFL does not treat test
alteration the same as a positive laboratory test for a prohibited substance. Efforts to resolve this matter are ongoing.
v. Apparently, these sanctions apply only to positive tests for steroids. As noted above, testing for other substances and drugs prohibited by the league will not be done as part of its
ongoing testing program (though players may be tested for these other substances when reasonable cause exists). Nevertheless, it bears noting that no sanctions are included
for positive tests of other substances. The 2005 draft of Mb’s anti-doping policy states that, for first through fourth violations, a fine may be levied in lieu of imposing a suspension.
(Major League Baseball, Major League Baseball’s Joint Drug Prevention and Treatment Program, n.d., pp. 11-12.) However, as reported in the Washington Post on Mar. 21,
2005, both parties (MB and MLBPA) have agreed to eliminate fines, leaving suspensions as the only sanction. (“Agreement Reached to Drop Fines,” Washington Post, Mar.
21, 2005, p. D5.)
w. Apparently, the MBA’s policy does not mention what, if any, penalties are imposed for subsequent violations involving the use of amphetamines.

---

CRS-17
Elements of Model Anti-Doping Policies
Experts in the field of drug testing and policy have described what they believe
to be the requisite elements of an effective anti-doping policy. For example,
speaking at a Senate committee hearing in 2004, the Chief Executive Officer of
USADA said such a policy:
... begins with a sample collection plan that includes appropriately timed, year-
round, no-advance-notice testing. The plan must provide for the collection of
samples at the time that athletes most benefit from doping and must be flexible
and responsive to evolving doping techniques.
... must be built around a comprehensive list of categories of prohibited
substances and methods .... programs must incorporate sufficient flexibility to
deal with the creation and use of ‘designer drugs’ .... Therefore, the continued
dedication of resources to the testing laboratories that are charged with
developing and validating testing methods for this wide array of substances is an
important aspect of deterrence.
... also combines defined sanctions of sufficient magnitude to deter drug use with
a fair means of imposing such sanctions .... Significantly, while USADA
believes the privacy rights of individuals accused of a doping violation must be
respected, no individual’s right should outweigh the rights of all athletes to
compete in clean sport and to be assured that those who break the rules are
appropriately sanctioned.
... [provides for] the education of athletes as to why healthy competition is
important and why taking the uninformed health risks associated with prohibited
substances is a bad choice. The achievements in sports, like the achievements
in life, should be the result of hard work, commitment, and dedication.
... must devote significant resources to research for the detection of new doping
substances and techniques and the pursuit of scientific excellence in doping
control.21
Similarly, General Barry R. McCaffrey, U.S. Army (ret.), then-Director, Office
of National Drug Control Policy, appeared at a Senate hearing in 1999 and stated
that, with regard to international competition, the agency was focused on achieving
these principles:
! A truly independent and accountable international anti-doping
agency;
! Testing on a 365-day-a-year, no notice basis;
! No statute of limitations — whenever evidence becomes available
that an athlete cheated by doping, the athlete will be stripped of his
or her honors;
21 U.S. Congress, Senate Committee on Commerce, Science and Transportation, Steroid Use
in Professional and Amateur Sports, Mar. 10, 2004, 108th Cong., 2nd sess., statement of
Terry Madden, Chief Executive Officer, United States Anti-Doping Agency, unpublished,
available at [http://commerce.senate.gov/hearings/witnesslist.cfm?id=1100].

---

CRS-18
! Deterrence through the preservation of samples for at least 10 years
— while a dishonest athlete may be able to defeat today’s drug test,
he or she has no way to know what will be detectable through
tomorrow’s scientific advances; and,
! Advanced research to end the present cat-and-mouse game of doping
by closing the loopholes created by gaps in science.22
Conclusion
Combining elements of Madden’s and McCaffrey’s plans, such as a well-
thought-out sample collection plan and a comprehensive list of prohibited substances,
could result in an anti-doping program that would increase the probability of catching
athletes who use prohibited substances, which, in turn, might also increase athletes’
perceived risk of being caught. For example, requiring that samples be preserved for
at least 10 years could aid in identifying athletes who have used performance-
enhancing substances that were undetectable previously. As the investigation of the
Bay Area Laboratory Co-Operative (BALCO) has shown, it is possible for
individuals to develop what are known as designer steroids — substances that are
advertised as providing effects similar to steroids, but are not identifiable by
conventional laboratory tests.23 A 10-year (or longer) retention period could help in
closing this gap, particularly if it is accompanied by an aggressive research program
aimed at detecting, and developing tests for, previously unknown substances. Also,
imposing sanctions of sufficient magnitude and providing an education program on
health risks could help to counterbalance incentives that might prompt athletes to use
prohibited substances. Finally, establishment of an independent agency to manage
testing, education, and research appears to be vital to a successful anti-doping
program. It would seem desirable to place these functions in an organization
independent from the organization that is responsible for supporting or employing
athletes and that benefits directly, or even indirectly, from their performances.
While the anti-doping initiative of the Olympic movement includes many of
these elements, it is uncertain whether major professional sports leagues in the
United States, such as Major League Baseball and the NBA and NFL, are in a
position to take similar steps. Public pressure and congressional interest may have
played a role in prompting Major League Baseball and the players association to re-
open their collective bargaining agreement in 2005 and modify the league’s anti-
doping policy. One notable outcome was a change in the sanctions imposed on
players caught using steroids.
22 U.S. Congress, Senate Committee on Commerce, Science, and Transportation, Effects of
Performance Enhancing Drugs on the Health of Athletes and Athletic Competition, 106th
Cong., 1st sess., Oct. 20, 1999 (Washington: GPO, 2002), p. 21.
23 Steve Fawner, “A Search for Truth in Substance,” Washington Post, Dec. 4, 2003, pp. D1,
D10.

---

CRS-19
Appendix
Table 2. Comparison of Selected Features of Major League
Baseball’s 2003-2004 Policy and 2005 Policy
Major League Baseball
Major League Baseball
(MB) 2003-2004 Policy
(MB) 2005 Policy
(draft)a
— What organization or
— Health Policy Advisory
— HPAC.
individual is responsible
Committee (HPAC).
for administering the anti-
doping policy?
— Is the organization or
— No. Major League
— No.
individual independent
Baseball and the Major
from the sponsoring
League Baseball Players
organization(s)?
Association each select
two members of the
HPAC.
Are athletes tested for all
No.f
No.f
prohibited substances?
Does the anti-doping
policy prohibit:
— Steroidse
— Yes.
— Yes.
— Hormones and related
— Unclear.l
— Yes.f
substances

— Beta-2 agonists
— Unclear.l
— Unclear.l
— Agents with anti-
— Unclear.l
— Unclear.l
estrogenic activity
— Diuretics and other
— Yes.i
— Yes.i
masking agents
— Enhancement of
— No.
— No.
oxygen transfer
— Chemical and physical
— Yes.i
— Yes.i
manipulation
— Gene doping
— No.
— No.
— Stimulants
— Unclear.k
— Unclear, except for
ephedra, which is
prohibited but not tested.n,l
— Glucocorticosteroids
— Unclear.m
— Unclear.m

---

CRS-20
Major League Baseball
Major League Baseball
(MB) 2003-2004 Policy
(MB) 2005 Policy
(draft)a
Is a player responsible for
Unclear.l
No.
what is in his body?
What laboratory tests the
Subject is not addressed in
Subject is not addressed in
samples?
the policy.
the policy, but MB has
indicated that testing is
conducted at a WADA-
accredited laboratory in
Montreal.q
Are sanctions applicable
No.f
No.f
to all prohibited
substances?
What are the sanctions for
testing positive for
steroids?
— First violation
— Played placed on
— 10-day suspension
clinical track (treatment
without pay.q
program).
— Second violation
— 15-day suspension
— 30-day suspension
without pay or a maximum
without pay.
fine of $10,000.
— Third violation
— 25-day suspension
— 60-day suspension
without pay or a maximum
without pay.
fine of $25,000.
— Fourth violation
— 50-day suspension
— One-year suspension
without pay or a maximum
without pay.
fine of $50,000.
— Fifth violation
— One-year suspension
— MB Commissioner
without pay or a maximum
imposes further discipline.
fine of $100,000.
Is testing conducted during
No.
Yes.
the off-season?

What types of specimens
Urine.
Urine.
are collected and tested?
Sources: Major League Baseball, Major League Baseball’s Joint Drug Prevention and Treatment
Program, n.d., p. 6, available at [http://reform.house.gov/UploadedFiles/031705%20MLB%20Policy.
pdf]; Major League Baseball and Major League Baseball Players Association, 2003-2006 Basic
Agreement, n.d., available at [http://us.i1.yimg.com/ us.yimg.com/i/spo /mlbpa/mlbpa_cba.pdf].

---

CRS-21
Notes:
a. The policy negotiated by Major League Baseball and the players association that takes effect during
the 2005 season has not yet been ratified by the players, but apparently it is in effect. An article
issued by MLB.com stated that an outfielder for the Tampa Bay Devil Rays tested positive for
steroid use and, as a result, was suspended for the10 days. (Barry M. Bloom, “Rays’ Sanchez
Suspended for 10 Days,” MLB.com, Apr. 3, 2005, available at [http://mlb.mlb.com/NASApp/
mlb/mlb/news/mlb_ search_archive.jsp].
b. The federal government has established five schedules of controlled substances. The following
three criteria are used to determine on which schedule to place a substance or drug: its potential
for abuse, whether the item has a currently accepted medical use in the United States, and the
probability that abuse of the substance could lead to physical or psychological dependence.
Schedule I includes substances and drugs that have a high potential for abuse, that currently have
no accepted medical use in the United States, and that lack accepted safety for use under
medical supervision. Substances and drugs listed on one of the remaining four schedules have
currently accepted medical uses, and the potential for abuse and the probability that abuse could
lead to physical or psychological dependence declines from Schedule II through Schedule IV.
(21 U.S.C. § 812(a) and (b).) Major League Baseball’s list of prohibited substances includes
drugs of abuse (cocaine, LSD, marijuana, opiates, Ecstasy, GHB, PCP, all drugs or substances
listed on Schedule II, and all Schedule I drugs listed on Addendum C of the league’s anti-doping
policy) and all anabolic androgenic steroids listed on Schedule III. Section 3.C. of this policy
explicitly excludes drugs of abuse from the testing program: “Except as set forth in Section 3.D.
[reasonable cause testing], Players shall not be subject to either Survey or Program Testing for
the use of any Drug of Abuse.” (Major League Baseball and Major League Baseball Players
Association, 2003-2006 Basic Agreement, n.d., pp. 159-160, 163, available online at
[http://us.i1.yimg.com/us.yimg.com/i/spo /mlbpa/mlbpa_cba.pdf].)
c. The federal government has established five schedules of controlled substances. The following
three criteria are used to determine on which schedule to place a substance or drug: its potential
for abuse, whether the item has a currently accepted medical use in the United States, and the
probability that abuse of the substance could lead to physical or psychological dependence.
Schedule I includes substances and drugs that have a high potential for abuse, that currently have
no accepted medical use in the United States, and that lack accepted safety for use under
medical supervision. Substances and drugs listed on one of the remaining four schedules have
currently accepted medical uses, and the potential for abuse and the probability that abuse could
lead to physical or psychological dependence declines from Schedule II through Schedule IV.
(21 U.S.C. § 812(a) and (b).) Major League Baseball’s list of prohibited substances includes
drugs of abuse (cocaine, LSD, marijuana, opiates, Ecstasy, GHB, PCP, ephedra, all drugs or
substances listed on Schedule II, and all Schedule I drugs listed on Addendum B of the league’s
anti-doping policy) and all anabolic androgenic steroids listed on Schedule III. Section 3.B. of
this policy explicitly excludes drugs of abuse from the testing program: “Except as set forth in
Section 3.C. [reasonable cause testing], Players shall not be subject to testing for the use of any
Drug of Abuse.” (Major League Baseball, Major League Baseball’s Joint Drug Prevention and
Treatment Program, n.d., pp. 3 and 6, available at [http://reform.house.gov/UploadedFiles/
031705%20MLB%20Policy.pdf].)
d. The use of the term “steroids” in this context refers to anabolic or anabolic androgenic steroids,
substances which may help an athlete increase his or her muscle size and strength and re cover
more quickly from injury. The class of substances known as “steroids” includes other types of
substances. See “anabolic androgenic steroids” and “steroids” in the glossary.
e. The list of prohibited substances includes all of Schedule II and an extensive list of substances from
Schedule I. It is unclear whether any substances known as “hormones” are listed on either of
these schedules. Efforts to obtain clarification on this matter from Major League Baseball or
the players association are continuing.
f. Human growth hormone (hGH) is on the list of prohibited substances, under the heading “steroids,”
but MB does not test for it. In testimony offered during a House Committee on Government
Reform hearing, Robert D. Manfred Jr., Executive Vice President, MB, and Elliot J. Pellman,
M.D., Medical Advisor to the Commissioner of Baseball, indicated that Major League Baseball
does not test for human growth hormone (hGH). The rationale they offered was that no valid
urine-based test exists. Mr. Manfred added: “Contrary to published reports, there is not an
available, verified test for HGH, even with a blood sample.” (U.S. Congress, House Committee
on Government Reform, statements of Robert D. Manfred Jr., Executive Vice President, Major

---

CRS-22
League Baseball, and Elliot J. Pellman, M.D., Medical Advisor to the Commissioner of
Baseball, unpublished hearing, 109th Cong., 1st sess., Mar. 17, 2005, available online at
[http://mlb.mlb.com/NASApp/mlb/news/press_releases /intro.jsp] and [http://reform.house.gov/
UploadedFiles/Pellman%20Testimony.pdf].) It should be noted that the World Anti-Doping
Agency tested athletes for hGH at the 2004 Athens Olympics, using a blood test that had been
developed and validated in partnership with the IOC and USADA. (World Anti Doping
Agency, “Minutes of the WADA Executive Committee Meeting,” Nov. 20, 2004, p. 20, at
[http://www.wada-ama.org/en/dynamic.ch2?pageCategory_id=44].)
g. The list of prohibited substances includes all of Schedule II and an extensive list of substances from
Schedule I. It is unclear whether any substances known as “beta-2 agonists” are listed on either
of these schedules. Efforts to obtain clarification on this matter from Major League Baseball
or the players association are continuing.
h. The list of prohibited substances includes all of Schedule II and an extensive list of substances from
Schedule I. It is unclear whether any substances known as “agents with anti-estrogenic activity”
are listed on either of these schedules. Efforts to obtain clarification on this matter from Major
League Baseball or the players association are continuing.
i. Masking substances (and methods) are not identified on the list of prohibited substances, but the
policy states that any test will be considered “positive” if a player “attempts to substitute, dilute,
mask, or adulterate a specimen sample or in any other manner alter a test.” (Major League
Baseball, 2003-2006 Basic Agreement, p. 164.)
j. Masking substances (and methods) are not identified on the list of prohibited substances, but the
policy states: “Attempts to substitute, dilute, mask, or adulterate a specimen sample are
considered a positive test result.” (Major League Baseball, Major League Baseball’s Joint Drug
Prevention and Treatment Program, p. 6.)
k. The list of prohibited substances includes all of Schedule II and an extensive list of substances from
Schedule I. It is unclear whether any substances known as “stimulants” are listed on either of
these schedules. Efforts to obtain clarification on this matter from Major League Baseball or
the players association are continuing.
l. Ephedra is a prohibited substance, but it is not included in regular testing of players. (Major League
Baseball, Major League Baseball’s Joint Drug Prevention and Treatment Program, p. 3.) See
footnote c. above.
m. The list of prohibited substances includes all of Schedule II and an extensive list of substances from
Schedule I. It is unclear whether any substances known as “glucocorticosteroids” are listed on
either of these schedules. Efforts to obtain clarification on this matter from Major League
Baseball or the players association are continuing.
n. Absent an explicit statement about a player’s responsibility for what is in his body, the following
excerpt suggests that, depending upon the circumstances, a player’s claim that a positive test
resulted from a contaminated over-the-counter supplement could have been valid : “If ... a
Player tests positive in the initial test for a Steroid and such positive test cannot be a result of
a Player taking an over-the-counter supplement, the initial test shall be considered a positive
result regardless of the outcome of the follow-up test.”(Major League Baseball and Major
League Baseball Players Association, 2003-2006 Basic Agreement, p. 162.)
o. Major League Baseball and the players association agreed, in spring 2004, to have all drug testing
under the MB Joint Drug Prevention and Testing Program conducted by the Doping Control
Laboratory at the INRS-Instituted Armand-Flapper Research Center in Montreal. This is a
WADA-accredited laboratory. (Major League Baseball, “MB Drug-Testing Programs Move
to Olympic-Certified Laboratories,” May 11, 2004, available at [http://mlb.mlb.com/NASApp/
mlb/content/printer_friendly/mlb/y2004/m05/d11/c740823.jsp].)
p. Apparently, sanctions apply only to positive tests for steroids. As noted above, testing for other
substances and drugs prohibited by the league will not be done as part of its ongoing testing
program. Though players may be tested for these other substances when reasonable cause exists
for doing so, no sanctions are included for positive tests of other substances.
q. The 2005 draft of MLB’s anti-doping policy states that, for first through fourth violations, a fine
may be levied in lieu of imposing a suspension. (Major League Baseball, Major League
Baseball’s Joint Drug Prevention and Treatment Program, n.d., pp. 11-12.) However, as
reported in the Washington Post on Mar. 21, 2005, both parties (MB and MLBPA) have agreed
to eliminate fines, leaving suspensions as the only sanction. (“Agreement Reached to Drop
Fines,” Washington Post, Mar. 21, 2005, p. D5.)

---

CRS-23
Glossary
Agents with anti-estrogenic activity — An agent with anti-estrogenic activity
blocks the conversion of testosterone to estrogens (female hormones), or prevents or
minimizes the body’s response to estrogens present in the body. A male athlete who
uses steroids may ingest an agent with anti-estrogen activity to help mitigate against
breast development resulting from steroid use.24

Anabolic androgenic steroids — “Anabolic-androgenic steroids [AAS] are
synthetic derivatives of testosterone .... Testosterone itself is not effective when
taken orally or by injection, because it is susceptible to relatively rapid breakdown
by the liver. The chemical structure of testosterone has been modified by
pharmaceutical companies and pharmacologists to surmount this problem.”25
“‘Anabolic’ refers to muscle-building, and ‘androgenic’ refers to increased masculine
characteristics.26 Using steroids may help an individual increase his or her muscle
size and strength and recover more quickly from injury.”27 Also see “Steroids.”
Analogues (analogs) — “[S]ubstances derived from the modification or alteration
of the chemical structure of another substance while retaining a similar
pharmacological effect.”28 For example, the chemical structure of a steroid analogue
would differ from the structure of a steroid, but it would promote the development
of muscle.
Beta-2 agonists — “Beta-agonists are bronchodilator medicines that open airways
by relaxing the muscles around the airways that tighten during an asthma attack.”29
Some beta-2 agonists, when taken into the bloodstream, may help to increase
“skeletal muscle mass and decrease body fat.”30
24 U.S. Anti-Doping Agency, 2005 Guide to Prohibited Substances and Prohibited Methods
of Doping, p. 25; William N. Taylor, Anabolic Steroids and the Athlete, 2nd ed. (Jefferson,
NC: McFarland and Co., 2002), p. 35.
25 Michael S. Bahrke and Charles E. Yesalis, “Anabolics,” in Performance-Enhancing
Substances in Sport and Exercise, p. 33.
26 National Institutes of Health, National Institute on Drug Abuse, “NIDA InfoFacts:
Steroids (Anabolic-Androgenic),” n.d., available at [http://www.nida.nih.gov/Infofax
/steroids.html].
27 U.S. Anti-Doping Agency, “Medical,” n.d., available at [http://www.usantidoping.org/
resources/glossary/medical.aspx].
28 Australian Sports Drug Agency, “Fact Sheet: Hormones and Related Substances,” n.d.,
available at [http://www.asda.org.au/athletes/sub_fact_sheets/hormones.htm].
29 U.S. Anti-Doping Agency, “Medical.”
30 Australian Sports Drug Agency, “Fact Sheet: Beta-2 Agonists,” n.d., available at
[http://www.asda.org.au/athletes/sub_fact_sheets/beta2.htm]; Gordon S. Lynch, “Beta-2
Agonists,” in Performance-Enhancing Substances in Sport and Exercise, p. 47.

---

CRS-24
Beta-blockers — “Beta-blockers are commonly used for heart disease to lower blood
pressure and decrease the heart rate, and may be used to decrease fine motor tremor.31
Athletes may use beta-blockers illegally to try to stop their hands and bodies from
shaking while competing in precision sports that require accuracy, a calm state and/or
a steady hand.”32
Diuretics — “Diuretics remove the excess water from the body. They are used in
sports where the athletes are categorized by their body weight .... .”33 Sports that
have weight classes include wrestling, boxing, judo, and weightlifting. Diuretics also
aid in diluting an athlete’s urine “so that the presence of performance-enhancing
drugs, or their metabolic counterparts, cannot be detected.”34
Doping control — “The process including test distribution planning, Sample
collection and handling, laboratory analysis, results management, hearings and
appeals.”35 (“Doping control” is a term specific to WADA and the international
sports community to describe efforts to eliminate the use of prohibited performance-
enhancing substances and methods from sport.)36
Enhancement of oxygen transfer — An athlete may increase his body’s oxygen
capacity either by “artificially enhancing the uptake, transport, or delivery of
oxygen,” such as through the ingestion of erythorpoietin (see below), or through
blood doping.37 Blood doping involves the administration of blood cells. “Two to
four units (one unit corresponds to 450 ml [milliliters] of whole blood are collected
from the individual ... [and then] three to five days before the competition [the blood
is] infused [into the individual].”38
Ephedra — “Ephedra is a plant that contains the chemical ephedrine, a stimulant
similar to amphetamines. Athletes may take an over-the-counter supplement
31 U.S. Anti-Doping Agency, “Medical.”
32 Australian Sports Drug Agency, “Fact Sheet: Beta Blockers,” n.d., available at
[http://www.asda.org.au/athletes/sub_fact_sheets/beta.htm].
33 U.S. Anti-Doping Agency, “Medical.”
34 Lawrence E. Armstrong, “Diuretics,” in Performance-Enhancing Substances in Sport and
Exercise, p. 111.
35 World Anti-Doping Agency, International Standard for Testing, p. 8.
36 Information provided electronically by the U.S. Anti-Doping Agency to the author on Apr.
8, 2005.
37 U.S. Anti-Doping Agency, 2005 Guide to Prohibited Substances and Prohibited Methods
of Doping, 2004, p. 10, available at [http://www.usantidoping.org/athletes/downloads
.aspx?cid=2].
38 Björn T. Ekblom, “Blood Doping,” in Performance-Enhancing Substances in Sport and
Exercise, pp. 94-95; U.S. Anti-Doping Agency, “Medical.”

---

CRS-25
containing ephedra to reduce physical fatigue, lose weight or improve mental
alertness.”39
Epitestosterone — Epitestosterone, which is a natural steroid, plays an important
role in testing an individual for the presence of excess testosterone. The ratio of
testosterone to epitestosterone (T/E) usually is 1:1. A ratio of 6:1 or higher generally
is an indication of illegal supplementation of testosterone.40 (However, the World
Anti-Doping Agency lowered its T/E threshold to 4:1 in 2005.41)
Erythropoietin (EPO) — EPO, which is an alternative to blood doping, stimulates
red blood cell production. It increases an individual’s aerobic power by increasing
the number of his or her red blood cells to “unnatural levels.”42

Gene doping — “The non-therapeutic use of genes, genetic elements or of the
modulation of gene expression, having the capacity to enhance athletic performance
....43 This includes attempts to modulate hormonal control of production of normal
substances in the body, such as growth hormone or erythropoietin.”44
Glucocorticosteroids — “Glucocorticosteroids are powerful anti-inflammatory
agents, 45 [which] affect the metabolism, and athletes may use them to get more
energy.”46 Glucocorticosteroids are also known as glucocorticoids.
Human chorionic gonadotropin (hCG) — In males, hCG helps to stimulate the
production of male hormones such as testosterone.47 Male athletes may take hCG “to
39 Mayo Clinic, “Teen Athletes and Performance-Enhancing Substances: What Parents Can
Do,” Dec. 22, 2004, available at [http://www.mayoclinic.com/involke.cfm?id=SM00045].
40 R. Craig Kammerer, “Drug Testing in Sport and Exercise,” in Performance-Enhancing
Substances in Sport and Exercise, p. 328.
41 World Anti-Doping Agency, The 2005 Prohibited List International Standard, n.d., p. 7,
available at [http://www.wada-ama.org/en/dynamic.ch2?pageCategory_id=174].
42 National Center on Addiction and Substance Abuse at Columbia University, Winning at
Any Cost: Doping in Olympic Sports, Sept. 2000 (New York: Columbia University), pp. 24-
25; U.S. Anti-Doping Agency, 2005 Guide to Prohibited Substances and Prohibited
Methods of Doping, p. 49.
43 U.S. Anti-Doping Agency, 2005 Guide to Prohibited Substances and Prohibited Methods
of Doping, p. 10.
44 Ibid., p. 29.
45 Australian Sports Drug Agency, “Fact Sheet: Glucocorticosteroids,” n.d., avaialble at
[http://www.asda.org.au/athletes/sub_fact_sheets/glucocorticosteroids.htm].
46 Information provided electronically by the U.S. Anti-Doping Agency to the author on Apr.
1, 2005.
47 U.S. National Library of Medicine and National Institutes of Health, Medline Plus, “Drug
Information: Chorionic Gonadotropin (Systemic),” Jan. 21, 2004, available at
[http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202266.html].

---

CRS-26
increase the ability of their body to produce testosterone and to prevent atrophy of the
testicles that results from taking large doses of anabolic steroids.”48
Human growth hormone (hGH) — HGH is “the hormone ... responsible for
growth and when administered to an adult whose growth has stopped increases
protein synthesis.”49 Athletes might use it to “induce anabolic effects, reduce muscle
cell breakdown and reduce body fat.”50
Insulin — Insulin is used by individuals who have diabetes to manage their blood
sugar levels. Some athletes may use insulin in an effort “to increase muscle growth
and improve muscle definition.”51
Masking agents — “Substances that are used to prevent the detection of other
substances or methods used by an athlete in doping. An example would be the
attempt to change the pH of the urine to enhance excretion of a doping substance.”52
Mimetics — Synthetic compounds “that produce the same (or a very similar effect)
as another (especially a naturally occurring) compound.”53
Pharmacological, chemical, and physical manipulation — “Pharmacological,
chemical and physical manipulation is the Use of substances and methods, including
masking agents, which alter, attempt to alter or may reasonably be expected to alter
the integrity and validity of specimens collected in doping controls. These include
but are not limited to catheterization, urine substitution and/or tampering, inhibition
of renal excretion and alterations of testosterone and epitestosterone
concentrations.”54 Manipulation may include “the addition of chemicals or other
contaminants to the actual specimen following collection, with the intent of
preventing the detection of a doping substance ....”55 (This is an illustrative
description. The actual substances and methods considered to constitute
manipulation may vary from organization (or professional sports league) to
organization.)
48 Cynthia Kuhn, Scott Swartzwelder, and Wilkie Wilson, Pumped (New York: W.W.
Norton and Co., 2000), p. 83.
49 U.S. Anti-Doping Agency, 2005 Guide to Prohibited Substances and Prohibited Methods
of Doping, p. 49.
50 Australian Sports Drug Agency, “Fact Sheet: Human Growth Hormone (hGH),” n.d.,
available at [http://www.asda.org.au/athletes/sub_fact_sheets/human.htm].
51 Australian Sports Drug Agency, “Fact Sheet: Insulin,” available at [http://www.
asda.org.au/athletes/sub_fact_sheets/insulin.htm].
52 U.S. Anti-Doping Agency, 2005 Guide to Prohibited Substances and Prohibited Methods
of Doping, p. 26.
53 Oxford English Dictionary Online, available at [http://dictionary.oed.com].
54 U.S. Anti-Doping Agency, 2004 United States Anti-Doping Agency Guide to Prohibited
Substances and Prohibited Methods of Doping, 2003, p. 19. (Italics in original.)
55 U.S. Anti-Doping Agency, 2005 Guide to Prohibited Substances and Prohibited Methods
of Doping, 2004, p. 26.

---

CRS-27
Precursor — “Steroid precursors are substances that are converted in the body into
steroids ....”56
Prohormone — “A natural precursor of a hormone;57 any substance that can be
converted into a hormone.”58
Steroids — “A class of compounds with common elements of their chemical
structures, but wide ranging effects. Androgenic-anabolic steroids are the hormones
responsible for secondary male sex characteristics; estrogens are the hormones
responsible for development and maintenance of female secondary sex
characteristics; glucocorticosteroids regulate carbohydrate, fat and protein
metabolism; mineralocorticoids regulate the balance of water and electrolytes. In
addition, steroids have been used for a variety of medical purposes, including
reducing inflammation.”59 Also see “anabolic androgenic steroids.”
Stimulants — “Stimulants are substances that act directly on the central nervous
system to speed up parts of the brain and body.”60 Stimulants “can reduce fatigue,
suppress appetite, and increase alertness and aggressiveness.”61
Testosterone — “Testosterone is the main male hormone that maintains muscle
mass and strength ....”62
56 U.S. Olympic Committee, “USA Luge Joins Coalition Formed to Support Dietary
Supplement Regulation,” press release, Apr. 24, 2003, available online at
[http://www.usolympicteam.com/73_8410.htm].
57 Oxford English Dictionary Online, available at [http://dictionary.oed.com].
58 Dorland’s Illustrated Medical Dictionary.
59 Information provided electronically by the U.S. Anti-Doping Agency to the author on Apr.
8, 2005. (Italics in original.)
60 Australian Sports Drug Agency, “Fact Sheet: Stimulants,” n.d., available at
[http://www.asda.org.au/athletes/sub_fact_sheets/stimulants.htm].
61 Mayo Clinic, “Performance-Enhancing Drugs: Dangerous, Damaging and Potentially
Deadly.”
62 Mayo Clinic, “Testosterone Therapy: The Answer for Aging Men?” Apr. 13, 2004,
available at [http://www.mayoclinic.com/invoke.cfm?id=MC00030].

---