Anti-Doping Policies: The Olympics and Selected Professional Sports

Anti-Doping Policies: The Olympics and Selected Professional Sports

Order Code RL32894
Anti-Doping Policies: The Olympics
and Selected Professional Sports
Updated October 17, 2007
L. Elaine Halchin
Analyst in American National Government
Government and Finance Division

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. Beginning in the
1980s, several professional sports leagues in the United States, such as the National
Football League (NFL) and Major League Baseball (MLB), followed suit.
This report compares current anti-doping policies for performance enhancing
substances among the Olympic movement and six professional sports leagues.
Details associated with the policies of the Olympics, Major League Baseball, the
NFL, and the National Basketball Association (NBA) policies are presented in Table
1. Table 2 includes the same details about the policies of Major League Soccer
(MLS), the Women’s National Basketball Association (WNBA), and the National
Hockey League (NHL). 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 3) 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
the six professional sports leagues discussed in this report, 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 the NBA imposes a 10-game suspension without pay for a
first violation.
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.
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 . . . . . . . . . . . . . . . . . . . . . . 5
Changing Nature of Policies . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5
No Tests or Sanctions for Some Prohibited Substances . . . . . . . . . . . . 6
Comparison of Olympic Movement and Professional Sports Leagues
Anti-Doping Policies . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8
Elements of Model Anti-Doping Policies . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 22
Conclusion . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 23
Appendix . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 24
Glossary . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 30
List of Tables
Table 1. Comparison of Selected Features of Anti-Doping Policies . . . . . . . . . . . 9
Table 2. Comparison of Selected Features of Anti-Doping Policies . . . . . . . . . 16
Table 3. Comparison of Selected Features of Major League Baseball’s
2003-2004, 2005, and 2006 Policies . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 24

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 several major
professional sports leagues in the United States were not drafted until the latter part
of the 20th century. On the other hand, the two youngest sports leagues — Major
League Soccer (MLS) and the Women’s National Basketball Association (WNBA)
— first addressed the issue of performance-enhancing substances when they were
created.
! 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
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=312].

CRS-2
! The National Football League (NFL) followed suit, in 1982, when
it began to test players, although testing for anabolic steroids did not
begin until 1987.4
! The National Basketball Association’s (NBA) first anti-doping
policy was issued in 1983.5
! Major League Baseball implemented an anti-doping policy in 2003.
! At its inception in 1996, MLS established a “zero tolerance” policy
on illegal drug use. Eight years later, the Major League Soccer
Player Substance Abuse and Behavioral Program and Policy, which
prohibits the use of performance-enhancing substances, was
established as part of the league’s first collective bargaining
agreement (CBA).6
! In July 2005, the National Hockey League (NHL) and the National
Hockey League Players Association ratified a CBA that includes a
performance-enhancing substances program.
! The first CBA for the WNBA, which was signed April 29, 1999,
included a drug program.7
These sports leagues have continued to maintain, and update, their anti-doping
policies.
This report compares current anti-doping policies among the Olympic
movement and six professional sports. Table 1 includes the Olympic movement,
Major League Baseball, the NBA, and the NFL. Table 2 also includes the Olympic
movement — because its policy is generally considered to be the most stringent one
and, as such, serves as a baseline for comparison purposes — and the MLS, NHL,
and WNBA policies.
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
4 Ibid., p. 2.
5 Information provided by the NBA’s Basketball Communications Office, to the author,
May 19, 2004.
6 U.S. Congress, House Energy and Commerce Committee, Subcommittee on Commerce,
Trade, and Consumer Protection, The Drug Free Sports Act of 2005, hearing on H.R. 1862,
109th Cong., 1st sess., May 18 and 19, 2005, (Washington: GPO, 2005), pp. 19-21.
7 Letter from Jamin Dershowitz, General Counsel, Women’s National Basketball
Association, to Representative F. James Sensenbrenner, Jr., Chairman, and Representative
John Conyers, Jr., Ranking Minority Member, House Committee on the Judiciary, dated
June 20, 2005.

CRS-3
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 3) and a glossary of related
terms.
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, the NFL, MLS, the NHL, and the WNBA, 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 medical director that
administers the NBA’s anti-doping policy is selected jointly by the NBA and the
National Basketball Players’ Association (NBPA)). 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
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=311].) 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 Paralympic
Games is an international competition among each nation’s elite athletes with physical
disabilities and is second in size only to the Olympic Games. The Paralympic Games and
Paralympic Winter Games follow the Olympic Games and Olympic Winter Games at the
same venues and facilities. The Paralympic Games have been contested since 1960 and now
feature competition in 19 sports. The Paralympic Winter Games showcase four sports, and
were first held in 1976.” (U.S. Olympic Committee, “The Paralympic Games,” n.d.,
available at [http://www.usolympicteam.com/paralympics/paralympic_games.html].) 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
(continued...)

CRS-4
A comparison of selected features of anti-doping policies shows, among other
things, that the Olympic movement and MLS maintain the most comprehensive lists
of prohibited substances and methods. (Major League Soccer has incorporated
WADA’s list of prohibited substances into its doping policy.) The development of
a comprehensive list by WADA may be due, at least in part, to the general
understanding that some substances or drugs benefit only athletes in certain sports.9
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 the policies of other
professional leagues either are silent on this issue or include provisions that suggest
an athlete may not be subject to strict liability for substances in his or her body.
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, in the
NBA, a first violation results in a 10-game suspension, a second violation results in
a 25-game suspension, and a third violation leads to a one-year suspension.
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
8 (...continued)
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 16 sports (and only
during competitions) including archery, curling, and gymnastics. (World Anti-Doping
Agency, The 2007 Prohibited List, International Standard, 2006, available online at
[http://www.wada-ama.org/rtecontent/document/2007_List_En.pdf], p. 10.)
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” (World Anti-Doping
Agency, World Anti-Doping Code, 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 and 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 Federation of Associated
Wrestling Styles. (World Anti-Doping Agency, “List of Sports Organizations Who Have
Accepted the Code,” n.d., available at [http://www.wada-ama.org/en/dynamic.ch2?
pageCategory.id=270].)

CRS-5
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
lists of controlled substances.11 Examples of substance names found on one of the
lists of controlled substances are thiopental, phendimetiazine, and clortermine.
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
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.

CRS-6
substance.13 Because designer steroids are developed specifically to avoid detection,
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 changed their anti-
doping policies. The NFL’s most recent change added agents with anti-estrogenic
activity to its list of prohibited substances, increased the number of times a player
may be tested during the off-season from two to six, and lowered the ratio of
testosterone to epitestosterone that constitutes a presumptively positive test. A
comparison of Major League Baseball’s former and current policies (Table 3 in the
appendix) also shows several significant differences. Under the original policy
(which applied to the 2003 and 2004 seasons), 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 policy in place for the 2006 season prohibits the use of
hormones; imposes a 50-game suspension without pay for a first violation, a 100-
game suspension without pay for a second violation, and a permanent suspension for
a third violation; and includes a provision for off-season testing.
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,
a blood-based test for human growth hormone (hGH) has been developed, and has
been used by the Olympic movement, but the professional sports leagues use only
urine-based tests.14
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 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 22, 2004, p. D5.)
14 See Table 1, table note h. for additional information about the blood-based test for human
(continued...)

CRS-7
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.”15 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....”16 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....”17 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.18
Thus, it appears that WADA and the NFL, and possibly other organizations as well,
recognize that the value of an anti-doping program or policy extends beyond testing
to include messages about harmful substances and how they might undermine athletic
competition.
14 (...continued)
growth hormone.
15 R. Craig Kammerer, “Drug Testing in Sport and Exercise,” in Performance-Enhancing
Substances in Sport and Exercise, pp. 330-331.
16 World Anti-Doping Agency, World Anti-Doping Code, 2003, available online at
[http://www.wada-ama.org/rtecontent/document/code_v3.pdf], p. 1.
17 Ibid., p. 3.
18 National Football League and NFL Players Association, National Football League Policy
on Anabolic Steroids and Related Substances, 2007, available at
[http://www.nflpa.org/pdfs/RulesAndRegs/BannedSubstances.pdf], pp. 1-2.

CRS-8
Comparison of Olympic Movement and Professional
Sports Leagues 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.19 Table 2 does
the same for the Olympic movement, MLS, the NHL, and the WNBA. 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.
Table 3, which is in the appendix, compares specific elements of Major League
Baseball’s original policy and two revised versions. Since the policies are undated,
each one is identified by the year or years it was in effect.
19 It bears noting that NFL players also are banned from participating in any endorsement
agreement with companies that manufacture products that are found on the NFL’s list of
prohibited substances. The list, which includes nearly 70 companies, is available at
[http://www.nflpa.org/RulesAndRegs/BannedCompanies.aspx].

CRS-9
Table 1. Comparison of Selected Features of Anti-Doping Policies
Major League Baseball
National Basketball
National Football League
(MLB) and Major League
Association (NBA) and
Olympic Movement
(NFL) and NFL Players
Baseball Players
National Basketball Players
Association (NFLPA)
Association (MLBPA)
Association (NBPA)
— What organization or
— U.S. Anti-Doping
— Independent Program
— Medical director.
— NFL Advisor on
individual is responsible for
Agency (for American
Administrator (IPA).
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
jointly select the IPA.a
is selected jointly by the
conducted under the auspices
the sponsoring
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.c
No.
Yes.
season (or out of competition,
for the Olympics)?
Is an athlete responsible for
Yes.
No.d
Subject is not addressed in
Yes.
prohibited substances found in
the policy.e
his or her body?
Does the responsible
No. No.h
Yes.h
No.h
organization test athletes for
all prohibited substancesf,g
Does the anti-doping policy
prohibit:i

CRS-10
Major League Baseball
National Basketball
National Football League
(MLB) and Major League
Association (NBA) and
Olympic Movement
(NFL) and NFL Players
Baseball Players
National Basketball Players
Association (NFLPA)
Association (MLBPA)
Association (NBPA)
— Steroidsj
— Yes.
— Yes.k
— Yes.
— Yes.
— Hormones and related
— Yes.l
— Yes.
— Yes.
— Yes.m
substances
— Beta-2 agonists
— Yes.
— Unclear.n
— No.o
— Yes.
— Agents with anti-
— Yes.
— Unclear.p
— Yes.
— Yes.
estrogenic activity
— Diuretics and other
— Yes.
— Yes.q
— Yes.
— Yes.
masking agents
— Enhancement of oxygen
— Yes.
— No.r
— No.
— Yes.
transfer
— Chemical and physical
— Yes.
— Yes.q
— Yes.s
— Yes.
manipulation
— Gene doping
— Yes.
— No.
— No.
— No.
— Stimulants
— Yes, but only in
— Yes.
— Yes.
— Yes.
competition.
— Glucocorticosteroids
— Yes, but only in
— Unclear.t
— No.
— No.
competition.
— Beta-blockers
— Yes, but only for certain
— Unclear.u
— No.o
— No.
sports.

CRS-11
Major League Baseball
National Basketball
National Football League
(MLB) and Major League
Association (NBA) and
Olympic Movement
(NFL) and NFL Players
Baseball Players
National Basketball Players
Association (NFLPA)
Association (MLBPA)
Association (NBPA)
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 NBA and NBPA,
bargaining agreement,
approved by WADA.
indicated that testing is
approved by the medical
samples to be analyzed for
conducted at a WADA-
director, and certified by the
prohibited substances are to
accredited laboratory in
World Anti-Doping Agency,
be submitted to the UCLA
Montreal.v
the Substance Abuse and
Olympic Analytical
Mental Health Services
Laboratory at the UCLA
Administration, or the
School of Medicine, or the
International Olympic
Sports Medicine Research
Committee.w
and Testing Laboratory at the
University of Utah.x
Are sanctions applicable to all
Yes.
Yes.
Yes.y
Yes.
prohibited substances?
What are the sanctions for
testing positive?f,z
— First violation
— Two-year banaa
— Steroids: 50-game
— 10-game suspension
— Suspended without pay
suspension without pay.
without pay.
for a minimum of four
Stimulants: No sanction.
games.
— Second violation
— Lifetime ban.
— Steroids: 100-game
— 25-game suspension
— Suspended without pay
suspension without pay.bb
without pay.
for a minimum of eight
Stimulants: 25-game
games.
suspension without pay.

CRS-12
Major League Baseball
National Basketball
National Football League
(MLB) and Major League
Association (NBA) and
Olympic Movement
(NFL) and NFL Players
Baseball Players
National Basketball Players
Association (NFLPA)
Association (MLBPA)
Association (NBPA)
— Third violation
— Not applicable.
— Steroids: Permanent
— One-year suspension
— Suspended without pay
suspension from MLB.bb
without pay.
for at least 12 months.
Stimulants: 80-game
Ineligible for selection to the
suspension without pay.
Pro Bowl, or to receive any
other honors or awards from
the NFL or the NFLPA.
— Fourth and subsequent
— Not applicable.
— Stimulants: Suspension
— SPEDs: Dismissed and
— Not addressed.
violations
by the Commissioner, up to
disqualified from any
permanent suspension.
association with the NBA or
any of its teams for a
minimum of two years.
What types of specimens are
Blood or urine.
Urine.
Urine.
Urine.
collected and tested?
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/protocol.pdf]; U.S. Anti-Doping Agency, “USADA Press Kit,” Sep. 13, 2007, available at [http://www.usantidoping.org/files/active/resources/press_kits/
2007%20fact%20sheet_updated%20september%2013,%202007.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, The 2007 Prohibited List, International Standard, 2005, available at
[http://www.wada-ama.org/rtecontent/document/2007_List_En.pdf]; Major League Baseball and Major League Baseball Players Association, 2003-2006 Basic Agreement, n.d.,
available from author; National Basketball Association and National Basketball Players Association, NBA Collective Bargaining Agreement, 2005, available at
[http://www.nbpa.com/cba_articles.php]; National Football League and NFL Players Association, National Football League Policy on Anabolic Steroids and Related Substances, 2007,
available at [http://www.nflpa.org/pdfs/RulesAndRegs/BannedSubstances.pdf].

Notes:
a. Although Major League Baseball and the players association select the independent program administrator (IPA), the policy states that this individual “shall have no affiliation with
the Office of the Commissioner, any Major League Club or the [Players] Association.” (Major League Baseball and Major League Baseball Players Association, 2003-2006 Basic
Agreement, n.d., available from author, p. 2.)

CRS-13
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, Apr. 18, 2005.)
c. Under the heading “Additional Random Testing,” the policy states that “as many as 60 tests may be conducted at unannounced times during the off-season ...; provided, however,
that any off-season tests shall only be for the presence of Performance Enhancing Substances [steroids].” (Major League Baseball and Major League Baseball Players Association,
2003-2006 Basic Agreement, p. 6.) Assuming that off-season testing would test 60 different players, approximately 8% of the players would be subjected to tests for performance
enhancing substances during the off-season. Although the active player limit apparently is imposed only during the season, the active player limit of 25 players per team (that
is, each team can have no more than 25 active players on its roster from opening day through midnight, August 31; the active player limit increases to 40 on September 1 each
year) was used to calculate this percentage. (Ibid., p. 49.)
d. The Office of the Commissioner has an initial burden to establish “that a Player’s test result was ‘positive’ ... and was obtained pursuant to a valid test conducted under Attachment
18 [the anti-doping policy]. The Office of the Commissioner is not required to otherwise establish intent, fault, negligence or knowing use of a Prohibited Substance on the
Player’s part to establish such a violation. If the Office of the Commissioner meets its initial burden, the Player then has the burden of establishing that his test result was not
due to his fault or negligence.” (Ibid., pp. 19-20.)
e. This excerpt from the NBA’s anti-drug program suggests that a player may not be responsible for any prohibited substance found in his body: “Any positive test [for a prohibited
substance] shall be reviewed by the Medical Director. If the Medical Director determines, in his professional judgment, that there is a valid alternative medical explanation for
such positive test result, then the test shall be deemed negative.” (National Basketball Association and National Basketball Players Association, Collective Bargaining Agreement,
2005, available at [http://www.nbpa.com/cba_articles.php], p. 367.)
f. Even though most anti-doping policies include non-performance-enhancing substances or drugs, such as marijuana, Ecstasy, and opiates, this item pertains only to performance-
enhancing substances and related substances and methods.
g. In some cases, accurate laboratory tests do not exist for certain prohibited substances or levels. In other cases, tests are available to detect the prohibited substances but are not used.
See table note h.
h. Human growth hormone (hGH) is on the list of prohibited substances for Major League Baseball, the NBA, and the NFL, but none of these leagues tests 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://oversight.house.gov/features/steroids/testimony_manfred.pdf] and
[http://oversight.house.gov/features/steroids/testimony_pellman.pdf].) Reportedly, the NFL and the NFLPA have expressed reservations about the reliability of the blood test
for hGH, and the NBPA has indicated that it would not agree to having players submit to blood tests for hGH. (Mark Maske, “NFL Questions Effectiveness of Blood Testing
for Hormone,” Washington Post, June 10, 2006, p. E2.) As for the NBA, a newspaper article reported that the commissioner plans to discuss blood testing with the players union;
however, another article noted that the players association would not agree to blood-based tests. (Mike Wise and Michael Lee, “Commissioner Is Concerned about Exploitation
of Athletes,” Washington Post, June 10, 2006, p. E3; “NBA Union Will Not Allow HGH Testing,” Philadelphia Daily News, June 13, 2006, n.p.) 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/rtecontent/
document/201104-ENG.pdf].)
i. 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.

CRS-14
j. 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.
k. Designer steroids are mentioned for the first time in the 2006 policy. The following excerpt from the policy shows, through the addition of italics, the language that was added:
“Anabolic androgenic steroids that are not covered by Schedule II but that may not be lawfully obtained or used in the United States (including “designer steroids”) shall also
be considered Performance Enhancing Substances covered by the Program.” (Major League Baseball and Major League Baseball Players Association, 2003-2006 Basic
Agreement, p. 4.)
l. The Olympic movement’s policy is a good example of the fact that doping policies are dynamic. In commenting on changes made to its 2006 list of prohibited substances, WADA
stated: “The status of both human chorionic gonadotrophin (hCG) and luteinizing hormone (LH) is changed and both substances are now only prohibited in males. Despite the
scientific rationale to prohibit these substances in women, the experience during 2005 has led, in some cases, to detect elevated hCG levels due to physiological (pregnancy) or
pathological conditions with potentially significant psychological or social consequences for the athlete, in addition to the difficulty, to date, to discriminate at the laboratory level
these cases from doping abuse.” (World Anti-Doping Agency, WADA Prohibited List, 2006: Summary of Major Modifications, 2005, available at
[http://www.wada-ama.org/rtecontent/document/Explanatory_Note_2006.pdf], p. 2.)
m. As an example of how the lists of prohibited substances vary from organization to organization, it appears that the only hormone included on Major League Baseball’s list of
performance enhancing substances. The WADA list includes several other hormones and related substances. (World Anti-Doping Agency, The 2007 Prohibited List, International
Standard, Sep. 2006, available at [http://www.wada-ama.org/rtecontent/document/2007_List_En.pdf].)
n. The list of prohibited substances includes any and all drugs or substances included on Schedules I and II of controlled substances (see 21 U.S.C. § 812). 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.
o. The NBA’s list of steroids, performance enhancing drugs, and masking agents (SPEDs) does not appear to include any beta-2 agonists or beta blockers. However, the list includes
zilpaterol, which, based on a search of the Internet, appears to be a pharmaceutical for animals. (K.C.M. Verhoeckx, R.P. Doornbos, J. Van Der Greer, R.F. Witkamp, and R.J.T.
Rodenburg, “Inhibitory Effects of the $ -Andrenergic Receptor Agonist Zilpaterol on the LPS-Induced Production of TNF-" in vitro and in vivo,” Journal of Veterinary
2
Pharmacology and Therapeutics, Dec. 2005, p. 531, available at [http://www.blackwell-synergy.com/doi/abs/10.1111/j.1365-2885.2005.00691.x].)
p. The list of prohibited substances includes any and all drugs or substances included on Schedules I and II of controlled substances (see 21 U.S.C. § 812). 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.
q. Masking substances (and methods) are not identified on the list of prohibited substances, but the policy states that a 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.... The presence of a diuretic or masking agent in a Player’s sample shall be treated
as a positive test result if the Independent Program Administrator determines that the Player intended to avoid detection of his use of a Prohibited Substance.”(Major League
Baseball and Major League Baseball Players Association, 2003-2006 Basic Agreement, p. 8.) However, unlike Olympics testing, it is unclear whether baseball players are tested
for masking agents and methods.
r. Apparently, a decision regarding how to treat erythropoietin (EPO) is pending. The following paragraph is included in baseball’s 2006 policy: “The Medical Testing Officer randomly
selected 200 samples collected pursuant to Section 3.A.1. [this section involves testing for performance enhancing substances and stimulants] during the 2005 Testing Year for
an additional screening for the presence of Erythropoietin (“EPO”). The Medical Testing Officer shall report the results of such testing, on an anonymous, aggregate basis, to
the Party Representatives [the parties are Major League Baseball and the players association] when such testing has been completed and the Parties shall then determine the
appropriate treatment of EPO.” (Major League Baseball and Major League Baseball Players Association, 2003-2006 Basic Agreement, p.6.)

CRS-15
s. The NBA’s policy states that “[i]f the player attempts to substitute, dilute, or adulterate a specimen sample or in any other manner [alter] a test result....,” or “[i]f the test is positive
for a Diuretic, and it is confirmed by laboratory analysis at any detectable level,” the test result will be considered positive. (National Basketball Association and National
Basketball Players Association, Collective Bargaining Agreement, p. 366.)
t. The list of prohibited substances includes any and all drugs or substances included on Schedules I and II of controlled substances (see 21 U.S.C. § 812). 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.
u. The list of prohibited substances includes any and all drugs or substances included on Schedules I and II of controlled substances (see 21 U.S.C. § 812). 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.
v. Major League Baseball and the players association agreed, in spring 2004, to have all drug testing conducted by the Doping Control Laboratory at the INRS-Institute Armand-Frappier
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://www.mlb.com/news/press_releases/press_release.jsp?ymd=20040511&content_id=740823&vkey=pr_mlb&fext=.jsp&c_id=mlb].)
w. The Substance Abuse and Mental Health Services Administration is an agency within the Department of Health and Human Services.
x. Both laboratories are accredited by WADA.
y. Although the NBA’s policy does not include penalties for diuretics, it states that a positive test for a diuretic is considered a positive test for a prohibited substance. (National
Basketball Association and National Basketball Players Association, Collective Bargaining Agreement, pp. 365-366, 382-383.)
z. In addition to imposing a penalty or sanction for a positive test, in some instances professional sports leagues also require their players to enter a treatment program.
aa. This sanction is specific to Articles 2.1 (presence of a prohibited substance in an athlete’s specimen), 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 Federation of Associated Wrestling Styles. (World Anti-Doping
Agency, “List of Sports Organizations Who Have Accepted the Code,” n.d., available at [http://www.wada-ama.org/en/dynamic.ch2?page Category.id=270].)
bb. Any positive test result reported before the first reporting date for spring training in 2006 is not to be considered when determining the number of times a player has tested positive
for performance enhancing substances or stimulants. (Major League Baseball and Major League Baseball Players Association, 2003-2006 Basic Agreement, p. 17.)

CRS-16
Table 2. Comparison of Selected Features of Anti-Doping Policies
Women’s National
National Hockey League
Major League Soccer
Basketball Association
(NHL) and National
(MLS) and Major League
Olympic Movement
(WNBA) and Women’s
Hockey League Players
Soccer Players Union
National Basketball Players
Association (NHLPA)
(MLSPU)
Association (WNBPA)
— What organization or
— U.S. Anti-Doping
— Program Committee.
— Medical director.
— Qualified doctors and a
individual is responsible for
Agency (for American
certified substance abuse and
administering the anti-doping
athletes).
behavioral health counselor,
policy?
who are identified
collectively as Substance
Abuse and Behavioral Health
(SABH) Program
professionals by the MLS.
— Is the organization or
— Yes.
— No. The committee
— No. The medical director
— No. The SABH program
individual independent from
consists of an equal number
is selected jointly by the
professionals are selected
the sponsoring
of league and players
WNBA and WNBPA.
jointly by the commissioner
organization(s)?
association representatives,
(or his or her designee) and
and one doctor.
the players union.
Is testing conducted off-
Yes.
No.
No.
Unclear.a
season (or out of
competition, for the
Olympics)?
Is an athlete responsible for
Yes.
No.b
Subject is not addressed in
No.c
prohibited substances found
the policy.
in his or her body?
Does the responsible
No.
Yes.
Yes.
Yes.
organization test athletes for

all prohibited substances?de

CRS-17
Women’s National
National Hockey League
Major League Soccer
Basketball Association
(NHL) and National
(MLS) and Major League
Olympic Movement
(WNBA) and Women’s
Hockey League Players
Soccer Players Union
National Basketball Players
Association (NHLPA)
(MLSPU)
Association (WNBPA)
Does the anti-doping policy
prohibit:f
— Steroidsg
— Yes.
— Yes.
— Yes.
— Yes.
— Hormones and related
— Yes.h
— Yes.
— No.
— Yes.
substances
— Beta-2 agonists
— Yes.
— Yes.
— No.
— Yes.
— Agents with anti-
— Yes.
— Yes.
— No.
— Yes.
estrogenic activity
— Diuretics and other
— Yes.
— Yes.
— Unclear.i
— Yes.
masking agents
— Enhancement of
— Yes.
— Yes.
— No.
— Yes.
oxygen transfer
— Chemical and physical
— Yes.
— Yes.
— Unclear.i
— Yes.
manipulation
— Gene doping
— Yes.
— Yes.
— No.
— Yes.
— Stimulants
— Yes, but only in
— No.j
— Yes.
— Yes.
competition.
— Glucocorticosteroids
— Yes, but only in
— No.
— No.
— Yes.k
competition.
— Beta-blockers
— Yes, but only for certain
— No.
— No.
— Yes.
sports.

CRS-18
Women’s National
National Hockey League
Major League Soccer
Basketball Association
(NHL) and National
(MLS) and Major League
Olympic Movement
(WNBA) and Women’s
Hockey League Players
Soccer Players Union
National Basketball Players
Association (NHLPA)
(MLSPU)
Association (WNBPA)
What laboratory tests the
WADA-accredited
Laboratoire de Controle du
Laboratories are selected by
Laboratories in the United
samples?
laboratories or as otherwise
Dopage, INRS-Institut
the medical director and
States are selected by the
approved by WADA.
Armand Frappier.l
approved by the WNBA and
SABH program
WNBPA.
professionals. Laboratories
must be certified by the
Substance Abuse and Mental
Health Services
Administration (SAMSHA),
the U.S. Department of
Transportation, or the World
Anti-Doping Agency.m
Are sanctions applicable to
Yes.
Yes.
Yes.
Yes.
all prohibited substances?
What are the sanctions for
testing positive?
— First violationdn
— Two-year ban.o
— 20-game suspension
— Steroids: Two-game
— Discipline may include
without pay.
suspension.
up to and including, without
Androstenedione, DHEA,
limitation, fines, suspension
and testosterone: One-game
(with or without pay), and/or
suspension.
termination of the player’s
contract.p
— Second violation
— Lifetime ban.
— 60-game suspension
— Steroids: Five-game
— See above.
without pay.
suspension.
Androstenedione, DHEA,
and testosterone: Three-game
suspension.

CRS-19
Women’s National
National Hockey League
Major League Soccer
Basketball Association
(NHL) and National
(MLS) and Major League
Olympic Movement
(WNBA) and Women’s
Hockey League Players
Soccer Players Union
National Basketball Players
Association (NHLPA)
(MLSPU)
Association (WNBPA)
— Third violation
— Not applicable.
— Permanent suspension.
— Steroids: 10-game
— See above.
suspension.
Androstenedione, DHEA,
and testosterone: 7-game
suspension.
— Fourth violation
— Not applicable.
— Not applicable.
— Steroids: Same as third
— See above.
violation. Androstenedione,
DHEA, and testosterone:
same as third violation.
— Subsequent violation(s)
— Not applicable.
— Not applicable.
— Steroids: Same as third
— See above.
violation. Androstenedione,
DHEA, and testosterone:
same as third violation.
What types of specimens are
Blood or urine.
Urine.
Urine.
Urine.
collected and tested?
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/protocol.pdf]; U.S. Anti-Doping Agency, “USADA Press Kit,” Sep. 13, 2007, available at [http://www.usantidoping.org/files/active/resources/press_kits/
2007%20fact%20sheet_updated%20september%2013,%202007.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, The 2007 Prohibited List, International Standard, 2005, available at [http://www.wada-ama.org/rtecontent/document/2007_List_En.pdf]; Letter from
William L. Daly, Deputy Commissioner, National Hockey League, to the author, Apr. 21, 2006; National Hockey League and National Hockey League Players Association, Collective
Bargaining Agreement, 2005, available from author; Major League Soccer and Major League Soccer Players Union, Major League Soccer Player Substance Abuse and Behavioral
Health Program and Policy, n.d.; Women’s National Basketball Association and Women’s National Basketball Players Association, Women’s National Basketball Association Collective
Bargaining Agreement, n.d., available from author.

CRS-20
Notes:
a. The MLS’s policy states: “All Players are subject to unannounced Prohibited Substance testing. Such testing may be based either on random selection or by testing the entire Team.”
(Major League Soccer and Major League Soccer Players Union, Major League Soccer Player Substance Abuse and Behavioral Health Program and Policy, n.d., p. 6) In
congressional testimony, the head of the players union stated: “Testing includes: (a) random testing, in which players are tested at least once each year ....” (Testimony of Bob
Foose, Executive Director, Major League Soccer Players Union, in U.S. Congress, House Energy and Commerce Committee, Subcommittee on Commerce, Trade, and Consumer
Protection, The Drug Free Sports Act of 2005, hearing on H.R. 1862, 109th Cong., 1st sess., May 18 and 19, 2005, (Washington: GPO, 2005), p. 25.) At the same hearing, the
MLS commissioner stated: “We conduct year-round testing without prior notice. Each player is tested at least once with no limit on tests.” (Testimony of Don Garber,
Commissioner of Major League Soccer, in U.S. Congress, House Energy and Commerce Committee, Subcommittee on Commerce, Trade, and Consumer Protection, The Drug
Free Sports Act of 2005, p. 19.)
b. The NHL’s policy states: “A strict liability standard will be employed with respect to all positive tests. Notwithstanding the above, the Player shall be entitled to challenge the
imposition of any discipline in the event he is able to establish an applicable therapeutic use exemption ..., a testing error, mistaken use, or the use of a tainted supplement or other
production (i.e., where the Player could not have reasonably ascertained the presence of the Prohibited Substance). (National Hockey League and National Hockey League Players
Association, Collective Bargaining Agreement, 2005, available from author.)
c. Apparently, MLS does not have strict liability for what a player has ingested. Speaking at a congressional hearing in 2005, the league’s commissioner said: “We ... believe that
disciplinary discretion is important, because mandatory minimum standards may create unjust results given the presence of very real mitigating circumstances. In some cases,
a 2-year suspension might be too harsh. For example, we do not believe it is appropriate to impose the same suspension on a player who knowingly uses performance-enhancing
substances as a player who unknowingly ingested a tainted nutritional supplement....” (Testimony of Don Garber, Commissioner of Major League Soccer, in U.S. Congress,
House Energy and Commerce Committee, Subcommittee on Commerce, Trade, and Consumer Protection, The Drug Free Sports Act of 2005, p. 20.)
d. Even though most anti-doping policies include non-performance-enhancing substances or drugs, such as marijuana, Ecstasy, and opiates, this item pertains only to performance-
enhancing substances and related substances and methods.
e. In some cases, accurate laboratory tests do not exist for certain prohibited substances or levels. In other cases, tests are available to detect the prohibited substances but are not used.
See Table 1, table note h.
f. 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.
g. 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.
h. The Olympic movement’s policy is a good example of the fact that doping policies are dynamic. In commenting on changes made to its 2006 list of prohibited substances, WADA
stated: “The status of both human chorionic gonadotrophin (hCG) and luteinizing hormone (LH) is changed and both substances are now only prohibited in males. Despite the
scientific rationale to prohibit these substances in women, the experience during 2005 has led, in some cases, to detect elevated hCG levels due to physiological (pregnancy) or
pathological conditions with potentially significant psychological or social consequences for the athlete, in addition to the difficulty, to date, to discriminate at the laboratory level
these cases from doping abuse.” (World Anti-Doping Agency, WADA Prohibited List, 2006: Summary of Major Modifications, 2005, available at
[http://www.wada-ama.org/rtecontent/document/Explanatory_Note_2006.pdf], p. 2.)
i. No masking agents or diuretics are included on the WNBA’s list of prohibited substances, but the policy states that “[i]f the player attempts to substitute, dilute, mask, or adulterate
a specimen sample or in any other manner alter[s] a test result,” the test will be considered positive for a prohibited substance. (Women’s National Basketball Association and
Women’s National Basketball Players Association, Women’s National Basketball Association Collective Bargaining Agreement, n.d., Exhibit 2, Sec. 4(c), available from author.)

CRS-21
j. The NHL uses WADA’s out-of-competition list of prohibited substances, which does not include stimulants.
k. In its doping policy, MLS includes “glucosteroids” on its list of prohibited substances. This may be a misspelling, as the commonly used terms are “glucocorticosteroids” or
“glucocorticoids.” (Information provided electronically by the U.S. Anti-Doping Agency, to the author, on Apr. 18, 2006.)
l. This is a World Anti-Doping Agency-accredited laboratory located in Montreal.
m. The Substance Abuse and Mental Health Services Administration is an agency within the Department of Health and Human Services.
n. In addition to imposing a penalty or sanction for a positive test, in some instances professional sports leagues also require their players to enter a treatment program.
o. This sanction is specific to Articles 2.1 (presence of a prohibited substance in an athlete’s specimen), 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 Federation of Associated Wrestling Styles. (World Anti-Doping
Agency, “List of Sports Organizations Who Have Accepted the Code,” n.d., available at [http://www.wada-ama.org/en/dynamic.ch2?page Category.id=270].)
p. Major League Soccer does not have any explicit sanctions for first, second, third offenses and so on. (Major League Soccer and Major League Soccer Players Union, Major League
Soccer Player Substance Abuse and Behavioral Health Program and Policy, pp. 10-11.)

CRS-22
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.20
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;
20 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 from the author.

CRS-23
! 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.21
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.22 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.
21 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.
22 Steve Fawner, “A Search for Truth in Substance,” Washington Post, Dec. 4, 2003, pp. D1,
D10.

CRS-24
Appendix
Table 3. Comparison of Selected Features of Major League Baseball’s 2003-2004, 2005, and 2006 Policies
2003-2004 Policy
2005 Policy
2006 Policy
— What organization or individual is
— Health Policy Advisory
— HPAC.
— Independent Program
responsible for administering the anti-
Committee (HPAC).
Administrator (IPA).
doping policy?
— Is the organization or individual
— No. MLB and MLBPA each
— No. MLB and MLBPA each
— No. MLB and MLBPA jointly
independent from the sponsoring
selected two members of the
selected two members of the
select the IPA.a
organization(s)?
HPAC.
HPAC.
Does the responsible organization test
No.
No.
No.d
players for all prohibited substances?b,c
Does the anti-doping policy prohibit:
— Steroidse
— Yes.
— Yes.
— Yesf
— Hormones and related
— Unclear.g
— Yes.g
— Yes.
substances
— Beta-2 agonists
— Unclear.h
— Unclear.h
— Unclear.i
— Agents with anti-estrogenic
— Unclear.j
— Unclear.j
— Unclear.k
activity
— Diuretics and other masking
— Yes.l
— Unclear.m
— Yes.n
agents

CRS-25
2003-2004 Policy
2005 Policy
2006 Policy
— Enhancement of oxygen
— No.
— No.
— No.o
transfer
— Chemical and physical
— Yes.l
— Unclear.m
— Yes.n
manipulation
— Gene doping
— No.
— No.
— No.
— Stimulants
— Unclear.p
— Unclear, except for ephedra,
— Yes.
which was prohibited but not
tested.q
— Glucocorticosteroids
— Unclear.r
— Unclear.r
— Unclear.s
— Beta-blockers
— Unclear.t
— Unclear.t
— Unclear.u
Is a player responsible for what is in his
Unclear.v
Subject was not addressed in the
No.w
body?
policy.
What laboratory tests the samples?
Subject was not addressed in the
Subject was not addressed in the
Subject is not addressed in the policy,
policy.
policy, but MLB has indicated that
but MLB has indicated that testing is
testing is conducted at a WADA-
conducted at a WADA-accredited
accredited laboratory in Montreal.x
laboratory in Montreal.x
Are sanctions applicable to all
No.y
No.y
Yes.
prohibited substances?

CRS-26
2003-2004 Policy
2005 Policy
2006 Policy
What are the sanctions for testing
positive for steroids, or stimulants?z,aa
— First violation
— Player placed on clinical track
— Steroids: 10-day suspension
— Steroids: 50-game suspensions
(treatment program).
without pay.
without pay. Stimulants: No sanction.bb
— Second violation
— 15-day suspension without pay
— 30-day suspension without pay.
— Steroids: 100-game suspension
or a maximum fine of $10,000.
without pay. Stimulants: 25-game
suspension without pay.bb
— Third violation
— 25-day suspension without pay
— 60-day suspension without pay.
— Steroids: Permanent suspension
or a maximum fine of $25,000.
from MLB. Stimulants: 80-game
suspension without pay.bb
— Fourth violation
— 50-day suspension without pay
— One-year suspension without
— Stimulants: Suspension by the
or a maximum fine of $50,000.
pay.
Commissioner, up to permanent
suspension.bb
— Fifth violation
— One-year suspension without
— MLB Commissioner imposes
— Subject is not addressed.
pay or a maximum fine of
further discipline.
$100,000.
Is testing conducted during the off-
No.
Yes.
Yes.cc
season?

What types of specimens are collected
Urine.
Urine.
Urine.
and tested?
Sources: Original and two revisions of Major League Baseball’s drug policy, which is Attachment 18 of the collective bargaining agreement negotiated by Major League Baseball
and the Major League Baseball Players Association. Neither the drug policies nor the CBA is dated, so each policy is identified by the year or years it was, or is, in effect: 2003-2004
(original), 2005 (first revision), and 2006 (second revision). All three versions are available from the author.

CRS-27
Notes:
a. Although Major League Baseball and the players association select the independent program administrator (IPA), the policy states that this individual “shall have no affiliation with
the Office of the Commissioner, any Major League Club or the [Players] Association.” (Major League Baseball and Major League Baseball Players Association, 2003-2006 Basic
Agreement (2006 policy), n.d., available from the author.)
b. Even though most anti-doping policies include non-performance-enhancing substances or drugs, such as marijuana, Ecstasy, and opiates, this item pertains only to performance-
enhancing substances and related substances and methods.
c. In some cases, accurate laboratory tests do not exist for certain prohibited substances or levels. In other cases, tests are available to detect the prohibited substances but are not used.
See Table 1, table note h.
d. 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 to the Commissioner of Baseball, unpublished hearing, 109th
Cong., 1st sess., Mar. 17, 2005, available online at [http://oversight.house.gov/features/steroids/testimony_manfred.pdf] and [http://oversight.house.gov/features/steroids/
testimony_pellman.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/rtecontent/document/201104-ENG.pdf].)
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. Designer steroids are mentioned for the first time in the 2006 policy. The following excerpt from this policy shows, through the use of italics, language the that was added to the
policy: “Anabolic androgenic steroids that are not covered by Schedule II but that may not be lawfully obtained or used in the United States (including “designer steroids”) shall
also be considered Performance Enhancing Substances covered by the Program.” (Italics added to show new language.) (Ibid., p. 4.)
g. The list of prohibited substances included 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.
h. The list of prohibited substances included 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.
i. The list of prohibited substances includes any and all drugs or substances included on Schedule I and Schedule II. It is unclear whether any substances known as “beta-2 agonists”
are listed on either of these schedules. Efforts to obtain clarification from Major League Baseball or the players association are continuing.
j. The list of prohibited substances included 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.
k. The list of prohibited substances includes any and all drugs or substances included on Schedule I and Schedule II. It is unclear whether any substances known as “agents with anti-
estrogenic activity” are listed on either of these schedules. Efforts to obtain clarification from Major League Baseball or the players association are continuing.

CRS-28
l. 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 and Major League Baseball Players Association, 2003-2006
Basic Agreement (2004-2004 policy), n.d., available from the author, p. 164.)
m. Masking substances (and methods) are not identified on the list of prohibited substances, but the policy states 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 and Major League Baseball Players Association, 2003-2006 Basic
Agreement (2005 policy), n.d., available from the author, p. 6.)
n. Masking substances (and methods) are not identified on the list of prohibited substances, but the policy states that a 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.... The presence of a diuretic or masking agent in a Player’s sample shall be treated
as a positive test result if the Independent Program Administrator determines that the Player intended to avoid detection of his use of a Prohibited Substance.” Major League
Baseball and Major League Baseball Players Association, 2003-2006 Basic Agreement (2006 policy), p. 8.) However, unlike Olympics testing, it is unclear whether baseball
players are tested for masking agents and methods.
o. Apparently, a decision regarding how to treat erythropoietin (EPO) is pending. The following paragraph is included in baseball’s 2006 policy: “The Medical Testing Officer randomly
selected 200 samples collected pursuant to Section 3.A.1. [this section involves testing for performance enhancing substances and stimulants] during the 2005 Testing Year for
an additional screening for the presence of Erythropoietin (“EPO”). The Medical Testing Officer shall report the results of such testing, on an anonymous, aggregate basis, to
the Party Representatives [the parties are Major League Baseball and the players association] when such testing has been completed and the Parties shall then determine the
appropriate treatment of EPO.” (Ibid., p. 6.)
p. The list of prohibited substances included 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.
q. Ephedra was a prohibited substance, but it was not included in regular testing of players. (Major League Baseball and Major League Baseball Players Association, 2003-2006 Basic
Agreement (2005 policy), pp. 3 and 6.) See table note c. above.
r. The list of prohibited substances included 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.
s. The list of prohibited substances includes any and all drugs or substances included on Schedule I and Schedule II. It is unclear whether any substances known as
“glucocorticosteroids” are listed on either of these schedules. Efforts to obtain clarification from Major League Baseball or the players association are continuing.
t. The list of prohibited substances included 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 from Major League Baseball or the players association are continuing.

u. The list of prohibited substances includes any and all drugs or substances included on Schedule I and Schedule II. 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.
v. 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 (2003-2004 policy), p. 162.)
w. The Office of the Commissioner has an initial burden to establish “that a Player’s test result was ‘positive’ ... and was obtained pursuant to a valid test conducted under Attachment
18 [the anti-doping policy]. The Office of the Commissioner is not required to otherwise establish intent, fault, negligence or knowing use of a Prohibited Substance on the

CRS-29
Player’s part to establish such a violation. If the Office of the Commissioner meets its initial burden, the Player then has the burden of establishing that his test result was not
due to his fault or negligence.” (Major League Baseball and Major League Baseball Players Association, 2003-2006 Basic Agreement (2006 policy), pp. 19-20.)
x. Major League Baseball and the players association agreed, in spring 2004, to have all drug testing under the MLB 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, “MLB Drug-
Testing Programs Move to Olympic-Certified Laboratories,” May 11, 2004, available at [http://www.mlb.com/news/press_releases/press_release.jsp?ymd=20040511&content_id
=740823&vkey=pr_mlb&fext=.jsp&c_id=mlb].)
y. Apparently, sanctions applied only to positive tests for steroids. As noted above, testing for other substances and drugs prohibited by the league was not done as part of its ongoing
testing program. Though players could have been tested for these other substances when reasonable cause existed for doing so, no sanctions were included for positive tests of
other substances.
z. Even though Major League Baseball’s policy includes non-performance-enhancing substances or drugs, such as marijuana, Ecstasy, and opiates, this item pertains only to
performance-enhancing substances and related substances and methods.
aa. A player who has used, or is suspected of using, stimulants may be placed in a treatment program. (Major League Baseball and Major League Baseball Players Association, 2003-
2006 Basic Agreement (2006 policy), p. 9.)
bb. Any positive test result reported before the first reporting date for spring training in 2006 is not to be considered when determining the number of times a player has tested positive
for performance enhancing substances or stimulants. (Major League Baseball and Major League Baseball Players Association, 2003-2006 Basic Agreement (2006 policy), p.
17.)
cc. Under the heading “Additional Random Testing,” the policy states that “as many as 60 tests may be conducted at unannounced times during the off-season ...; provided, however,
that any off-season tests shall only be for the presence of Performance Enhancing Substances.” (Ibid., p. 6.) Assuming that off-season testing would test 60 different players,
approximately 8% of the players would be subjected to tests for performance enhancing substances during the off-season. Although the active player limit apparently is imposed
only during the season, the active player limit of 25 players per team (that is, each team can have no more than 25 active players on its roster from opening day through midnight,
August 31; the active player limit increases to 40 on September 1 each year) was used to calculate this percentage. (Ibid., p. 49.)

CRS-30
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 breast
development resulting from steroid use.23

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.”24
“‘Anabolic’ refers to muscle-building, and ‘androgenic’ refers to increased masculine
characteristics.25 Using steroids may help an individual increase his or her muscle
size and strength and recover more quickly from injury.”26 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.”27 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.”28
Some beta-2 agonists, when taken into the bloodstream, “may have anabolic
effects.”29
23 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.
24 Michael S. Bahrke and Charles E. Yesalis, “Anabolics,” in Performance-Enhancing
Substances in Sport and Exercise, p. 33.
25 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].
26 U.S. Anti-Doping Agency, “Medical,” n.d., available at [http://www.usantidoping.org/
resources/glossary/medical.aspx].
27 Australian Sports Drug Agency, “Substances: Hormones and Related Substances,” n.d.,
available at [http://www.asada.gov.au/substances/facts/hormones.htm].
28 U.S. Anti-Doping Agency, “Medical.”
29 Australian Sports Drug Agency, “Substances: Beta-2 Agonists,” n.d., available at
[http://www.asada.gov.au/substances/facts/beta2agonists.htm]; Gordon S. Lynch, “Beta-2
Agonists,” in Performance-Enhancing Substances in Sport and Exercise, p. 47.

CRS-31
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.30
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.”31
Diuretics — “Diuretics remove the excess water from the body. They are used in
sports where the athletes are categorized by their body weight.... .”32 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.”33
Doping control — “The process including test distribution planning, Sample
collection and handling, laboratory analysis, results management, hearings and
appeals.”34 (“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.)35
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.36 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].”37
Ephedra — “Ephedra is a plant that contains the stimulants ephedrine and
pseudoephedrine, which have been used by athletes to reduce physical fatigue, lose
30 U.S. Anti-Doping Agency, “Medical.”
31 Australian Sports Drug Agency, “Substances: Beta Blockers,” n.d., available at
[http://www.asada.gov.au/substances/facts/betablockers.htm].
32 U.S. Anti-Doping Agency, “Medical.”
33 Lawrence E. Armstrong, “Diuretics,” in Performance-Enhancing Substances in Sport and
Exercise, p. 111.
34 World Anti-Doping Agency, International Standard for Testing, p. 8.
35 Information provided electronically by the U.S. Anti-Doping Agency to the author on Apr.
8, 2005.
36 U.S. Anti-Doping Agency, 2007 Guide to Prohibited Substances and Prohibited Methods
of Doping, 2006, p. 26, available at [http://www.usantidoping.org/files/active/athletes/
USADA%202007%20Prohibited%20Guide.pdf].
37 Björn T. Ekblom, “Blood Doping,” in Performance-Enhancing Substances in Sport and
Exercise, pp. 94-95; U.S. Anti-Doping Agency, “Medical.”

CRS-32
weight and improve mental alertness.” Ephedra is available as a dietary
supplement.38
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.39 (However, the World
Anti-Doping Agency lowered its T/E threshold to 4:1 in 2005.40)
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.”41

Gene doping — “The non-therapeutic use of genes, genetic elements or of the
modulation of gene expression, having the capacity to enhance athletic performance
....42 This includes attempts to modulate hormonal control of production of normal
substances in the body, such as growth hormone or erythropoietin.”43
Glucocorticosteroids — “Glucocorticosteroids are powerful anti-inflammatory
agents, 44 [which] affect the metabolism, and athletes may use them to get more
energy.”45 Glucocorticosteroids are also known as glucocorticoids.
Human chorionic gonadotropin (hCG) — In males, hCG helps to stimulate the
production of male hormones such as testosterone.46 Male athletes may take hCG “to
38 Mayo Clinic, “Performance-Enhancing Drugs and Your Teen Athlete,” Jan. 5, 2007,
available at [http://www.mayoclinic.com/health/performance-enhancing-drugs/SM00045].
39 R. Craig Kammerer, “Drug Testing in Sport and Exercise,” in Performance-Enhancing
Substances in Sport and Exercise, p. 328.
40 World Anti-Doping Agency, The 2005 Prohibited List International Standard, n.d., p. 7,
available at [http://www.wada-ama.org/rtecontent/document/list_2005.pdf.
41 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.
42 U.S. Anti-Doping Agency, 2005 Guide to Prohibited Substances and Prohibited Methods
of Doping, p. 10.
43 Ibid., p. 29.
44 Australian Sports Drug Agency, “Subtances: Glucocorticosteroids (Cortisone),” n.d.,
available at [http://www.asada.gov.au/substances/facts/glucocorticosteroids.htm].
45 Information provided electronically by the U.S. Anti-Doping Agency to the author on Apr.
1, 2005.
46 U.S. National Library of Medicine and National Institutes of Health, Medline Plus, “Drug
Information: Chorionic Gonadotropin (Systemic),” Jan. 21, 2004, available from the author.

CRS-33
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.”47
Human growth hormone (hGH) — HGH is “the hormone ... responsible for
growth and can increase protein synthesis when administered to an adult whose
growth has stopped.”48 Athletes might use it to “induce anabolic effects, reduce
muscle cell breakdown and reduce body fat.”49
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.”50
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.”51
Mimetics — Synthetic compounds “that produce the same (or a very similar effect)
as another (especially a naturally occurring) compound.”52
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.”53 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....”54 (This is an illustrative
description. The actual substances and methods considered to constitute
manipulation may vary from organization (or professional sports league) to
organization.)
47 Cynthia Kuhn, Scott Swartzwelder, and Wilkie Wilson, Pumped (New York: W.W.
Norton and Co., 2000), p. 83.
48 U.S. Anti-Doping Agency, 2007 Guide to Prohibited Substances and Prohibited Methods
of Doping, p. 18.
49 Australian Sports Drug Agency, “Substances: Human Growth Hormone (hGH),” n.d.,
available at [http://www.asada.gov.au/substances/facts/human.htm].
50 Australian Sports Drug Agency, “Substances: Insulin,” available at
[http://www.asada.gov.au/substances/facts/insulin.htm].
51 U.S. Anti-Doping Agency, 2007 Guide to Prohibited Substances and Prohibited Methods
of Doping, p. 24.
52 Oxford English Dictionary Online, available at [http://dictionary.oed.com].
53 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.)
54 U.S. Anti-Doping Agency, 2005 Guide to Prohibited Substances and Prohibited Methods
of Doping, 2004, p. 26.

CRS-34
Precursor — “Steroid precursors are substances that are converted in the body into
steroids....”55
Prohormone — “A natural precursor of a hormone;56 any substance that can be
converted into a hormone.”57
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.”58 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.”59 Stimulants “can reduce fatigue,
suppress appetite, and increase alertness and aggressiveness.”60
Testosterone — “Testosterone is the main male hormone that maintains muscle
mass and strength....”61

55 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].
56 Oxford English Dictionary Online, available at [http://dictionary.oed.com].
57 Dorland’s Illustrated Medical Dictionary.
58 Information provided electronically by the U.S. Anti-Doping Agency to the author on Apr.
8, 2005. (Italics in original.)
59 Australian Sports Drug Agency, “Substances: Stimulants,” n.d., available at
[http://www.asada.gov.au/substances/facts/stimulants.htm].
60 Mayo Clinic, “Taking Performance-Enhancing Drugs: Are You Risking Your Health?,”
Dec. 26, 2006, available at [http://www.mayoclinic.com/health/performance-
enhancingdrugs/HQ01105].
61 Mayo Clinic, “Testosterone Therapy: The Answer for Aging Men?” Apr. 14, 2006,
available at [http://www.mayoclinic.com/invoke.cfm?id=MC00030].