Drug Exemptions Triple in MLB
Wednesday, January 16, 2008
The number of Major League Baseball players granted permission to use banned drugs for medical reasons more than tripled last season from the previous one, according to statistical information released during yesterday's hearing on steroids in Major League Baseball in front of the House Committee on Oversight and Government Reform.
Major League Baseball gave permission to 111 of the 1,354 players who were tested in 2007 to use performance-enhancing drugs because of medical disorders, up from 35 of 1,356 the previous year, raising questions among medical experts as to what caused the increase.
The vast majority of the players (103 in 2007 and 28 in 2006) requested the exemptions for stimulants used to treat attention-deficit disorder such as those found in Adderall or Ritalin. That fact troubled medical experts contacted after the hearing because baseball included amphetamines in its drug-testing program for the first time during the 2006 season.
Two players last season and three the previous year also received exemptions for "androgen deficiency," according to information released by the committee. Several medical experts said the language seemed to indicate MLB granted exemptions for testosterone or other steroids. MLB Executive Vice President Rob Manfred said in an e-mail he was bound by the collective bargaining agreement and could not comment. He added that MLB made a limited exception to release the information to the committee.
By comparison, the U.S. Anti-Doping Agency in 2007 granted 27 exemptions for attention-deficit disorder medication -- an estimated 90 percent of which were for athletes younger than 21 -- and none for testosterone for an athlete population of around 10,000.
Rep. John F. Tierney (D-Mass.) mentioned some of the numbers, which MLB had previously declined to release, during the hearing, which focused on baseball's efforts to implement recommendations by former Senate majority leader George J. Mitchell in his December report on performance-enhancing drug use in baseball.
Lawmakers requested the figures because Mitchell had mentioned in his report that the union and MLB refused to provide them to him, according to a committee spokesman.
Tierney contended that the incidence of attention-deficit disorder in baseball was eight times that of the normal population. Baseball Commissioner Bud Selig acknowledged the numbers were "a little higher" than is typical in the adult population. He said the rise in exemptions -- known as therapeutic use exemptions or TUEs -- was "one of the major subjects" of discussion during a meeting last week with MLB trainers.
Selig and MLB Players Association chief Donald Fehr noted that TUEs are overseen and granted only by the sport's independent program administrator, Bryan W. Smith, who was the team physician for the University of North Carolina for 10 years. Smith, according to the statistics provided by the committee, declined to grant 13 TUE requests in 2007. Two were withdrawn. The other TUEs granted in 2007 were for medications for hypertension (five) and alopecia (one).
They also noted that players are required to get a doctor's recommendation before taking the request to Smith, who was appointed in early 2006.
John Ratey, an associate clinical professor of psychiatry at Harvard Medical School, said the incidence of attention-deficit disorder among ballplayers was not out of line with the general male population since diagnoses of the disorder had increased in recent years. Ratey, however, said he was perplexed by the leap in diagnoses from 2006 to 2007.
"I don't know" how to explain that, said Ratey, author of the book "Spark: The Revolutionary New Science of Exercise and the Brain." "They didn't get that many more minor leaguers who had ADD. . . . All of a sudden there are [nearly four] times the diagnoses? It's like, 'What?' "
Said Gary Wadler, chairman of the World Anti-Doping Agency's prohibited list and methods committee, "If that happened in society, we would have a health epidemic on our hands."
Christiane Ayotte, a Montreal lab director who conducts the testing of MLB's urine samples, described diagnoses of androgen deficiency in athlete populations as "a slippery slope."
"I don't know in amateur sports how many athletes would be diagnosed with androgen deficiency," she said.
Wadler said a testosterone exemption was once granted in the Olympic movement to a sailor (Kevin Hall of Bowie) who had both testicles surgically removed and could no longer produce testosterone naturally, but he noted that "it's not common."