Taking meldonium for performance enhancement | Hacker News Reader

Taking meldonium for performance enhancement

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142 pointsuntangle151 comments

Honestly PEDs should be legal and regulated in athletics, if not for performance, then at least for recovery. It's completely arbitrary what's legal and not anyway and a good training program and the best coaches also function as a PED.

Make it uniform and regulate it and maybe you keep everyone safe. Or not. I don't really care, I build scripts for a living. /shrug

The argument I've heard against this is about safety. Firstly, you don't want athletes needing to push the limits of safe pharmaceutical use just to win. This forces all competitive athletes to dose the maximum amount allowed. Moreover, though perhaps less of an issue, it forces those who seek an illegitimate advantage to push even further than they need to now.

Secondly, this 'sets a bad example'. Not in the moral sense, but in a pragmatic sense. Regulated doping in competition encourages enthusiastic amateurs to also start doping. Not only does it seem wrong to require aspiring amateurs to take medical steps, there is the added issue of lack of guidance. Amateurs have less of a support team around them, thus making mistakes or uneducated use more likely.

In the end, you rule against doping not to keep the sport fair, but to keep the sport safe for aspiring amateurs and professionals. In turn, this keeps the sport alive by having a steady influx.

There is a fairness issue regarding 'pay to win' becoming a more effective strategy whilst, at the same time, also increasing the financial barrier to entry.

I don't think that argument really holds up. After all, athletes already push the limits of safe exercise in order to win; all competitive athletes are forced to exercise the maximum amount allowed, and exercise is not purely positive: it has negative as well as positive effects.

I don't follow you. You seem to be saying that since athletics is about pushing the limits of the human body, it's already unsafe, so there's no problem with making it much less safe. I strongly disagree. For context, I'm thinking mostly of athletics (track and field).

Pro athletes generally strive to achieve excellence at some task the human body is adapted for -- running, jumping, throwing. But it's within the limitations imposed by their own human bodies, which are very well-adapted for keeping themselves safe while accomplishing these tasks. They know that going overboard risks burnout and injury, so their incentives are generally aligned with staying healthy. Chemically tricking the body into doing something long-term unsafe in return for short-term performance is a different ballgame.

(Of course there are a few outlier sports like American football and sumo wrestling which are just clearly unhealthy. Even for those, I don't see why we should make matters worse by sanctioning unhealthy PEDs.)

I believe there was an article posted on HN a while about about whether or not humans could improve the speed of a fastball in baseball. If I recall correctly, the suggestion was that one of the ligaments can not stand the stress above a certain speed.

There are many sports (especially in track and field!) where we are meeting the limitations of normal humans. Can you be a world class sprinter if your body is not aligned to it at birth? If you are disadvantaged at birth, how reasonable is it that after sacrificing most of your life to training you are going to accept inevitable failure? What if a PED can push you over the top?

One of my favourite quotes of all time is from the Simpsons: "Cheating is the gift man gives himself".

With billions on the planet and hundreds of millions who are rich enough to pursue sport, the pool of people who have the drive and are willing to dedicate everything to being the best at their sport is HUGE. What is sport at that point? Filtering for genetic freaks?

But then, looking at it another way, should we then see it as a technological challenge? Let's look at cycling. Whether or not we accept the premise that doping and PEDs in the pro peloton are a thing of the past, it's hard to argue with the success of Sky's "marginal gains" strategy. The margins of victory in large stage races are so minute that even a 10 watt difference could be meaningful.

I kind of look at this as an F1 style of sports. Those with the access to money for research will win (as we see with Sky in cycling). If we include PEDs? Well, then money for research becomes even more important.

Now, I actually like F1 racing (even while not really liking cars -- I'm complicated ;-) ). I like pro cycling. I like a lot of things. But, I honestly don't think this is the direction that sports should go. As someone who participated in track and field in his youth, I'm highly disillusioned with current trends -- competition for medals, the need to beat world records, people sitting on their sofa watching 10 minute vignettes of "life drama" with occasional intermissions of some guys running.

Sports for me is 50 year olds getting together for a game of soccer; jogging in the morning every day to get ready for the 10 km "marathon"; riding in a "sportive"; softball; hockey; kendo; whatever you enjoy doing.

Watching people at the top level is awesome, but we don't need to enhance it. We don't need to embellish it. We certainly don't need to pay someone the GDP of a small country so that we can have bragging rights at the office the next week. Especially if a PED makes the difference between a struggling athlete bagging groceries for a living or living the life of a super star.

PEDs can also greatly improve the safety profile of a sport. For example, anabolic steroids increase strength and improve recovery, which significantly lowers the risk of missing an olympic lift such as the clean and jerk and possibly injuring oneself. Anabolic steroids can also increase bone density, which lowers the risk of general injury across all sports.

That's an interesting angle.

The risk of missing a lift would still be the same since they would just try to lift heavier weights.

They would only try to lift heavier than their competition, so there's an artificial limit on how heavy one would go.

But the real crux of the situation is this: For a given individual, on every possible lift and every possible weight, it is always safer to use anabolic steroids than not.

Athletes in many high paying and highly respected disciplines were caught on short and long term use of forbidden drugs. This includes top names e.g. in tennis and cycling. These sportsmen dont seem to care about safety too much. They just probably want to win.

If professional orgs would ban athletes for life, there would be little doping, but somehow nobody does that. Why? Perhaps money from sponsors is much more important than safety and fairness?

Is it fair to punish people so harshly?

Make the punishment for burglary the death penalty, and burglary would go down. And yet, such harsh punishment is generally frowned upon.

> Make the punishment for burglary the death penalty, and burglary would go down.

Depends on the context, if it's hard to be caught or people who commit burglary today are people that are ready to accept any risk due to their socioeconomic condition then it's not a good deterrent.

This doesn't seem an adequate analogy to banning someone from sports: if a burglar was sentenced to death we would be taking all he has and also permanently punishing his loved ones. By banning a sportsman we take away his career, but he is free to pursue anything else and continue life in his community, contributing to it. We may consider taking back some of the winnings as punishment. Removing someone from a circle of trusted athletes is not really a punishment -- it's a punishment for that community to endure such misconduct.

My point is that the efficacy of a punishment as a deterrent isn't sufficient reason to instate that punishment. There needs to be proportionality between the offense and the punishment.

So, just because lifetime bans would be an effective deterrent doesn't mean that we should instate lifetime bans.

Yes, I agree that how strong a deterrent is is not necessarily the best way to decide how to punish. But again, I can't claim it _would_ work, I'm just saying that there are other reasons to punish people who willingly violate basic rules they agreed to previously. If there were no consequences to those violations (like there often aren't any if you violate some less important road traffic rules) I'd say "screw the rules", but if someone is winning millions, fame, respect etc. at the expense of his fair competitors, I'd say "bye bye" as soon as I could.

Such moral violation is for me first sign that counterparty is dangerous to the well being of others. Why not exclude such counterparties from the game altogether? I don't care as much if it will deter the future ones, I just want the ones already caught to be out of the game!

If you make the penalty for burglary the death penalty, then any burglar will kill anyone they can to avoid being caught. I.e. why rob a house with an elderly occupant who might identify you when you could just kill them? Escalating penalties put more things on the table, too.

The problem there is that you are then encouraging people to use substances which are potentially detrimental to their long term health. In fact, they'd have to use them to be competitive.

Of course, it's perfectly valid to say that we're already at that point, but I don't know that sanctioning their use is the right thing to do for the governing bodies. I don't know what the answer is, but I agree completely that they should be illegal in the eyes of the law.

As opposed to playing football or hockey, which is super good for your long term health!

Admittedly, those two are at an extreme in terms of destroying your body, but they're not alone. Gymnastics leaves people in rough shape in their later years. I'd imagine figure skating and tennis are also pretty hard on you too.

Sounds like an argument for better safety measures in those sports, not fewer.

With American football there is a paradox; modern safety equipment makes the big hits possible.

Rugby and Australian rules football are good controls.

Boxing too, was made to be more harmful long term by the introduction of safety measures (the gloves). Previously headshots were less frequent to avoid damage to the hands.

Sports like football and hockey would be even more dangerous if "everyone" was able to use PED's. You're just going to raise the physicality that much more.

Unless football and hockey leagues are randomly testing their athletes year-round, like the UFC does with USADA, it is very safe to assume that everybody is on steroids.

Basically everything about professional sports is detrimental to long-term (or even mid-term) health, yet no-one seems to have a problem with it unless it involves "chemicals".

Some sports.

Is there any evidence for this? Other than possible joint pains, which are likely no worse than doing a regular factory job, and sports like NFL and fighting where hitting each other is the point, and are probably more comparable to gladiator sports than something like basketball or baseball.

I suspect the better fitnes that sports persons have in most other sports, combined with the above average income, means they almost certainly have better health than the average person, even after adjusting for the fact that they likely have better physical health genes.

The problem is that the worst coaches exist too. The reality is that you're going to have kids with even worse chronic long term problems after they play through.

I wish there were a sport where anything goes performance enhancement wise. Full-on hulks just roiding out and showing PEAK human performance. Is there anything like this in the world?

PRIDE fighting in Japan explicitly does not test for anything.

they haven't been around for a while. I don't think ONE championship tests, and if they do, it isn't very rigorous.

In MMA the UFC is way way more strict than any of the other orgs. You very rarely see champs or big celebs pulled off card ever like you in the the UFC under USADA testing

Rizin FF[1] is the new PRIDE, in essence. It too has a 'relaxed' stance on PEDs.

[1]: http://www.rizinff.com/en/

And a 'relaxed' stance on stupid matches. Not a fan of the org after the Gabbi Garcia shenanigans

PRIDE has its fair share of preposterous exhibition matches though, to be fair. But no, I'm not a fan either.

There are power lifting federations where they are not tested which can give you some information. PED seems to increase strength between 5-20 percent with most around 10% probably.

https://fivethirtyeight.com/features/what-powerlifting-tells...

If you want watch people go all out with AAS, HGH, insulin and all that you can watch modern bodybuilding.

By the way, that's not a 10% increase in individual performance, but rather a 10% increase in relative performance for your weight. People on PEDs will usually move up a weight class from increased muscle mass.

Edit: See here for a really detailed comparison from someone who knows what he's talking about: https://www.strongerbyscience.com/steroids-and-strength-diff...

Imagine if you did have the two classes in an endurance race, with no prize money for the doped up classes. Imagine in cycling if there was Lance and co doing the Tour we know and then another clean race, much like in Learning Mans with motor sport. Lance and co would be the LMP class.

As per motor sport it is obvious what class a car is in, there is no pretending to be the other class.

The testing would be more part of signing up to a given class, everyone would know what everyone was taking whether that be nothing or everything. Much like how in Motorsport you know cylinder count, oil used and so on.

World's Strongest Man, Mr. Olympia.

I'm with you on this. I'd be really interested in seeing, for example, an "Open Division" in Track-and-Field, whereby anything goes, up to and including gene modification and cybernetic enhancement.

It would be both a sport and a laboratory for transhumanism. I'd be incredibly interested to see what science came out of it.

There are probably ethical arguments to be made against doing that, but... meh.

There was a periodic survey of Olympic athletes asking "would you take a PED that guaranteed a gold medal and shortened your lifespan to five years?", more than half said yes.

https://en.wikipedia.org/wiki/Goldman%27s_dilemma

The update in that wikipedia link point to changing attitudes in more recent years.

"It would kill you five years after you took it", that's quite more drastic than reducing your life span by 5 years.

A somewhat recent update (delayed release) with anonymous survey shows around 50% to be the actual number of admitted dopers. https://www.theguardian.com/sport/2017/aug/29/sport-doping-s...

How would you regulate it? If you decide some things are dangerous and forbid their usage then you are back to testing athletes because they might use it anyway if it is still effective.

Over the past couple of dozen years, I've wondered if we could have a second set of competitions where we allowed participants to enhance their performance with the use of drugs.

I admit, my curiosity was piqued by Mutant League Football, but I still think it might be viable. They can maintain separate records and petty much allow anything. One might even make another group that allowed body modifications.

"Regulating it" means creating new rules. Which would, once again be broken if athletes thought it would help their performance. And you'd end up at square 1, except everybody who was previously clean was now forced to take all the drugs the new rules permitted.

And there's nothing really arbitrary about the rules, or at least no more arbitrary than almost any other rule you can find. Just because you can argue about the exact requirements to become a lawyer in Iowa doesn't mean that my hamster is as good a lawyer as the top graduate of Harvard Law.

    > Make it uniform and regulate it and maybe you keep everyone safe. Or not. I don't really care, I build scripts for a living. /shrug

Well, if you don't care, why do you bother to profess an opinion? There are plenty who do care about the well-being of athletes.

I am skeptical, however, that doping will ever get under control unless the pressure behind the doping relents. The rewards in elite sports are perhaps too great. By the time athletes reach their prime mentally, the body is no longer at its peak, and they're desperately trying to compensate to finally reap the rewards of a career of brutal training.

Well, "legal" and "allowed in the sport" are two different concepts.

Anabolic steroids are legal in many countries, like Mexico and Poland. It's just the US that criminalizes them, and probably has influenced the decision to ban them outright.

Regulation is another thing. I'd actually say they are regulated, in that the current rule is "don't take them". And even enforcing that relatively simple rule - just detect them, is actually a hard problem we can't solve very well, given the amount of athletes that lost medals over the last couple of olympics.

In the end, PED regulation is just another set of rules added to each sport. These are professional athletes, and most manage to not run into any problems understanding and following the rules. Adding some kind of "permitted level of use" is theoretically possible, but I suspect you'll just end up spending a lot more money trying to detect how much anyone is using at a particular period of time, etc. etc. Add stupid political pressure from the US federal government, and I'd imagine any kind of "lenient system" would just be far, far more expensive to execute.

> Anabolic steroids are legal in many countries, like Mexico and Poland

This is not entirely true. You will not be penalized for possessing anabolic steroids in Poland but selling without prescription is illegal. So without prescription the only way to get them is black market and there are tons of fakes on black market. So you don't really know what you are buying..

There's also testing kits you can buy and most of these markets the customers are posting results of the tests and blood work to verify the source is legitimate. It's actually a quite reliable and honest economy because of how much scrutiny people have over putting vials of oil in their bodies. It's an interesting market dynamic considering it's completely unregulated and illegitimate.

The point is that the athlete isn't considered a criminal for possessing them in Poland, whereas in the US, they are.

To further muddy the waters, in the context of sports, "legal" generally means "allowed in the sport", not just "non-criminal".

That would probably change e.g. a bicycle race into something like Formula 1 racing.

The irony of your statement is that Formula 1 places a huge list of engineering limitations on teams (engine displacement, weight, dimensions, even ECM firmware), and any "performance enhancing" outside of these parameters has historically led to scandals in the sport.

So does cycling. Everything from wheel size, tube profile, saddle angle even down to the basic double diamond shape is regulated.

The entire modern sport of cycling is based around the idea that riders sheltering behind forward team mates or rivals burn much less energy pushing through the air.

Without the rules governing bike design riders would probably gravitate to the use of fully faired recumbent bikes and the team dynamic would be lost. We'd be reduced to what amounts to individual time trials.

This is one reason why we have individual and team time trials on slightly less restricted designs to separate the desciplins.

The UCI is relaxing some of its aero rules, though: http://www.cyclingweekly.com/news/latest-news/uci-set-to-scr...

Isn't air resistance still the limiting factor even on a fully faired recumbent bike? A cooperating team should still handily beat a soloist.

Do you only mean professional athletics?

My only issue is that athletics start at a young age for most. For some sports, people routinely go pro in their teenage years (tennis, baseball, etc.). We would have parents PEDing up their kids just to get the college scholarships or drafted out of high school. Feels like that would do more harm than good.

> Do you only mean professional athletics?

The vast majority of Olympic athletes are not professionals.

I have recently suffered a traumatic brain injury (tbi) - not unlike what may be common in football, hockey and other contact sports - and not exactly pleased with the medical response that there is no real treatment other than rest, I began doing some research and came across an open letter from a Harvard PhD to the NFL commissioner regarding cannabis and concussions, CTE and TBI. They focus on the CBD heavy variety and suggest it acts as a neuroprotector. Then a little more research I came across an Israeli study regarding TBI improvements in rats using cannabis, I even thought I found an article saying the Israeli military uses cannabis for treatment of soldiers and enemy combatants with TBI but I can't seem to find it now.

I'm not so sure about peds for competition or recovery, but if cannabis is considered a ped by various sports commissions and can be beneficial to brain injury that is a damn shame.

https://motherboard.vice.com/en_us/article/ae3gqe/the-nfl-sh...

http://www.timesofisrael.com/cannabis-could-treat-traumatic-...

To me, this doesn't seem to fall under performance-enhancing drugs as much as medication for injuries sustained in the sport.

Cannabis is not considered a PED (anyone who has taken Cannabis can easily atttest to that).

Cannabis is a problem due to other political issues which means it's illegal in most major sport playing jurisdictions.

It might be performance enhancing. I say that partially because marijuana may be a bronchodilator, but mostly because I know many college and some pro athletes who use marijuana. I can run a sub 11 second 100m while very high.

> Cannabis is not considered a PED (anyone who has taken Cannabis can easily atttest to that).

Cannabis is very, very, much considered a PED. It is banned in competition by USADA and WADA.

Anesthetizing effects, motor processing effects, lung performance, etc...

I will agree that most people most of the time are not smoking and becoming super athletes. I do not agree that athletic performance is unaffected by it and that it's consequences are universally negative. Hence the ban against using it in fair athletic competition.

If you have suffered TBI I highly suggest getting neurofeedback training to try and repair any possible damage caused to the brain by the injury. It is a very powerful tool to change the structure of your brain. Just make sure you find a specialist that can accurately create a profile for your particular set of circumstances and creating a special training program for that. I almost signed up for a borderline scam, but luckily found the leading expert in the field (She essentially pioneered Neurofeedback training).

The problem is that sports competition is zero-sum: it doesn't really matter whether the fastest run takes 4 minutes or 3:59, but it does matter whether you're a second faster than your competitor. This quickly generates a "race to the bottom" where everyone has to pay absolute costs for relative advantages.

This is less desirable outcome than is ideal, which is why there's room for making everyone better off through enforcement of norms against PEDs. It's a question of what everyone must do in order to be competitive.

That said, there should be a conversation about whether the cure is worse than the disease. If PEDs are safe enough, the costs of enforcement and allowing the cheaters who make it through the screens to win will outweigh the benefits of having the bar for competition lowered.

"This quickly generates a "race to the bottom" where everyone has to pay absolute costs for relative advantages."

I really like this framing. You've expressed something I've felt intuitively but never really been able to articulate (either to myself or others).

As a side note: this framing is why I oppose subsidizing college in the US. Having a college degree is mostly a relative advantage, especially outside of STEM. We only need so many firefighters, so if we preferentially hire applicants with college degrees and subsidize college, it's kinda pointless.

Better is making sure that economic opportunities remain available for those without degrees, when possible. Make it illegal to discriminate against those without college degrees unless it's a bona-fide occupational qualification.

Why can't we do both? Poor kids who would get a great benefit from college deserve as much help as poor kids who wouldn't benefit from college but would benefit from vocational training. If the object is to effectively help everyone, only doing half is a bad thing.

Because there's a limited number of "slots" for the sorts of white-collar professional careers that a college degree gives you preferential treatment for. Putting another student through law school does not make law firms hire more lawyers. It means that the average quality of hired lawyers goes up while one more person with a law degree fails to get employed in the field.

The analogy would be more clear with sports - putting more effort into youth basketball training won't make more NBA players, it will just make NBA players better.

This is the "lump of labor" fallacy. The NBA has a finite number of teams and only adds to them slowly. Having more good white-collar professionals often means that companies can expand and make more money.

Even if there were a finite number of "slots", not funding smart poor kids to go to college is a dumb idea. Having smarter/better candidates for the "slots" is better.

Of course, different professions have different amounts of "get a bigger piece of the pie" versus "make the pie bigger". The trades are more obviously positive-sum: if people get better at making houses, more houses end up getting built for people to enjoy. Things like patent trolling are negative-sum: when a patent-trolling office expands, they do so at the cost of putting others out of work at a greater rate.

However, this isn't the point that the "free college for everyone" crowd is aware of, let alone considering. It's straight equivocation between "college degree holder earns on average $X more" and "an extra college degree is worth $X more to society as a whole".

> Honestly PEDs should be legal and regulated in athletics

Well, it is regulated. What is not regulated is that for example steroids permanently modify the amount of myonuclei so that a steroid user will have better long term recovery (rebuilding from reduced muscle state) for decades after usage. Or take EPO: the effect of using EPO is the same as using a compression chamber and has the same dangers (arguably, using EPO is safer than subjecting your body to a outdated compression chamber sourced from the landfill), yet one is allowed and one is forbidden. Then there's steroid usage after injuries (why do teams have a dedicated physician? so he can give people steroids if they stub their little toe).

You can either forbid (on paper) or completely deregulate; "some" regulation will not change very much vs. prohibition.

Doping does work. There are reasons athletes do it and take enormous risk with their careers and health.

I remember a long article in Outside magazine where the journalist doped with EPO and HGH to compete in amateur cycling at a level he found to be surprising: https://www.outsideonline.com/1924306/drug-test

Using the word "cheating" is too simplistic of a dismissal for doping, I think.

Doping really, really, really works!

Once I did a lot of weight lifting. I gained weight from 65 kg to 75 kg but then hit a wall. Whatever I did I couldn't get above 75. There were several guys like me but all of a sudden some gained weight again. Not just a little, but 10 kg in 8 weeks. I asked them what's going on and they all told me they got steroids from Poland. The progress was amazing. Since then I am pretty sure that all top athletes take something. The advantage is just too much.

A lot of that was water. Of course AAS has a ton of potential and can put help you put on muscle like no other but there are so many lifters who go on a cycle put on 10 kg then when they go off they lose 6 of those kilos fast; get unmotivated because their natural testosterone is pretty low (even with pct) and then half ass their diet and training for a while and then they are almost back where they started. But with potentially less hair on their head, gyno and acne scars if they are prone to it.

Of course that is not true for all but when evaluating always ask someone a couple of months after the cycle and not during it because at that time they are kings.

100% of people that want to start in Mr Olympia takes steroids, not 99% or 70% but 100%.

Not just Olympia but majority of "natural" fitness models you find on instagram are on steroids as well. It's just impossible to look like that year round naturally.

Personally I think you can extend this to (almost or all?) any sport.

Interesting article, even if it is a bit silly to say you would use testosterone but not steroids.

Fascinating article. I've always wondered about the proportionality of increase with drugs like this, and he makes it sound quite a bit more dramatic than I imagined.

I pretty frequently place in the top 5% in amateur mid-distance running, like 10k or half marathon. Sounds like if I was on the juice I could easily be in the running for podium finishes.

Not that I would, but, geez.

I suspect that some of the amateur runners on the podium at the larger local races are geared. No way to prove it though. There's no prize money and no drug testing. People will do crazy stuff just for pride.

From what I've heard, it sounds like a lot of the benefits are in recovery, i.e. the drugs don't make you faster, but they allow you to train harder and still recover/improve which is what makes you faster. (I would guess maybe EPO is an exception...) So if you're not already training hard enough that you struggle to recover, I wonder if they'd really make a difference beyond placebo.

It IS a big risk career-wise, but from reading things people in-the-know say, it seems that if you have a knowledgeable person administering the PEDs, it's a relatively low-risk endeavor health-wise.

Low risk in the short term. Who knows what effects will show up 30 years later?

Yes, also, one of the ways that PED's work is that they allow athletes to step up their training volume and intensity. This accelerates additional wear and tear on the body beyond what one would see with "non-superhuman" levels of training.

Testosterone replacement is a fairly common treatment for older men. It seems that the main downside (at least at an advanced age) is an increased risk of cardiovascular problems:

https://en.wikipedia.org/wiki/Androgen_replacement_therapy#A...

I'd highly recommend the Netflix documentary Icarus. The filmmaker starts out trying to more or less replicate the doping routine of Lance Armstrong while competing in amateur cycling.

I don't want to give anything away, but the documentary takes an incredible turn once the filmmaker meets Dr. Grigory Rodchenkov — who ran the Russian anti-doping lab prior to Russia's ban from the Rio Olympics.

https://www.theatlantic.com/entertainment/archive/2017/08/ic...

+1 for Icarus. Excellent, fascinating documentary. Don't get distracted by the weird title.

Weird title? Clever and apt title I would have thought.

How is it a weird title? Icarus flew too close to the sun and suffered the consequences. Fairly good analogy for athletes using Performance Enhancing substances and flying to high and have it all crash down.

The problem with performance enhancing drugs isn't their use per se, it's the fact that competition at a high level more or less forces you to use any and all means at your disposal to win, and this forces would-be winners to consume large, unhealthy, long-term unstable and harmful amounts of drugs.

People who manage sports associations are comfortable with people sacrificing time and fortune for their passion, but they are not (in general) comfortable with creating an environment in which people must sacrifice their health and well-being to compete.

PEDs in some form should probably be (and in fact are, in most states) legal for personal use, but I believe that anything with the potential to cause long term bodily harm when abused should be banned in organized competition by the organizers (not some state, unless it's a publicly funded athletic organization). I further believe that unless demonstrated to be safe, most medications should be assumed to be damaging, within reason. There should be a long, slow, tedious path to approval.

That's the world view that, to me, does the best job of creating a healthy environment for athletic competition.

As a sports outsider I see the problem with doping to be moral and societal.

Moral: we agree on some rules, compete, and the guy who won may have broken a trivial rule to get an advantage. How is this acceptable?

Societal: I'm not a fan of spectator sports in general, but... when people become rich and famous and powerful by cheating, that probably strenghtens the view in many people that winning at the expense of others and ignoring our own earlier declarations is more important than cooperation, fair conduct, honesty etc. Not a world I would like to live in.

I think sports have always been war games of sorts in that they carve out boundaries of in groups and out groups. People overwhelming support the team that they identify with (geographically determined for the most part) regardless if they win a lot or lose a lot because it is not enough to win, you need to win with identity. To unleash "win at any means" is far too close to war itself which subverts the intention of the game to replace war.

The stigma steroids have gotten because of MLB and a few other notable famous athletes is really unfortunate. Low doses of testosterone in men shows great health benefits especially for men >40. HGH and other growth hormones like IGF-1 have also shown great general health benefits. Steroids are schedule 2 drugs on the same level as opioids so just about everyone who is taking them (besides wealthy people who can afford to go to anti-aging clinic where you can be prescribed for this) is doing so low key which makes awareness and education very difficult.

That stigma started with the parents of teenagers, who committed suicide while taking steroids, appealing to their congressman. Prior to reading The Waxman Report, I had no idea what the fuss was about.

http://www.thenewatlantis.com/publications/the-steroids-era

https://www.amazon.com/Waxman-Report-Congress-Really-Works/d...

The generic concept of performance enhancing drugs has always concerned me. I've seen nootropics crop up on hacker news occasionally, and I have this terrible feeling that someday the only way to remain competitive in whatever you do will be to take performance drugs regardless of the consequences (unknown or not), be they mental, physical, or otherwise...

Like Gattaca

You still won't be able to compete with robots, cyborgs and AI.

> I have this terrible feeling that someday the only way to remain competitive in whatever you do will be to take performance drugs

Nicotine gum is pretty much the only reason I can stay focused at work.

Interesting how Meldonium works.

When I was doing research on SARMs, GW501516 often came up. It basically works in the opposite way that Meldonium does, increasing cellular metabolic preference for lipids as opposed to glucose. I wonder which metabolic pathway is optimal for weight-loss; probably a combination of the two.

I hiked up a modest mountain to watch the eclipse and found myself winded after about 1 hour of light (~10-15 degree incline) and my feet were like trudging through molasses for the remaining 4 hours of climb (45+-ish degree incline)... I'm not in terrible shape (I can do 11 pull ups, and maybe about an hour of medium cardio without discomfort at sea level). I wonder if meldonium could be used to combat altitude sickness.

I would think twice about it although. GW501516 for example: 'was abandoned in 2007 because animal testing showed that the drug caused cancer to develop rapidly in several organs'

that's understandable, since it kicks in fat burning, which is a more oxidative process, there's likely to be more oxidative stress on the cell. Meldronum on the other hand reduces the net oxidation performed by the cell by shifting. Of course, the eye is a very bad medchemist, so take what I say with a grain of salt

Viagra is for altitude sickness... Serious(ly)

Check the studies with obese people and GW501516. It doesn't work. They didn't lose much weight.

I don't know the regimen of tests players go through in professional sports, but I've thought for many years that players who depend more on mental sharpness than physical performance (For example a QB in the NFL) are doping to improve mental performance. It always seems the investigations and testing that I hear about or read about in the news revolve around (a) illegal drugs, and (b) drugs that improve physical performance. I've never heard of a case of testing for drugs that improve mental performance.

What are you thinking, modafinil?

I'm not educated enough in this to specify a single drug / nootropic. It's just always seemed like the professional leagues leave a large gap in coverage of their tests if they are (a) testing for "performance enhancing drugs", and (b) leave out drugs that improve mental performance. If they do test for this type of drug I've just never been made aware of it.

It's a good question.

Would be interesting to know from an evolutionary standpoint why the heart preferentially burns fatty acids, when burning glucose is supposed to be better. The heart muscles have one of the highest rates of use. Maybe there are long-term side effects associated with the glucose pathway?

Purely speculation, but that could be because fatty acid is easier to store, so you need to use it later, and because glucose would be kept in reserve of high intensity effort (like running away from a predator) in case you really need it. Several fitness websites suggest that when exercising at 50% of your maximum heartrate, you burn more fat compared to carbs than when exercising at, say, 75% of your max heart rate. But that may be completely false, I don't know.

There isn't any proof that this drug provides any benefit to athletes. It is easy to think all PEDs work when your only knowledge is EPO and steroids. Other stuff... much less testing and the performance boost might be neglible.

When I first heard about this drug (from the Sharapova incident) and looked it up, it sounded like a miracle drug for Rock Climbers, which I am. I have family in Russia as well, where you can buy it over the counter, but I haven't had the courage to try it out yet.

This article really makes me want to give it a shot, just for curiosity sake. My main limit on wall climbs isn't technique or strength, it's getting pumped out. Training endurance has been incredibly hard for me. Even when I was younger and played soccer, I was getting winded way before anyone else, even though I was just as active. I've always felt like I have some kind of oxygen weakness, compared to other people.

> I was getting winded way before anyone else, even though I was just as active. I've always felt like I have some kind of oxygen weakness, compared to other people.

This should go without saying, but you should really get that seriously checked out before trying doping. You might have a heart problem that isn't a problem until it is the last problem you'll ever have, or it might be nothing.

Better explanation https://www.youtube.com/watch?v=uk-eiAUgO9w albeit information from the manufacturer.

Ironically it could prevent sudden death syndrome in sports.

author cheats, thinks it works, roots for cheaters

Please describe your feelings on athletes wearing contact lenses. How about athletes who have ever had a surgery? What about athletes who are, at the time of competition, using non-prescription antihistamines? How about pseudoephedrine?

Simple. Look up what the WTA/<insert authority of sport you play> regulations ban; everything else is fine.

I think the argument was to build a logical rationale for this. Appeal to authority is somewhat weak, in that regard.

I think OP tried to make the point that anyone participating in a competition should stick to the rules of that competition.

That doesn't preclude discussion about whether those rules make sense, but "Yes, I broke the rules to get an advantage, but the rule really shouldn't be there because of these reasons" is never a good defence. It might help to further the cause of rule change, but it never makes a result from cheating fair.

Right, I took that too. I took the post they were responding to as a request to build a logical rationale.

I'm not trying to appeal to authority. When you play a WTA tournament, it's only fair that you have to abide by their rules. Playing tennis, or playing in another tour that doesn't ban your drug of choice shouldn't be banned.

This has nothing to do with my opinion on general drug use, which I agree has been demonized.

It was pretty clear that the post you responded to is looking for "why has the governing body chosen this particular set of rules."

Otherwise, it is a pretty boring discussion. Yes, the authority on whether or not this substance is banned has (or has not) banned this substance. :)

Drugs are bad.

Why?

Because they're illegal.

Why are they illegal?

Because they're bad.

Who said drugs are bad? I'm pretty sure they are great, from the vast literature out here.

To be fair, the original commenter only mentioned "cheating," not "bad." It's pretty reasonably to claim that using drugs that are banned by the governing body of your sport qualifies as cheating.

Help, help, I'm stuck in a tautology factory.

Cool. The authority of the sport that the author played was the USTA, not the WTA. The author says, "For the record, meldonium is not illegal (or “scheduled”) in America, nor is it banned specifically by the USTA." I presume you have now 100% flipped your opinion on whether the author cheated, based on your not having read the article carefully.

Oh I don't think the author cheated, at all. My takeaway from the article was that he felt good on moldonium, and played in a(n?) USTA tournament where it isn't banned.

I thought your contact lenses nonsense was about your OPs 'roots for cheaters'

Edit: Thinking back, I think I'll support Sharapova too, but there is no question in my mind that she was on illegal (acc to WTA) drugs for 26 days.

I thought that you were the person who kicked off this thread, and you weren't, so snark on the subject of careful readings is fully deserved! My apologies.

Hey I actually thought I was rude and edited out the snark. No worries.

It's pretty obvious, isn't it? If something is used as treatment for a pathology it's not doping.

Besides, the difficulty to define something so as to cover any potential eventuality is a fallacy: -100degF is cold, 200degF is hot, and saying that any line we might draw as a cutoff for hotness is arbitrary in no way challenges the concept of heat itself.

It doesn't "challenge the concept of heat," but it does make pretty ridiculous a line on one side of which is "hot" and on another side of which is "cold" and "cold" is bad and wrong and immoral and "hot" is awesome.

(And "pathology" has all the same bright-line-distinction problems that performance-enhancing-substances do, so your proposal to clear up the problem actually makes things even less clear.)

Nobody is saying that one side of that divide is uniformly "bad" and the other is "awesome". There's obviously no "morally awesome" in doping–only "not doping". And nobody is denying that there is a grey area. But the existence of a grey area doesn't mean that the extremes don't exist.

To try another example: within the infinity of possible human actions, you can probably find something for every nuanced level of morality from "saving a hundred babies" all the way to genocide, with parking in a handicapped spot slightly on the "bad" side of average, and "looking at the watch" somewhere really close to neutral.

But just because we can't always draw a bright line between "good" and "bad" actions doesn't mean we should abolish all criminal law, does it?

You're trying very hard to create analogies to explain something that I already understand, have said I understood, and don't disagree with you on.

And if this article were about someone taking a shit-ton of steroids and attaching a cybernetic device that super-oxygenated her blood during the match, then we could reasonably say that it doesn't matter where the line is, she's way over it.

To beat your analogy into the ground, go to a car show and see what happens if you flick a single grain of sand onto some of the cars.

My only point is to draw attention to there being wildly different views on where the line should be drawn.

I am way over on the permissive side, if you're curious. I do think it needs to be disclosed and separate records kept/established.

I think your examples actually proves my point: even though there are wildly different views on where the line should be drawn, we don't consider that to be a reason not to draw any lines.

So there's disagreement over the damage inflicted on a car by various actions: the car aficionado will consider it an assault on himself if you look at his car the wrong way, whereas the hippie will shrug his shoulders and bemoan the spelling mistake if someone tagged his VW Camper van with "I sukk". But even though these differences exist, nobody is arguing that setting someone's car on fire should be a criminal offence.

To get back to doping: you can reasonably argue that caffeine in huge doses is doping, and you can reasonably argue the opposite. But that's no reason not to limit EPO or genetic doping.

That line is not so clear. For example, it is not that uncommon for medical students to take beta blockers for increased performance during lab practicals and patient procedures, or surgeons. There is a murky line between jittery nerves and anxiety.

Also, what is to be done about athletes that are diagnosed with ADD? This was a major controversy in esports, although im not sure if those individuals were clinically diagnosed.

Modafinil is specifically prescribed to people who need to stay alert during work hours if their schedule has a disruptive sleep routine. The 24 hr Le Mans is certainly disruptive to one's circadian rhythms.

This may be a nonsense scenario, but what about transgender men powerlifters or bodybuilders who regularly need to take testosterone to conform to their gender identity? Should they have their own class? If we allow them, since natural production is over a wide spectrum, it becomes difficult to say what the threshold is. From their perspective, it maay seem unfair that they are limited while people like Arnold Schwarzenegger naturally produce large amounts.

Kobe Bryant used plasma therapy to quickly heal his Achilles tear. NFL teams use hyperbaric chambers to improve injury recovery speeds. Robin van Persie uses horse placenta to recover from muscle injuries.

It doesnt matter if the sport is based on skill(pool), pure strength/speed, or mental acuity(chess, go). Your genetics can confer advantages in all 3.

It's cheats only if you get caught.

According to the coach of my middle-school friend (anecdotally, possible apocryphally), "if you're not cheating, you're not trying".

Was a shocking concept to me at the time that people thought that.

The author did not cheat.

Meldonium isn't doping. It's an antioxidant, like drinking a cup of coffee.

Meldonium is included in the WADA Prohibited List of substances, therefore its use in sport is by definition doping.

https://www.wada-ama.org/en/what-we-do/the-prohibited-list

In a technical sense, yes.

But really it's only prohibited because it's not licensed by Western corporations.

In Eastern Europe meldonium is an over-the-counter drug that's routinely prescribed for all sorts of maladies and is considered a very mild and inoffensive medicine, just a step above drinking green tea.

That's a surprise, as there's at least some indication that antioxidants are contraindicated for athletic training[1]

1: https://sciencebasedmedicine.org/antioxidants-and-exercise-m...

Yes, meldonium is prescribed to help with recovery after stress and injury. It won't make you stronger or faster or tougher.

It's simple, have two leagues.

1. Human performance only - no drugs, no implants, no performance boosts. 2. Unlimited league. Take all the drugs you want, when we have them, install new muscles, cybernetic implants, whatever. Go wild.

This way, the real purists, who want to push the envelope of human capability get to do so without having to compete with dopers.

AND

High dollar/prestige sports will fund new and interesting areas of biomedical research. It will be like indy car racing for human bodies.

This doesn't work like that. You will have dopers in first (clean) league, because there will be all the fame, prestige and money. Unlimited league would be marginal and no one would promote drug users.

While it is probable that some will dope in the clean league, a simple matter of instituting lifetime bans and reclassifying any and all records held by an athlete would put a strong disincentive.

As to your unsupported statement that all the fame and prestige will be associated with the clean league, that is a matter of marketing. If there wasn't a market for doped up, super-humans athletes professional sports would be very different. Look at WWE, it's not even really a sport, but it takes in half a billion dollars a year on the promise of watching steroid guzzling guys throw each other around.

For many people the problem with PED is the dishonesty, the unfair advantage it gives a cheat. But when the stigma of cheating is lifted, all that changes.

A more likely outcome is that fans of some sports would shun PED and unlimited league events, others would see it as a natural extension of their attitudes about competition.

https://www.wired.com/2012/09/sports-and-doping/

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