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February 2, 2006

Under The Knife

Amphetamines and Baseball

by Will Carroll

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"I don't want to say guys are addicted, but it's like putting on your uniform. You have your glove, your batting gloves, your bat, you take your greenie and you're ready to go."
--Chipper Jones (as quoted in the Pittsburgh Post-Gazette)

The shadow of steroids may still hang dark over the game, but the key story of 2006 is likely to be amphetamines. Whether they're obtained illegally (the fabled greenies, beans and uppers) or legally (various attention-deficit disorder drugs), amphetamines and similar performance-enhancing substances have penetrated the game in ways that steroids never came close to doing. During a recent discussion with a team staffer, I claimed that 75% of major-league players used banned amphetamines during the course of a season. "More," was his immediate response.

The story of amphetamines is big enough to fill a book, or at least a chapter in a book. Since that's already written, I won't rehash it all here. What's important to know is that amphetamines have been in the game since shortly after World War II, and have only recently been forced into hiding. The jars of greenies kept in the training room are gone now, but the drugs themselves are not. All that's changed is the source, not the effect.

Amphetamines, as a broad class of drug, are pretty simple to explain. By amping up the central nervous system, they create feelings of wakefulness, euphoria and even concentration. Players often talk about feeling "locked in" when they have their dosing done properly. For most players, they know exactly what to take and when to take it depending on the situation.

"Red Bull or coffee is one thing, but there are times--day after night, east after west, sixth day of a seven-day run--when you grab a bean and go," said one current player who wished to remain anonymous for obvious reasons. "Some teams use them more. I think it really depends on who's running the team. I've had pitchers practically enforce it and I've had managers who you had to sneak it past. Now, with the new stuff, it's a bit different."

Greenies--the common term for the prescription drug Dexedrine and similar stimulants--are all but gone. While still used for some conditions, such as epilepsy and Parkinson's, there are new drugs that generate the same or better results without the side effects or dependency issues. The jar of greenies has not moved as much as it has been rendered irrelevant. Just as with most other classes of pharmaceuticals, baseball is seeing better chemistry. Instead, players are using new classes of drugs intended for use in attention-deficit disorder (ADD).

Some question how widespread the use of amphetamines ever was in baseball. While we will never know more than anecdotes, we again have to define usage. It's likely that a high percentage of players have used amphetamines at some point, most of them experimentally. It's likely that a smaller, but still large, percentage of players used amphetamines occasionally. It is likely that a much smaller number of players used the drugs regularly or developed an addiction.

It is important to note that any usage of these drugs, especially without the supervision of a physician, is extremely dangerous. There is a reason that amphetamines have been a controlled substance for far longer than steroids have and why methamphetamine use and manufacture is perhaps the biggest drug-related issue in American society. Simply put, amphetamines are addictive and potentially deadly. "They can stone cold kill you immediately," said Charles Yesalis, an oft-quoted professor from Penn State who is an acknowledged expert in the field of performance-enhancing drugs. In an interview with the AP last year, Yesalis said "[amphetamines] dwarf steroids as potentially dangerous drugs."

So how have amphetamines escaped the black-hat reputation of steroids? Why did Congress scarcely bat an eye when amphetamines were not a part of 2005's initial drug policy? More concern was given to DHEA, a legal testosterone precursor, when it was left off MLB's banned list despite the fact that it was left off due to the agreed definition being "illegal." It goes to the very genesis of amphetamines and their use in baseball nearly 60 years ago. Pilots and other servicemen were given the drugs to keep them alert during marathon sessions, and they brought the usage back to the game after the war ended. Some have pointed to Ted Williams as one of the initial sources, though there is no hard evidence that this is true. Williams was but one of several pilots returning from the war.

Yet it is clearly true that amphetamine usage was as accepted as stealing signs. From the late forties to the late seventies, it was no big deal to see a large jar of greenies available to any player in the clubhouse. It was Pete Rose who mentioned the widespread use of greenies in a 1979 Playboy interview. Milt Pappas, in a 2003 ESPN interview, stated that Rose "took handfuls" and that his running to first base on a walk was less hustle than greenie-induced jitters. Greenies were also mentioned prominently in Jim Bouton's Ball Four--along with nearly every other vice imaginable.

We know that there was amphetamine use, that cocaine seeped into the game in the late sixties, and that players were experimenting with steroids and hormones in that same time period. It coincides with increased drug use in society, yet once again, we seem to be expecting more from our athletes that we do from our chemistry-fueled society. According to Quest Diagnostics, the same firm once used by Major League Baseball, workers that were subject to federally-mandated drug tests showed an increase in amphetamine usage while all other positive tests decreased. This isn't among athletes; this is among safety-sensitive workers like pilots and nuclear power plant workers. The U.S. drug positivity rate of 4.7% is likely very similar to that of Major League Baseball. Remember, use is far different than a positive. Amphetamines stay in the body for only one to three days.

Even so, baseball players are likely to move away from Dexedrine and other "street" amphetamines and towards the more advanced pharmaceuticals that have been developed for ADHD and similar conditions. Drugs such as Ritalin, Adderal and Strattera are already being abused inside the game. A policy for gaining a "therapeutic use waiver" had to be put in place by teams to insure that players didn't just go to their family doctor, wave the wallet and walk out with a prescription. Instead, players are required to follow team-level policies, some of which are far more strict than others. MLB has offered little in the way of a league-wide policy or even offered much guidance on how to administer the policy.

Beyond these drugs, there are new substances, both prescription ones and others concocted by some of the same chemists that brought us THG, DMT and the rest of steroids' greatest hits. One drug, modafinil (marketed as Provigil), is being used in baseball and other sports. Its abuse is well-known; it was one of the drugs given out by Victor Conte to BALCO-associated track athletes. There is no question it is amazingly effective. Given the need for players to fight the fatigue of travel, poor sleep cycles and the possibility of all-night parties, we would have to be very na´ve to believe that we won't see usage inside the game.

Some have suggested going after the cause by reducing games on the schedule, adding extra off days to the calendar and other such reasonable suggestions. No one seems to want to give up the money or potential record chases that the 162-game season provides. Indeed, it is the very marathon nature of the season, with its coast-to-coast flights, day games after night games, and the prospect of 18-inning, five-hour duels, that causes players to believe that they need a little pick-me-up.

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