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April 21, 2010

UTK Special

The Volquez Suspension

by Will Carroll

We have our "semi-big" name.

Edinson Volquez was suspended by the commissioner's office on Tuesday for 50 games after testing positive for a performance-enhancing substance. That's pretty much what we know, so I'll try to fill in the gaps of knowledge as much as possible, based on the process, Volquez's less-than-illuminating post-suspension statement, and the minimal leaks surrounding the case.

Volquez, a Reds pitcher currently on the disabled list as he rehabs from Tommy John surgery, was tested on or about the first day of spring training, a normal and expected part of the testing program. Volquez, it appears, was not selected at random at either possible point. He could have been selected during the offseason or later in spring training, but was not. Baseball will test each player twice, some three times, while those in the "accelerated program" can be tested significantly more. (Josh Hamilton's near-daily testing is part of his agreement to return to baseball.)

Volquez stated that he was using a drug prescribed to him in the Dominican Republic to assist in starting a family, but that the drug was on the banned list in MLB, causing the positive. He did not name the drug, though many speculated that it was hCG, the drug that Manny Ramirez was popped for. hCG is more often used to assist with the female side of the pregnancy equation, but can be used. Much more likely is something like Clomid, an anti-estrogen drug that can help block side effects of steroids, such as gynecomastia. Clomid's performance-enhancing effects are low in sports such as baseball and show no real tendency to create muscle mass.

There's an additional clue pointing towards Clomid in that Volquez says that it was prescribed in the Dominican Republic. We don't know whether Volquez and his wife sought any sort of fertility treatment in the United States, but we do know that Clomid is not approved for use as a fertility treatment for males in the U.S. It is not approved due to the high incidence of vision problems. Those that have used Clomid in the bodybuilding world often complain of vision changes, usually "floaters" in their fields of vision.

In fact, few drugs that could be reasonably used for fertility, save one, would give much of a performance-enhancing effect. They could however mask the effects of other drugs, which is why they are rightly on the banned list. That one drug is testosterone. The defining male hormone would assist with sperm production and motility if Volquez was not already producing the normal amount of testosterone. Massive testosterone supplementation, as steroid users normally do—and remember, almost all anabolic-androgenic steroids convert to testosterone in the body during metabolization—can cause the opposite effect, including testicular shrinkage, as the body attempts to regulate the levels. If the blood has plenty of testosterone, the body shuts down the testicles. For those with reduced natural testosterone levels, supplementation up to the natural level has none of those nasty side effects, though it can still have plenty of other noticeable effects, such as skin and mood issues.

If the drug was one of these—and again, it's most likely Clomid— then there's no doubt why Volquez failed the test. The drugs are easily detected and Clomid is actually known to increase the detectable period of some steroids by as much as two weeks. Clomid itself has a drug "half-life" of five days, though it can be detected as much as two weeks after last ingestion, depending on the type of test used and the body's metabolism. Other similar drugs have similar detectable periods. If Volquez was using this drug as part of a long-term fertility treatment, the levels were likely quite low in comparison to someone using to stave off the side effects of steroid usage.

If the drugs were prescribed, there are a couple interesting areas to investigate. First, Volquez should probably get his doctor to speak and explain the usage. Clomid is used in non-FDA regulated countries for male infertility, but with access to some of the world's leading fertility specialists in Cincinnati, it takes a bit of a leap to imagine that Volquez would go back to the Dominican Republic for this. Volquez could have elected to file for a therapeutic use exemption (TUE).

Digging through the archives of the Reds beat writers—Mark Sheldon of MLB.com, John Fay of the Cincinnati Enquirer, and Trent Rosecrans of CNati.com—I found no mention that Volquez looked any different during the early days of spring training. There was also no mention of much of anything in regards to the rehabbing Volquez, aside from on-field references to how quickly he was progressing from his Tommy John surgery. Volquez was on track to return at the low end of the rehab period for the surgery, approaching the record. Of course, that record raises some problems of its own. Many forget that the pitcher who returned from surgery in that short amount of time was Jason Grimsley, a player deeply implicated in the BALCO case.

It's well known that steroids can help a pitcher recover, both from fatigue and injury. It's less clear that any sort of Clomid-type drug could have similar effects. Again, these drugs can be used in combination with steroids, as it is suspected in the case of Manny Ramirez. Given the timing of the test at the start of spring training, it is well within the realm of possibility that a player could have done a cycle or two of steroids during the offseason, hoping that he would avoid the random testing, and then use Clomid or hCG to "kick start" their normal testosterone production as they came off cycle. Cutting it so close to a known testing date is dangerous and stupid (as if using the drugs weren't dangerous and stupid enough) but certainly possible. It makes it difficult to accept Volquez's excuse at face value, absent more corroborating evidence.

The timing of the announcement also raises questions. Why was there a better than two-month gap between the test and the suspension? Some of it can be explained by the standard process. After a player is tested, the samples are collected, shipped to MLB's lab in Montreal, and tested. Any positive test is then re-tested using a process known as "A/B." At collection, each urine sample is divided into two containers, an "A" sample and a "B" sample. The "A" sample is tested and if positive, the "B" sample is re-tested using more sensitive (and expensive) techniques for confirmation. If the "A" sample is negative, the "B" sample is discarded. This process can take weeks, depending on the lab's backload. In the spring when nearly all players are tested, there's a significant amount of testing to be done and many factors that go into how those tests are processed.

After a sample is tested and confirmed as a positive result, the process negotiated in the Joint Drug Testing Agreement goes into effect. On Tuesday, Volquez stated that he did not appeal the test's result, making many question the gap between testing and suspension's length. We've seen a similar gap in the past, with Rafael Palmeiro being the best remembered example, allowing him to reach the 3,000 hit-milestone during the gap. During an interview on Sirius/XM yesterday, Jim Bowden offered up the best explanation I've heard. He suggested that while Volquez may not have appealed (or even been aware of the positive), the MLBPA may have appealed on questions of its own. Gene Orza has long taken a personal interest in testing protocols, so to have the MLBPA questioning testing procedures is possible, if not probable. In fact, the baseball executive from whom I found out about the impending suspension spoke of "the woman" involved in testing, a reference to Christiane Ayotte, head of the drug testing lab used by MLB. While two months is not an ideal gap, it does show the thoroughness of the process and, as I pointed out yesterday, the fact that there were no leaks on this case speaks well to the process in place.

Yesterday's announcement brought out the worst in baseball, darkening the cloud of performance-enhancing drugs that continues to hang over the game despite the most effective testing program in sports. We saw the very basest of fact-less speculation, a gleeful near-universality of suspicion, and a general ignorance that isn't often seen without pitchforks or nooses. Players were smeared by guessing games with no recourse. It makes it difficult to raise interesting questions and nearly impossible to educate. The frenzy—which I recognize started with a cryptic Tweet of my own— will die down to nothing as Edinson Volquez goes from "semi-big name" to just another near-anonymous rehabber on the back fields of Goodyear. It's unlikely that when he returns this summer that anyone will show up to the ballpark with asterisks or syringes. Reds fans will cheer, just as Dodgers fans cheered when Manny Ramirez returned to "Mannywood" and that Phillies fans cheered for J.C. Romero.

Volquez's suspension is another opportunity for both MLB and the MLBPA to show how effective the drug testing program is. Despite an increase in suspensions in 2009, largely a function of increased testing of young Dominicans who have been pushed to use PEDs by buscones, baseball is doing what it is supposed to be doing. Many will raise the red herring of hGH, the continual cat-and-mouse games played by chemists on both sides of the battle, and the near-inevitability of advances in new chemical compounds and genetic techniques making their way into sport, but MLB is one of few winners in yesterday's announcement.

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