sarm, the new ped

Sunday, March 26, 2017

There has been an ongoing arms race in the chemistry world that pits athletes who dope and against the lab techs who test their urine samples looking for that illegal performance enhancing drug. The battle rages fiercely in the background, while the general public has become blasé about it, almost accepting the fact that many pro athletes use PEDs and when another star is suspended, the fallout is muted. The latest to do the perp walk is Joakim Noah who was suspended for 20 games, a quarter of an NBA season.

The drug in question for Noah was a selective androgen receptor modulator (SARM), LGD-4033, a substance that has been banned by the World Anti-Doping Agency since 2008. It’s an interesting drug because, while it can be easily available on the internet as a supplement (labelled not for human use), there is a good chance that perhaps this drug may actually have a significant positive use in the future. LGD-4033, tentatively named Ligandrol, was discovered by Ligand Pharmaceuticals and is now undergoing human testing by Viking therapeutics.

This class of drug, selective androgen receptor modular, are non-steroidal anti-inflammatories that are supposed to act like anabolic steroids, building up muscle and decreasing fat, but without the side effects that occur when the androgen receptors are also affected. The goal is to affect muscle and bone while leaving androgen levels (like testosterone) at normal levels. Testosterone is responsible for male sex characteristics and too much hormone may lead to high blood pressure, diabetes, acne, increased hairiness, liver disease, aggressive behavior and more. The anabolic to androgen effect ration of testosterone is 1 to 1, but some SARMs have ratios as high as 90 to 1, meaning if the correct dose can be found, the benefits would well outweigh the side effects.

The key is to get the dosing right. If the drug can be used to build muscle and prevent osteoporosis. The studies are ongoing at the present time. Phase 1 trials in 2012 in more than 70 adult males found that lean body mass could be increased and the more of the drug used, the better the outcome. Phase 2 studies began in November 2016, looking at 120 patients who were recovering from hip surgery to find out whether body mass could be maintained in people who were going to be increasingly sedentary as they recovered from surgery. This is the phase that also begins to look at side effects, safety and how the drug is metabolized (pharmacokinetics). If the drug still looks promising, then it’s off to phase 3, where thousands of patients will get the drug and their results, including side effects and complications, will be compared to a similar large group of patients who will be given placebo drugs as a control group.

For Joakim Noah, he was caught by chemists who tested his urine and found a drug that is not yet available for human consumption. For Noah, choosing this PED might have let him slip under the radar of the testing lab. The risk that was his downfall is that the characteristics of the drug in the human body aren’t yet well known. How long does it take for the body to metabolize and get rid of it? Does it interact with other medicines? Is it affected by other foods or how it’s stored? Lots of questions that will need to be answered before it is approved for human use.

The bottom line is that Noah cheated. For whatever reason, whether it was to recover from an injury or to try to escape the inevitability of age on his performance, he cheated. His inability to perform legally on the basketball court affected not only him, but also every other player on the court. Charles Barkley, Basketball Hall of Famer, said:” I’m not a role model… Just because I dunk a basketball doesn’t mean I should raise your kids.” Barkley may have been right when he talked about parenting, but was absolutely wrong with respect to PEDs. High school and college players look at Joachim Noah and wonder if they can make it to the big leagues without also having to use a performance enhancing drug. How many will choose to live better by chemistry instead of by spending hours in the gym? May be Noah can think of an answer while he serves his suspension.

 

Photo attribution: Getty Images

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child abuse

Monday, September 15, 2014

Football is supposed to be about great catches, amazing runs, open field tackles and your favorite team winning in the last minute. It is supposed to be about joy and community, the celebration of individual performance and team accomplishment. It is not supposed to be about injuries and Robert Griffin’s dislocated ankle, Knowshon Moreno’s dislocated elbow, Ryan Matthews sprained knee or DeSean Jackson’s separated shoulder. But football is a violent sport and behavior on the field should not expected to be acceptable away from the stadium and for that reason, it is difficult to read about Adrian Peterson’s indictment on child abuse for disciplining his son with a switch.

The facts are not in dispute. Peterson used a switch or tree branch to hit his son and leave cuts and bruises on his back, legs, buttocks, scrotum and hands. The child was hit between 10 and 15 times but Mr. Peterson could not remember the exact number and it was not the first time that the child and his siblings had been punished in that way. CBS Houston has summarized the police reports. However, what is in dispute, and what is frustrating for those who care for beaten children, is the pretense that a parent bestowing corporal punishment on a child is a legally accepted form of child abuse.

Celebrity athletes have come to the defense of Mr. Peterson, describing their upbringing where “whooping” a child was an accepted form of behavior. Charles Barkley felt that his beatings as a child did not affect his personal development and had no trouble admitting in a CBS interview that he continued the tradition saying that his daughter was “spanked pretty good”. I’m from the South. Whipping — we do that all the time.” He tried to distinguish between using a switch and beating or child abuse, but also admitted that perhaps his grandmother had sometimes crossed the line. During a radio interview, Tony Dungy, former NFL coach and now NBC analyst, wanted to wait to see what the courts had to say whether, the whooping with a switch was child abuse. He talked about getting the same disciplinary beatings as a child.

The issue is not one of action but presumably of intent. Abuse is rage against the child, while corporal punishment that inflicts the same physical and emotional damage is somehow different. Because one generation felt it appropriate to beat children does not make it the norm. Physical violence is not acceptable, except perhaps on the football field, and on the field there are referees to enforce the rules. It is unacceptable to hit a defenseless receiver or an exposed quarterback. Players who attempt to injure are thrown out of the game. The same protections are not in place in a home where a large adult has chosen to beat a defenseless child.

What is child abuse? For most people, it’s like pornography, and paraphrasing Justice Potter Stewart: it’s hard to define but they know it when they see it. The Child Welfare Information Gateway  has a summary of signs and symptoms and how to recognize abuse and neglect, and explains the different forms that child abuse can take. But the legislature and legal system give wide latitude to parental discretion and each state has its own acceptable forms of behavior that are allowed when beating a child in name of parental discipline. From a legal paper on where and how to draw the line between reasonable corporal punishment and abuse:

Twenty-one states, along with the District of Columbia, except reasonable physical discipline from their statutory definitions of physical abuse. Theseprovisions typically use the term “reasonable” to describe legally acceptable corporal punishment, although some employ the term “excessive” to describe corporal punishment that has crossed the line of acceptability. For example, the District of Columbia’s statute provides that abuse “does not include discipline administered by a parent, guardian, or custodian to his or her child;provided, that the discipline is reasonable in manner and moderate in degreeand otherwise does not constitute cruelty. ”The statute then provides an illustrative list of specific acts that are unacceptable forms of discipline for purposes of the exception. Among these acts are “burning, biting, or cutting a child” and “nonaccidental injury to a child under the age of 18 months.” Similarly, in Florida, physical discipline can be considered excessive when it results in “significant bruises or welts,” among other enumerated injuries.

Whatever the NFL and Adrian Peterson decide must happen with his playing career matters little. He is but one player out of many in the league who have been accused of violent crimes. They are in the minority of the millions of people who have played on high school, college and pro teams, but they are also representative of what happens when star athletes are not held accountable because their performance on the field counts more than in real life.

Mr. Peterson got caught and because of his indictment, there is an opportunity to discuss openly, a subject that most of us want to pretend does not exist. In 2012, there were more than3.1 million reports of child abuse. 1,593 children died of their injuries. The NFL is the number one program on television and we celebrate, as a nation, the holiday that is Super Bowl Sunday. Perhaps if we concentrated more on our neighborhood children we wouldn’t have to be silent spectators to the child abuse that surrounds us. Adrian Peterson, Charles Barkley, and Tony Dungy have given us a wake-up call, but I refuse to thank them.

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