Andy Pettitte and the Prohibition of Performance Enhancing Substances

George Mitchell’s recent report on performance enhancing drugs in baseball identified many players as users of various substances, including steroids and human growth hormone. Of those identified, Yankee ace Andy Pettitte is perhaps the most prominent to confirm his use of such substances and give his side of the story. In a nutshell, Pettitte claims he used HGH for 2 days in 2002 to help him recover from an injury, and that he did not take steroids or use HGH to gain a competitive advantage.

Pettitte’s explanation raises an interesting question about performance enhancing substances that has, to my limited knowledge, gone relatively unexamined in the aftermath of the Mitchell report. Is the use of performance enhancing substances somehow different when used for therapeutic purposes, as opposed to some kind of “on the field” advantage? If there is a difference, can or should sports permit or condone the use of those substances for therapeutic purposes?

Personally, I am skeptical that these distinctions should hold. As an initial matter, a “therapeutic use only” purpose presupposes that an athlete has a “natural” level of physical prowess that is being restored after injury. What is that natural level? Let’s assume for the sake of discussion that an athlete has a particular level of strength and coordination that he can reach without any kind of chemical enhancement. Once he reaches that peak, presumably in his early 20s, his body will begin to degrade under the stress of aging and injury. If therapeutic use were permitted, the athlete should be allowed to use HGH to “recover” from the injuries breaking down his body until he regains his hypothetical 20-something body. That sounds to me like a justification for most athletes to be using HGH all the time, because it promotes recovery from the every day injuries degrading their bodies. At the very least, it would become impossible to tell whether an athlete was “legitimately” using performance enhancement or faking injury.

This does not necessarily mean that Pettitte is deserving of condemnation. The whole premise of performance enhancing substances is troubled and likely to come under stress soon. I don’t think that performance enhancing substances can be banned out of some commitment to the “all-natural” athlete. Separate and apart from permissive use of certain prescription drugs, athletes are allowed to take “non-natural” things to help them all the time, whether ibuprofen to control swelling and pain, caffeine to increase alertness, or special sports drinks that never occur in nature. If athletes are already “non-natural,” it seems to me that the primary justification for banning steroids and the like is health. It’s unfair to ask an athlete to jeopardize her health (say increasing the risk of cancer) simply to participate in a sport.

But, if health is the primary justification for policies against performance enhancing substances, what happens when science designs steroids or other compounds that are no more dangerous than commonly taken over-the-counter drugs? It seems to me that this is the real question posed by Pettitte’s story. If his use of HGH was at a level that did not meaningfully risk his overall health, do we truly have a basis for criticizing him?