Libertarians of the sport world who say athletes should be free to do what they want to their bodies neglect an aspect of PEDs' health risks: The effect on
young athletes when doping pervades a sport. Alex Hutchinson, who ran for Canada in the world cross country championships and writes a column about science
and fitness for The Globe and Mail, puts it this way: "If you allow doping, then there's a trickle-down effect. You'll have to dope just to get to
the professional level, at which point you'll have doctors supervising your red blood cell count and so on. So it's the kids who will be most at risk,
forced to dope just to reach the level where doping can be done 'safely.'"
Note that cost doesn't factor into this attempt to create a level playing field. The blood booster EPO, one of Armstrong's go-tos, is prohibited, but
hyperbaric chambers, which simulate high altitude and therefore theoretically impart some of the benefits of EPO, aren't. Three-time American Olympic
runner Dathan Ritzenhein spends 12-14 hours a day in his sealed-off bedroom; the device that simulates high altitude in the room costs between $15,000 and
$20,000, depending on the size of the room. A month's supply of EPO for a cheating endurance athlete can cost just a few hundred dollars.
There are some oddities on the list of banned substances, if we're considering the combination of athletic boost and health risk. Marijuana and heroin (!)
are prohibited, although it's hard to imagine a scenario where you would say, "I would have won if the guy who beat me wasn't strung out." Caffeine,
meanwhile, was removed from the banned list in 2004, even though it's a proven performance enhancer that, when taken in excess, can land you in the hospital.
What are some of the most popular types of PEDs and their health risks?
are used primarily by endurance athletes to increase the oxygen-carrying capacity of their blood. EPO, a drug used to treat anemia in cancer patients
getting chemotherapy, is the best known, and not just because of the irony of Armstrong's post-cancer embrace of it. Early attempts to cheat with EPO were
often fatal. In the late 1980s and early 1990s, at least 20 elite European cyclists died suddenly while sleeping or at rest, as did seven Swedish
orienteerers. The deaths are now attributed to EPO, which increases hematocrit, or the percentage of red blood cells in blood. Too much EPO causes the
phenomenon known as "blood to mud": as hematocrit gets higher, blood gets thicker. The risk of blood clots, which can lead to stroke or heart attack,
increases. "Thick blood" is even more dangerous when athletes get dehydrated, as tends to happen when you ride or run hard for hours at a time.
A urine test for EPO was introduced in 2001, by which time dopers better knew how to use EPO without killing themselves. When the EPO test came out, some
athletes reverted to a more old-school version of blood boosting known as blood doping, in which the athlete receives a blood transfusion (either someone
else's or their own). This is what Armstrong's former teammate Tyler Hamilton admitted to, which cost him the gold medal he had won at the 2004 Olympics.
Blood doping carries not only the blood-to-mud risk of EPO but also the small but significant contamination risk inherent in any blood transfusion. Blood
doping wasn't prohibited until 1986.