A conversation with Dr. Margaret Goodman Part Two: PEDs in Boxing
When we left off in Part One, Dr. Margaret Goodman and I were discussing the problems with licensing fighters and fighter safety in general. We now shift to the topic of Performance Enhancing Drugs in combat sports. In today’s culture, the topic of PEDs is commonplace. As we know, Floyd Mayweather, Jr. is demanding that anyone who fights him submit to the testing protocol provided to him by USADA, what many call ‘Olympic Style’ testing. Since that first mention of it, in his negotiations with Manny Pacquiao, who passed on the fight and the tests at the time, PEDs is the subject on everyone’s minds. But like ring tragedies are the only time the mainstream seems to get excited about our sport, it took a moment like this to bring this subject to the fore.
PEDs are nothing new in boxing. We know for a fact several boxers, among them James Toney and Fernando Vargas, have been caught for using PEDs. Shane Mosley was never caught but there is grand jury testimony regarding his use of EPO (Erythropoietin, which boosts your red blood count). In other sports, like Major League Baseball, the steroid era has come in large waves. In boxing, up until now, we have had ripples. Now in the new landscape of “test or you’re dirty,” one of the questions that should be asked is ‘How rampant are PEDs in boxing?”
One of the people I have posed this question to is Dr. Margaret Goodman, who served as a ringside physician from 1994 to 2005. Dr. Goodman, a licensed and practicing neurologist in Las Vegas, NV, was also was appointed by Nevada’s governor, Kenny C. Guinn, in September of 2001 to serve as Chairman of the Medical Advisory Board to the Nevada State Athletic Commission, a position she held until her resignation in 2007. Most recently, Dr. Goodman’s name has been mentioned in connection with VADA, (Voluntary Anti-Doping Agency) which is rumored to be entering the “better drug testing in boxing” fray. For those who missed Part One, Dr. Goodman declined to discuss VADA at the moment but weighed in on other issues surrounding the topic.
“Well, boxing is in many respects no different than any other sport,” she began. “I first started as ring physician many, many years ago. They used to tell me ‘Well just talk to the fighter but don’t give him any other information. Don’t go into detail about trying to educate them on anything because the trainers would get nervous that I was telling them about medications.’ Just ‘see the fighter and do that.’ [The trainers approach to the fighters was] like ‘Hey you don’t need to know this. I take care of all this for you.’ I think that day has long come and gone. And I think boxers are intelligent. I think they want to be responsible for their own health. And just like any other major sport, even though boxing in many respects has been reduced to a niche sport, I still think that boxers are out there looking for an edge just like everybody else. So, the question ‘rampant?,’ I don’t know how we define ‘rampant.’ But is it prevalent? I’m sure it is. Why wouldn’t it be? When I talk to fighters, trainers and people call me now, I believe that it is very prevalent.”
These days, sophisticated ways of enhancing performance are readily available to any athlete willing and able to acquire them. Cyclists have been blood doping for years, doing auto-transfusions of their own EPO-doped blood everywhere from hotel rooms to tour busses. In boxing, a relatively untested sport, what boxers are up to in the off-season much less training camp is a blurry mystery. The way commissions test now, using urine samples and scarce out of competition testing, if any at all, is antiquated. But even in sports like cycling or for Olympic athletes, where testing protocols are cutting edge, the cheaters still find a way to evade detection which raises a question for me. Should we simply legalize and regulate PEDs? If we educate the athletes to the dangers (and gains) of using drugs like EPO, do we save ourselves the trouble of building a new cat and mouse game in boxing between cheaters and testers?
“I think it should be regulated,” said Dr. Goodman. “I think it should be tested for in an appropriate way. No I don’t think it should be legalized because I think that number one nobody knows how potentially harmful these things are and how harmful are the usage of these things to someone’s opponent. And plus, it takes the fairness out of the sport. I guess you can argue that with baseball or the NFL or any of these other endeavors whether or not it is the right thing to do. I just think that it’s important for someone to not be on some sort of performance enhancing substances if they are going to be beating somebody else in the head. It’s just not fair to the opponent. It’s not fair to the sport and it is not what boxing is about.”
EPO was originally designed to be used to treat anemia in cancer patients and those suffering from kidney disease as well as HIV patients. Because of its ability to boost red blood cells and thus increase stamina, giving the athlete substantial gains in training and competition, it is now a widely used PED by athletes the world over. I asked Dr. Goodman if it was a safe drug to use.
“I don’t think on any level, [EPO] is a safe thing,” she said. “I think that even if athletes, I know that even with Olympic athletes they have to keep monitored their . . .well I don’t know so much if it is Olympic athletes but I know with cyclist they have to keep monitored their blood count, their hematocrits on a regular basis and how [cyclists] scoot around that. I don’t think that anybody should be blood doping on any level because of the danger. I can’t see how that could ever be interpreted as being safe.”
One of the issues Mixed Martial Arts is facing is medical exemptions for use of testosterone. To date, two MMA athletes in Nevada have received this exemption to use testosterone as prescribed by a doctor. To some, it is a loophole found by athletes who have depleted their body’s ability to produce testosterone through use of anabolic steroids, which is a side effect of that usage. To date, no boxer has asked for this exemption but the day it happens is probably not that far off.
“That leads to the other thing of testosterone replacement,” said Dr. Goodman, still on the topic of legalization and regulation. “It’s probably almost unheard of that a young, healthy athlete, I am including in ‘young’ someone that is licensed to fight, let’s put it that way, really needs testosterone replacement unless they have been using anabolic steroids. So to me, it creates an uneven playing field and it isn’t safe. Unfortunately it is really hard to do prospective studies on something that can be potentially dangerous. It can have a whole bunch of dangers. But I just think that EPO is one of the worst things that’s out there that I see athletes more and more regularly using. [Any] kind of blood doping, whether it is auto-transfusion, transfusing their own blood before a fight or using drugs like EPO. There’s another drug out there that they can use as well. I just think it’s terribly dangerous. Because it cause sludging of the blood, heart attacks, a whole bunch of things. I don’t even think that doing it smaller amounts so it is not detectable so that their hematocrit isn’t too high even if they are testing. I think that there are a whole other bunch of factors that can affect the blood and then can affect the organs that just isn’t safe.”
During the whole debate between Manny Pacquiao and Floyd Mayweather fans over the testing issue, one thing that has been brought up is a sort of eyeball test. Those who suspect Pacquiao say ‘Just look at him” as if it is some sort of evidence. The eyeball test, in Dr. Goodman’s assessment, does not work.
“This is the thing, and trust me I am not an expert on anabolic steroids, metabolisms and all this. I used to be able to sit there and name all of the side effects and benefits, different steroids and how you stack them and pyramid them,” Dr. Goodman qualified. “I can’t do that off the top of my head right at this moment. But what I can say is that you don’t always know who is using what. You bring up a good thing.
“When Dr. Homansky first proposed that they NSAC test for anabolic steroids, they were really opposed because they thought that it was unnecessary, expensive testing,” she continued. “They said ‘This isn’t the WWE. How many guys, how many heavyweights do we have? How many big muscle guys do we have?’ And that’s the whole point. Because if anabolic agents are used appropriately, and even more beneficially, the athletes don’t look like the muscle bound guys like unfortunately Fernando [Vargas] looked when he got caught with Winstrol [following his fight with Oscar De La Hoya.] That’s not what you see. So yes they are still prevalent. They are easily attainable compared to other treatment. A doctor can make an athlete feel really good really quick when they don’t have an injury by giving them those types of substances.”
Just as with a fighter getting licensed who passes an MRI but fails other obvious tests, the question of “Are we using the right tests’ came up. With licensing, a boxer can pass the rudimentary tests and get a license, even with slurred speech. In the case of PEDs, a cheating athlete can pass all the necessary tests and come up clean. Which again, begs the question, are we administering the right tests?
“What you have to remember, and this came up in the discussion of PEDs and MMA, is that just because someone’s levels are normal doesn’t mean they are not getting beneficial performance enhancing effects from these drugs,” said Dr. Goodman. “And so to just simply say to athletic commissions you need to just check someone’s testosterone levels when they should be normal consistently between a certain range a week or two before a fight, that doesn’t mean they are not getting performance enhancing effects from it and doing something illegal which is cheating and unfair to their opponents.”
One such test is Carbon Isotope Ratio testing, developed by Dr. Don Catlin who founded the UCLA Olympic Analytical Laboratory, the first anti-doping lab in the US. The test is designed to differentiate between testosterone naturally produced by the body and testosterone introduced into the body by some other means. While the test is expensive, it is, in both Dr. Goodman’s and Victor Conte’s estimation, an essential addition to any testing protocol.
But that is just one missing link in a long chain of them. At this point, what we have is antiquated testing and one fighter, Floyd Mayweather, Jr, ordering up a testing protocol through USADA and demanding his opponents take the test as part of getting a lucrative shot at him in the ring. In between, there is wide gulf that needs to be bridged. Testosterone exemptions, new ways to cheat coming out every day and a sport that can barely get it’s judging or list of champions straight all add up to boxing facing the kind of reckoning that baseball underwent in recent years once someone starts poking in the right areas.
“Who’s to say who is giving who what? How are we checking for it? And just doing a drug test and just checking someone’s testosterone levels after a fight isn’t necessarily going to tell if someone was using,” said Dr. Goodman. “You have to do serial evaluations. You have to get baseline evaluations. It is a really difficult thing to do and that’s why it makes me nervous with these therapeutic exemptions that are popping up.”
So is Mayweather Testing the solution? It is hard to say. But should we stop there? Should we leave the testing in the hands of the boxers? Or is his commendable step forward just a jumping off point from where a new era of impartial testing that is actually 365 days a year, 24 hours a day?
Likely, now that the step is made, we will move towards better testing in an impartial system. By impartial, I mean not the way Mayweather and USADA are doing it. What is wrong with it? Well, two things.
For one, there is a lack of transparency regarding what the protocols involved actually are? To this writer, if we are looking to catch cheaters, why are we not allowed to know how we are doing it?
For two, in Olympic Style testing, the kind amateur athletes go through every day, there is a loophole. In an 18 month period, an athlete can miss two tests. A third test missed results in a positive result and the athlete is suspended for a period of time. The problem is with the missed tests, there is no fine or penalty and the missed tests are not disclosed to the public. Essentially, a cheating athlete can come up with a reason he has to miss an appointed test, clean out his system and then take his test free and clear from detection with the public none the wiser.
Now, shrink down that eighteen month window to a twelve week training camp which is the window for Mayweather Testing. With a loophole this wide, and PEDs like testosterone able to be cleared from your system with 7-24 hours, and EPO, depending on how you administer it able to leave your system within a 24 hour window, two missed tests can be significant in that time frame.
“Obviously that would be nice,” said Dr. Goodman. “You bring up a good point. Someone is doing testing. You know when a patient comes to me and they tell me ‘I don’t need any more lab work. My doctor said my labs are normal.’ Well what labs have they had done? There is lab work I need done as a neurologist as opposed to lab work a family doctor needs or a heart doctor needs. When they say they are doing testing, what specific testing are they doing? What are they testing for? How often are they testing? Is it unannounced? Is it show up here within 48 hours? Is it somebody showing up at their door? That is more under the realm of Olympic style testing when it is completely unannounced. The athlete has to let the [sample collectors] know where they are all the time so that they can show up at any point. Nobody is really answering these questions. So you bring up a very interesting point.”
As Victor Conte said to me, “Boxing is hungry and a half loaf of bread is better than no bread at all.” Testing under the USADA/Mayweather connection is possibly better than what we have, even with the loophole.
“Of course, in an ideal situation that would be wonderful and that is what is needed,” said Dr. Goodman of year round unannounced testing. “But boxing is a lot more complicated than some other sports. It’s not like major league baseball where guys have a certain off-season. They have training camps for a certain period of time. Then they are playing. You have some control over what they are doing. And in the way boxers and MMA fighters compete, it is a little more difficult to accomplish that but yes that would be ideal. But do I expect that to be the norm or is that something we should shoot for right away? No. But I think that it is so much better than the current situation, doing it when a fighter is entering training camp than doing it the way it has been before.”
Dr. Goodman went on to say that with the way fighters fight, which is sporadically and not in any sort of league or season fashion like other sports, building the right testing system could be difficult.
“I think [year round testing] is so much better than the current system, then who could find fault with that?” said Dr. Goodman. “In an ideal world it would be nice but the way boxers are and the way they fight, the schedule of matches, it would be very difficult to do that. The only way to do that is if you handed over the drug testing to an independent agency or an independent group which in my estimation is what should happen anyway. Commissions don’t have the manpower, the finances and the ability to do that. Just like you said, nobody is policing the gyms, how are you going to get an actual commission to oversee out of competition drug testing the way it should be?”
To that last point, I cite the example of banned from boxing trainer Javier Capetillo, who still trains fighters in a southern California gym. To date, no California State Athletic Commission inspector has sought him out in the gym to enforce the ban. If we can’t depend on a commission to enforce their own penalties, how can we expect to hand them a whole new set of tasks to perform?
“If it going to be done, it needs to be done thoroughly,” said Dr. Goodman. “For example, in order to detect if someone is blood doping you need to have blood count, baseline tests. Just showing up and doing a drug test is probably not ideal.”
But who pays for that kind of extensive testing? Recently, I asked Golden Boy Promotions CEO Richard Schaeffer two questions regarding the testing for the Floyd Mayweather, Jr vs. Shane Mosley fight. I asked “Who paid for it?” and “Would Golden Boy be subjecting their entire stable to this brand of testing which they so thoroughly endorsed. A few days after I left the questions on Mr. Schaeffer’s answering service, his assistant called back to say “No comment” to both. Again, an unnecessary lack of transparency.
So who pays for it? Perhaps in the future, we can have an organization that provides sponsorships for fighters wanting to submit to this kind of testing. Recently, Governor Brian Sandoval signed Senate Bill no. 498 into law which will use funds generated by fight promotions to help fund out-of-competition testing; certainly a step in the right direction.
“I don’t expect everyone to have the finances like Mayweather or Pacquiao. You have to do what you can do,” said Dr. Goodman. “Do the best you can do for now which is certainly better than what is going on in the current situation. I don’t think a fighter has to be tested for everything that is a comprehensive WADA panel. I don’t think that’s necessary. I think there are some basic things that have to be checked for that probably are not. EPO tests, which is expensive and can only be done at certain labs. Following someone’s blood count. Baseline steroid levels and adequate steroid testing and then for stimulants and things like that.”
But beyond the testing, there is one more question that Dr. Goodman raised.
“The other thing is, and we faced this when started doing MRI’s in Nevada, is what do you do with the results?,” she asked. “This is another reason that it has to be in the hands of someone other than the commission is that it’s too much work for a commission. The results can be deceiving. They can look normal but not necessarily be normal. For example, Don Catlin’s [CIR test]. Now you ask ‘how much of this stuff do you want to do?’ But I’m kind of like you that you want to do as much as you can the right way. But I definitely think that unannounced, random testing in a training camp is reasonable to do.”
With so many questions and so many things to work out, it should be noted that while we sit and argue “Will they fight or won’t they” it’s important to remember that really, this is not about two fighters. This is about all fighters present and future. This is about the betterment of a sport. On that, I think we can all agree.
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