D-Bag O' the Day (v.1.16)—The FDA Goes "Loko"

Over the past couple of weeks, several states have overreacted to a spike in alcohol-related deaths among college students by rushing to ban a popular alcoholic energy drink—Four Loko.   Like many popular energy drinks, Four Loko contains caffeine, taurine, and guarana, with a 23 ounce can providing roughly the equivalent caffeine content as a tall Starbucks coffee.  Four Loko also contains alcohol equivalent to many malt liquor beverages, ranging from 6% to 12% ABV (12-24 proof).  By comparison, most wine is roughly 12%-15% ABV, while hard alcohol generally clocks in at 35%-45% ABV (70-90 proof).

Anyway, I didn't think much of the Four Loko loco-ness initially; after all, it's hardly news when a state or municipal government does something silly to "protect" its residents from the health crisis du jour.  But the Four Loko crisis achieved D-Bag O' the Day status when the federal government decided to get involved:

Last November the Food and Drug Administration warned 27 companies that they probably were breaking the law by selling beverages that contain alcohol and caffeine, since this combination has never been officially approved.  Today, after a year of review, the FDA is expected to announce that it was right; caffeinated alcoholic beverages are illegal.  Rather than seize all existing stocks of Four Loko, Joose, etc., the FDA probably will send more letters, warning the manufacturers that they are producing "adulterated" beverages.

—Jacob Sullum, "Four Loko Banned ... by Its Manufacturer (One Step Ahead of the FDA)", Reason Hit & Run Online (Nov. 17, 2010).

Let me get this straight—putting caffeine in an alcoholic beverage creates an "adulterated" beverage?!?  Excuse me, but we aren't talking strychnine, or cocaine, or opium here.  We're talking about caffeine, quite possibly the world's most commonly used "drug".  In a typical day at the office, I probably drink 3-5 cups of coffee, and down an additional 3-5 cans of diet cola.  At the poker table, I routinely drink a diet cola, cup of coffee, or cup of green tea every half hour, for stretches of up to 15 hours at a time.  I suspect there are tens of millions of American adults who consume substantial amounts of caffeine on a regular basis.

So is it the combination of alcohol and caffeine that poses a health risk?  Some of the people interviewed for stories about Four Loko seem to think that combining the intoxicating effect of alcohol with the stimulant effect of caffeine somehow creates a dangerous situation by making drunk folks more alert.  Has the FDA ever heard of, oh, maybe ... Rum and coke?  Whiskey and coke?  Irish coffee?  Or how about the premier cocktail of the young and trendy for nearly a decade—Vodka Red Bull?  Hmm, that seems an awful lot like an alcoholic energy drink.  Frankly, the alcoholic content of some Vodka Red Bulls likely exceeds the alcoholic level of Four Loko; it can be hard to know the alcoholic content if one doesn't see the drink being mixed. 

College kids have been mainlining Vodka Red Bulls at clubs, at parties, in bars, and at the poker tables for years now; on my Vegas poker trips the past few years, I would have to say that Vodka Red Bull is the most common mixed drink ordered at the poker tables (followed closely by classic caffeinated booze cocktails like Jack & Coke and Captain & Coke).  Although I personally hate the taste of Red Bull, many of my friends drink Vodka Red Bulls, including several of the Ironmen while at the poker tables.  I can't see any health hazard from their choice of beverage, though it certainly doesn't help their meager poker skills.  It's no coincidence that Vodka Red Bull has earned the nickname "The Devil" (or "The Debil" several drinks in to a session) among the Ironmen.

Alcohol-related deaths are always tragic, because they are preventable.  Alcohol-related deaths among college-age (or younger) folks are especially tragic, given that they usually arise from binge-drinking (often with some sort of peer pressure involved).  But these deaths are not the result of an energy drink problem nor a caffeinated alcohol problem; they are the result of an alcohol abuse problem.  Kids can easily mix up an alcohol-energy drink cocktail if they want.  Banning premixed versions of such beverages won't solve a binge-drinking problem, and may in fact make the problem worse if kids wind up mixing their own super-strong versions of Vodka Red Bull (or their personal alcohol-energy drink cocktail of choice).  Back in my college days, beer kegs were banned from campus parties.  So, we turned to hard liquor, and got hammered on kamikazes, lemon drop shots, cheap tequila, bad vodka, Captain & Coke, Jack & Coke, and of course, Jägermeister.  I have no doubt the keg beer was actually safer for students.  I suspect a similar phenomenon will occur with today's kids.  The FDA's ban on caffeinated alcoholic beverages won't stop kids from binge-drinking and occasionally dying.  All the ban will do is change the kind of alcohol they consume while binge-drinking.

To be blunt, this FDA ban of alcoholic energy drinks is worse than pointless.  The ban is a superficial bandage that makes the public think their government has acted decisively to fix an alcohol-related death problem, when in fact the real issue—our country's culture of youth binge-drinking—continues to fester untreated.  It's shameful that the FDA, with its expertise in drug safety, is pandering to the public hysteria over these alcoholic energy drinks without any scientific evidence that the drinks are any more dangerous than caffeinated or alcoholic beverages in general, or pose any health risk not found with cocktails which use a caffeinated mixer.  The FDA's pious posturing on this issue is nothing more than a public relations charade.  It's enough to drive one to drink.

Vodka Red Bull, anyone?

The Tour de WSOP

Kumar:  Hang on a second, nurse. What we should probably use is marijuana. That'll sufficiently sedate the patient for surgery.

Male Nurse:  Marijuana? But why?

Kumar:  We don't have time for questions. We need marijuana now, as much of it as possible! Like a big bag of it.

—Harold & Kumar Go to White Castle

In what is likely the world's most pointless survey since Maxim discovered women lie about sex as much as men:

A Nova Southeastern University study recently presented at a national conference found that 80 percent of poker players around the world reported using drugs and other substances to enhance their performance in poker.

Poker players are using drugs such as marijuana, cocaine, amphetamines, Valium, and other prescription medications, as well as substances including caffeine, energy drinks and guarana to get an edge over their opponents.

Apparently the survey involved having a mere 198 poker players fill out an online questionnaire.  The players self-selected to participate in the survey after seeing it advertised on online poker site.  Not surprisingly, the demographics were heavily male (96%) and young (average age of 26).  Also not surprisingly, the participants probably have an inflated sense of self, with a whopping 60% claiming to be professional (25%) or semi-professional (35%) players.  Two-thirds were primarily online players.  Now onto the pharmacology:

• 28% report using one or more prescription medications to improve their game.  I suppose in the age of widespread use of "study drugs" (a/k/a "nootropics") like Ritalin and Adderall, it really should not be a shock that younger people who are college age or just out of college might have access to and past experience with such drugs, and use them to enhance their online poker performance.  Most of the drugs reported in the prescription category either have or are reputed to have positive effects on concentration and memory.  It should come as little surprise that these drugs were obtained by illicit means by a 3:2 rate over legitimate prescriptions.
• The high reported usage (by roughly 20% of respondents) of benzodiazepines (sedative/hypnotic drugs) and hydrocodone (a common opioid) might be as a method of counteracting the stimulant qualities of other drugs, rather than for their own benefits.  It certainly doesn't appear as though these types of medications would have any independent positive effect on poker performance.
• With respect to "other" performance enhancing substances, caffeine is the king, as might be expected (71%), while the use of energy drinks (51%) seems rather low, at least given their ubiquity in the poker media.  Scotty Nguyen will be happy that plenty of youngsters (30%) emulate his use of booze as a method for enhancing, well ... his personality, at least.
• One-third of those surveyed use marijuana to improve their poker play.  This one just doesn't seem to add up.  I suppose it might relax someone who is hyper or on super-monkey tilt.  Maybe marijuana is like alcohol—a little bit helps relax a player and lower natural risk-averse inhibitions to allow aggression in play, but too much and the edge evaporates, along with the bankroll.
• Finally, 46% took some kind of nutritional supplement to improve poker performance.  The most common were Vitamin B12, guarana, Gingko biloba, ephedra, and ginseng.  Seriously?!?  Online poker guys spend tons of time researching game theory and calculating odds, and then fall for the nutritional supplement scam?  I get that guarana and ephedra are just alternative stimulants (though ephedra is rather risky), but for the most part, science really doesn't support the claims for most herbal supplements. 

Frankly, I don't much care one way or the other about the use of performance enhancing drugs in poker, partially because I am not terribly worked up about the illegality of the kinds of drugs involved, and mostly because I doubt these drugs give most players a significant edge at poker.  After all, a bad player on drugs is just a bad player who can stay awake longer to give away his money.

Wake me up if poker players ever figure out a way to hide an electric motor in a bicycle ...

The Real Flaws in Big Mac's Apology

Mark McGwire has finally completed the de rigueur three-step Kabuki dance of the public figure caught in some indiscretion: outraged denial, stonewalling silence, tearful apology. Now we await the final thumbs-up or thumbs-down from the self-appointed critics in the sports media as to whether Big Mac’s dramatic performance was satisfactory according to their standards: Was he sincere enough? Did he admit enough? Is it too little, too late? Never mind that most of these self-righteous media critics were the same individuals who shirked their professional responsibilities by turning a blind eye to steroid use in the late 1980s and through most of the 1990s to serve their own self-interests in maintaining access to these same players they now pillory. Why let a little hypocrisy get in the way of a good opinion piece about why Big Mac should or shouldn’t be welcomed back into MLB’s good graces, and possibly even voted into the Hall of Fame?

Frankly, though, all the focus on whether McGwire’s apology was “sincere” enough is misplaced. I have no doubt McGwire is truly sorry—not for his decision to use steroids, but that his steroid use became public knowledge. Big Mac is little different than the 6 year-old who breaks his mother’s favorite vase and tries to hide it; when his misbehavior is inevitably discovered, the kid’s tearful apology is certainly sincere, but he’s mostly sorry he got caught (or he’s only sorry after he got caught).

As I’ve written previously, I don’t give a flying pig if McGwire ever apologized for using steroids. But since he has done so, I do take issue with a couple of his ridiculous assertions:

"I did it [for] health purposes," McGwire told Costas. "If you look at my career, injured '93, '94, '95, '96, I was a walking M*A*S*H unit. I told my dad yesterday when I finally had to tell him about this. I remember calling him in '96. I was so frustrated with injuries, I wanted to retire. He's the one who told me to stick it out. At that time I was using steroids thinking it was going to help me. It was brought to my attention that it was going to help me heal faster, make my body feel back to normal."

Asked repeatedly by Costas if he believed that his statistics and records were legitimate in light of the disclosure, McGwire did not budge.

(“McGwire opens up about steroid use,” Matthew Leach, MLB.com).

Although it stretches credulity, let’s grant Big Mac his contention that he only used PEDs to recover from injuries, and not to increase his strength.* Let’s also assume Big Mac had improved as a player to the point that, if only he stayed healthy, he would inevitably have broken the home run record based on his natural skill, talent, and strength. Even under this rose-colored hypothetical, McGwire’s use of PEDs was nonetheless indirectly responsible for his breaking the record by permitting him to remain healthy for a full season, something he had trouble doing in the latter part of his career. Even McGwire himself admits, at least obliquely, that PEDs added games to his seasons, and seasons to his career. Those added games and seasons enable him to set the single season home run record (in more dramatic fashion than Barry Bonds’ subsequent effort) and pad his career home run stats. It is these two accomplishments that form a large part of the justification for his Hall of Fame consideration. Now, whether those accomplishments were achieved against pitchers also using PEDs, and whether his stats are still impressive in the context of other juiced hitters of the same era, is a debate for another day by people who actually care about MLB. What can’t be denied is that PEDs benefited McGwire’s career even by McGwire’s own arguments.

"I wish I had never touched steroids. It was foolish and it was a mistake. I truly apologize. Looking back, I wish I had never played during the steroid era.”

(McGwire press release, MLB.com) (emphasis added).

Big Mac makes it seem inevitable that he used PEDs, simply because he was living in an era when lots of players were using PEDs. That reeks a bit of bovine excrement. It’s not like an unscrupulous doctor or trainer was slipping the PEDs to McGwire without his knowledge. Look, I went to college in the late 80s and early 90s, and most of my friends would smoke marijuana on occasion. I never did, not because of some moral judgment, but simply because I wasn’t sure what career path I would take, and didn’t want any hint of drug use in my record (not to mention tequila was always sufficient for my recreational purposes). Likewise, even if PED usage was endemic in MLB in the 90s, there were certainly a significant number of players who played within the rules, and avoided PED use. It’s possible that McGwire cost other non-PED-using players money by using PEDs to extend his career: pitchers who lost games** or gave up home runs to McGwire getting cut or getting less money, hitters who didn’t break in to the big leagues because McGwire’s career was extended, hitters who would have gotten bigger contracts or more endorsement deals if their performances weren’t diminished when viewed in comparison to McGwire’s PED-aided stats, and players from other teams who would have made the playoffs but for McGwire's ability to play a full season (or several extra seasons). It is these players to whom Big Mac owes a sincere apology, and it is these players whose voices should be the loudest in expressing outrage at those players who used PEDs, and in demanding that fellow players compete on a level playing field.

As for me, I still don't give a flying pig how the McGwire situation shakes itself out, and frankly, I want my sports media coverage to turn back to the NFL playoffs and college basketball.  At least we seem to have stopped talking about Tiger Woods and his terrible taste in mistresses ...

---------------
* Whether athletes should be allowed to use steroids, HGH, or similar drugs to assist in treating injuries rather than enhancing performance is an interesting issue that merits serious debate. Allowing this type of supervised medical use of PEDs for treatment purposes would probably prove to be a big loophole ripe for abuse. In any event, McGwire’s possession and use of PEDs was certainly illegal (though ironically, not against MLB rules) at the time he made his decision to use those PEDs, so the reason for his use of PEDs is ultimately irrelevant to the debate.

** It would be intriguing to learn how many baseball games were lost because of a decision to pitch around McGwire or Barry Bonds during the height of their PED-enhanced home run streaks, or how many additional games the Cardinals and Giants won because of the extra games and seasons played by McGwire and Bonds.  It's also entirely possible that McGwire's and Bonds' PED use kept teams out of the playoffs, directly impacting those teams and their players financially.

Of Big Mac & My Flying Pigs

I was at home sick today, when the news broke that Mark McGwire had admitted to using performance enhancing drugs (PEDs), specifically, steroids and human growth hormone (HGH). While the public admission is technically “news” in the sense of a new development, that Big Mac had used PEDs during his baseball career had been more or less established in my mind, at least since his bizarre Congressional testimony in 2005, if not as early as the discovery of his use of androstenedione (“andro”) during his 1998 record-setting home run duel with Sammy Sosa, or the later revelations from McGwire’s unapologetic former teammate and mega-juicer, Jose Canseco. So, concerning McGwire’s admission today, I say, so what?

That’s right, I said it. I don’t give a flying pig if McGwire finally has publicly admitted to using PEDs, since I’ve presumed for a long time he had used PEDs. But more to the point, I also don’t give a flying pig that Big Mac was on the juice. This may come as a surprise to those who know me. After all, I’m a lawyer by trade, a basketball referee for nearly two decades, and a rules nit at nearly every card game I play. Shouldn’t I care more that McGwire was cheating?

Well, you’re probably right. On some level, I really ought to care about the cheating aspect of PED use. After all, as a kid in the late 70s and 80s, I grew up learning that the only reason we good Americans could ever lose in the Olympics to those evil East Germans, Soviets, or other assorted “Commies” was because the bad guys were all doping. Of course, in the late 80s and early 90s, we found out that American Olympians were also doping. We also found out that PED usage was rampant in the NFL, college football, the Tour de France, swimming, boxing, heck just about every sport. At some point, any serious sports fan learned to assume PED usage is pervasive in sports, and that testing for PEDs is, at best, a crude method for keeping PED usage in check and behind the scenes, but no more effective at preventing a motivated athlete from juicing up than a purity ring is at stopping a motivated teen from “rounding the bases”.

So please forgive me for not jumping on the moral outrage bandwagon we’re sure to hear in the sports media the next few weeks, and again when the Baseball Hall of Fame ceremonies roll around. Because here’s the dirty little not-so-secret:  PED use was and is widespread in major league baseball, just like most other sports. The same sports media people who pontificate on the evils of PED usage are the same media members who ignored reporting the issue for years because they didn’t want to jeopardize their access to sports stars. And we fans are likewise in no position to wax righteously indignant—we saw players getting bigger and faster, we saw records topple like dominos, yet we didn’t want to look too closely at how the sports sausage was being made, so long as it was served to us in a tasty stew of exciting highlight reel plays and home team success. So when discussing Big Mac—or A-Rod, Roger Clemens, Barry Bonds, or any of the other big names of the era—let’s simply acknowledge the obvious:  they were juiced men playing against other juiced men. In evaluating their achievements, compare them to each other, not against players from some prior era. If their achievements relative to the players of their own era merit their inclusion in the Hall of Fame, so be it. Let them in, and move along.

As for what message might be sent by rewarding athletes who flouted the PED rules, well once again I don’t give a flying pig if athletes decide to juice up. PEDs certainly pose health risks, but grown men can decide for themselves whether the risk is worth the reward, much as we allow people to decide whether to pursue any risky occupation or activity. Setting a good example for kids sounds like a valid concern, but the concern is misplaced. High school and college players shouldn’t be permitted to use PEDs because most PEDs are versions of hormones whose effect on adolescents is unknown and may well be dangerous to their health. But we don’t ban adults from using tobacco or alcohol simply because they may be dangerous to children. Protecting kids from the risks of PEDs properly falls on parents and coaches, not on professional sports leagues or Olympic athletes.

The one group of people who have a valid objection to the use of PEDs on the professional level is that group of players who wish to play but do not want to risk the use of PEDs. To maintain a competitive equality with PED-using players, non-users may feel pressured to take PEDs they would otherwise avoid. The answer to this issue lies solely with the players themselves—if players don't want PEDs, the unions should express the desire of their memberships by consenting to mandatory drug testing with strong sanctions for violation of PED rules, and encouraging its members to self-police its own ranks through anonymous reporting of fellow players violating the PED rules. If PEDs are truly a problem in sports, then it is up to the athletes themselves to show the will to crack down on PEDs in a meaningful way, for the benefit of all the players.

As for me, so long as the players don’t care about PEDs, neither will I.