The doping suspension of Dodgers slugger Manny Ramirez on Thursday has revived a debate that Major League Baseball undoubtedly hoped it had put behind it: Is the sport's anti-drug program finally harsh enough to deter potential dopers, or is it still too lenient?
Baseball "has come a long way in the last seven years," said Dr. Gary I. Wadler, a New York sports medicine expert and a key official of the World Anti-Doping Agency. "But it's still not where it needs to be."
Yet Howard Jacobs, a leading defense attorney for athletes accused of doping offenses, said that "it's fair to say" the Ramirez case signals that Major League Baseball is serious about stamping out doping. "He's as big a player as there is."
Many details of the Ramirez case were still unclear Thursday night. Sources confirmed to The Times that the drug in question is human chorionic gonadotropin, or HCG, which can be used to boost testosterone levels. But although Ramirez, in a statement issued through the players union, the Major League Baseball Players Assn., said it was a medication prescribed by a physician for a "personal health issue," the list of its legitimate therapeutic uses by an adult male is short.
"In the legitimate world, HCG is used for infertility [by women] or for delayed puberty," Wadler said. "But for a man of his age [36] with a testosterone deficiency, there are much better drugs."
It's unclear why, if it was legitimately prescribed, Ramirez did not obtain a therapeutic-use exemption for taking the substance. Baseball's anti-drug policy, like other sports doping regulations, provide for waivers for medically necessary but otherwise banned substances.
In 2008, the league reported, three such waivers were issued in cases of hypogonadism, a diagnosis that would encompass low testosterone production.
Anti-doping experts say bodybuilders and other athletes often use HCG after cycles of steroid use to restore the testosterone-producing capabilities of the testicles, which is suppressed by steroid abuse.
"HCG helps them to jump-start their own . . . production of testosterone again," said Victor Conte, the founder of the Bay Area Laboratory Co-Operative, or BALCO. Conte pleaded guilty in 2005 to distributing steroids to elite athletes, allegedly including sluggers Barry Bonds and Jason Giambi.
