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Outside the Lines: Truth or Scare

Here's the transcript from Show 54 of Outside The Lines - Truth or Scare

Host: Bob Ley, ESPN.
Reported by -Larry Rawson, ESPN
Guests: Gen. Barry McCaffrey (ret.), former director of White House Office of National Drug Control Policy; Johan Olav Koss, Olympic gold medallist and chair of IOC Athletes Commission; Phillip W. Harvey, director of science and quality assurance, National Nutritional Foods Association.
Coordinating producer: Jonathan Ebinger, ESPN.

Announcer -April 8, 2001.

Bob Ley, host - The Denver Broncos, back-to-back Super Bowl champions and human billboards for a nutritional supplement company. Mark McGwire's mythical record had questions of his use of a supplement.

Mark McGwire, St. Louis Cardinals - It's legal stuff. It's sold over the counter. Anybody can go in there and buy it.

Ley - High school kids and elite athletes are fueling a multi-billion-dollar supplement industry.

Dr. Gary Green, NCAA Drug Testing Committee - These compounds are steroids.

Ley - And for Olympians, that could mean disaster.

Frank Shorter, Chairman, U.S. Anti-Doping Agency - The United States internationally is considered to be the nation with the most cheaters.

Ley - Today on Outside The Lines, whether these supplements offer help or harm.

Announcer - Outside The Lines is presented by State Farm Insurance. Joining us from ESPN Studios, Bob Ley.

Ley - Back when there were both a Soviet Union and an East Germany, suspicions ran deep here in the West that these sporting nations were cheating, using performance-enhancing drugs to dominate competition. History has proven many of those suspicions correct.

How ironic then that in the wake of the Sydney Olympics, the label of most suspected nation belongs to the United States. This is a story that winds from those Denver Bronco endorsements to a supplement Mark McGwire no longer takes, from high school athletes seeking an edge to Olympians who test positive and then loudly proclaim their innocence.

It involves what these supplements become inside the body and what is on or not on a label. Labels are hardly foolproof. This week, the "New York Times" reported that the Food and Drug Administration found that as many as one in four food manufacturers mislabeled packages, omitting ingredients that could cause fatal allergic reactions.

But athletic supplements, the hottest sector in the supplement industry, are made and sold largely outside the overview of the FDA. Larry Rawson reports these substances could, among other things, cause the United States some Olympic embarrassment.

Unidentified Male - The International Olympic Committee has decided to award the Olympics in 2002 to the city of Salt Lake City.

Larry Rawson, ESPN Correspondent - In less than a year, Salt Lake City will be the sports center of the world. It will also be ground zero for a major problem, which has brought criticism from the International Olympic Committee and finger pointing from the rest of the world.

Dr. Don Catlin, UCLA Olympic Analytical Laboratory - There are about 15 or 20 different steroids which are available over the counter.

Rawson - U.S. law classifies steroids as a controlled substance, but allows a booming over the counter trade in some supplements which more and more scientists say are indeed steroids, supplements used by everyone from high school students to Olympic athletes.

Catlin - And of those, maybe about six that are most commonly known and have the highest sales.

Shorter - We very often like to think of ourselves as the vanguard leading the charge. And we're playing catch-up.

Rawson - Frank Shorter, who oversees the U.S. Olympic drug testing effort, is aware of the problems with supplements as well as the growing overseas perception that the United States is lax on performance-enhancing drugs.

Shorter - Yes, England, for example, has decided that supplements that may not contain a banned drug but might -- do cause your body to produce one are controlled. They're prescription drugs now, or prescription supplements if you want to call them that.

Guy Gugliotta, "Washington Post" - Dietary supplements, hundreds and hundreds of different compounds, hundreds of pills, hundreds of things that people take on a daily basis are on the market without ever having been tested.

Rawson - Don Catlin and a team of researchers did test supplements over the course of 18 months to see if the over the counter supplements were mislabeled or contained precursors such as andrestindione, which are converted by the body into steroids.

Catlin - What we are really concerned about is that every day athletes, who are oftentimes trying to do right and trying not to take things that are banned, end up with a positive urine test. And they may not have any idea where they got it from.

Rawson - The study, while not naming specific brands, found many problems with supplements.

Green - Some of the supplements contained things that were not supposed -- that were not listed on the label. Other ones didn't contain things that were supposed to be on the label. These compounds are steroids.

And to me, it's amazing that an athlete who would never think of taking testosterone or an anabolic steroid can walk into a nutrition store or on the internet and buy as much of it as they want and take as much of it as they want without any regulation and no quality control.

Rawson - American shot putter C.J. Hunter claimed his positive test for nandrolone revealed last summer at the Sydney games was the result of a tainted supplement. While Hunter's extremely high level caused many to question his defense, researchers say that basic explanation may well be plausible for other athletes.

Dr. Charles Rich, Chief Medical Officer, Salt Lake Organizing Committee - I think that in some instances there that there were athletes who had done nothing more wrong than take a dietary supplement that hadn't been correctly labeled and that they paid a dear price for it, and that those athletes deserve better.

Rawson - Most of the supplements made in the United States are manufactured in Utah, where that industry is the third largest in the state. Utah Senator Orrin Hatch co-sponsored the 1994 Dietary Supplement Health Education Act, which deregulated supplements.

Green - Because of the provisions of the act, of the Dietary Supplement Act, it takes a great deal of research to get something banned.

Rawson - After the Sydney Olympics, Dr. Rich, the chief medical officer of the Salt Lake City games, publicly warned Hatch of the testing dangers that some supplements posed to Olympians. Rich suggested an amendment to Hatch's original law, which would regulate the supplement industry. After speaking with Hatch, Dr. Rich changed his mind.

Rich - I think that one of the unfair characterizations to me is that the whole dietary supplement industry is irresponsible. And that's just not fair or accurate. We have companies here in Utah that have been scrupulous about their labeling, that have good products.

Rawson - But oversight is supplements is left to the Food and Drug Administration, which some say is under-funded and understaffed for the job.

Gugliotta - The FDA is almost powerless because the FDA must prove that a supplement is dangerous before it can pull it off the market. Now for prescription drugs and for pharmaceuticals, the burden of proof is the other way around. The FDA, the Food and Drug Administration, doesn't have the ability to take them off the market unless it can prove that they are a health risk.

Unidentified Male - Tom Gugliotta.

Tom Gugliotta, Phoenix Suns forward - I remember two teammates just prior to where I passed out, and then I don't remember anything until 4:00 that morning.

Rawson - Sixteen months ago, Tom Gugliotta of the Phoenix Suns suffered a near-fatal post-game seizure caused by his use of the supplement GHB, which was subsequently banned by federal law.

T. Gugliotta - I did something that was stupid. And it nearly cost me my life. And if I can talk about it and at least make people aware that just because it's on the market doesn't mean it's 100 percent great for you and doesn't have adverse side effects that could kill you. Some things do.

Rawson - According to a leading NCAA drug researcher, supplements account for 90 percent of the positive drug tests among collegiate athletes today. At the high school level, the extent of the problem is not known because testing is not allowed.

Among Olympic hopefuls, the question is whether to trust the labeling and the science of the supplements they take as they balance their quest for glory against the disgrace of a positive drug test. For Outside The Lines, I'm Larry Rawson.

Ley - And when we continue, I'll be speaking with a four-time Olympic gold medalist, a man who has directed U.S. drug control policy, and a representative of the supplements industry.

Ley - Joining us this morning to discuss supplements, Johann Olav Koss, who won four speed skating Olympic gold medals for Norway. He's also a medical doctor and a member of the IOC Medical Commission. And he is joining us from Toronto.

General Barry McCaffrey served as director of the White House Office of National Drug Control Policy in the Clinton administration. He's now a professor at West Point. And he joins us today from Washington.

Phil Harvey is the director of science and quality assurance for the National Nutritional Foods Association. He joins us from Anaheim, California.

Johann, as a medical doctor, as an Olympic athlete, as a member of the IOC Medical Commission, what's the view from outside of the United States of this country towards performance enhancing drugs in general and supplements in particular?

Johann Olav Koss, International Olympic Committee Medical Commission Member - Well, good morning, first of all.

I have to say that, of course, we are very concerned, have been very concerned about the use of the prohibited substances in all Olympic sports. And certainly through Sydney Olympics you saw there was even more attention on the American athletes in those games, and fairly I will say sometimes because, of course, many of those athletes from America have never used any of these prohibited substances.

When it comes to the food supplement industry, we are very critical to the mislabeling of these substances that there is not any indication of these precursors or metabolites of steroids in them. And there is not only the U.S. market, but this is an international problem that athletes can take supplements anywhere in the world, mislabeling, not knowing that they contain steroids and will then test positive and be sanctioned for most of their life.

Ley - But the supplements are largely produced in the United States. General, is that a fair impression of the U.S. internationally?

Gen. Barry McCaffrey, former Drug Czar - Oh, sure. You know, Johann Koss has been a huge influence on the world's understanding of this issue, not just as an athlete, but also as a physician. We need to listen to people like Dr. Don Catlin at UCLA and Dr. Gary Wadler, the most brilliant sports medicine person in the country.

Lots of us now believe this '94 DeShay act needs to be modified so that these precursors to steroids only get issued with a doctor's prescription. It's clear from the scientific evidence that many of them have lots of impurities in them. And even more importantly, they apparently -- things like andro produce high levels of estrogen, which is devastating potentially for both men and women, cancer or heart disease, other problems, as well as like drugs like creatine, we really know very little about except potentially they also have very devastating side effects.

We've got to rethink what we're doing and get the FDA and the National Institute of Health back in the business of regulating things that turn out to be perhaps legal when you ingest them but illegal when you excrete them.

Ley - All right, Phil Harvey, that's your industry we're talking about. Your chance to respond.

Phil Harvey, PHD, Director of Science and Quality Assurance, National Nutritional Foods Association - Yeah, well, I just want to say, I mean, there is some misinformation here and some misrepresentation. These substances -- I mean, at the National Nutritional Foods Association, we have programs in place that test these products. And we have not found these steroids that have been mentioned in these products.

There's definitely a need for these products to be controlled. And, of course, there is the responsibility on the athlete...

Ley - Controlled by whom, though, Phil?

Harvey - Well, the FDA, the Food and Drug Administration, does have we feel adequate controls. The former commissioner of the FDA stated publicly that DeShay adequately protects the public and that there is manufacturing processes in place, especially in the United States, for companies to manufacture these products.

And we haven't seen as yet FDA's good manufacturing practices out. Our association and NNFA do have a GMP certification program that we have a process of certifying these products.

Ley - And, General, I would have to believe that you would think the FDA overview is not sufficient at the moment?

McCaffrey - No, clearly it isn't. You know, look, at the end of the day, the 1990 Controlled Substance Act banned steroids. And they should be, except with a doctor's prescription.

The problem with the DeShay Act in '94 is it eliminated these precursors to steroids, which no longer have any guarantee of safety, efficacy or purity. So when an athlete, and hundreds of them have tested positive for drugs like 19 norandro is a byproduct of using these supplements, dietary supplements. We've got to get science back in what we're allowing athletes to take.

I might add we're not talking about elite athletes. More than a half million boys and girls in this country as young as 10 or 11 are taking some form of steroid or dietary supplement, 175,000 girls. The impact on adolescent development could be devastating in the coming years. I think there's a legal liability problem here that the industry is going to have to think through quite clearly.

Harvey - I'd just like to comment to the General. Our position at NNFA and just within the trade association, that any dietary supplement that would have a steroid added to it, is in fact misbranded and adulterated...

McCaffrey - Sure.

Harvey - ... and we do not support that at all.

McCaffrey - No, sure.

Harvey - I mean, we're clearly in favor and we spend a lot of effort on producing within the industry products that are of good quality and safe and meet GMP. So we do not support adulterated products...

McCaffrey - Yeah.

Harvey - ... and the FDA does have the power to remove these products off the market if they have evidence that they have been adulterated.

Ley - Johann?

Koss - I think this is kind of interesting because we have seen hundreds and hundreds of athletes test positive. And they're even proven that through the different laboratories that their supplements have been contaminated with these precursors to steroids. And then when we say it's not happening, and it shouldn't be up to -- I mean, these are strong athletes around the world who have means and abilities to do this testing.

If the customer should sit there, as in a teenager, after putting these steroids in them, having seen those side effects, as a girl, it will change the voice. You will get hair growth and do all that stuff. How can they prove that this isn't against these multi-billion-dollar companies? I think that we certainly need very much -- and Congress has to come in here and step up and be very active and change these rules.

Ley - OK, we're going to step aside just a second, gentlemen, for a commercial. We'll have more with Johann Koss, General Barry McCaffrey and Phil Harvey as we look at supplements and athletes Outside The Lines.

Ley - We continue discussing nutritional supplements with Olympic champion Johann Koss, General Barry McCaffrey and Phil Harvey.

Phil, let me pick up with you. I know you said there are safeguards internally in your own industry to produce safe nutrients. But why would the United Kingdom, Great Britain, last December suddenly declare everything that's made under your industry, for example, now require a doctor's prescription? It's now prescription medicine in Great Britain, that which you can buy over the counter here in the U.S. Why would that be?

Harvey - Well, I -- you know, laws vary throughout the world. And we do have an international association that is trying to deal with that. It's true that in Europe and in England, as you mentioned, there may be a need for a prescription. But those are really those laws that regulate those products in the UK.

In the U.S., of course...

Ley - But that would seem to indicate they feel that there's something rather serious here.

Harvey - ... Well, it depends on what supplement you're talking. I mean, we tend to be lumping everything into one category. Dietary supplements as defined by this law in 1994 clearly include vitamins, minerals, amino acids, sports nutritionals, things like that.

The steroids that are being mentioned appears to be portrayed as a mainstream dietary supplement, which it is not. And...

McCaffrey - Phil, I wonder if I might add because I would absolutely defer to a judgment that the U.S. industry would not tolerate knowingly testosterone or steroids being mixed in as contaminants. I'd give them that point in the argument.

There is, however, an enormous argument to be made that taking pure andro in doses up to 300 milligrams particularly for adolescents ends up with young boys in development with enlarged breasts, shrunken testes, with girls ending up with potentially irreversible gender problems.

So we do believe that estrogen is a potential cancer-causing agent in women. Why would we allow young women to take andro in heavy doses when older women have to go to a doctor to get a prescription?

Harvey - Well, General, we do not recommend for -- and there's lots of labeling that includes, "Do not take if you're under 18." I mean, we do not support any young person, women of child bearing age, to take andro in their diet.

McCaffrey - Sure. But they are taking it.

Ley - And, Johann, what is the mindset of an athlete, because if there's a benefit to be had from something, an athlete is not going to take two that's indicated on a vial, they're going to take 10.

Koss - Yeah. And also, totally understanding that the UK has taken the prohibited, have this over prescription because it is steroids. I mean, these precursors are steroids. And the question is why do they put it also not labeling these things and putting all type of these nutritional supplements so they don't even know what they're getting.

So I think we need to ban it. And we need to have much more stricter control on this.

Athletes, of course, will take much more if they believe the benefits and sometimes can feel the benefits of this so-called legal substances. But if they do test positive, they're out of the sport.

Harvey - You know, NNFA, we support an athlete to read labels carefully. You know, athletes or non-athletes are not...

Koss - I agree with you if you read the labels. But I've sat in lots of these hearings. And they have been showing me these supplements. And there has been no labeling at all that it contains steroids.

McCaffrey - Right. The '94 DeShay Act deliberately excluded from coverage these dietary supplements, which unfortunately did include these precursors to steroids, which do promote muscle growth, limited though it may be, and have these potentially adverse side effects.

We ought to say, "Buyer beware. Athletes understand you could be banned from competition for two years development."

And to their parents and pediatricians and coaches, let's set an example for young people. Let's thank Mark McGwire for coming out so unequivocally and saying he's not going to use andro anymore. It quintupled after his 1998 home run extravaganza. We don't want these youngsters following his lead.

Ley - Phil, let me quickly ask you. I think everyone would agree nandrolone is a dinosaur of a drug. It's easily detectable. Yet about 80 percent of the positives after the Atlanta and Sydney games involved nandrolone for athletes, suggesting that they didn't know they were taking it. Wouldn't that suggest that they're unknowingly taking something that's producing a steroid in their body?

Harvey - Well, there are -- this is a very complex issue...

Ley - And we've got 20 seconds, please.

Harvey - ... There are individuals that have been shown that nandrolone is in the urine, have tested positive, not even taken a steroid...

Koss - But they have taken a precursor to a steroid in the case of nandrolone. I think Congress has to step in here and change the law and legislation because this is harming a lot of people, not only the athletes but public health.

Ley - All right, and Johann has the final word. Gentlemen, thank you. Johann Koss, thank you from Toronto. General Barry McCaffrey, thank you sir. Phil Harvey, thanks for joining us from Anaheim.

Next, your thoughts on last week's show on sports gambling in Nevada on Outside The Lines.

Ley - The push by the NCAA to ban college gambling in Las Vegas got a boost this week with the introduction of a bill by Senator John McCain. Last week's program produced a number of e-mails critical of the NCAA.

From New York - "I find the NCAA to be somewhat hypocritical in asking us to believe that "adults shouldn't be gambling on sports played by young men," when a primary reason that they can command the TV fees that they can get from CBS is their knowledge that people watch because they are in a bracket pool. These pools are gambling, just as betting in Vegas is gambling. Having UCLA play at Duke during finals week is more corrupting to student athletes than allowing adults to legally gamble in Las Vegas."

Minneapolis - "The proposal is so ludicrous that I am surprised this notion was even part of a broadcast. Was this an April Fools joke? The most obvious conflict in the idea of outlawing gambling is a little thing called the stock market. Try to convince the millions of people affected by the recent performance of the markets that by calling their losses the result of investments instead of wagers that they hadn't gambled with their money. I would wager that most bets on sports events are made from a more informed basis than most investments."

You can access the interactive Outside The Lines with the keyword otlweekly. Type that on the home page. And our site features streaming video and transcripts of all Sunday morning programs.

You can also join or begin public discussions on our new message board. We always welcome your e-mail, our e-mail address

Ley - Tomorrow evening, the monthly edition of Outside The Lines shows you athletes on the road again.

Unidentified Male - Road trip.

Ley - They travel early and often. No one is on the road more than the modern athlete.

Unidentified Male - Fifteen days ain't nothing on the road.

Ley - There's luxury and there's convenience, but also the possibility of tragedy.

Unidentified Female - You heard the engine go out.

Unidentified Male - Yeah.

Unidentified Female - What went through your mind then?

Unidentified Male - Well, I knew we were going down.

Ley - "Have Game, Will Travel." You'll spend several weeks with an NBA team and meet the most traveled athlete in history. That's tomorrow evening at 7:00 p.m. Eastern on Outside The Lines.

Next, "SportsCenter" live at the Masters as Tiger is chasing his unique slam.

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