The quixotic prohibition of attention-enhancing drugs in sport.

Amphetamines and major league baseball are in the news again, with a number of busts made for the prescription drug Adderall, which contains several amphetamine stimulants in its list of active ingredients.

From the New York Daily News:

Thirteen players tested positive for the amphetamine-based drug Adderall in the past season, and 105 were granted exemptions for attention deficit disorder, for which Adderall is frequently prescribed. The exemptions excuse players in advance for banned substances they take on doctor’s orders.
The piece goes on to say that if 105 players in the league have diagnoses of attention deficit disorder (ADD), that represents 10% of the total population of players, while the highest estimates of the population rate are around 5%. The most reasonable explanation of the discrepancy is that a number of players are deliberately obtaining an ADD diagnosis so that they can use adderall for its stimulant properties. Central nervous system stimulants like amphetamines reduce a player’s reaction time, among various other effects that are beneficial in a skill-based sport like baseball. That’s why Adderall is on the prohibited list for baseball; a player needs a medical exemption in order to use the drug while playing.

In order to obtain a diagnosis of ADD, a player needs to show a number of things to either a doctor, a neurologist, psychiatrist or psychologist. They need to demonstrate six or more symptoms from a checklist of nine symptoms, and they need to show evidence that the symptoms appear in two settings (work and home, for example) for at least six months. They need to show that they had some signs of these symptoms before the age of seven, and that their symptoms cause problems in their occupation.
For example, I might obtain a diagnosis of ADD by saying this:
For as long as I can remember, I have been easily distracted. I get bored easily and have difficulty holding attention on my work. I procrastinate, and at school I sometimes failed to hand in my homework. I forget to do important things, I’m often indecisive, and I miss out on a lot of opportunities due to inaction. All this is holding me back from my maximum potential at work, and it is a source of friction with my spouse.
It is still controversial whether ADD exists. But by the more generous estimates, up to 5% of the adult population suffers from ADD. However high that estimate may be, it leaves the vast majority of the population unaffected with ADD — and yet, a far higher proportion could truly attest to the foregoing description of symptoms. Human beings are easily distracted, forgetful procrastinators, and it does cause problems for them in work and in play.

In other words, if we are motivated to get an ADD prescription, most of us do not even need to lie to our doctors. If we simply describe the limits of our free agency in a particular way, we are candidates for an ADD prescription. It is not illegal to do this. It is a legal way to wilfully obtain a prescription-controlled substance.

My point here is not to criticize the diagnostic criteria for ADD — assuming ADD exists, and that the afflicted are worse off in the relevant ways than ordinary people, it is certainly possible that we should prefer a set of diagnostic criteria that are over-inclusive rather than under-inclusive, so that people who are genuinely impaired with ADD are not prevented from obtaining effective therapy. However, the case of ADD brings into stark relief the absurdity of current doping policy.

If a player is prepared to tell the truth to a doctor in a certain way, he is allowed to enhance his performance with legal, prescription-only stimulants. But if he uses the same stimulant without visiting his doctor, he is deemed to be cheating and barred from playing in the league. No matter how we construct our rationale for conducting anti-doping schemes, there can be no argument for the injustice involved in banning one player but not the other for taking the same performance enhancing drug, when that drug is legal and—for all intents and purposes—freely available.
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4 Responses to The quixotic prohibition of attention-enhancing drugs in sport.

  • Peter Wicks says:

    To say there can be no argument for injustice is close to being a tautology, and seems more appropriate as political rhetoric than as philosophical discourse. Essentially the injustice is caused by a political compromise between two conflicting principles. (1. Performance-enhancing drugs should not be used in sport. 2. People should be allowed to get appropriate treatment for medical disorders and should not then be barred from participating in sports competitions.) It’s a problem, which should perhaps be addressed, but it says nothing about the merit of the principles involved.

  • For professional athletes the work setting is also the sport setting. So if they find they have problems in difficult game situations they hence have an argument for being given the enhancer. So the enhancing effect during games becomes an argument *for* having the drug prescribed, while a drug that did not help with attention during the sport situation would be judged as unsuitable to their type of ADD.

  • Bennett says:

    Peter: the thing about the first principle you mention is that it can only be binding if it is applied equally. The primary rationale for banning drugs in sport is that they confer an unfair or exceptional advantage; if you are (by force of principle 2.) allowing some people to have this advantage without penalty, then principle 1 dissolves.

  • Peter Wicks says:

    Anders: the problem with this argument is that sport is only “work” (i.e. economic activity) to the extent that somebody is willing to pay for it. For better or worse, the clients in this context (I.e. fans) generally are against chemical enhancement.

    Bennett: as a moral subjectivist I do not believe that principles “dissolve”, or “can” or can’t be binding. It’s a matter of choice. It’s of course better when such principles are applied equally, but the fact that this doesn’t always happen does not, in my opinion, by itself invalidate the principle.

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