Lance Armstrong’s Only Sin Was Getting Caught

Lance ArmstrongThe furore over Lance Armstrong’s confession to Oprah, and by extension the world, of the fact he used performance enhancing drugs and blood doping to help him win his seven Tour de France titles, says more about the mass ignorance that surrounds the issue than it does about the integrity of Lance Armstrong. Indeed elite sport remains one of the few arenas of modern life where a massive gulf remains between public perception and reality. In other words the surprise is not that someone like Lance Armstrong was using performance enhancing drugs throughout his career, the surprise would have been if he had not.

Anyone with a basic knowledge of human physiology, nutrition, and high performance sports will know that elite athletes repeatedly transcend the limits of natural human potential both in their training and performance. Regardless of advances in science surrounding training, nutrition, and recovery, and regardless of genetics, it is impossible for the extraordinary feats of athletic and sporting performance we have become accustomed to witnessing on a regular basis without the aid of performance enhancing drugs. This at least is my contention.

The male hormone testosterone determines an individual’s natural level of strength, muscle mass, and aggression. The natural level of testosterone produced by a male in his peak years of physical development – from 18-21 – is around 6 mg per day. When it comes to growth hormone, essential for muscular development, a healthy immune system, bone density, growth, and cell regeneration, an average male’s levels drop off around the age of 30 by 1-2 percent per year, and by age 40 a man is naturally producing half of what he was at age 20. It is this decrease in GH that drives the ageing process.

Athletes are not average people. The stress they place on their muscular and skeletal systems, the demands placed on their cardiovascular system, and the impact this has on their central nervous system, is monumental. The ability to do so on a regular basis and recover makes the use of performance enhancing drugs, such as synthetic testosterone in its various forms, or growth hormone, not just desirable but essential for those whose aim is to compete at the highest level.

When it comes to Lance Armstrong and cycling in particular, the Tour de France is an event that requires those competing to smash through the limits of endurance, speed, and power time after time. Consequently the use of drugs and blood doping is almost required.

Just on the level of formal logic the stakes involved in professional sports – millions of dollars in prize money, endorsements etc for those at the top – fuels a win at all costs ethos, mirroring the emphasis on success that is so prevalent in society and sits at the apex of our cultural values.

Many serious athletes will view the taking of performance enhancing drugs as levelling the playing field. Moreover within the closed and highly pressurised world of competition, with its own values and understanding of what it takes to win, it will not be considered a big deal. Armstrong himself stated during his interview with Oprah that taking PEDs was as natural to him as putting air in his tires or water in his water bottle.

Viewed in this light it would be more shocking to find elite athletes who don’t or have never used them rather than those who do or have. Increasingly the challenge for those athletes who do use them is to remain one step ahead of advances in testing, though there are still sports, pro boxing in particular, in which the testing regime remains lax.

Ultimately Lance Armstrong’s sin lay in getting caught. His extraordinary success, magnified in his case by a successful battle with cancer, led to him becoming the prisoner of a public which demands that its sporting heroes jump higher, run faster, punch harder, and cycle faster while conforming to a level of moral purity and rectitude rendered impossible in a culture in which success and human virtue are considered two sides of the same coin.

Lance Armstrong’s achievement in winning the Tour de France seven times still stands as a remarkable feat worthy of the admiration and respect. More importantly, it is high time there was an honest conversation on the use of performance enhancing drugs in sport.



The NHS and cancer drugs: what price on life?

Excellent article from Socialist Worker by the great Karen Reissman, big pharm is short selling the NHS if you ask me!  While I may have a number of political differences with this newspaper, you can’t knock essential information when you see it.  Pharmaceutical companies are a bit of capitalism which is particularly nasty, the media campaigns for more drug spending should be asking why these companies are making millions out of those in the most extreme suffering.


The government’s decision to allow cancer patients to buy private drugs will mean a two-tier NHS, says Karen Reissmann

If you’ve got money maybe you can buy some extra life. If you haven’t you’re only worth what the NHS can afford. That will be the effect of the government’s decision last week to allow cancer patients to pay for extra drugs without forfeiting NHS treatment.

Previously, those who decided to pay for care which the health service said it could not afford were deemed to have opted-out of the NHS into the private sector. They would then have to pay for all their treatment.

The about-turn by ministers threatens to institute a two-tier national health service and will introduce a new wave of health rationing. It runs completely against the government’s own oft-repeated mantra that the NHS is free at the point of delivery, even if it is provided by private companies.

Of course the previous system was also unsatisfactory – the only fair solution is for all clinically proved drugs to be available to all on the NHS.

Many patients have already spent a fortune trying to extend their survival chances by buying “non-NHS” drugs.

The new rules mean that cancer sufferers no longer have a universal NHS – with prescription charges no longer the standard £7.10 but effectively running into thousands of pounds.

This system will mean many will end their lives in debt, while many more who cannot afford treatment will die early.

The government argues that the NHS would be bankrupted if it was allowed to prescribe all it might want to.

But for many cancer patients, access to certain drugs is a matter of life and death. Such people will be angry at the sight of the greedy bankers lining their pockets with public money. Just who has decided upon this set of priorities?

A discussion of which drugs should be available on the NHS also raises questions about the role of pharmaceutical companies. Few of us want to see the NHS simply hand the drug firms more money. Last year the health service drug bill rose to £11 billion – more than 10 percent of the total NHS budget.

In the same year, Pfizer – the multinational drug firm that manufactures the Sutent kidney cancer drug that the NHS says it cannot afford – recorded profits of £9.8 billion.

Drug companies don’t exist to find cures but to make money. Companies choose which drugs to invest in on the basis of expected long-term returns.

So they tend to chase the anti-arthritis and anti-depression markets – which are huge and often require a lifetime of medication – but have little interest in the illnesses where there is little chance of such regular profits.

The firms say that their huge profits reflect the risks they take when spending on research.

Yet they spend a similar amount – about a third of their total costs – on marketing, including launches, gifts, sponsorship, and conferences abroad to try to persuade doctors to prescribe their medicines. Stop this practice and the prices would plummet.

The task of evaluating the usefulness of any new drug is made difficult because the companies themselves conduct the vast majority of research into how they perform. And, as most research and academic facilities rely on drug company sponsorship, it is virtually impossible to get an independent assessment.

The government-run National Institute for Clinical Excellence (Nice) was created to provide genuine independent research. But Nice doesn’t just use clinical evidence about how well a drug works when considering whether it should be available on the NHS, it also assesses “economic evidence”.

So, for example, when Nice looked at drugs for dementia, it did not just assess how the medication impacted on patients and their carers, but whether or not it delayed the need for “expensive” residential care.

The fact that so many effective cancer drugs are denied to NHS patients partly explains why survival rates in Britain are so much lower than comparable countries such as France.

Nice says that many effective treatments that are excluded from the NHS offer “demonstrable and substantial survival benefits over current NHS practise but are deemed not to offer a good use of NHS resources”.

Nice values every extra year of life at £30,000. So if you are faced with a diagnosis of cancer, you cannot expect the NHS to simply prescribe the best treatment – you can expect it to consult its balance sheet.

Until healthcare and drug companies are taken out of the equation, it will be impossible to know what drugs are best in any given situation.

I believe that all clinically proven drugs should be available on the NHS, but that we should not allow the pharmaceutical companies to carry on fleecing us.

If the government can see its way to nationalising banks in the public interest, why not nationalise the firms with the power of life and death too?

Karen Reissmann is a nurse and a member of the Unison union’s health executive. She writes in a personal capacity