Manny Ramirez retires amidst talk of positive drug test

Tampa Bay Rays slugger, and 12-time All-Star, Manny Ramirez told MLB that he would retire, amidst talks that he had failed a recent blood test for performance enhancing drugs.  MLB ‘s statement said:

“Major League Baseball recently notified Manny Ramirez of an issue under Major League Baseball’s Joint Drug Prevention and Treatment Program. Rather than continue with the process under the Program, Ramirez has informed MLB that he is retiring as an active player. If Ramirez seeks reinstatement in the future, the process under the Drug Program will be completed.”

Ramirez had already served a 50 game suspension for a violation of the drug program while playing with the Los Angeles Dodgers. A second violation would mean a 100 game suspension.

The most common types of performance-enhancing drugs are anabolic steroids, which is the familiar name for synthetic substances related to the male sex hormones (e.g., testosterone). They promote the growth of skeletal muscle (anabolic effects) and the development of male sexual characteristics (androgenic effects) in both males and females. These drugs were originally developed in the late 1930s to treat diseases where the body is deficient in normal concentrations of sex hormones but were also found to increase the growth of skeletal muscles in laboratory animals. This led to the abuse of these substances, first by weightlifters and body builders but later by athletes in other sports as well.

Performance-enhancing drugs can be divided into a number of categories:

  • Lean mass enhancers- increase muscle and lean body mass. This group includes anabolic steroids, but also includes hormones, such as human growth hormone (HGH- see below)
  • Stimulants- such as amphetamines and caffeine, which stimulate alertness and increase aggressiveness
  • Painkillers- mask pain so that athlete can compete when injured
  • Diuretics- decrease weight by increasing urine output. Used by wrestlers and jockeys who need to meet weight restrictions
  • Masking drugs- usually have no performance enhancing effect on their own, but are used to mask the detection of banned substances. This is an ever-changing landscape as these drugs evolve in tandem with drug testing techniques. The most notable one of these drugs is epitestosterone. A common criterion for many testosterone tests is actually the ratio of testosterone to epitestosterone. If the level of epitestosterone is raised then a higher amount of testosterone will still give a normal ratio.

Human Growth Hormone (HGH) is a normally occurring hormone that is essential for growth and cell reproduction, and which can increase muscle mass. Originally used to treat children and adults with growth problems, the hormone was replaced by obtaining small amounts of the hormone from cadaver pituitary glands. Affected children were only able to receive enough to bring them closer to a “normal” adult height, but distribution of the hormone was tightly rationed. Later, HGH was synthesized in the lab and became plentiful. At that time people began to use the drug not only to increase muscle mass but as an “anti-aging” medication. This latter indication has never been proven. The International Olympic Committee banned HGH in 1989.

Michele R. Berman, M.D. was Clinical Director of The Pediatric Center, a private practice on Capitol Hill in Washington, D.C. from 1988-2000, and was named Outstanding Washington Physician by Washingtonian Magazine in 1999. She was a medical internet pioneer having established one of the first medical practice websites in 1997. Dr. Berman also authored a monthly column for Washington Parent Magazine.

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