what is "doping"

gds said:

At my last physical my internist suggested that I go on statins.

"Why?" I asked.

"Because research indicates that almost everyone should." He replied.

During our ensuing discussion he argued that research was now showing a
positive effect of statins on most folks- regardless of symptoms or
risk factors for heart desease.

If we move to medical "best practice" including prophylactic use of
drugs for nom symptomatic non risk factor indviduals how would that be
different from doping?

It is not different and that is the whole point.

We watch movies and television shows where all the characters are
silicone "enhanced" superhumans, we watch bicycle races where the
competitors are drug-enhanced Borg contraptions, we fight precision
wars where the weapons are remote controlled and our children spend
most of their "idle" time playing gameboy.

gds said:

At my last physical my internist suggested that I go on statins.

"Why?" I asked.

"Because research indicates that almost everyone should." He replied.

During our ensuing discussion he argued that research was now showing a
positive effect of statins on most folks- regardless of symptoms or
risk factors for heart desease.

If we move to medical "best practice" including prophylactic use of
drugs for nom symptomatic non risk factor indviduals how would that be
different from doping?

The difference is that taking a medication to treat or prevent a
distinct disease process (in this case hypercholesterolemia or ASHD) is
not the same as performance enhancement.
Far be it for me to contradict your internist, but many doctors would
NOT make the sweeping generalization that almost everyone should be on
statins. These are medications with significant risks. Judging a
recommendation to medicate based on one parameter (in this case blood
lipid profile) without taking collateral effects into consideration
(say, hepatotoxicity) is less than honest. This last consideration is
one way in which the comparison is valid. Most folks taking EPO for
performance enhancement probably think that as long as they take it with
medical supervision that risk is negligable. Maybe it is, maybe
not--but it must be evaluated in any case.

Steve

--
Mark & Steven Bornfeld DDS
http://www.dentaltwins.com
Brooklyn, NY
718-258-5001

gds said:

At my last physical my internist suggested that I go on statins.

"Why?" I asked.

"Because research indicates that almost everyone should." He replied.

During our ensuing discussion he argued that research was now showing a
positive effect of statins on most folks- regardless of symptoms or
risk factors for heart desease.

If we move to medical "best practice" including prophylactic use of
drugs for nom symptomatic non risk factor indviduals how would that be
different from doping?

"Doping" as usually meant in rbr is only meaningful in a competitive
context with rules, like sports or chess or something. It involves
gaining an advantage through some kind of modification. We can
argue about whether the modification has to be ingestion of a substance
that is harmful, or not, but that's another story. Whether or not
you actually should go on statins, it's not in the context of a
competition. It's a fine distinction between this prophylactic use
of medication and popping a multivitamin, or eating food that's
good for you.

Similarly, guys who abuse steroids solely for training rides or
to look good at the gym aren't doping in the competitive
bike-racing sense - they're engaging in recreational drug use.

Mark & Steven Bornfeld said:

Quoted message said:

The difference is that taking a medication to treat or prevent a
distinct disease process (in this case hypercholesterolemia or ASHD) is
not the same as performance enhancement.
Far be it for me to contradict your internist, but many doctors would
NOT make the sweeping generalization that almost everyone should be on
statins. These are medications with significant risks. Judging a
recommendation to medicate based on one parameter (in this case blood
lipid profile) without taking collateral effects into consideration
(say, hepatotoxicity) is less than honest. This last consideration is
one way in which the comparison is valid. Most folks taking EPO for
performance enhancement probably think that as long as they take it with
medical supervision that risk is negligable. Maybe it is, maybe
not--but it must be evaluated in any case.

OK fair enough and I don't want to draw this out to the absurd. And I
agree with your position and declined to take statins. That said I have
several physician friends who agree with my internist and feel that
statins offer a level of protection with little associated risk. And
further, the main risk (liver damage) is mitigated by monitoring and
simple testing. But I am not qualified to argue the science so Iet it
be simply that lots of physicians feel this way.(Although I do have
some training in epidemiology and am less than convinced that statins
do much in asymptomatic, low risk populations)

But here is the "moral" issue. Essentially they are arguing for
widespread use of perfomance enhancing medicine (longer life, better
quality of life etc.). They feel that if science has dicovered the
"soltuion" that the population should benefit. So, then my question is
"what difference, morally, ethically is that situation from using EPO
in a carefully monitored situation (i.e. little risk) from what is
being proposed with the statins. If we accept that at a certain level
of safety that drugs are good for us-even if we aren't sick, because
they are likely to improve some aspect of life that seems to come very
taking away any moral or ethical issue of doping. Then doping becomes
just another life style choice-like diet.

I know I'm pushing it a bit- but, at least to me the moral lines are
becoming blurred.

Quoted message said:

--
Mark & Steven Bornfeld DDS
http://www.dentaltwins.com
Brooklyn, NY
718-258-5001

Quoted message said:

"Doping" as usually meant in rbr is only meaningful in a competitive
context with rules, like sports or chess or something. It involves
gaining an advantage through some kind of modification.

If he lives longer because of the medication, he gets more time to spread
his genes. It's unfair.

--
E. Dronkert

Ewoud Dronkert said:

If he lives longer because of the medication, he gets more time to spread
his genes. It's unfair.

Well that certainly describes another class of drugs that have moved
from "medicine" to "why not sounds like fun." Although spreading genes
is not the main idea it is part of the package.

Ask your internist what the "number needed to treat" is for someone in
your risk factor bracket. NNT is the number of people needed to take
the drug to stop one death or one cardiac event.

If you are otherwise healthy, the NNT is probably in the range of
200,000. If the drugs cost several thousand dollars for a one year
prescription - do the math about how much is being spent on that one
person!

Plus - there are other side effects other that liver ones. Some people
get muscle pain +/or weakness which can stuff up your ability to
compete in the master fatties.

gds said:

But here is the "moral" issue. Essentially they are arguing for
widespread use of perfomance enhancing medicine (longer life, better
quality of life etc.). They feel that if science has dicovered the
"soltuion" that the population should benefit. So, then my question is
"what difference, morally, ethically is that situation from using EPO
in a carefully monitored situation (i.e. little risk) from what is
being proposed with the statins. If we accept that at a certain level
of safety that drugs are good for us-even if we aren't sick, because
they are likely to improve some aspect of life that seems to come very
taking away any moral or ethical issue of doping. Then doping becomes
just another life style choice-like diet.

I know I'm pushing it a bit- but, at least to me the moral lines are
becoming blurred.

It's really quite simple. With regards to the concept of the greater
population benefitting from the use of a drug (or vitamin, or better
food, or whatever) there is no limit to how many people can benefit,
and one person's benefit does not preclude another from benefitting.

But, in the case of performance-enhancing drugs in sports, you're
talking about the use of substances that have possible deleterious
side-effects, which not everyone is willing to risk. There is a
limited amount of $$$ available for sports and therefore any additional
$$$ one person gains will limit the $$$ available for another. There's
not an unlimited supply of 'benefit'.

So long as the governing bodies of 'sport' deem that sport should be
fair and that participants should not have to put themselves at
extraordinary risk to participate, then any gains attained via
performance enhancing drugs in essence defraud those who are not
willing to risk their health and who don't cheat.

The lines are only blurred if you don't have a strong moral compass.

In article
<[email hidden]>,

gds said:

Mark & Steven Bornfeld said:

Quoted message said:

The difference is that taking a medication to treat or prevent a
distinct disease process (in this case hypercholesterolemia or ASHD) is
not the same as performance enhancement.
Far be it for me to contradict your internist, but many doctors would
NOT make the sweeping generalization that almost everyone should be on
statins. These are medications with significant risks. Judging a
recommendation to medicate based on one parameter (in this case blood
lipid profile) without taking collateral effects into consideration
(say, hepatotoxicity) is less than honest. This last consideration is
one way in which the comparison is valid. Most folks taking EPO for
performance enhancement probably think that as long as they take it with
medical supervision that risk is negligable. Maybe it is, maybe
not--but it must be evaluated in any case.

OK fair enough and I don't want to draw this out to the absurd. And I
agree with your position and declined to take statins. That said I have
several physician friends who agree with my internist and feel that
statins offer a level of protection with little associated risk. And
further, the main risk (liver damage) is mitigated by monitoring and
simple testing. But I am not qualified to argue the science so Iet it
be simply that lots of physicians feel this way.(Although I do have
some training in epidemiology and am less than convinced that statins
do much in asymptomatic, low risk populations)

But here is the "moral" issue. Essentially they are arguing for
widespread use of perfomance enhancing medicine (longer life, better
quality of life etc.). They feel that if science has dicovered the
"soltuion" that the population should benefit. So, then my question is
"what difference, morally, ethically is that situation from using EPO
in a carefully monitored situation (i.e. little risk) from what is
being proposed with the statins. If we accept that at a certain level
of safety that drugs are good for us-even if we aren't sick, because
they are likely to improve some aspect of life that seems to come very
taking away any moral or ethical issue of doping. Then doping becomes
just another life style choice-like diet.

I know I'm pushing it a bit- but, at least to me the moral lines are
becoming blurred.

Do not apologize, let's explore this further. The best way
to accumulate statistically significant data is to monitor
a large number of people who are ingesting statins. Then
in a few years the prescribing physicians can report their
results, the researchers correlate the data, and the
medical bodies announce the effects of statins on various
types of people.

--
Michael Press

Patricio Carlos said:

Ask your internist what the "number needed to treat" is for someone in
your risk factor bracket. NNT is the number of people needed to take
the drug to stop one death or one cardiac event.

If you are otherwise healthy, the NNT is probably in the range of
200,000. If the drugs cost several thousand dollars for a one year
prescription - do the math about how much is being spent on that one
person!

Plus - there are other side effects other that liver ones. Some people
get muscle pain +/or weakness which can stuff up your ability to
compete in the master fatties.

I have a friend who had a minor stroke and was subsequently put on
statins--he feels they have really slowed him down (in general, not
cycling).
I am hardly an expert--I have no idea what long-term studies have been
done on matched samples comparing cardiac death rates (and not inferring
a benefit due to demonstrated improvement of blood lipid profile). In
any case, morbidity from other cases must be compared as well.

Steve

Quoted message said:

Michael Press said:

In article
<[email hidden]>,

gds said:

Mark & Steven Bornfeld said:

The difference is that taking a medication to treat or prevent a
distinct disease process (in this case hypercholesterolemia or ASHD) is
not the same as performance enhancement.
Far be it for me to contradict your internist, but many doctors would
NOT make the sweeping generalization that almost everyone should be on
statins. These are medications with significant risks. Judging a
recommendation to medicate based on one parameter (in this case blood
lipid profile) without taking collateral effects into consideration
(say, hepatotoxicity) is less than honest. This last consideration is
one way in which the comparison is valid. Most folks taking EPO for
performance enhancement probably think that as long as they take it with
medical supervision that risk is negligable. Maybe it is, maybe
not--but it must be evaluated in any case.

OK fair enough and I don't want to draw this out to the absurd. And I
agree with your position and declined to take statins. That said I have
several physician friends who agree with my internist and feel that
statins offer a level of protection with little associated risk. And
further, the main risk (liver damage) is mitigated by monitoring and
simple testing. But I am not qualified to argue the science so Iet it
be simply that lots of physicians feel this way.(Although I do have
some training in epidemiology and am less than convinced that statins
do much in asymptomatic, low risk populations)

But here is the "moral" issue. Essentially they are arguing for
widespread use of perfomance enhancing medicine (longer life, better
quality of life etc.). They feel that if science has dicovered the
"soltuion" that the population should benefit. So, then my question is
"what difference, morally, ethically is that situation from using EPO
in a carefully monitored situation (i.e. little risk) from what is
being proposed with the statins. If we accept that at a certain level
of safety that drugs are good for us-even if we aren't sick, because
they are likely to improve some aspect of life that seems to come very
taking away any moral or ethical issue of doping. Then doping becomes
just another life style choice-like diet.

I know I'm pushing it a bit- but, at least to me the moral lines are
becoming blurred.

Do not apologize, let's explore this further. The best way
to accumulate statistically significant data is to monitor
a large number of people who are ingesting statins. Then
in a few years the prescribing physicians can report their
results, the researchers correlate the data, and the
medical bodies announce the effects of statins on various
types of people.

Of course, this is done (on a more limited basis) with clinical trials.
But once a drug is approved for general use, there is a powerful
disincentive to continue study. Doctors are supposed to report
suspected drug-related incidents to the FDA, but this is not the same as
a comprehensive study.

Steve

Quoted message said:

In article <[email hidden]>,

Steven Bornfeld said:

Michael Press said:

In article
<[email hidden]>,

The best way
to accumulate statistically significant data is to monitor
a large number of people who are ingesting statins. Then
in a few years the prescribing physicians can report their
results, the researchers correlate the data, and the
medical bodies announce the effects of statins on various
types of people.

Of course, this is done (on a more limited basis) with clinical trials.
But once a drug is approved for general use, there is a powerful
disincentive to continue study. Doctors are supposed to report
suspected drug-related incidents to the FDA, but this is not the same as
a comprehensive study.

Oh, I was being snarky as I watch the population at large
paying to be guinea pigs in medical experiments.

--
Michael Press

In article <[email hidden]>,

Steven Bornfeld said:

Of course, this is done (on a more limited basis) with clinical trials.
But once a drug is approved for general use, there is a powerful
disincentive to continue study. Doctors are supposed to report
suspected drug-related incidents to the FDA, but this is not the same as
a comprehensive study.

Isn't that essentially what happened with Viox, Steve?

--
tanx,
Howard

The sheriff is near...

remove YOUR SHOES to reply, ok?

In article <[email hidden]>,

Michael Press said:

In article <[email hidden]>,

Steven Bornfeld said:

Michael Press said:

In article
<[email hidden]>,

The best way
to accumulate statistically significant data is to monitor
a large number of people who are ingesting statins. Then
in a few years the prescribing physicians can report their
results, the researchers correlate the data, and the
medical bodies announce the effects of statins on various
types of people.

Of course, this is done (on a more limited basis) with clinical trials.
But once a drug is approved for general use, there is a powerful
disincentive to continue study. Doctors are supposed to report
suspected drug-related incidents to the FDA, but this is not the same as
a comprehensive study.

Oh, I was being snarky as I watch the population at large
paying to be guinea pigs in medical experiments.

e.g. thalidomide or hormone replacement therapy. I suspect there's many more
like that.

--
tanx,
Howard

The sheriff is near...

remove YOUR SHOES to reply, ok?

Scott said:

gds said:

I know I'm pushing it a bit- but, at least to me the moral lines are
becoming blurred.

It's really quite simple. With regards to the concept of the greater
population benefitting from the use of a drug (or vitamin, or better
food, or whatever) there is no limit to how many people can benefit,
and one person's benefit does not preclude another from benefitting.

But, in the case of performance-enhancing drugs in sports, you're
talking about the use of substances that have possible deleterious
side-effects, which not everyone is willing to risk. There is a
limited amount of $$$ available for sports and therefore any additional
$$$ one person gains will limit the $$$ available for another. There's
not an unlimited supply of 'benefit'.

So long as the governing bodies of 'sport' deem that sport should be
fair and that participants should not have to put themselves at
extraordinary risk to participate, then any gains attained via
performance enhancing drugs in essence defraud those who are not
willing to risk their health and who don't cheat.

The lines are only blurred if you don't have a strong moral compass.

I'll leave off the dig about the "moral compass" I know where my
points. But I do think the issue is broader than you paint it. I
understand the difference between drugs for the health benefit of large
populations vs. performance enhancers for sport. My point is that as
the use of drugs, recreational, therapeutic, prophylactic, increases so
does "societies" tolerance for the use of drugs for a broader spectrum
of solutions. And to a large extent sport reflects the mores of society
(with some leads and lags of course). So, I am simply positing that as
the braoder acceptance of drug use in society for a broadeer range of
uses continues to increas

Scott said:

gds said:

I know I'm pushing it a bit- but, at least to me the moral lines are
becoming blurred.

It's really quite simple. With regards to the concept of the greater
population benefitting from the use of a drug (or vitamin, or better
food, or whatever) there is no limit to how many people can benefit,
and one person's benefit does not preclude another from benefitting.

But, in the case of performance-enhancing drugs in sports, you're
talking about the use of substances that have possible deleterious
side-effects, which not everyone is willing to risk. There is a
limited amount of $$$ available for sports and therefore any additional
$$$ one person gains will limit the $$$ available for another. There's
not an unlimited supply of 'benefit'.

So long as the governing bodies of 'sport' deem that sport should be
fair and that participants should not have to put themselves at
extraordinary risk to participate, then any gains attained via
performance enhancing drugs in essence defraud those who are not
willing to risk their health and who don't cheat.

The lines are only blurred if you don't have a strong moral compass.

I'll leave off the dig about the "moral compass" I know where my
points. But I do think the issue is broader than you paint it. I
understand the difference between drugs for the health benefit of large
populations vs. performance enhancers for sport. My point is that as
the use of drugs, recreational, therapeutic, prophylactic, increases so
does "societies" tolerance for the use of drugs for a broader spectrum
of solutions. And to a large extent sport reflects the mores of society
(with some leads and lags of course). So, I am simply positing that as
the braoder acceptance of drug use in society for a broadeer range of
uses continues to increas

gds said:

Scott said:

gds said:

I know I'm pushing it a bit- but, at least to me the moral lines are
becoming blurred.

It's really quite simple. With regards to the concept of the greater
population benefitting from the use of a drug (or vitamin, or better
food, or whatever) there is no limit to how many people can benefit,
and one person's benefit does not preclude another from benefitting.

But, in the case of performance-enhancing drugs in sports, you're
talking about the use of substances that have possible deleterious
side-effects, which not everyone is willing to risk. There is a
limited amount of $$$ available for sports and therefore any additional
$$$ one person gains will limit the $$$ available for another. There's
not an unlimited supply of 'benefit'.

So long as the governing bodies of 'sport' deem that sport should be
fair and that participants should not have to put themselves at
extraordinary risk to participate, then any gains attained via
performance enhancing drugs in essence defraud those who are not
willing to risk their health and who don't cheat.

The lines are only blurred if you don't have a strong moral compass.

I'll leave off the dig about the "moral compass" I know where my
points. But I do think the issue is broader than you paint it. I
understand the difference between drugs for the health benefit of large
populations vs. performance enhancers for sport. My point is that as
the use of drugs, recreational, therapeutic, prophylactic, increases so
does "societies" tolerance for the use of drugs for a broader spectrum
of solutions. And to a large extent sport reflects the mores of society
(with some leads and lags of course). So, I am simply positing that as
the braoder acceptance of drug use in society for a broadeer range of
uses continues to increas

I don't buy your contention that the broader tolerance of drugs in
society increases as the use of drugs does. If it did, why is
practically the entire sporting world (not just cycling) in such a
tizzy over performance enhancing drugs?

It's one thing to accept individual use of recreational or therapeutic
drugs, in that it supposedly doesn't harm anyone else, and another
thing altogether to accept the use of illegal performance enhancers in
sport, which is widely accepted as cheating and therefore not
acceptable to the general public.

Scott said:

I don't buy your contention that the broader tolerance of drugs in
society increases as the use of drugs does.

That's OK. I think htere is a lot of ambiguity here.

If it did, why is

Quoted message said:

practically the entire sporting world (not just cycling) in such a
tizzy over performance enhancing drugs?

But the tizzy is exactly what one would predict when publicly stated
goals and private behavior conflicts. We don't see many athletes in a
tizzy. And I don't see many fans in a tizzy. We do see governing
officials (sport governance and state governance) in a tizzy. But since
I feel that governing officials tend to lead from the rear- that is
they follow public opinion with a time lag; the idea that public (and
clearly the athletes) have changed mores and the governors have yet
catch up is what I see.

Quoted message said:

It's one thing to accept individual use of recreational or therapeutic
drugs, in that it supposedly doesn't harm anyone else, and another
thing altogether to accept the use of illegal performance enhancers in
sport, which is widely accepted as cheating and therefore not
acceptable to the general public.

Of course, if those are the moral standards of the time. But cheating
means breaking the moral code. I'm simply suggesting that perhaps the
moral code is changing. And if that is the case then the line where
cheating begins will also be changing.

BTW, cheating and acceptance to the public have a curious relationship.
I think it depends on what the cheating is. For example I'd bet that a
poll of all baseball fans would put Pete Rose in the Hall of Fame. The
"public" feels that while he cheated- broke the rules and lied about
it- that the sin was not so damning because he didn't throw games but
simply bet on the outcome. So, if this is true the moral line was drawn
beyond what the rules allow. But clearly Rose's popularity and
acceptance would be vastly diminished in the public's eye if he had bet
on his team to lose and then made it so.

We do live in a world with many shades of gray.

Dans le message de
news:[email hidden],
Scott <[email hidden]> a réfléchi, et puis a déclaré :

Quoted message said:

I don't buy your contention that the broader tolerance of drugs in
society increases as the use of drugs does. If it did, why is
practically the entire sporting world (not just cycling) in such a
tizzy over performance enhancing drugs?

Maybe, because it keeps our minds off root causes ?
--
Bonne route !

Sandy
Verneuil-sur-Seine FR