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Was Lance Armstrong Taking Jerk-Enhancing Drugs?

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The interview that Lance Armstrong gave to Oprah Winfrey was a masterful slice of a never-ending sports-fabulism spectacle, and while it made for good  at times, it was also nearly infuriating to watch. Armstong didn't say very much about how he got his drugs or who else took them on his teams. And after years of denial, even his admission didn't come across as terribly authentic. Never mind that he was neither contrite nor emotional; when he denied claims by a teammate that he pressured others on the team to use steroids, it was, forgive us, hard to believe.

His explanation was also suspect—that taking steroids amounted to a competitive decision, simply a matter of doing what his competitors were doing. That may sound like one argument for the decriminalization of steroid use in sports, but it's not going to convince anyone in the International Cycling Union. And for his admissions, Armstrong is not going to win much sympathy, especially not from the people he once inspired.

As he admitted, he behaved like a "bully" and a "jerk" and an "arrogant prick," though no one had have to wait for Oprah's interview to learn that. Armstrong wasn't content with simply denying the accusations against him, repeatedly and fervently; when the U.S. Anti Doping Agency's official report emerged last summer, Armstrong wrote about the "outlandish and heinous claims" that "The only physical evidence here is the hundreds of controls I have passed with flying colors.”

That was the humanitarian side of Armstrong's fury. He also rampaged against nearly anyone who claimed he had doped, threatening teammates and doling out lawsuits to associates and journalists. As Deadspin wrote in October of the USADA's report, "Variations on the terms 'verbally berated,' 'a living hell' and 'threatening text message' pop up often enough in the report to suggest that Armstrong only pauses in his steroid regimen long enough to intimidate and harrass people that know he has a steroid regimen." In 2006, he won a half-million dollar libel settlement against London's Sunday Times

With his "territory being threatened, team being threatened, reputation being threatened," one of his accusers, the team's former massuese, he called "a whore." Of Betsy Andreu, one of the many people he tried to sue and harass into submission--and for whom an associate of Armstrong's once left an answering message hoping that "somebody breaks a baseball bat over your head"--Armstrong told Oprah:

"I did call her crazy. I did. I did … I think she'd be OK with me saying this, I said, 'Listen, I called you crazy; I called you a bitch; I called you all of these things, but I never called you fat.' "

"I am flawed, deeply flawed," he told Oprah, by way of explanation. The flaw: "This ruthless desire to win, win at all costs truly." What link, if any, could there be between and the nastier side of that desire and Armstrong's abuse of steroids?

For decades, the aggressive tendencies of steroid users has been a focus of scientists and the media, and even had a name, "roid-rage"; in 2007, the term took flight again after steroids were found in the blood of wrestler Chris Benoit at the time that he killed his family and himself (an investigation later pinned more blame on chronic brain damage). The steroid community has in turn disputed these claims, arguing that there is no causal link between steroids and being a huge jerk. 

While it's not possible to draw any conclusions in Armstrong's case, research does indicate that long-term use of steroids can contribute to changes in personality, including aggressiveness, mania, and worse. In a 2006 study, scientists tested steroids on two pairs of identical twins–one twin used anabolic steroids and the other did not–and found that in both cases the twin using steroids exhibited high levels of aggressiveness, hostility, anxiety, and paranoid ideation not found in the "control" twin.

Another small-scale study of ten steroid users found that these effects were confounded by cluster B personality disorders--which includes histrionic, antisocial, and narcissistic disorders. In 2010, when this cluster was controversially removed from the newest edition of the DSM, psychologist Charles Zanor described some of the traits of Narcissistic Personality Disorder.in the Times:

a special kind of self-absorption: a grandiose sense of self, a serious miscalculation of one’s abilities and potential that is often accompanied by fantasies of greatness... since the narcissist is so convinced of his high station (most are men), he automatically expects that others will recognize his superior qualities and will tell him so... the narcissist, who longs for the approval and admiration of others, is often clueless about how things look from someone else’s perspective. Narcissists are very sensitive to being overlooked or slighted in the smallest fashion, but they often fail to recognize when they are doing it to others.

Armstrong told Oprah he knew he was narcissistic and was in therapy. It is possible that the long-discussed link between steroids and aggression-- "roid rage"--may be more a reflection of the type of highly-competitive person who would use or abuse steroids rather than a cause of the steroids themselves. Still, a number of studies have pointed to a relationship between steroids and aggressive behavior; there's also evidence to indicate the effects of steroids can last even after a person has stopped using steroids, as Armstrong claims to have done in 2009 (a claim the USADA disputes).

Richard Melloni, a psychology professor who runs a lab at Northeastern University dedicated to studying aggression, has found that, after administering anabolic steroids to adolescent hamsters, a part of their brains called the anterior hypothalamus, which regulates aggression and social behavior, pumped out more of the neurotransmitter vasopressin, which is linked with aggression, and less serotonin (pdf).

"We know testosterone or steroids affect the development of serotonin nerve cells, which, in turn, decreases serotonin availability in the brain," Melloni said in 2002, when the first study was published. "The serotonin neural system is still developing during adolescence and the use of anabolic steroids during this critical period appears to have immediate and longer-term neural and behavioral consequences. What we know at this point is that aggressiveness doesn’t simply cease after the ingestion of steroids does."

The research is especially bad news for young people who abuse anabolic steroids; according to the Centers for Disease Control, in the U.S. five to 12 percent of male high school students and one percent of female students are estimated to have used anabolic steroids by the time they are seniors. Other research has shown that steroid use can also lead to paranoia and hallucinations, liver and kidney damage and high blood pressure, and increased risk of heart disease, stroke and some types of cancer.

That latter possibility has contributed to some speculation that steroids may have contributed to the onset of Armstrong's testicular cancer. (It was during a hospital visit in 1996 that Frankie Andreu, Armstrong's teammate, first overheard Armstrong tell his oncologist that he had used “steroids, testosterone, cortisone, growth hormone and EPO [an illegal performance-enhancing drug].”) E.M. Swift, a former Sports Illustrated columnist, has twice speculated on a linkage; the steroid-cancer theory was also echoed by Bob Weiner, a former spokesman for the White House's drug policy office and for the World Anti Doping Agency, during a lecture in 2011, and again by Whoopi Goldberg during a recent episode of The View.

But the speculation is sloppy science: while some studies have associated steroid use with liver and kidney cancers, no one is sure what causes testicular cancer, and the scientific literature shows no links with steroid use. Dr. Philip Kantoff, an oncologist at the Dana-Farber Cancer Research Institute in Boston, told NPR that it's a "whole understudied field. Nobody’s ever taken a look at 20-to-30-year-olds with normal testosterone levels and given them super high levels and [looked at] the side effects from that…" Still, he acknowledged--using a word that has lingered around this strange, maddening saga since it began--"it's conceivable." 

Steroid abuse can't be linked to Armstrong's behavior or to his cancer. But is it responsible for the ruination of his life. However humbled, he's clearly struggling with a narcissism that sits at the heart of all these abuses--of drugs, of people, of the truth. Armstrong knows he has a long way to go to something resembling redemption. "I deserve it," he says of the criticism and abandonment he's inspired, even from his own Livestrong Foundation. He hasn't communicated yet with the anti-doping agency or any of the other people who are owed an apology, and possibly a lot more. But he hasn't lost his ferocious drive either, and he's determined to win the chance to race again. “If you’re asking me if I want to compete again?” he said to Winfrey. “The answer’s hell yes.” To do that, however--and this, as Michael Specter notes, may answer the question as to why he confessed--he'll need to come clean about the very people he spent years aggressively threatening to destroy. 


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