Tuesday, January 13, 2009

ADHD and Baseball

I’m not entirely sure why or how this made headlines, but Major League Baseball is just like the rest of America. That’s correct; according to baseball’s recent ‘Therapeutic Use Exemptions (TUEs)’ eight percent of baseball players have Attention Deficit Hyperactivity Disorder (ADHD). This is on par with the national rate of ADHD; in fact, this is actually lower than the estimated twelve percent among males nationwide.

What caught my attention is that players are being given exemptions to take medication for this disorder, medications that otherwise would have shown up on baseball’s banned substance list. Let’s keep in mind, that baseball upholds a much higher ethical standard then the rest of professional sports and under no circumstance would encourage members of their organization to ‘pretend’ to have ADHD.

Or would they?

It is said that with proper treatment, an individual with ADHD could cut down their need for medication by up to 66%. Treatment, which ranges from simply being more active to coping mechanisms, coupled with a decreased amount of medication, is the best way to fight ADHD. However, do we really think that a Major League Baseball team would lower the prescription dosage for a player if it helped the player on the field?

We aren’t talking a cough syrup which may contain chemicals that raise red flags to the International Olympic Committee. We are talking about players being allowed to take amphetamines and other stimulants that are often provided to those suffering from ADHD.

According to the National Institute on Drug Abuse (NIDA), medications that treat ADHD increase the level of dopamine in an individual. An increased dopamine level will lead to an increase in libido. An increased libido means the body has more energy.

This sounds an awful lot like a performance enhancer, does it not? While these drugs are prescribed, it isn’t as if the testing for ADHD is necessarily vigorous. In most cases, ADHD will be diagnosed through the observation of patterns and based on a checklist. Search for “ADHD Checklist” and you will get a feel for how vague this checklist is.

While I am not going to immediately suggest that those doing these checklists do not know what they are talking about, I simply would urge baseball to enforce mandatory MRI’s on the players said to have ADHD. It has been found that an individual with ADHD has thinner brain tissue, and a small brain, between three and four percent. While inconsequential, this is a simple way to diagnose the disorder.

With all of this in mind, what is to stop a Major League organization from ‘mis’-diagnosing an extra player or two on their 40-man roster? With national ADHD rates for males around twelve percent, each Major League team could conceivably have up to five players on its 40-man roster with ADHD; five players whom would be eligible to test positive for amphetamines under baseball’s TUE.

ADHD is a relatively new disorder, having only been recognized by the American Psychological Association since 1980. Some believe that ADHD is simply cultural; however there is evidence against this. The research I have studied does assert that the gender deviations with ADHD exist predominantly due to the current structure of education in the west. This is not to say that ADHD is being overdiagnosed; instead, I would argue that if every child were to take an MRI, we would see that far more then eight percent of children would have ADHD.

That aside, we are still talking about a potentially major loophole in baseball’s drug testing policy. One that, despite how “moral” or “ethical” the league claims to be, will be open to abuse until it is closed. As it stands, the league is essentially allowing five players per team to take amphetamines.

Of course, this is only an issue if the ballplayer invariably becomes a star and breaks records.

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