New SI.com Sports Law Column on Exemptions in Baseball for Amphetamines

I have a new column on SI.com concerning Major League Baseball authorizing nearly 8 percent of its players to use drugs to treat Attention Deficit Hyperactive Disorder.

Here's an excerpt:

While the clinical link between amphetamines and baseball performance is less established than links between steroids, human growth hormone and performance, it is thought that amphetamines and similar substances improve the focus and concentration of players and also enhance their reaction time. Although coffee and energy drinks offer similar types of advantages, amphetamines, which are available through prescriptions, are more potent, more addictive, and more likely to trigger threatening side effects.

In defense of baseball and its players, it is unclear how many requests were rejected, either formally or informally, by team physicians or by Dr. Smith (who received approval power last year) between '06 and '08. Indeed, if the number of requests increased by a higher percentage than the number of approvals, then the increase in approvals would be far less notable. The only available information is that the number of new requests to Smith for TUE exemptions for ADHD drugs declined from 72 to 56 last year.

In addition, there may be viable clinical explanations that at least partially account for the precipitous rise in TUEs granted by baseball. Diagnostic challenges for physicians who treat persons claiming to have attention disorders may, for example, prove relevant: it may be scientifically difficult for physicians to separate legitimate from illegitimate cases of attention disorders, thus making it difficult for physicians to reject prescription requests.

It is also possible the increase connects to decreased stigma in acknowledging that one has an attention disorder and needs treatment for it. There is a long history of mental illnesses receiving less sympathy by the public and less protection by courts than physical illnesses, though as neuroscience has increasingly shown that mental illnesses are as much "physical" as physical illnesses, that gap has narrowed. Consequently, as more players apply for TUEs, less stigma may be attached to doing so, thus encouraging more players to apply.

It is also possible that the increase reflects mere coincidence, in that more and more players are simply suffering from attention disorders. Likewise, it could represent a rush to not miss out on a competitive advantage, in that some players may feel disadvantaged by not taking amphetamines while their teammates and competitors do.

Absent a viable explanation, however, suspicions will remain that some players are circumventing the policy to obtain otherwise prohibited amphetamines and that baseball has acquiesced to those players.

I hope you have a chance to check out the rest.