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Rx For Trouble: Inside the Steroid Ring

March 12, 2007
March 12, 2007

Table of Contents
March 12, 2007

Table of Contents
SI Bonus Section: Golf Plus
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Environment
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BASEBALL
Wrestling
Investigation
Bill Walsh

Rx For Trouble: Inside the Steroid Ring

SI's Luis Fernando Llosa and L. Jon Wertheim, on the scene for the Florida raids, continue to report on the ongoing investigation that promises to rock sports

By Fernando Llosa

THE PALM BEACHRejuvenation Center is decidedly less exotic than its name might suggest.Wedged between a lawyer's office and a brokerage firm on the third floor of adreary Jupiter, Fla., office building, it is a glorified boiler room,"basically a call center," as one employee explains. Yet investigatorscontend that the Palm Beach Rejuvenation Center (PBRC)--and dozens of so-calledantiaging or wellness centers like it--is a vital component in a massiveillegal distribution network that enabled customers to place orders over theInternet for performance-enhancing drugs, including steroids and human growthhormone (HGH).

This is an article from the March 12, 2007 issue Original Layout

"This is thenewest frontier," says Christopher Baynes, a prosecutor in New York'sAlbany County, whose office initiated the investigation three years ago."The guy with the black bag at the gym now has his own website."

On Feb. 27, SIaccompanied investigators from multiple law-enforcement agencies (box, page 62)on a raid of PBRC. Simultaneously, agents in Orlando were raiding SignaturePharmacy, a compounding pharmacy that last year did more than $40 million insales, much of it with PBRC. On Monday, PBRC co-owner Glen Stefano and 10others pleaded not guilty to multiple charges during arraignment proceedings inAlbany. Stefano was charged with illegally selling steroids and hormones.Earlier, Signature owners Robert Loomis and his wife, Naomi, were charged withcriminal diversion of prescription medications, criminal sale of a controlledsubstance and insurance fraud.

It will take weeks,months perhaps, for authorities to sift through the client lists, hard drives,invoices and trash from Dumpsters that were seized in the raids--more than aton of documents was confiscated. And when they're through, investigatorsbelieve they'll unearth the names of hundreds, even thousands of clients whohave received a wide array of drugs; and that list is likely to includeprominent athletes.

Just consider thefruits of a similar Drug Enforcement Administration (DEA) raid last fall,code-named Operation Netroids. On Aug. 29, agents converged on Applied PharmacyServices, a compounding pharmacy in Mobile. (A compounding pharmacy makes itsown drugs generically.) Seized client records revealed the names of more than20 athletes in a variety of sports who received drugs from Applied Pharmacy. A37-page classified intelligence report reviewed by SI alleges that, amongathletes:

• Outfielder GaryMatthews Jr., whose career year with the Texas Rangers in 2006 earned him afive-year, $50 million free-agent deal with the Los Angeles Angels, was sentGenotropin (glossary, page 63) in 2004. The prescription was written by adoctor at a now-defunct antiaging clinic in Florida. (Through his agent,Matthews declined comment, but the lawyer who represents the outfielder saidlast Saturday that Matthews has not broken any laws and would cooperate withthe investigation.)

•Kurt Angle, a 1996Olympic gold-medal-winning freestyle wrestler and now a star professionalwrestler, received two prescriptions for trenbolone and one for nandrolonebetween October 2004 and February '05. (Angle did not return messages left withhis spokesman.)

•Rangers outfielderJerry Hairston Jr. received Genotropin, human chorionic gonadotropin (HCG) andClomiphene Citrate in 2004. One of Hairston's prescriptions was written by"A. Almarashi." Investigators believe Almarashi is an alias for aQueens, N.Y., doctor stripped of her medical license in 1999. She is awaitingtrial on multiple charges after allegedly writing bogus prescriptions forthousands of online customers she never examined. (Hairston, a third-generationmajor leaguer, emphatically denied any connection. "Not one time have Itaken steroids or anything like that," he said last Thursday. "I wouldnever do anything like that to jeopardize my career or my family'sname.")

•In June 2004 apatient named Evan Fields picked up three vials of testosterone and relatedinjection supplies from a Columbus, Ga., doctor, traced through Applied. Laterthat month Fields also obtained five vials of Saizen and three months laterreturned for treatment of hypogonadism, a condition whereby sex glands producelittle or no hormones. Investigators noted that Fields shares both the birthdate and home address of former heavyweight champion Evander Holyfield. What'smore, when SI called a phone number on a Post-It note attached to the Fieldspatient file, Holyfield answered. (Holyfield, who at 44 continues to fightprofessionally, told SI that he knew nothing of the drugs. Through Main Events,the promotional company that represents him, he released a statement denyingany steroid use.)

•David Bell, aveteran of a dozen major league seasons, received six packages of HCG at aPhiladelphia address last April, when he played for the Phillies. The cost was$128.80, and the drug was prescribed in conjunction with an Arizona antiagingfacility. Bell acknowledges receiving the shipment but tells SI the drug wasprescribed to him "for a medical condition," which he declined todisclose, citing his right to privacy.

•Jose Canseco, theretired major leaguer and an admitted steroid user, received somatropin,testosterone, stanozolol and HCG, as well as 340 syringes, in 2004. Theshipment to his California residence was arranged through the same defunctantiaging clinic that Matthews allegedly patronized. (Canseco did not returncalls seeking comment.)

•No birth date wasindicated on the prescriptions, but according to the Applied database, formerAtlanta Braves reliever John Rocker received two prescriptions for somatropinbetween April and July 2003. (Through his spokeswoman, Rocker denied anyknowledge of the prescription and denied ever receiving a bannedsubstance.)

Sources tell SIthat the clients appearing on invoices and customer lists are unlikely to faceprosecution, because the targets of the raids and investigations are themembers of the network of suppliers. "Our focus here is to shut downdistribution channels," says Albany County district attorney David Soares,one of the leaders of the investigation. And because the reports only allegereceipt (and in some cases, purchase) of the banned drugs--not usage--theathletes are unlikely to face disciplinary action from their respective leaguesor governing bodies. (Major League Baseball didn't add HGH to its list ofbanned substances until 2005.) Still, the information offers a clear andchilling glimpse into just how easily banned substances, including steroids andHGH, can be obtained by anyone, of any age, who possesses Internet access and acredit card.

The origins of thiswide-scale, multi-agency investigation can be traced to upstate New York. Inthe fall of 2004 state narcotics investigators based in Albany noticed that alocal doctor, David Stephenson, was running a website, docstat.com, and waspurchasing massive quantities of a variety of drugs, including narcotics andsteroids. According to authorities, Applied was his chief supplier. Afterreceiving the drugs at his residence, Stephenson repackaged them and resoldthem to "patients" who had visited his website. One investigator placedan order through docstat.com, claiming to be an overweight pilot with a heroinaddiction and a drinking problem. As part of a questionnaire offered whenregistering on the site, clients were asked the reason they were seekingparticular drugs. The investigator responded that he needed prescriptions forhydrocodone, methadone, nandrolone, Ritalin and testosterone because "Iwant to get high to fly." Within days the drugs arrived by way of expressmail.

In the summer of2005 Stephenson pleaded guilty to felony criminal sale of a controlledsubstance; he is serving a six-year jail sentence. The Stephenson case,however, stood for much more than a rogue doctor abusing his license. Studyingthe chain of supply, agents from Albany County were able to lay bare a drugpipeline that marries the power of the Internet with spurious antiagingcenters, board-certified compounding pharmacies and venal doctors. Soon, theagents shared their findings with federal and state authorities across thecountry.

As Mark Haskins, asenior investigator for New York State's Bureau of Narcotic Enforcement,explains it, "Basically you have an antiaging clinic with an Internetpresence. [Clinic operators] put the product on the Internet. The customerfinds them online, fills out a brief questionnaire and requests steroids,hormone therapy, whatever. Someone from the clinic contacts the customer andthen develops a prescription for the steroid treatment or hormone treatment.Then [the clinic] sends or e-mails the prescription to a doctor, who is oftennot even in the same state. He'll sign it [because] he's being paid by theclinic, usually $20 to $50 for every signature. The signed prescriptions getfaxed to the compounding pharmacies, which know from the very beginning thatthere is no doctor-patient relationship. The pharmacy then sends the product tothe customer."

Last spring, duringa raid on his Scottsdale, Ariz., home, Jason Grimsley, then a pitcher for theArizona Diamondbacks, admitted to using HGH, steroids and amphetamines. In anaffidavit he explained to investigators that another major leaguer, lateridentified as former first baseman David Segui, "told [me] of a doctor inFlorida that he was using at a 'wellness center' to obtain human growthhormone."

"It makes totalsense for athletes to do it this way," says agent Alex Wright of Florida'sMetropolitan Bureau of Investigation. "If they get caught, they can say, 'Isent my blood work to the clinic like [it] asked me, and the doctor said my[testosterone] levels are low.' This is the best way they can get stuff. Theyhave the comfort of anonymity because there is no face-to-face. They are just aname and a credit card."

In addition toexposing the architecture of the distribution ring, the ongoing investigationsappear to confirm what doping experts have suspected for years: HGH is apopular drug among athletes. A synthetic hormone, HGH is thought by some toaccelerate recovery times, speed healing, decrease body fat and, particularlywhen combined with steroids, increase muscle mass and therefore strength.

HGH can beprescribed by doctors for legitimate medical purposes. Historically, this hasmeant combating rare pituitary disease and treating patients with progressivelydebilitating conditions resulting from AIDS and some forms of cancer. Yetlately some doctors have ascribed a liberal definition to "legitimatemedical purposes," contending that aging is, in effect, a progressivelydebilitating disease and that any patients with diminishing hormone levels areeligible for the drug. The American Academy of Anti-Aging Medicine, aChicago-based group that supports using HGH to replace growth hormone as itslevels decline with age, counts more than 10,000 health-care practitionersamong its members. This "off-label," or unorthodox, use of HGH is thesource of significant controversy in the medical community. "It's aruse," says Dr. Thomas Perls, an associate professor at Boston UniversitySchool of Medicine, who maintains the website antiagingquackery.com. "Thepublic has equated hormones with youth, and HGH is the drug of choice for thesehucksters to push." (Through a spokesman the academy said in a statement toSI that Perls's comment "is on the level of that of a 'flat earth society'uninformed person.")

The risks of HGHuse are abundant, including diabetes, muscle and joint pain, hypertension,carpal tunnel syndrome, abnormal enlargement of organs and advancement ofcardiovascular diseases. Some researchers believe HGH can accelerate cancer."The issue is pretty straightforward," says Mark Schutta, a Universityof Pennsylvania endocrinologist. "You're giving people a hormone that canpotentially increase the growth of abnormal cells." Schutta also notes thatthe American College of Endocrinology does not recommend using HGH to treatadults except in the exceedingly rare instance that a patient produces nogrowth hormone naturally.

Regardless, HGH hasfound favor among athletes. "Of all the things out there, certainlysynthetic human growth hormone is way at the top of the list," says Dr.Gary Wadler, a New York University associate professor of medicine and a WorldAnti-Doping Agency member. "What athletes have [tried to do] is makemuscles bigger with HGH and then make those big muscles stronger by addingsteroids to the mix."

Another factorcontributing to HGH's popularity: Leagues that ban it don't test for it. Thereis only one effective test for HGH detection, and it involves a blood sample.Unions in most major sports have been unwilling to subject their players toblood work, deeming it a physical intrusion. As NFL Players Associationexecutive director Gene Upshaw recently put it, "I'm still not willing tohave our players stuck like a pin cushion."

In perhaps thebiggest doping scandal in NFL history, a South Carolina doctor, James Shortt,distributed HGH and steroids to members of the Carolina Panthers' 2003 SuperBowl team, including three of the five starting offensive linemen. (Shorttadmitted guilt and is serving a 366-day sentence.) Last fall, on the HBO showCostas Now, former NFL defensive tackle Dana Stubblefield said he believes 30%of the league's players use HGH. NFL officials have often expressed concernabout HGH, and the league recently pledged $500,000 to help develop a reliableHGH test.

That is whyinvestigators were particularly curious when they noticed that a University ofPittsburgh Medical Center-- affiliated internist, Richard Rydze, had used acredit card from his private practice to purchase more than $150,000 worth ofHGH from Signature Pharmacy. Since the mid-1980s Rydze has been an associateteam physician for the Pittsburgh Steelers. Questioned by SI, Rydze did notdeny making the purchases, but he asserted that he uses the HGH to treatelderly patients who are "deficient in growth hormone" and requiretendon repair. "[It's] not for athletes--never," says Rydze. "Idon't give it to people who want to come in here and look pretty and look youngand build up their muscles. I will not do that."

According toRydze, he dispenses HGH to "35 or 40" patients referred to him by otherphysicians, including the Steelers' orthopedist. (The orthopedist declinedcomment.) Rydze says that he treats these patients, including retired footballplayers, early in the morning--"mainly in my spare time"--and thatthese patients tend to "cycle through" every three or four months."We monitor their levels, and then they're gone, back to their owndoctors," says Rydze, 56, who won the silver medal in platform diving atthe 1972 Olympics. He also says that he ordered the HGH through Signature tosave money. (In the wake of this revelation, the University of PittsburghMedical Center says it is conducting an internal investigation of Rydze.)

One might assertthat at the very least, it shows questionable judgment for an NFL team doctorto purchase $150,000 of HGH--approximate street value: as much as $1million--at a time when drug issues are in the league's crosshairs and theShortt scandal remains a public relations scar. Rydze, however, asserts he hashis team's full support. "The Rooneys [the Steelers' owners] are aware thatI do this," he says. "I mean, they have my trust that I would never dothis with an athlete." (Steelers president Art Rooney II declined toaddress Rydze's specific characterization, but he released a statement thatread in part, "There is no evidence Dr. Rydze prescribed or provided anyhormone treatments to any of our players [and he] has assured me that this hasnever happened and will never happen.")

If the list ofimplicated sports stars and teams has already turned the investigation into acause cél√®bre, investigators are haunted by how many "nonfamous"athletes have been implicated in the sweeps. In the coming weeks authoritieswill seek answers to why, for instance, Signature sold performance-enhancingdrugs to a teenage in-line skating champion. Or why facilities offeringantiaging treatment are servicing so many clients born in the 1990s, some ofthem still in puberty. "Kids are watching ESPN or reading SPORTSILLUSTRATED¬†and making every effort to gain a competitive edge," saysSoares, the Albany County DA. "That we have steroids and human growthhormone so readily available presents a clear and present danger."

At last week'sraid of the Palm Beach Rejuvenation Center, a string of strikingly muscular,strikingly young employees filed out, somber expressions etched on their faces.Inside, authorities questioned executives, including Joseph Raich, listed on agovernment document as a company director. Raich, 44, is well-known in theSouth Florida youth wrestling community. He has provided financial assistanceto aspiring Olympians, and before the Athens Games in the summer of 2004, hesponsored a training camp in South Florida for the U.S. Olympic wrestling team.The Florida Amateur Wrestling Association website even lists Raich (who did notreturn repeated messages seeking comment) as the contact for the Wrestling Clubof the Palm Beaches. The listing also provides his e-mail address:Joe@hghtest.com.

FOLLOW THE STORY: Read more from Llosa and Wertheimabout the investigation on SI.COM.

How the Network Operates

View this article in the original magazine

Last week's raids were the culmination of a jointeffort among several law enforcement and prosecutorial agencies. Theyincluded:

•Albany County (N.Y.) district attorney

•Drug Enforcement Administration

•Florida attorney general's Medicaid Fraud Control Unitand Office of Statewide Prosecution

•Florida Department of Law Enforcement

•Florida's Metropolitan Bureau of Investigation

•Food and Drug Administration

•Internal Revenue Service

•New York State Bureau of Narcotic Enforcement

•New York State Insurance Department

•U.S. Anti-Doping Agency

•U.S. Justice Department

THE SYSTEM
Authorities allege that the process starts with a customer e-mail to anantiaging clinic. A prescription is written and sent to a doctor, who is paidby the clinic to sign it. A compounding pharmacy fills the order and usuallysends it directly to the customer.

The Drugs

Clomiphene Citrate: A prescription drug typically usedfor the treatment of female infertility, it is taken by male athletes to negatethe effects of increased estrogen, a result of anabolic steroid abuse.

Human Chorionic Gonadotropin (HCG): A hormone producednaturally during pregnancy, HCG is taken by anabolic steroid users to stimulatethe production of testosterone, which is suppressed as a result of steroiduse.

Human Growth Hormone (HGH): The primary purpose of thenaturally occurring growth hormone is the maintenance of normal bone growthfrom birth to adulthood. Synthetic HGH is typically used by physicians to treatgrowth disorders, but athletes often abuse the drug to build muscle anddecrease fat, usually in conjunction with anabolic steroids. The generic namefor synthetically produced HGH is somatropin; brand names include Genotropinand Saizen.

Nandrolone: This synthetic anabolic steroid has beenused to treat anemia, osteoporosis and breast carcinoma. It builds muscle andincreases red-blood-cell count.

Stanozolol: This synthetic anabolic steroid istypically used to treat a rare immune disease in humans and to increaseappetite, muscle mass and energy in animals--often horses recovering fromillness or injury. It might be preferred by athletes who value speed because itdoesn't build muscle quickly. Also, some abusers claim that stanozolol, unlikesome other steroids, doesn't cause water retention. Winstrol is a brandname.

Trenbolone: A synthetic anabolic steroid that someclaim is a more potent muscle builder than testosterone, it promotesred-blood-cell production and increases the rate of glycogen replenishment,both of which aid in postworkout recovery.

One investigator placed an order through docstat.com,claiming to be an overweight pil ot with a heroin addiction and a drinkingproblem. Responding in a questionnaire, the investigator said he was seekingprescriptions for nandrolone and testosterone because "I WANT TO GET HIGHTO FLY." Within days, the drugs arrived by way of express mail.
"It makes total sense for athletes to do it thisway," says agent Wright. "They have the comfort of anonymity. They arejust A NAME AND A CREDIT CARD."
TWO PHOTOSNEWSPAPERS: NEW YORK DAILY NEWS (LEFT); ORLANDO SENTINELPHOTOJOHN BIEVER (MATTHEWS)PHOTOMICHEL LIPCHITZ/AP (ANGLE)PHOTOJOEL AUERBACH/US PRESSWIRE (HAIRSTON)PHOTOED MULHOLLAND/WIREIMAGE.COM (HOLYFIELD)PHOTONICK LAHAM/GETTY IMAGES (BELL)PHOTOJAMIE SQUIRE/GETTY IMAGES (CANSECO)PHOTOCORBISPHOTOBOB ROSATOPHOTOGEORGE SKENE/ORLANDO SENTINEL 2/28/07PHOTOBUREAU OF NARCOTIC ENFORCEMENTPHOTOJOHN BIEVERHEADLINER
Matthews is alleged to have been sent HGH. His lawyer says the player did notbreak the law.