Members of the U.S. House of Representatives spent last week explaining this week's Capitol Hill hearings on baseball's steroid problem as a response to a matter of grave public concern.
Steroid abuse, goes one major line of argument, has significant economic costs that we'll all end up paying, through higher taxes or increased insurance premiums. But why would something a few athletes choose to do to their own, highly compensated bodies concern the rest of us? What does illegal steroid use really cost society?
Plenty, it turns out, because it's not just the Caminitis and Cansecos and Giambis of the world who are taking performance-enhancing substances to bulk up their offensive stats and bulging bank accounts. There are minor-leaguers, gym rats and high school athletes hoping to follow in their footsteps. No present study tracks the economic costs specifically associated with steroid abuse. "Unfortunately, WADA does not hold such information," said Marie-Claude Asselin, a spokeswoman for the World Anti-Doping Agency. But comparing several pieces of existing government research provides a decidedly nonscientific sketch of what society's up against.
The National Survey on Drug Use and Health estimates 19.5 million Americans use illicit drugs each month. A study by the National Office of Drug Control Policy, conducted between 1992 and 1998, found that such illegal drug use cost the United States more than $143 billion each year for expenses related to health care, law enforcement, lost productivity and treatment, among other things. Experts estimate that there are between 1 million and 3 million illegal steroid users roaming America's gyms and locker rooms, and that their share of the bill, even using conservative figures, stands at $7.4 billion annually.
How accurate is that guess? Hard to say. Researchers performing these economic cost studies use all kinds of formulas to adjust totals for factors that might make the bill for steroids greater or less than the bill for another narcotic. Is it more expensive to treat a heroin user with liver disease than a steroid user with the same problem? But if you make up a quick itemized bill, using the same broad categories as the government's study, the total societal cost could add up to about $7.8 billion.
Illegal drug abuse in general cost the health care system about $15 billion per year, a figure that takes into account everything from the price of hospital stays to rising insurance expenses. Steroid abuse might not cause more health problems per user than, say, cocaine and heroin addiction, but the deaths of admitted steroid users such as Ken Caminiti suggest the consequences might be just as dire.
It's more than dependency treatment and emergency care. In the 1970s and '80s, East German scientists administered steroids to about 10,000 athletes in that country, and hundreds later reported horrifying physical ailments, ranging from birth defects to liver damage to the much-noted testicular atrophy. Elite track athlete Diane Williams wept while telling a 1989 Senate Judiciary Committee hearing that, during her steroid use, she'd grown a moustache and stopped menstruating, even as her clitoris grew to "embarrassing proportions."
"I am greatly concerned if I will ever be able to bear a normal child," Williams said. "I have been experiencing ... intense itching, sore mouth, higher sex drive, depression, vaginal bleeding and, most of all, lower abdominal pain."
If there are a million U.S. citizens out there dosing themselves similarly, the cost of healing those who get sick could quickly mount into the hundreds of millions of dollars -- then add the cost of prevention and education efforts.
Estimated cost: $1 billion.
Illegal drugs do almost 70 percent of their economic damage through what the government study broadly defines as "productivity losses." This includes everything from premature deaths to the line slowdowns generated by that stoned convenience store clerk.
Of course, the whole point of taking steroids is to increase productivity. But steroids still inevitably drain resources, especially as they spread beyond the lucrative world of professional athletics. Health consequences generate sick days, for example. Doctors wind up in jail.
Estimated cost: $5 billion.
This includes the costs of investigating, prosecuting and jailing those involved in a black market estimated to be worth $300 million to $400 million each year. It's a cost on the rise. The Drug Enforcement Agency almost doubled the number of steroid cases it prosecuted between 2001 and 2003. Each one of these represents some kind of BALCO-like episode. Think federal prosecutors, multiple defendants, and hours and hours of courtroom wrangling.
The costs of investigating and prosecuting those involved with the Bay Area Lab Co-Operative has totaled more than $2.1 million so far. The investigation that linked nine current or former Carolina Panthers to a West Columbia, S.C., doctor under investigation for trafficking in steroids lasted 10 months and required prosecutors to sort through 21 boxes of patient records and 256 audiocassettes.
Building prisons, feeding inmates -- it all adds up. Overall, drug cases represent an economic drain of more than $100 billion, though some of that total overlaps with health care (for crime victims) or productivity (think work hours lost to jail time). Steroids' share?
Estimated cost: $1.7 billion.
The government folds these costs into the price of health care and enforcement, but the bill is mounting fast inside the world of athletics. Fifteen years ago, the NCAA instituted testing for Division I football and track athletes, at a cost of about $100 per test, or about $10,000 per school, according to Penn State football coach Joe Paterno, who testified on the subject before Congress in 1989. Today, the NCAA says it tests about 10,680 athletes, at a cost of about $271 per test, or about $3 million each year.
The Olympic movement budgets about $12.5 million annually for random and in-competition steroid testing. NFL commissioner Paul Tagliabue says his league spends $10 million a year on its testing program. Baseball, which has spent $1.2 million to test its minor-leaguers, just instituted its testing program on the major-league level. The NBA. High school athletes. AAU. It's kind of like peeling an onion; there's always another layer.
Estimated cost: $90 million.
Despite the concerns of sports talk radio (and baseball's cadre of attorneys), the cost of legislators summoning the cameras, dogs and ponies is relatively minimal, all things considered. "We tend not to look at the impact on our staff and resources," House Reform Committee spokesman David Marin said magnanimously. "This is what we're charged with doing."
But according to Keith Ashdown, a spokesman for Taxpayers for Common Sense, a nonprofit, nonpartisan budget watchdog group, the bill for parading witnesses to Capitol Hill to answer questions typically runs "in the six-figure range."
That's chump change, in Washington. "The cost of the time in front of the bright lights and the cameras isn't the expense -- it's the ongoing, long-term investigative costs," Ashdown said. But those expenses are still worth considering. "It's an indirect subsidy to baseball owners. Criminals cost us money when they break the law. So do baseball owners, when they refuse to enforce the law."
Let's say these hearings and the committee's investigation wind up costing something around $1 million. Add a couple hundred thousand dollars for the House Energy and Commerce subcommittee, which is also looking into the issue. Another million dollars or more for Sen. John McCain's hearings last March. And as much for Sen. Joseph Biden's hearings in 1989 and for distantly remembered hearings back in 1973.
Estimated cost: $4.5 million.
Total due: $7,794,500,000
That's a little more than society spends to fight cardiovascular disease in diabetes sufferers, but a good bit less than the estimated $184 billion cost of dealing with alcohol abusers. Still, a billion here, a billion there -- as the senator said -- soon you're talking about real money.
Aaron Kuriloff is a freelance journalist and a regular contributor to ESPN.com. He can be reached at firstname.lastname@example.org.