On the heels of Lance Armstrong’s confession to Oprah, many cycling enthusiasts are left wondering why. Why do professional athletes feel the need to take performance enhancing drugs (PEDs)? Fame? Fortune? Frustration?

About.com interviewed three sports medicine professionals who have experience working with athletes at the top of their game. Lee Gravlee, MA, CSCS, owner of Gravlee Fitness, Birmingham, AL; Loren Fogelman, MEd, EFT-Adv, founder of Expert Sports Performance.com; and Mark Alexander, CEO and founder of Efficient Exercise in Austin and San Antonio, TX, discuss whether PEDs should be allowed in professional sports, if world-class athletes have reached their limits of accomplishment without artificial involvement, and more.

About.com: What are some examples of PEDs used in cycling?

Gravlee:

• Testosterone- protein (muscle) sparing, for recovery, naturally occurring.
• Albuterol- for asthmatics, it opens the bronchioles and arterioles in the lungs to allow better flow of oxygen, made in a lab.
• Human Growth Hormone- spares protein, naturally occurring.
• EPO (erythropoietin)- increase production of red blood cells, helps carry more oxygen to the working muscles to clear/buffer lactic acid, naturally occurring.

Fogelman: There are different forms of PEDs. The most common that we hear about in the media are anabolic steroids. Basically they build muscle. The ability to train harder and longer is very appealing. Anabolic steroids offer relatively quick results without the extra work. Cyclists in pain use highly-addictive narcotics, i.e. morphine, methadone and oxycodone to mask pain from injury or discomfort from illness. Narcotics raise their pain threshold so they can continue training and competing through the pain.

Alexander: Endurance sports, specifically competitive cycling, is a game of recovery.

Therefore, any PEDs that are helpful in the body’s efficient use of oxygen and recovering from a strenuous bout of activity will be implemented into a professional athlete’s training program. Blood doping, anabolic steroids, testosterone, growth hormone and blood transfusions are all part of the training program of high-level competitive cyclists. There have been many resources dumped into the policing to detect these banned substances and in my opinion there are many more worthwhile causes to allot that time money, and energy – how about curing cancer?

About.com: Why do professional athletes feel the need to take PEDs?

Gravlee: Because they have to. Plus, there is large money involved and the governing bodies need spectators, and super-human efforts sell.

Fogelman: The business of sports is a primary factor. There’s lifestyle and money at stake. Professional cyclists are under enormous pressure to perform. Their earnings are directly tied to winning. The more wins, the more endorsements and contracts. On the flip side, not performing to expectations leads to replacement. Regardless of the reason, the commonality is that they are using thinking errors to justify their decision. Power can be dangerous causing some cyclists to believe they won’t get caught. Others do it under pressure because they don’t have the gumption to say “no.” And then there’s fear. Fear of failure and fear of disappointment top of the list.

Alexander: The mindset of a professional athlete is extremely different than the general public. The stakes are high in professional athletics, often times resulting in the need to perform and succeed in a relatively short career that might only last a few years. Endless hours of training are poured into a competitive athlete’s training program and the dependence of success is critical, as in many cases an athlete making it or not will dictate the family tree’s legacy of financial independence and wealth or remaining in poverty for generations to come. Endorsement deals can be worth tens if not hundreds of millions of dollars, so the win-at-all-costs mindset will be taken by the athlete in order to succeed not only in their given arena, but also to secure that lucrative endorsement deal.

About.com: Do you think athletes have reached their limits of accomplishment without artificial intervention?

Gravlee: No. Training protocols are getting very scientific. Sadly, it doesn’t make up for the difference between natural and “juiced.”

Fogelman: At one point, no one believed that breaking the 4-minute mile was possible. Scientists were convinced the heart couldn’t handle the pressure and it would lead to certain death. Then Roger Bannister changed that in 1954, opening the door to what’s possible. New records continue to be set during the Olympic games as science and technology improve. If you’ve ever rooted for the underdog you know they are able to perform better than anyone ever expects when their heart is in the right place and they embrace a personal reason to win. Innovation is the solution. Sometimes we have to step outside of the box, looking at cycling from a new perspective. Then something never tried before will work and change the entire way cyclists train and compete.

Alexander: The human body is capable of tremendous feats. If you look back historically, there are many genetic specimens that have accomplished outstanding physical accomplishments with the proper training towards their respective goals. It is often difficult, in my opinion, to compare athletes of different generations because there are so many different variables that come into play that make the comparison more subjective than objective. These variables include equipment design improvements and more focused training programs. In a sense, I do not think humans have accomplished more with PEDs, just have fine-tuned their approaches towards more specific measurable goals displayed in competitive sporting events. As a matter of fact, there is now archeological evidence suggesting that men and women of the Neolithic period were probably much stronger than we are today according to their bone structures, etc.

About.com: Should performance enhancing drugs be allowed in sports?

Gravlee: The governing bodies can set limits, but the athletes and scientists will try to figure out a way to beat the tests. I don’t know what the answer is. Should drugs be allowed in sports? My heart says absolutely not, but there is absolutely no way around it. The culture is rampant.

Fogelman: Definitely not. PEDs artificially raise the level of entry for athletes, placing clean athletes at a disadvantage. Let’s take the recent Armstrong scandal and create the opportunity for a correction. Sports are about performing well under pressure. We’re testing physical and mental strength. Drugs interfere with the normal functioning of both. Allowing PEDs contributes to short-term benefits with long-term consequences. And that is actually the definition of an addiction.

Alexander: In my opinion, PEDs should not be policed and enforced in high-level professional athletics. The resources used to test and police those substances could be better directed towards many more worthwhile causes and efforts. The reality is athletes will take their win-at-all-costs mindset into their given sport. This means they will do whatever it takes in their training program, including using PEDs, to be successful at their given sport. This is analogous to asking the mother of a small child if she would do anything to make sure her child is safe—of course she would!