Use of drugs in Major League Baseball is something that has been viewed under a microscope over the couple of decades. Street drugs, PED’s, and stimulants are all different kinds of drugs that Major League Baseball has cracked down on. So much so, that Major League Baseball published a list of every single banned substance that has been revised and re-evaluated over the years. The list is divided into 3 major categories compiling over 140 different substances.

The first category on the list is Drugs of Abuse. Drugs of abuse, as defined by Major League Baseball are “Any and all drugs or substances included on Schedules I and II of the Code of Federal Regulations’ Schedule of Controlled Substances (“Schedule I or Schedule II”), as amended from time to time, shall be considered Drugs of Abuse” Some of the drugs included in this category are cocaine, codeine, heroin, MDMA, LSD, and PCP.

The next category within the banned substance list is stimulants. Stimulants are drugs that improve brain to body communication. Amphetamines are the commonly known types of stimulant drugs and are a part of Major League Baseball’s banned substance list under the stimulant category.

The third category of banned substances is performance enhancing substances. This category is divided into multiple subcategories. One of the subcategories is Anabolic Agents which are defined by Major League Baseball as “Any and all Anabolic Androgenic Steroids included in Schedule III of the Code of Federal Regulations’ Schedule of Controlled Substances (“Schedule III”), as amended from time to time, shall be considered a Performance Enhancing Substance covered by the Program.” Some notable anabolic agents that are included on the list are trenbolone, testosterone, oxymetholone, nandrolone, boldenone, and oxandrolone. The next subcategory is Peptide Hormones, Growth Factors and Related Substances. These substances initiate and regulate cortisol release and tissue production. Some notable substances banned from this category are hGH, IGF-1, and HGC. The last subcategory of PED’s I’ll cover is Diuretics and Masking Agents. Major League Baseball defines these substances as “products that substitute, dilute, mask, or adulterate a specimen used in drug testing, or impair the excretion of Prohibited Substances to conceal their presence in a specimen.” Thiazides are on the banned list and are the most common diuretic. Examples of Thiazides are Bendroflumethiazide, Chlorothiazide, and Hydrochlorothiazide.

Of each category of banned substances in Major League Baseball, Performance Enhancing Substances have accounted for the most suspensions at the major league level. Since suspensions became the punishment for violating performance enhancers policies in 2005, an average of over 6 players a year have been suspended at the major league level for banned performance enhancers.

The most recent and notable suspension for PED’s was one of the games most coveted superstars, Fernando Tatis Jr. of the San Diego Padres. Tatis was suspended 80 games after testing positive for clostebol, an anabolic-androgenic steroid that serves a similar purpose as testosterone. Clostebol is a part of the MLB’s banned substance list. However, Tatis claims he didn’t use the drug to improve his performance. Tatis claims to have taken the drug as a treatment for ringworm. In an article from MARCA, a sports media outlet, it states “This is a fungus that is very common in athletes and they treat it with medication that contains Clostebol….Tatis trusted his physician and made a terrible mistake that cost him nearly a full season’s worth of suspension. ” Although in Tatis’ case he wasn’t using PED’s to improve his game, the history of past abuse in the league left Major League Baseball no choice but to suspend Tatis. This is where I believe a line needs to be drawn.

I fully understand the history of PED abuse in baseball and why Major League Baseball went to the extremes they went to in hopes to prevent the power trips and blatant abuse of steroids that we saw in the 1990’s and 2000’s. But there are cases where these banned substances are a necessary means of recovery for athletes. Tatis’ case is a perfect example. A solution to a case like Tatis’ is a network of medical personnel from the players personal doctor to the league office. If a player’s personal doctor prescribes them a medicine that includes a banned substance, there should be a communication network from that doctor, to a league medical official who authorizes/monitors the prescription/dosage. Another step that would be necessary to this process is baseline testing. If a player has a baseline test of certain levels of hormones and other internal/physical factors, there will be a way of telling if a player is using the substances for their medically intended purpose and if the player abused the drug based on the comparison of their baseline to their retest.

One of the key reasons I’d like to see the MLB adopt a system similar to this is because of oblique injuries. In a study done on oblique injuries from the 2011 season to the 2015 season, 259 players at the major league level suffered oblique injuries resulting in 6,132 days missed. Batters/Position Players averaged 3 weeks missed per injury with over an 8% chance of re-injury. Starting Pitchers averaged nearly a month missed with a re-injury rate of around 5% and relievers averaged about 24 days missed with a re-injury rate of nearly 10%. The average days missed on recurrent oblique injuries is also higher compared to the days missed from the primary injury. These injuries are not a day to day type of injury and a statistical analysis of recovery methods shows that some players required injection of a corticosteroid, a legal steroid in Major League Baseball. However, this still didn’t speed up recovery process as it took players 30 days to recover post injection.

Anabolic steroids are known for speeding the recovery of muscle injuries at rates much better than others. Regulation and supervision of anabolic steroids in Major League Baseball specifically for injury recovery could lead to injuries like oblique strains having faster recovery times and less recurrence. With the system in place that I mentioned previously, there could definitely be a way to make sure that the substances aren’t abused and that players don’t exceed their baseline levels/capability while using these substances.

Reference List:

“MLB steroid suspensions (2005-2022).” Baseball Almanac. Retrieved March 6, 2023

Epidemiology and Impact of Abdominal Oblique Injuries in Major and Minor League Baseball Christopher L. Camp,* MD, Stan Conte,†‡ PT, DPT, ATC, Steven B. Cohen,§ MD, Matthew Thompson,|| MD, John D’ Angelo,{ BS, Joseph T. Nguyen,# MPH,
and Joshua S. Dines,** MD. Retrieved March 6, 2023

What is Clostebol? the steroid Fernando Tatis Jr. took by accident and got him suspended“. MARCA. (2022, August 13) Retrieved March 6, 2023

Major League Baseball’s Minor League Drug Prevention And Treatment Program.“. (2021). Retrieved March 6, 2023,

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