A brief history of androgenic anabolic steroids (AAS) and professional wrestling

1889:

• Charles Brown-Sequard, a French neurologist, describes the rejuvenating effects of a self-administered extract from dog testes. (1)

1931:

• Adolf Butenandt, a chemist in Marburg, Germany, isolates the gonadal steroid androsterone. (2)

1935:  

• Testosterone is isolated from the testes. (3)
• Testosterone is synthesized. (4)

1937:   

•  Clinical trials using oral methyltestosterone and intramuscular testosterone propionate begin. (5)

1940's:

• AAS are used to enhance performance in Soviet Union and German Olympian and amateur weightlifters.

1954:

• Bob Hoffman, coach of the United States Olympic weight lifting team learned of AAS use at the World Championship in Vienna.

1958:

• The Food and Drug Administration approves methandrostenolone which is marketed by Ciba Pharmaceuticals as Dianabol.

1960:

• John Ziegler, the appointed physician of the United States Olympic weight lifting team gave AAS to the team at the Rome games.
• It is speculated that William Afflis (Dick the Bruiser) may have been one of the first professional wrestlers to use AAS in the early part of the decade. (6)

1965:  

•  Wayne Coleman (Superstar Billy Graham) begins using AAS. (7)

1975:

• Terry Bollea (Hulk Hogan) begins using AAS. (8)

1982/83:

• It is estimated that upwards of 80% of professional wrestlers on the WWE roster are using AAS. (9)

1987: 

• May 26, Jim Duggan and Khosrow Vaziri (Iron Sheik) were arrested in New Jersey.  Duggan for possession of marijuana and drinking while driving.  Sheik was arrested for possession of cocaine and marijuana.
• Later this year the first WWE drug testing program is instituted.  The testing was primarily aimed at drugs such as cocaine, opiates and barbiturates.  The first offense resulted in  a 6 week suspension without pay.  The second offense carried with it mandatory rehabilitation.  A third violation resulted in termination.  It was revealed that wrestlers Tully Blanchard and Aurelian Smith (Jake "The Snake" Roberts) both were served with suspensions.

1988:

• The Anti-Doping Abuse Act is passed.  It is now a felony to sell or possess with intent to distribute AAS.

1990:

• The Anabolic Steroid Control Act is passed.  AAS are now a Schedule III drug.  The Act criminalizes illegal drug trafficking.

1991:

• In March, FBI agents raided the medical offices of George Zahorian, III, D.O.  Zahorian was the longtime WWE ringside physician in Allentown, Pennsylvania.  He was subpoenaed for shipping AAS to 43 professional wrestlers.  Thirty seven of the wrestlers were actively employed by WWE. 
• June 19: Zahaoian was formally indicted.
• June 24:  The United States of America v. George T. Zahorian trial begins.  At the trial four wrestlers testified about receiving AAS from Zahorian.  Dan Spivey reported receiving Deca-Durabolin, Anavar, Anadrol, and testosterone.  Roderick Toombs (Roddy Piper) testified he received Deca-Durabolin, Anavar, and Stanozolol.  Richard Vigneault (Rick Martel) and Brian Blair both testified to being sold  Anavar, Deca-Durabolin, and testosterone.
• June 25:  A jury finds Zahorian guilty of 12 counts of illegally distributing steroids and other controlled substances.
• July:  WWE announces the start of a new drug testing program that includes testing for AAS.  Serving as Medical Director was Mauro Di Pasquale, M.D.  Aegis Analytical Laboratories, under the directorship of David Black, Ph.D, did the specimen testing.  Wrestlers David Smith and Jim Hellwig (Ultimate Warrior) are terminated because of violating the policy.
• July 16:  WWE owner Vincent K. McMahon admits to having experimented with Deca-Derabolin.  This same day Terry Bollea (Hulk Hogan) appears on the CBS Arsenio Hall show and denies AAS use except for the sole purpose of treating an injury under the supervision of a physician.
• December 27:  Judge William W. Caldwell sentences Zahorian to 36 months imprisonment followed by 2 years of supervised release.  He was also fined $12,700.

1993:   

•  November 18, the U.S. Justice Department indicted Vincent K. McMahon for conspiracy to distribute AAS and defraud the Food and Drug Administration.

1994:

• July 5,  the United States v. Vincent K. McMahon and Titan Sports trial begins.  During the trail Zahorian testifies he sold AAS to WWE wrestlers from 1981/82 to 1989.  Wrestlers Randy Cully (Moondog Rex), Tom Zenk, Terry Szopinski (Warlord), Tully Blanchard, Rick Rood (Rick Rude), Jim Hellwig (Ultimate Warrior), Kevin Wacholz (Nailz), John Minton (Big John Studd), and Terry Bollea (Hulk Hogan) all gave testimony about illegal drug use.

• July 22, McMahon was acquitted of all charges.

1996:

• October 25, drug testing in the WWE ceases.

2000:

• August, the Indiana Medical Licensing Board suspends Joel Hackett, M.D. for providing controlled substances to 11 professional wrestlers.  Wrestlers linked to Hackett include Brian Pillman, Louis Muccciolo (Louie Spicolli), Tony Norris (Ahmed Johnson), Jim Hellwig (Ultimate Warrior), Scott Hall and Del Wilkes (The Patriot).

2006:   

•  February 26, WWE institutes the Talent Wellness Program.

2007:   

• March 19, SI.com reports 11 professional wrestlers linked to an illegal performance enhancing drug distribution network.  Specific wrestlers mentioned in the article were Kurt Angle (trenbolone and nandrolone from October 2004 to February 2005), Eddie Guerrero (HCG and stanozolol, early 2005), Oscar Gutierrez  (Rey Mysterio, nandrolone and stanozolol), Randy Orton (stanozolol, nandrolone, testosterone, anastrozole from March 2004 to August 2004), Adam Copeland (Edge), and Gregory Helms (Shane Helms/Hurricane) were reported to have received HGH. (10)
• June, 22-24,  The Chris Benoit double murder/suicide occurs in Fayettville, Georgia.
• June 27, the medical office of Phillippe Astin, III, M.D. in Charrollton, Georgia is raided by federal agents.  It is learned that during a 3 year period leading up to May 2007 Astin had prescribed Benoit, on average, a ten-month supply of testosterone every three to four weeks. 
• July: Astin is indicted on 175 counts of illegally prescribing medications.  Professional wrestlers linked to Astin included Chris Benoit, Oscar Gutierrez (Rey Misterio), Mark Jindrak, Michael Durham (Johnny Grunge), Nancy Benoit (Woman), Lawrence Pfohl (Lex Luger), Robert Howard (Hardcore Holly), and Marcus Bagwell (Buff Bagwell).
• August 30, Sports Illustrated releases the names of 14 wrestlers who were clients of Signature Pharmacy in Orlando, Fl.  Names mentioned were Randy Orton, Charlie Haas, Adam Copeland (Edge),  Gregory Helms (Shane Helms/Hurricane), Mike Bucci (Simon Dean),  John Hennigan (Johnny Nitro), Darren Matthews (William Regal), Ken Anderson (Mr. Kennedy), Eddie Fatu (Umaga), Brian Adams (Crush), Shoichi Funaki, Sylvian Grenier, Chavo Guerrero, Eddie Guerrero, and Chris Benoit.  (11)  The New York Daily News adds Robert Huffman (Booker T, ), Mike Bucci (Simon Dean), and Anthony Carelli (Santino Marella) to the list of clients.  (12)  ESPN.com reported Dave Bautista (Batista) and Chris Mordetsky (Chris Masters) were also clients.  (13)

   
    

References:

1. Lancet 1889;2:105.
2. http://nobelprize.org/nobel_prizes/chemistry/laureates/1939/butenandt-bio.html.
3. Hoppe Seylers Z Physiol Chem 1935;233:281.
4. Chemische Berichte 1935;68:1859.
5. Scientific American 1995;272(2):76.
6. Muchnick, I. Chris & Nancy.  The true story of the Benoit murder-suicide & pro wrestling's cocktail of death.  Toronto, Ontario, Canada.  ECW Press. 2009.
7. Graham, B.  WWE Legends.  Superstar Billy Graham.  Tangled Ropes.  New York, NY.  Pocket Books.  2006.
8. Hogan, H.  Hollywood Hulk Hogan.  New York, NY.  Pocket Books.  2002.
9. United States v. Vincent K. McMahon and Titan Sports.  No-93-CT-1276.
10. http://sportsillustrated.cnn.com/2007/more/03/19/wrestlers
11. http://sportsillustrated.cnn.com/2007/more/08/30/wrestlers/index.html
12. http://www.nydailynews.com/sports/2007/08/30/2007-08-30_top_wwe_names_emerge_in_doping_scandal.html
13. http://sports.espn.go.com/espn/news/story?id=2998062
    
    
    
    

Zach Gowen the one legged wrestler

Zach Gowen

     Professional wrestler Zach Gowen was diagnosed with an osteosarcoma of the left leg in 1991 at the age of 8 years old.  He underwent a successful amputation of his leg.

     Osteosarcomas are uncommon malignant tumors of bone.  Approximately 750 to 900 new cases are diagnosed each year in the United States, of which 400 arise in children/adolescents.  The tumor is more common in boys than girls.

     The most common site of osteosarcoma in children is a long bone, especially the in the leg (femur, tibia), and arm (humerus).  The majority of individuals present with pain, typically of several months' duration.  Pain frequently results in decreased movement of the affected body part. The most important finding on physical examination is a soft tissue mass, which is frequently large and tender.

     Surgery to remove the tumor is the primary therapy.  Chemotherapy is often given before surgery to shrink the tumor size.



Photographs are for illustrative purposes only.  Wrestling with Death does not claim ownership.

Could an Ox Baker heart punch really kill a man?

Alberto Torres

     On June 13, 1971 in Verdigre, Nebraska a tag team match took place that would end in tragedy.  Douglas Baker (Ox Baker) teamed with Tom Andrews (The Claw) to take on Alberto Torres and partner "Cowboy" Bob Ellis.  The match was for the AWA Midwest Tag Team Championship held by Ellis and Torres.  As legend has it, Ox Baker delivered his famous heart punch to Torres, knocking him out.  Torres died on June 16 in Immanuel Hospital in Omaha. While promoters credited Baker's heart punch as the cause of death, it was later revealed that Torres died from complications of pancreatitis that developed before the match.

     Ox Baker was also linked to the August 1, 1972 death of wrestler Ray Gunkel.  Gunkel, the Georgia Championship Wrestling Brass Knuckles champion, and Baker wrestled in a match held in Savannah, Georgia.  During the match Gunkel was the recipient of a heart punch.  Although he went on to win the match, Gunkel later collapsed and died in the locker room.  The autopsy revealed Gunkel had underlying coronary artery disease.  It has always been controversial what role the chest trauma contributed to his death. (1)

     Nevertheless, the question still remains:  Could an Ox Baker heart punch really kill a man?


 

Ox Baker

     The answer is yes.   Such an event is known as commotio cordis (Latin for "agitation of the heart"), and is defined as a combination of ventricular fibrillation and sudden cardiac death due to chest trauma. (2)  It is a common cause of sudden cardiac death in athletes.  While the exact prevalence of commotio cordis is unknown, the following epidemiologic data have been reported: (2) 

• Young persons are most commonly affected (mean age about 15 years); only nine percent of reported cases occurred in someone older than 25 years of age.
• 95 percent of reported cases have been in males.
• 75 percent of cases have occurred during athletics (50 percent during competitive sports, 25 percent during recreational sports).
• Most cases have been reported in sports with blunt projectiles (eg, baseball, lacrosse, hockey) and/or more physical contact (eg, football, hockey).

      The trauma to the chest results in a lethal rhythm known as ventricular fibrillation.  For this event to occur the chest wall trauma must be directly over the heart and at a specific point in the heart beat cycle.  Only impacts occurring during a 20 to 40 millisecond window during early ventricular repolarization  will cause ventricular fibrillation (see figure taken from reference 3).

Part of heart rhythm were commotio cordis a risk

     Survival from commotio cordis is poor, with one registry reporting only a 25% survival.  The chances of surviving may be improved with timely emergency medical resuscitation. (2)


     In addition to Ox Baker, the heart punch was also utilized by former WWE champion George Stipich (Stan Stasiak). 


Reference:

1. http://slam.canoe.ca/Slam/Wrestling/2008/06/24/5975651.html
2. N Engl J Med. 2010;362(10):917.
3. http://en.wikipedia.org/wiki/Commotio_cordis

The medical reference www.uptodate.com was used in the preparation of this blog.

Photographs are for illustrative purposed only, Wrestling with Death does not claim ownership.

Drug overdose and American professional wrestling

     For nearly three decades there has been an epidemic of American professional wrestlers dying young.   A frequent cause of death has been drug overdose.  A summary of the recent data from the United States poisoning centers revealed the following data about drug overdose: (1)

• 95% of episodes caused minor/reversible effects.
• 92% were due to acute rather than chronic ingestion.
• 92% involved a single substance.
• 85% were unintentional. 
• 59% of fatalities occur in individuals ages 20 to 49 years old. 
• 47% involved prescription drugs.

     During the 1980's cocaine was a popular drug used by American professional wrestlers.  Cocaine is found in the leaves of the coca plant, which is abundant in parts of South America.  It can be consumed intravenously, orally, intranasally, and by smoking.  Users are at high risk for abuse and dependence.

Gino Hernandez

     Acute intoxication of cocaine can lead to a number of complications including myocardial infarction, cardiac arrhythmias, heart failure, hypertension, stroke, seizures, and muscle breakdown leading to kidney failure.  It has been reported that professional wrestlers Charles Wolfe (Gino Hernandez), Curt Hennig, and Scott Bigelow (Bam Bam Bigelow) died from cocaine intoxication.

     The 1990's saw the use of gamma hydroxybutyrate (GHB) and carisoprodol (Soma) increase among American professional wrestlers.  GHB is classified as a central nervous system depressant and is approved by the Food and Drug Administration (FDA) for treatment of cataplexy and excessive sleepiness in narcolepsy.  GHB can increase the body's secretion of growth hormone and for this reason some athletes use it.  A common side effect is drowsiness.  It is the ingredient in the so-called "date-rape drug".  Nonprescription use of GHB has been reported to result in respiratory depression, coma, and death.

Louie Spicolli

     Soma is classified as a muscle relaxant.  It is recommended that it only be used short term (2 to 3 weeks) for treatment of musculoskeletal pain because of a lack of established benefit long term.  A significant side effect is excessive drowsiness.  Sedating effects are increased when mixed with other central nervous system depressants such as alcohol.  The professional wrestler Louis Muccolo, Jr. (Louie Spicolli) died from an overdose of Soma.

     The last decade has seen a rise in deaths due to prescription opioids which are commonly used for pain management.  The death of Bobby Duncan, Jr. was linked to fentanyl.  Sherri Schrull's (Sheri Martel) and Gertrude Herd-Nash's ( Luna Vachon) deaths were connected to use of oxycodone.

     Below is a list of American professional wrestlers from the National and Modern eras whose deaths were attributed to drug overdose.

Miss Elizabeth

• David Adkission (David Von Erich)  2/10/84.
• Rick McGraw  11/1/85.
• Charles Wolfe (Gino Hernandez)  2/2/86.
• Bruce Woyan (Buzz Sawyer)  2/7/92.
• Arthur Barr (Art Barr)  11/23/94.
• Herb Abrams  7/23/96.
• Louis Muccolo Jr. (Louie Spicolli)  2/15/98.
• Richard Rood (Rick Rude)  4/20/99.
• Bobby Duncum Jr.  1/24/00.
• Randy Anderson  5/5/02.
• Elizabeth Hulette (Miss Elizabeth)  5/1/03.
• Alex Rizzo (Big Dick Dudley)  5/16/03.
• Curtis Hennig (Mr. Perfect/Curt Hennig) 2/10/03.
• Anthony Durante  (Pit Bull #2)  9/25/03.
• Michael Durham (Johnny Grunge)  2/16/06.
• Joseph Magliano (Joey Maggs)  10/15/06.
• Scott Bigelow (Bam Bam Bigelow)  1/19/07.
• Sherri Schrull (Sheri Martel)  6/15/07.
• Brian Adams  (Crush) 8/13/07.
• Chase Tatum  3/23/08.
• Gertrude Hurd-Nash (Luna Vachon)  8/27/10.
• Michael Verdi (Trent Acid)  6/18/10.

References:

1. Am J Emerg Med 2002; 20(5): 391.

The medical resource www.uptodate.com was used in the preparation of this blog.


Photographs are for illustrative purposes only.  Wrestling with Death does not claim ownership.

Ric Flair and alcoholic cardiomyopathy

     In his autobiography, professional wrestler Richard Fleihr (Ric Flair) acknowledges being diagnosed with alcoholic cardiomyopathy. (1)

Ric Flair

     Low to moderate intake of alcohol has been shown to have positive health benefits including reduced risk of stroke and coronary artery disease.  The cut point at which alcohol intake goes from beneficial to harmful is not known.  Heavy alcohol intake is often defined as 14 drinks for males and 7 drinks for females in a week.  Excess alcohol consumption can lead to health complications such as cardiomyopathy (disease of the heart muscle leading to decreased function).

     The risk of developing a cardiomyopathy is a function of the amount of alcohol consumed on a daily basis and the total duration of drinking. The diagnosis is usually made based on an established history of heavy and consistent alcohol use and after other causes of cardiomyopathy have been excluded.  Symptoms may come on slowly and include shortness of breath, and irregular heart beat.  Many individuals do not have symptoms early in the disease course but will still have evidence of impaired heart function upon testing.  The condition can progress to congestive heart failure and death.

     The main treatment is total abstinence from alcohol.  Under these circumstances it is possible for the heart function to recover.  However, if a person continues to drink alcohol, the chances of dying as a result of deteriorating heart function are very high.





References.

1. Flair, Ric, Mark Madden (editor) and Keith Elloit Greenberg (contributor).  Ric Flair: To Be the Man.  World Wrestling Entertainment 2005.

The medical resource www.uptodate.com was used in the preparation of this blog.  Photographs are for illustrative purposes only.  Wrestling with Death does not claim ownership.