I met Dr Miller at his Lewisham Sports Medicine Clinic in Sydney some 35 years ago. He was a big man but I don't think he lifted a weight in his life. He was subscribing steroids to bodybuilders and athletes. I referred many aspiring bodybuilders to him because these guys would take black market drugs and I advised them to get pharmacy grade gear and do it under supervision.
Seems like little has changed re the mentality of bodybuilders and the risks they foolishly take. Dr Miller was giving evidence re drug abuse. Since that time steroids have been listed as illicit drugs.
AUSTRALIAN DRUG LAW REFORM FOUNDATION
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WREST POINT CONFERENCE CENTRE
HOBART
4 - 6 MARCH 1996
"Witness
Dr Tony Millar, Director of Research, Lewisham Sports Medicine Clinic, Sydney
Dr Millar's statement - A medical graduate of some 50 years. I was particularly interested in muscular- skeletal aspects of medicine which soon led me into the problems of sports injuries. Some 30 years ago I founded an Institute of Sports Medicine in Sydney and I maintain the Director's position still. Sporting injuries led to sporting performance which led to what can enhance performance and the obvious thing that was better than anything was an anabolic steroid. What I was taught was totally wrong. The drugs do work even though we were taught they didn't. The American College of Sports Medicine put out a statement in 1970 saying that they didn't work. Ten years later they put out one saying that they do work. There's a tremendous amount of literature available for those people in the usage field which is totally wrong but scientifically written and the users believe it. I thought we ought to do something about it so I reversed the process. I read it up, I didn't understand it, so I decided that the only way to go was to prescribe the anabolic steroids so that they got a pure preparation. I knew what the material was, I knew how much they were taking, I was able to impress the need to train heavily and to eat correctly. I've had no reason to regret that.
The Hon Mike Elliott, Chair - Have you also looked at the question of growth hormone which I understand is a growing problem? 5% of college students in football training in America are using growth hormones, I believe.
Dr Millar - In the higher performance sports there is no doubt about it. The cost is prohibitive but the gains at the end are such that the cost is relatively less than it would be to the person in, for example, body building for fun. It's increasing in use as it is here.
The Hon John White, Tas, MHA - I'm fairly interested in this debate, being 5 foot 8" but what happens when a person does have skills such as ball and eye skills and whatever else is necessary to be a cricketer or footballer at a national level, decide to play basketball and decide they need another growth spurt? Does that actually affect their ball skills in any way?
Dr Millar - What age are they?
The Hon John White, Tas, MHA - Say in their teens.
Dr Millar - They're wasting their time trying to get a growth spurt in their late teens. There's nothing that I know that suggests that it increases or decreases their performance but very obviously in basketball, if you can only reach 6'8", the 6'9" ball you've missed out, and if you've gone to 6'9", you're going to be a better basket baller. There's no proof of that but it does seem reasonable.
Mr Bryce Gaudry, NSW, MLA - Dr Miller, I'm a former patient of yours and unfortunately, I didn't get the anabolic steroids. I'm interested in the approach that you've taken. I take it that you see that as a harm minimisation approach, as you went to prescribing those athletes from the perspective of knowing the preparation that they were given and then being able to monitor its use. There are often media reports of very bad reactions to steroid use. It take it that's in an uncontrolled situation?
Dr Millar - My experience is that firstly it's hard to find out how much they took because they're using black market material. If you're going to deal with that sort of stuff, you've got to take your chances. The problems of black market materials, most of them are veterinary preparations, the problem is overdosage and the other problem is lack of education of the individual as to what to do with it. Some of them are absolutely counterfeit and made in the backyard. Those are the biggest single problems of all because it's easy to make once you know how to do it.
Mr Bryce Gaudry, NSW, MLA - So you could make it parallel with some of the illicit drug trade that does go on?
Dr Millar - Correct, but the difference with the anabolic user is, my experience over some 2000 patients now, is that the average length of use between day 1 and the last day is round about 2 years. Now, they don't take them all the time but they'll take them for a few months, knock it off for a few, take it for a few, knock it off and take it. This is a totally different concept with what you're doing with other types of drugs that we've been talking about. They deserve a different approach to the problem and it is something that can be fixed, I think, with medical prescription.
Mr Michael Moore, ACT, MLA - When I first started looking at anabolic steroids and I have to thank you for sending me quite a number of papers which I appreciated, quite a number of pharmacists said to me, look, when you're talking about heroin, amphetamines, cannabis, they're reasonably mild drugs, we know about them. But when you're talking anabolic steroids, then you're talking about something really dangerous. That's the same story I heard about heroin before I started looking into it. What is the truth?
Dr Millar - All mine are still alive, Michael, after 10 years, so I suppose that's a fair statement. The reasons they give you for not taking them, is that they cause cancer of the liver, heart trouble and psychiatric disturbances. These three things are also common with the oral contraceptive. You don't hear anybody saying don't use the oral contraceptive because of this, this and this. So we, the medical profession is dishonest in promoting it that way. Experience shows me that if you can get the person to control the dose, there's not a problem in their health aspects. Certainly a number develop gynaecomastia,, enlargement of the breasts), and this is due to the material being converted to oestrogen. It happens in very few but it does happen. There are a few who get acne on their backs and there are a few who will tell you straight out that they feel aggressive when they're on it. It doesn't happen with every preparation which I don't understand, but it certainly happens. They are the problems that I see in anabolic steroids. I've never seen a person develop hypertension. I've seen it stated that they do, that their blood pressure goes up but when I've looked at them and they've been raised, I've laid them down for 20 minutes, it comes down to normal and the same happens when they come back. I've not been able to document that. Others have said it happens. There are no other problems that I've dealt with.
Mr Michael Moore, ACT, MLA - Over 2000 people?
Dr Millar - Yes, approximately 2000.
The Hon Kevin Rozzoli, NSW, MLA - Following the recent excitement over the Samantha Riley issue which came from taking a headache tablet, is the drug interpretation of drug taking in sport in all its manifestations, actually got out of hand in interpretative terms? That would seem to us to be have been a total over reaction to what is basically the attitude of not allowing drug taking for performance enhancing purposes. Is there a generalisation of drugs in sport that has led to a complete confusion of what the role of drugs in sport are?
Dr Millar - Yes, it's totally hypocritical. In Seoul, there were 28 positives and 8 were acted upon, the other 20 were let go. Linford Christie was positive with pseudo ephedrine and he was let go. He says in his book, let's get rid of drug testing in sport, it doesn't work. He was one of those who got way with it. If Samantha Riley took it for her headache, she made a mistake. But why can't she take something for a headache if he can take insulin for his diabetes, somebody else can take Ventolin for their asthma and yet, who have coronary heart disease or hypertension, can't take a beta blocker because that's what I use for my blood pressure. All these things are unfair, unjust and irregular but I believe that if the law is there, it ought to be enforced. I disagree with it totally, absolutely. There are a lot of cheats at the other end who make those decisions in the Olympic Committee..
Mr Bryce Gaudry, NSW, MLA - Dr Miller, you agree with performance enhancing steroids, performance enhancing recreational drugs, like ecstasy, amphetamines. Would you agree that these also ought to be part of modern life?
Dr Millar - I don't agree with performance enhancing drugs. I think we would be better off if we didn't have them but we've got them and something has got to be done about it. I don't know anything about the others.
The witness withdrew."
