Although most pros probably use roughly the same amounts, something about his physique just screams drugs. Not too sure what it is.
To me he doesn't have that purple skin thing going on, doesn't look much older than he is, doesn't have that pained look where you see the body and mind is struggling with the massive androgen overload. Compare to for example Dallas McCarver, that guy looked like he was pushing more than the body wanted to accept, so to speak. Maybe it has to do with many bodybuilders today actually taking their BP meds, pulling blood if necessary, that sort of thing. I'm not saying he doesn't use massive amounts, just that he doesn't appear to be struggling, which of course doesn't mean he is healthy. Looks can be deceiving. I didn't even see very bad skin, though I then saw some clips where people pointed out his acne. People joke that the ones who get into trouble always blame hereditary factors, but something genetic could have someone drop dead all of a sudden, could for example be predisposed to blood clots which when combined with drugs then suddenly drops them. Or the heart genetically can't handle much hypertrophy and electrical problems ensue. Ruhl looked like he was overloaded, didn't look too well generally but is still alive.