How A Boxer Could Use PEDs Right In The Middle Of A Fight

When someone mentions performance-enhancing drugs, what comes to mind? For me, it's an image of two 'roided out home run hitters embracing on a baseball field. But as Adrien Broner might have discovered on Saturday night, the world of PEDs—which we traditionally associate with anabolic steroids and human growth hormone—is far more complex. And sometimes the results are instantaneous.

Video from the match appears to show Marcos Maidana ingesting a white pill between rounds of the welterweight title bout before pulling off his stunning upset of Broner. As the Texas Boxing Commission, the Keystone Kops of boxing, investigates what, if anything, Maidana actually ingested—the inquiry is expected to conclude later today—speculation abounds. Inquiring minds want to know: What could Maidana have taken, and how could it have helped him?

The World Anti-Doping Agency (WADA) list of banned substances includes five broad classes of PEDs: stimulants, diuretics and masking agents, growth hormones and growth factors, metabolic modulators, and anabolic steroids. A sixth category, painkillers (like morphine and oxycodone), represents a grey zone, but they are widely considered to enhance performance. Many of these agents require repeated use; PEDs in sports are are typically the long con. But some—like painkillers or stimulants (amphetamine or methamphetamine)—can provide an immediate benefit to a dazed, battered boxer like Maidana. Amphetamine, for example, has been shown to improve stamina, strength, and perhaps most importantly for a boxer, reaction times. (The benefit of taking a painkiller while sustaining repeated blows to the head seems obvious.)

Another, more unusual class of PEDs is the beta-2 agonist (salbutamol/terbutaline), which has traditionally been used to treat asthma. Several studies have shown that oral salbutamol improves strength and endurance. Popping a beta-2 agonist between rounds would have opened up Maidana's lungs beyond their normal capacity, allowing more oxygen to travel through his body during those final, sluggish rounds, and help him power through fatigue. Think of it as Lance Armstrong powers in pill form.

Not that Maidana was in a ton of trouble. Unless a comet crashed through the roof of Alamodome and turned him into paste, or Adrien Broner was allowed to fight the 12th with a crowbar, Maidana was going to win the fight. Still, the 12th was by far the worst round of the fight for Maidana, and if he did in fact receive a stimulant that increased stamina and endurance, it could have affected the fight in a dramatic way. Especially since, boxing being boxing, it's not impossible to imagine later rounds being nudged Broner's way by corruptible judges.

Aside from the ethical problem of taking a PED during a fight, there are the health risks. Painkillers, stimulants, and beta-2 agonists work by very different mechanisms to enhance performance, but they have one thing in common—all have been associated with palpitations, dangerous fluctuations in blood pressure, and central nervous system dysfunction.

We don't know what Maidana consumed on Saturday night, or if he consumed anything at all, but we shouldn't be surprised if it turns out to be one of these three types of PEDs.

Image via Getty Images

Matt McCarthy is board-certified in internal medicine. You can follow him on Twitter here.