Thanks to Luckylab and bikejenbike for their comments on the earlier post (Shadow of doping, 23 June). This post will address those comments.
First, for a quick and easy (and disturbing and fascinating) read on the East German doping "machine" of the 1950's to 1990, read Faust's Gold by Steven Ungerleider (pic below).
Luckylab asked in a comment about how much doping actually helps, while bikejenbike wondered how the smaller American swimmers actually beat the East Germans from time to time.
One thing we touched on briefly was that we do not know the real effect of all the different performance-enhancing drugs. This would require loads of studies that investigate each drug individually, and also in conjunction with other drugs (since often they are taken in combo with each other). The ethical issues here are too numerous to list, and that is why this research remains largely unperformed. Having said that, however, see the previous post that looks at the article of Franke and Berendonk, which does provide some data on how effective doping can be.
To go one step further on this, there is in many individuals a strong placebo effect. Some people, if they believe that the pills they are taking will enhance their performance, will indeed perform better. You can imagine that this placebo effect will vary among individuals, and so it is incredibly difficult to quantify the placebo + physiological effect(s).
David Millar, in some of his post-bust interviews, described how he used the EPO as a crutch and did not think he had to train as much since he was on this wonder drug. Therefore if he has a better approach to training post-bust, then this might explain why his performances are similar. Or, it could also mean that he is taking something else that is equally as effective!
Next, motivation is a crucial variable in athletic performance. So even if an athlete is doping, this does not mean he or she is the hands down winner. Many of the female swimmers in Faust's Gold described their unhappiness with themselves and life in general while they were being exploited by their coaches and doctors. While they were primed physiologically to win, some were battling with large amounts of self-loathing and low self esteem because of the undesirable effects of the steroids (namely, body hair everywhere and highly elevated libidos, along with depression and mood swings. Adolescence is hard enough without drugs, and you can imagine what these teenaged females were experiencing).
Third, the use of performance-enhancing drugs by themselves does not make an athlete successful, and therefore does not guarantee improved performance.
Our model of this area is that the drugs permit an athlete to recover more quickly and more completely between training sessions, which therefore permits the athlete to train harder (intensity) and longer (duration), which are the two primary variables one manipulates in a training program. Given that an athlete will respond to a training stimulus, then more training will equate to better performance (assuming factors such as motivation, equipment, tactics, etc. are all equal).
The problem most of us face is that sooner or later, and often times it is sooner, we stop coping with the increased intensity or duration of a training program. The consequence of this is most often an injury which requires us to stop training or to reduce greatly our intensity and/or duration of training.
So drugs, especially anabolics such as testosterone, growth hormone, and steroids, enhance an athlete's ability to recover, which then permits them to complete more (harder and longer) training, which in turn produces physiological adaptations that allow them to cycle harder or run faster or throw farther.
For an amazing read on one athlete's experience with performance-enhancing drugs, read Stuart Stevens' (right) "Drug Test," from the November 2003 edition of Outside Magazine. He is a recreational ultra-endurance cyclist who used drugs with a physician's assistance to see what all the hype was about, and to find out if the drugs really work. It is an incredibly insightful text and well worth taking a look at!