Why Adderall? Carlos Ruiz is just the latest to test positive for the amphetamine

PBR - Adderall is not the first performance-enhancing drug to tarnish an athlete, nor will it be the last, but it is the latest.

Carlos Ruiz was suspended by Major League Baseball for 25 games on Tuesday for testing positive for using the outlawed amphetamine for a second time. The suspension comes just days after a pair of football players tested positive for the banned substance and were suspended by the National Football League.   

Of all the illegal substances available for consumption, why Adderall? What is the lure of a medication meant to treat ADHD - Attention Deficit Hyperactivity Disorder?

Dr. Larry Fluking, a Philadelphia-based psychiatrist, claims the amphetamine can help an athlete immensely, especially when even the slightest of benefits can alter an outcome and result in success.
"Most of these players will take any edge they can get," Fluking said. "From alertness and concentration, to speed and aggressiveness, Adderall helps with it all. It can enhance hand-eye coordination and gives you an added jolt, mentally and physically."

Fluking contends Adderall can also increase speed, strength and power.

"Most people don't think of Adderall as something like a steroid because it doesn't have the same cachet, but it most certainly is a performance-enhancing drug," Fluking said. "The impacts are certainly evident."

Ruiz, who turns 34 in January, posted career highs last season in home runs, RBIs, batting average, slugging percentage, and on-base percentage, despite missing several weeks because of plantar fasciitis in his left foot.

Adderall has been banned by all four of America's professional sports. However, like other sports, Major League Baseball allows players to obtain an exemption if they have a medical need for the drug. According to published reports, MLB granted 105 exemptions in 2011.

"Not surprising in the least," Fluking said of the number of exemptions. "Among the disorders most commonly diagnosed ADHD is near the top. In turn, this means prescriptions are becoming easier to get."

According to MLB's drug policy, if a league-certified clinician diagnoses Ruiz with ADHD and prescribes him Adderall he can apply for an exemption. A similar procedure allows players to safely take Ritalin.  

A first positive test for a stimulant, such as Adderall, results in increased testing and a warning, but not a suspension. Since Ruiz previously tested positive he was subjected to six unannounced drug tests over the previous year and failed at least once. Ruiz would be suspended for 80 games if he tests positive for a third time.

According to Fluking, amphetamines like Adderall remain in the system for five days and are easily detectable in a standard drug test.

"With the ease of how a drug test finds Adderall usage, I'm baffled as to why athletes think they can get away with using it," Fluking said. "It isn't like this is a cutting-edge drug that is difficult to be detected." 

In September the Phillies exercised a $5 million option  on Ruiz for 2013. Both sides were hoping to discuss a long-term extension during the winter but these recent developments may alter those discussions.

- Patrick Gordon is the editor of the Philadelphia Baseball Review. Contact him at pgordon@philadelphiabaseballreview.com or @Philabaseball on Twitter.

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