“Of Course, It’s the Steroids!” (Here We Go Again…)

While working out recently in a local Gold’s Gym in Latham, New York, a man named Chad Brothers, 32, described as a “gentle giant” by his family, reportedly went berserk, toppling weight machines, throwing dumbbells, and assaulting a patron. After being Tasered numerous times by law enforcement officers and even allegedly taking a Taser from an officer and using it on himself, he suffered a heart attack an hour later and died. Brothers was a large man at 6’1″ and 235 to 240 pounds, he was working out in a gym, and toxicology reports apparently found anabolic steroids in his blood.

The local District Attorney’s office announced that Brothers’ spontaneous and unprovoked rampage was a case of excited or agitated delirium (AD). AD is usually characterized by extremely high body temperature, loss of contact with reality, out of control aggressive and agitated behavior, superhuman strength and an unwillingness to back down from confrontation in the face of overwhelming numbers (e.g., Grant, Southall, Mealey, Scott, & Fowler, 2009; Vilke, Payne-James, & Karch 2012). Not surprisingly, those suffering from the syndrome are often ultimately subdued via physical or electrical measures at the hands of law enforcement agents (Grant et al., 2009). The cause of death among those who exhibit AD is usually cardiac-related and it has been plausibly suggested that the syndrome emerges from extreme catecholamine (e.g., adrenergic) activity (e.g., Otahbachi, Cevik, Bagdure, & Nugent, 2010). Consistent with this “over-arousal” of the sympathetic nervous system, AD is often related to the abuse of stimulants. In fact, a finding of sympathomimetics (drugs that stimulate the sympathetic nervous system) in the blood has traditionally been one criterion used for diagnosing AD after fatal rampages like Brothers’ (Vilke et al., 2012). Drugs that have been linked to occurrence of this syndrome include cocaine (most often), methamphetamine, lysergic acid diethylamide, and phencyclidine (PCP) (e.g., Sztajnkrycer & Baez, 2005; Takeuchia, Ahern, & Henderson, 2011). In fact, PCP’s undesirable effects of “…agitation, violent behavior, paranoid delusions, disorientation, delirium, and hallucinations… (p. 658; deRoux, Sgarlato, & Marker, 2011)” led to its abandonment as an anesthetic.

The Albany Times-Union covered the Chad Brothers rampage with the headline: “Officials: Man had steroids in system“. The DA’s spokeswoman was quoted that AD is “a condition that can result from steroid use.”

Is this an open and shut case of steroid-induced aggression – the infamous “’roid rage”? Did steroids cause Brothers’ AD? Although some experts have suggested that if “’roid rage” exists at all, it occurs rarely and only in a small fraction of predisposed steroid users (p. 60; Yesalis & Cowart), we will probably never know for sure what role, if any, the man’s apparent use of steroids may have played in this tragic incident. Human behavior is generally too complex to pin-point a single cause, although simple explanations are much more attractive. As we have seen before in such cases (e.g., Chris Benoit, David Jacobs), selectively blaming steroids for a tragedy, rather than presenting a fuller account of other possible causative factors, is a convenient way to sensationalize the news.

There’s no direct causal evidence or documentation linking steroids to AD. But that doesn’t stop the media from quickly accepting knee-jerk conclusions. The Times-Union relied on the District Attorney (DA) as a source, apparently doing no independent fact-checking. It should be noted that this DA is the same controversial Albany politician who catapulted himself into national headlines by his anti-steroid investigations of doctors and pharmacies located in Florida. Up for reelection next year, he currently faces a Democratic primary challenger who has criticized his grandstanding anti-steroid crusade against businesses located far beyond his state’s boundaries and with minimal ties to New York.

Had the paper conducted even minimal due diligence, it would have learned a critical fact: that PCP – more popularly known as Angel Dust – was also found in Brothers’ blood. It would also have learned that a man with Brothers’ Body Mass Index (31) would be at increased risk for fatal AD (Park, Korn, & Henderson, 2001). If the Times-Union had learned these things, the public could have learned them as well. Although at this point we do not know how much PCP was in Brothers’ blood (nor do we know what steroid concentrations or types were found), the simple fact is that science links PCP to AD (e.g., Takeuchi et al., 2011). Additionally, a similar fatal case of AD occurred in Michigan only one month previously. Bradford Gibson, 35, also died after being Tased by police; autopsy reports showed he had PCP in his system (http://blogs.phoenixnewtimes.com/valleyfever/2011/12/taser_off_the_hook_for_two_dea.php). The relationship between the use of such “Electronic Control Devices” and AD remains a subject of investigation (e.g., Jauchem, 2011).

One would like to think there was no intent or collusion by the Times-Union and the DA to cherry-pick which facts to report, even though Times-Union reporters have had a virtual partnership with the DA’s press office in disseminating information about the anti-steroid investigations to the public. One would also like to think that the core of such investigations, whether by DAs or reporters, is the desire to know the truth, to understand what actually happened and why. But it’s hard to not be skeptical when the goal appears to be manipulation rather than knowledge. Once again, the media falls short on its obligations to report the important facts or help the public understand, choosing instead to blindly rely on sources that appear far from objective. The media’s role seems to have morphed from presenting and evaluating information to merely passing along what others say as fact. The public was misled into thinking that the only possible cause of the rampage was steroids. And if not for other news sources, the public would have never been the wiser.

In the midst of such abrogation of duty, is it any wonder that today’s public runs from one panic to another? This unfortunate situation emerges when “…a condition, episode, person or group of persons emerges to become defined as a threat to societal values and interest; its nature is presented in a stylized and stereotypical fashion by the mass media; the moral barricades are manned by editors, bishops, politicians, and other right-thinking people (p. 9; Cohen, 1972)”. With steroid headlines like this one, and steroid reporting in general, do mainstream media sources serve as bulwark against such panic … or its facilitator?

References

Cohen, S. (1972). Folk devils and moral panics: The creation of the mods and rockers. London: MacGibbon & Kee Ltd.

deRoux, S.J., Sgarlato, A, & Marker, E. (2011). Phencyclidine: A 5-Year retrospective review from the New York City Medical Examiner’s Office. Journal of Forensic Sciences, 56, 656-659.

Grant, J.R., Southall, P.E., Mealey, J., Scott, S.R., & Fowler, D.R. (2009). Excited delirium deaths in custody: Past and present. The American Journal of Forensic Medicine and Pathology, 30, 1-5.

Jauchem, J.R. (2011). Pathophysiologic changes due to TASER devices versus excited delirium: Potential relevance to deaths-in-custody? Journal of Forensic and Leal Medicine, 18, 145-153.

Otahbachi, M., Cevik, C., Bagdure, S., & Nugent, K. (2010). Excited delirium, restraints, and unexpected death: A review of the pathogenesis. American Journal of Forensic Medicine and Pathology, 31, 107-112.

Park, K.S., Korn, C.S., & Henderson, S.O. (2001). Agitated delirium and sudden death: Two case reports. Prehospital Emergency Care, 5, 214-216.

Sztajnkrycer, M.D., & Baez, A.A. (2005). Cocaine, excited delirium and sudden unexpected death. Emergency Medical Services, 34, 77-81.

Takeuchi, A., Ahern, T.L., & Henderson, S.O. (2011). Excited delirium. Western Journal of Emergency Medicine, 12, 77-83.

Vilke, G.M., Payne-James, J., & Karch, S.B. (2012). Excited delirium syndrome (EDS): Redefining an old diagnosis. Journal of Forensic and Legal Medicine, 19, 7-11.

Yesalis, C.E., & Cowart, V.S. (1998). The Steroids Game. Champaign: Human Kinetics.

© Darkes and Collins, 2011

About the author

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Jack Darkes

Director of the Psychological Services Center at University of South Florida

Jack Darkes, Ph.D. is a Clinical Psychologist and currently the Director of the Psychological Services Center in the Department of Psychology at the University of South Florida. He is well-known and respected both nationally and internationally for his research on psychological factors related to substance use and abuse. He has applied his experience to an examination of the use and behavioral effects of anabolic-androgenic steroids (AAS) and his writings on AAS are well-known to readers of various internet fitness and bodybuilding websites.

Rick Collins

Collins Gann McCloskey & Barry PLLC

Rick Collins, Esq., J.D. is a principal in the law firm of Collins Gann McCloskey & Barry PLLC, with offices on Long Island and in downtown New York City. He is nationally recognized as a legal authority on anabolic steroids, human growth hormone, and other performance-enhancing substances.