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Discussing PEDs in Boxing with Dr. Ronald Kamm, Sports Psychiatrist

By Hans Olson

The issue of Performance Enhancing Drugs in boxing has been one of the most intensely debated topics in boxing over the last few years. It began in late 2009, during the initial negotiation period between the super-fight that never was between Floyd Mayweather and Manny Pacquiao.

Then, Mayweather made a request to Pacquiao that he undergo Olympic-style drug testing should the two meet in the ring. At that time, Manny declined to undergo the unlimited testing. Since then, the sides have each gone back and forth on the issue…some say Manny has agreed, some say he hasn’t.

What is a fact, is that in each of Floyd’s subsequent prize fights, he has undergone random drug testing with the U.S. Anti-Doping Agency (USADA). He did so against Shane Mosley, against Victor Ortiz, and against Miguel Cotto.

Since the initial negotiation period in late 2009, Manny Pacquiao has gone on to fight Joshua Clottey, Antonio Margarito, Shane Mosley, Juan Manuel Marquez, and Timothy Bradley. In none of those fights did Manny Pacquiao undergo Olympic-style drug testing.

Recently, boxers Lamont Peterson and Andre Berto requested testing for their rematches with Amir Khan and Victor Ortiz, respectably. The Voluntary Anti-Doping Association (VADA) did the testing, and did not Khan or Ortiz testing positive, but instead Peterson and Berto.

To talk about this ongoing issue, Boxing Insider caught up with Dr. Ronald Kamm last week.

Dr. Ronald Hamm

Specializing in Sport Psychiatry, Dr. Kamm was selected as one of America’s 100 Most Influential Sports Educators by the Institute for International Sport. He is also a consultant to VADA. More info on Dr. Kamm can be found at


Boxing Insider: Let’s start off with the recent positive tests…

Dr. Ronald Kamm: About Andre Berto and Lamont Peterson, right. I am a consultant with VADA (Voluntary Anti-Doping Association). I’m available for boxers if they need counseling regarding performance enhancing drugs, or any drugs. My wife, Sharon, a psychologist, is as well. We’re affiliates, and consultants to VADA.

Boxing Insider: How would you describe VADA as being different from USADA (United States Anti-Doping Agency), for example.

Dr. Ronald Kamm: Well Margaret Goodman, it’s really her baby. I think it tries to be more fighter-specific and MMA-specific than USADA, which tries to do all sports. So Margaret is well known to boxers and MMA fighters, whereas, the general athlete doesn’t know anybody [with] USADA. I think boxers don’t have the highest level of trust among athletes just because of the way they’ve been taken advantage of by promoters and managers. So I think when someone they trust heads an organization, like Margaret, they feel a little more comfortable going along with it.

Boxing Insider: So Andre Berto. He tests positive for Norandosterone, and it was reported that the ultra trace amounts that Berto tested positive for is consistent with contamination, rather than intention. How would something be contaminated, and what supplements would he be taking?

Dr. Ronald Kamm: You know what? Interestingly, both Peterson and Berto were the ones suggesting it (random testing)! There’s a lot of denial when you’re abusing either drugs or steroids. You have to use that psychological defense mechanism of denial, meaning, you don’t believe you’re really even taking them, or that you’ll truly get caught. You also won’t admit it to anyone else. If the test comes up positive, you still act as if you’re not using, or didn’t use, or that this or that thing was contaminated. The point was I think with these boxers, or at least one of them, they didn’t report that they were using supplements…supplement A or supplement B…

Boxing Insider: Right. Peterson…

Dr. Ronald Kamm: Every elite athlete knows that they must check with their physician or their sport’s governing body, or USADA, or VADA, to see whether what they’re contemplating using may be contaminated or not. The burden is on them. And they must not take anything that’s not on the approved list. So you can’t say, “Oh, I took this stuff and it was contaminated.” It’s on the boxer. Or on the boxer’s people.

Boxing Insider: We’ll get back on the topic of contamination, but speaking of the boxer you just mentioned, Lamont Peterson, he had tested positive for synthetic testosterone. He claimed that it was a medical condition that he had that was due to low testosterone levels…

Dr. Ronald Kamm: Exactly. But he did not disclose it prior to the fight.

Boxing Insider: Correct. Is that normal for someone his age, and in his athletic shape to have levels like that?

Dr. Ronald Kamm: I can’t say. It’s not normal to have low testosterone to begin with. People can be in good shape and come up low. It can vary, it can change, so it’s possible. It’s not probable, but it’s possible.

Boxing Insider: Okay. Could having low testosterone be a result of using a certain drug which then causes lower levels if you go off it?

Dr. Ronald Kamm: Well, if you have low testosterone and you’re being supplemented, and you’re being given testosterone by a doctor under prescription, and you just suddenly go off of it, it definitely causes withdrawal and that can have all kinds of psychiatric effects.

Boxing Insider: Now if you’re a fighter—let’s take this over to boxing for example—in your medical opinion, what specifically is taking testosterone going to help you do in the sport of boxing?

Dr. Ronald Kamm: It makes you stronger. You have faster recovery from injury. In a fight, if you were hit you might recover faster than if you weren’t on steroids. I think Khan was surprised that Peterson had the recuperative powers he did in their first fight. It also raises the boxer’s level of confidence, and his appetite for risk. That’s where it’s particularly scary, because it makes you more aggressive. Of course fighters are aggressive, but it’s supposed to be controlled aggression, which the referee tries to oversee and encourage. Then there’s aggressiveness to the point of going over the line. That is hitting the opponent low, or really continuing to hit an opponent when the ref’s trying to stop it, or right off the break.

Obviously the extreme would be Mike Tyson biting Holyfield’s ear. I’m not saying Tyson was using steroids, but his behavior that night would be compatible with “roid rage,” that kind of overreaction. So, really, fighters are in danger. You are taking your life in your hands when you go into the ring, and you are more or less hoping—or expecting—that, yes, the other fighter wants to win…but he’s not out to destroy you or your career. It’s like what’s going on with the NFL today with head injuries. You understand there’s a risk. You understand you’ll be tackled, but you’re hoping that the other guy doesn’t want to end your career.

But if you’re in there with somebody who’s hyped up on steroids, this guy won’t necessarily care about your career or anything else. Interestingly, when I looked at Peterson’s background, his father was in prison, the mother had personal issues— and of course, a lot of fighters do come from troubled backgrounds. But having a family history of emotional problems or a family history of drug use does put an individual at more risk for steroid use and abuse.

Boxing Insider: Is that due to the nature of survival? Like you’ll do whatever you have to do to survive?

Dr. Ronald Kamm: Well no, I just think it’s a genetic thing. You’re just predisposed.

Boxing Insider: Something that you mentioned I found interesting was the factor of recovering faster in boxing. Of course if you get hit on the chin, you’d need that immediate recovery. What is your opinion medically when it’s said that somebody has a good chin in boxing? Do think that it’s based on conditioning? Genetics? Certain places that you’re more susceptible to being knocked out for instance—on the chin, above the temple, the back of the head—would a steroid necessarily help someone that gets hit flush on one of those spots? Would any kind of drug help that?

Dr. Ronald Kamm: Yes it would. Because one of the places that steroids really [help] are the neck muscles. If you strengthen your neck muscles, you’re going to be able to absorb a hit to the chin better. The neck muscles really thicken in a steroid user. If you look at the neck of Barry Bonds when he first came up, and then, years later, when he was finally shamed out of the sport, it’s amazing. Not just the forehead, and in the hat size getting bigger, but the neck. There are some actual mathematical equations that a colleague of mine at Harvard uses, looking at photos and using a caliper and being able to predict who’s using and who’s not. But there’s also absolutely a genetic ability to absorbing a punch. Obviously the more you train, and the better shape you’re in, you’re going to absorb it better, too. But some guys just genetically can take it on the chin better, and other guys have a quote “weak chin.”

Boxing Insider: Now you mentioned size of the head. Floyd Mayweather made reference to Manny Pacquiao, and the size of his head over the years. If you as a doctor, just with the eye test were to look at that, would you be suspicious of performance enhancing drug use based on that?

Dr. Ronald Kamm: Who, Manny?

Boxing Insider: Yes.

Dr. Ronald Kamm: I’m not, as I said…that’s a colleague of mine, Skip Pope up at Harvard. You know, I’d have to look at pictures of Manny. I know Manny’s gone up in weight and it’s been amazing that he’s been able to maintain his power as he’s gone up. It’s unlike just about any other fighter, and I think that scares Floyd. But that’s not my area of expertise. That’s Skip’s.

Boxing Insider: Okay. Back to the contamination issue. We’re talking about supplements here, and if Berto was taking a supplement that was contaminated. Roy Jones, back in the day was taking something called “Ripped Fuel,” which was available as a supplement over the counter until March 2004, which contained Androstenedione. So what I’m saying are that these supplements—supplements that can either be contaminated or supplements that are viewed as legal, then put on the banned substance list later—what would be your opinion on these supplements in general? Boxers 100 years ago weren’t taking a bunch of supplements…

Dr. Ronald Kamm: No, right? (Laughing) They’d eat steak!

Boxing Insider: Do fighters need these designer powders and everything like that?

Dr. Ronald Kamm: No! No, I mean, you know, I think it came more into vogue with Mackie Shilstone and Michael Spinks putting on the weight, and Evander Holyfield putting on the weight, and still doing well via the nutrition. But I’m not saying either of those guys, or that Shilstone gave them anything illegal, I’m just saying…the whole dietary nutrition approach, as well as working out in a specific manner to help a fighter gain weight and be more powerful started back then.

Boxing Insider: He was giving them like Whey Protein and stuff like that right?

Dr. Ronald Kamm: Yes or Creatine, which helps people work out and helps muscle strength. And that’s not banned, Creatine. But it does…it’s a reservoir for muscular endurance. And you become less fatigued. So weight lifters do use it and they do combine it with steroids when they’re abusing. But the problem is that with chronic use, or the use of any of these banned substances…any steroids or creatine, can have adverse medical consequences down the road.

Boxing Insider: Is it a psychological thing using stuff like this? Almost like a drug user’s mentality? If you say, “I’m going to use these three different powders and I’m using this and this and this,” is that more for psychological gain? Thinking you’re doing something somebody else isn’t doing in preparation?

Dr. Ronald Kamm: Yes. And I think all boxers are looking for an edge. And I think they feel they’ve gotten it even if you gave them a placebo. They feel better and they feel more confident. One other thought I wanted to mention to you Hans, was that, in addition to denial, there is a second defense mechanism called projection, where you’re feeling a certain way but you don’t want to admit it. So you think or “project” that feeling that the guy opposite you is feeling that way. You can’t admit to yourself that you want to cheat or that you’re hostile or whatever the negative trait is.

You can’t see yourself in that way, but you deal with that impulse or the fact that you are that way by denying it and then projecting it like a movie projector, saying “that guy’s like that!” And they both may have been doing it, Berto and Peterson. They may have been assuming that Khan and Ortiz were using, denying to themselves that they were, but knowing subconsciously that they were and assuming the other guy was! And that might have been one of the reasons they wanted the testing.

Boxing Insider: And that brings me to another question. People say the greatest sin in boxing would be loading your gloves. That wasn’t any more apparent than when Antonio Margarito allegedly attempted to do that against Shane Mosley. Mosley had admitted that he had used “the clear,” “the cream,” and EPO, you know, a substance that helps reload blood cells and what not. What I’m suggesting here, is do you feel that Margarito—based on those facts from Mosley’s past—is it possible that he could have thought “I think this guy is on something illegal still,” and that is what made his team want to load the gloves? Is that a possibility?

Dr. Ronald Kamm: Mosley had admitted it prior to that?

Boxing Insider: Mosley had, correct.

Dr. Ronald Kamm: And that made Margarito want to load his gloves? Correct! Yes, it’s always spy versus spy. “I’ve got to go one better…” “Now I’m suspicious of you…” “You went over the line, I don’t how much you’re going over the line this time, so I’ll beat you to it…”

Sure. Once one person does it, everybody else feels they’ve got to do it so that it’s a level playing field. That happened in the NFL back in the 80’s.

Boxing Insider: Would anybody that’s on some performance enhancing drug in boxing be just as dangerous as a fighter loading their gloves with plaster of paris for example?

Dr. Ronald Kamm: I couldn’t make that distinction but I’d say it’s the plaster of paris guy that’s a lot more dangerous. That’s just direct, and it’s force equals mass times acceleration. You know, when a guy gets hit with plaster-covered fists, he’s going to get hurt a lot more than if the guy hitting him was just on steroids. So we’re just talking about another order of cheating. They both are, but that would be a lot more dangerous, the plaster of paris.

A last thought, Hans. What managers and promoters cornermen really want to be telling their boxers and trainers…is that being a successful boxer is all about making the right decisions. When do you back away? When do you circle? When do you jab? When do you throw the right? When do you hook? When do you get in close? When do you dance? Making the right decision is what makes an athlete a champion.

Choosing to cheat and choosing steroids is a bad decision. You’re going to get caught, the testing is becoming more aggressive and you’re going to be shamed. But since you’ve already got to this level by making so many good decisions, keep making them! Use what you’re doing well, which is making the right decision. Don’t make a wrong one.

Finally, in this age of cheating, when I give a take to athletes who might be tempted to use PED’s, I share a quote with them from St. Jerome, whose Latin translation of the Bible profoundly influenced the early Middle Ages (240-420).

The quote is, “No athlete is crowned but in the sweat of his brow.”

Boxing Insider’s Hans Olson can be reached at [email protected]



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