Opinion: The Real Life-and-Death Question About MMA Health and Safety

Editor’s note: The views and opinions expressed below are those of the author and do not necessarily reflect the views of Sherdog.com, its affiliates and sponsors or its parent company, Evolve Media.

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Almost as soon as the U.S. Anti-Doping Agency started busting UFC fighters in and out of competition, USADA itself became an ingrained, almost memetic presence in MMA. Even before Jon Jones or Brock Lesnar's positive tests put an indelible stain on UFC 200, before Chad Mendes was slapped with a two-year suspension, fans had already taken to shouting “USADA!” any time a UFC fighter stepped on the scale with any difference in physique or changed weight classes. We're barely a year into USADA testing the UFC roster, but the size and scope of the project, combined with the sensationally news-y nature of a failed anti-doping test, ensures that every MMA outlet's newswire has one or two USADA-related stories per day, at least.

However, in the wake of Jones and Lesnar -- the sport's best fighter and arguably its most bankable star -- both getting popped for the estrogen blocker clomiphene, USADA conversations this week have headed in a more extreme direction. Maybe this is the natural extension of a philosophically charged, hot button topic like doping, especially when it becomes the dominant conversation for an entire sport. Maybe this is an expected outcome when that news concerns fighters with names like Jones and Lesnar, tempting opinionated people who otherwise don't traffic heavily in MMA to share their hot takes. Regardless of the reason, it was a week for ham-fisted and shortsighted moralizing, a week in which Forbes ran an article called “PED Use in Combat Sports Should Be a Criminal Offense”.

Whether you deeply care about a “clean sport” or think pro sports should be a chemical free-for-all, this vein of thinking isn't just reactionary, it's also wrong. This sort of media hysteria positions doping in MMA or combat sports on the whole as, if not the greatest of all evils to be purged, than at least the most pressing as it concerns fighter health and safety. This is simply not true.

The basic argument, of course, is that prizefighters' explicit goal is to do physical damage to one another and therefore a juiced-to-the-gills fighter is uniquely dangerous to his opponent. The great question in these discussions is always “What if a fighter in the UFC died as a result of injuries in a fight, then his opponent tested positive for PEDs?” This hypothetical shouldn't be completely disregarded; it's a very serious question that is not beyond the realm of possibility. However, if you consider the deaths that have occurred in MMA, there is a common theme and it's certainly not PEDs.

When Douglas Dedge died in 1998 after a bout in Ukraine, it wasn't because of PEDs, it was because he was an undertrained fighter who had been blacking out in the gym long before he flew across the Atlantic Ocean to fight. When Sam Vasquez became the first fighter to die after a sanctioned, regulated MMA bout in Texas in 2007, it wasn't steroids. When Michael Kirkham and Tyrone Mims died barely two years apart in the same state, South Carolina, hormones were not the cause.

Grim as it is, when you look over a list of the fatalities that have happened in MMA, the common theme is either non-existent or lacking regulatory and medical oversight. This has always been the case and will be the foreseeable future. Steroid moralizing at its critical mass, the kind we've seen this week, tacitly suggests that steroids are the operative threat to fighter health and safety, but it's an ironic position to take as a result of USADA's recent efforts. After all, why is USADA working with the UFC in the first place?

For years, Dana White and the UFC proudly used government regulation and sanctioning as a rhetorical sword and shield. Got a problem with how the UFC is run? “We're regulated by the government!” It was an unimpeachable retort, unless you've got any real knowledge about how athletic commissions work. Many commissions don't require anything more than an eye exam and some blood work from a lab of your choosing. Most commissions are not Nevada, not New Jersey and not California, they're tiny government offices with a few scant employees and nowhere near the necessary resources to test fighters regularly, let alone en masse. Even the great ones can end up in potentially horrific scenarios: on Thursday, Law Newz's David Bixenspan reported that deceased heavyweight boxer Tommy Morrison may have tested positive for HIV as early as 1989, but was able to conceal it for seven years, even bragging about beating HIV tests, while actively fighting in Nevada, the biggest and most influential athletic commission.

We ended up with the UFC-USADA relationship because athletic commissions signed off on the testosterone replacement therapy era and gave scores of fighters therapeutic use exemptions. We are here because it became abundantly clear year by year that athletic commissions were not catching experienced or savvy dopers and even if they wanted to, they didn't have the resources. We are here because in some cases, like the death of Dustin Jenson in South Dakota, it took a death to help the state government to realize an athletic commission was even necessary at all.

The aforementioned Forbes article by Brian Mazique mentions Bellator MMA prospect Michael Page's putting a dent in Evangelista Santos' skull with his knee and wonders “What if Page was on steroids, how would we feel?” Yet, he's talking about a fight on a Bellator card where Matt Mitrione flew across the Ocean to fight Oli Thompson in London, despite being nearly knocked out and definitely concussed three weeks beforehand, the promotion where this year, “Dada 5000” Dhafir Harris and “Kimbo Slice” Kevin Ferguson had their infamous fight after which the former claimed he clinically died twice after the bout due to renal failure, then four months later, the latter died for real due to heart failure.

After his win over Harris, Slice tested positive for the steroid nandrolone. In ways like this, steroid use is still intimately intertwined with broader health and safety issues. Nonetheless, the question becomes how either man was allowed to get into the cage at all given their physical health. Sadly, informed spectators suspect that Bellator took the Dada-Kimbo fight to Texas, the state Sam Vasquez died in, for calculated purposes, chiefly the state athletic commission's lax medical standards.

If you're attempting to assert a moral high ground, “What if someone died in the UFC and their opponent was on steroids?” is perhaps a perverse question to ask because in many cases, the person offering the morbid thought experiment isn't really making a tangible, critical point about fighter health and safety. When the Darren Rovells of the world become inclined to chime in on the PED hysteria and frame their statements in a business context, it's a reminder that what most people are really asking is “If someone died in the UFC and their opponent was on steroids, what does that mean for the UFC's business?”

The fact is that with the amount of fatalities MMA has had, especially in international, unsanctioned locales, a fighter has likely already died from injuries sustained in a fight with a steroid user. The UFC has nearly 600 athletes now, but there are tens of thousands of men and women all over the world fighting in countries with zero government oversight, where promoters create unconscionable mismatches to sell tickets, where there might not even be an ambulance on sight.

No one ever died in the Pride Fighting Championships, despite the promotion historically being associated with free PED use due to no testing policy, as well as outlandish freakshow fights. However, even anecdotally, what is a greater concern to health and safety: the late Kevin Randleman with 30 extra pounds jumping on Kenichi Yamamoto's head with his kneecaps, or a non-regulatory climate where Stefan Leko and his management claim he was shot up with painkillers at the promoter's behest, only to walk into the ring and be clobbered by promotional favorite Naoya Ogawa? Again, this is not to say that steroids are not beneficial and advantageous to the user, but rather that PEDs have not and do not turn fighters into markedly more lethal weapons, no matter what Vitor Belfort's 2013 campaign suggests.

After all, the primary reason that prizefighters take steroids isn't to put on massive amounts of lean muscle, though certainly some do. The major benefit for combat sports athletes taking PEDs is so they can train harder, longer and when they're inevitably hurt, they can recover faster, fight more often and make more money. MMA is a violent sport that is now contested all over the planet, with only a tiny fraction of that violence having any sort of medical or governmental oversight. Worse, even when medical and governmental oversight are part of the equation, we've seen how often that regulation falls short.

I won't categorically dismiss anyone calling for a clean sport, even I believe it's overly utopian. However, those who see fit to turn a recent rash of high-profile doping busts in the UFC into a philosophical life and death issue are ignoring why USADA testing has even come into practice, as well as ignoring the clear and explicit cause behind just about every fatality this sport has had to bear. If you despise the cheaters and think they're criminals, by all means, send the watchmen after them. Unfortunately, the life and death issue in combat sports isn't whether or not the watchmen will catch them, but rather “Who is watching the watchmen?”