In January 2004, Major League Baseball announced a new drug policy which originally included random, offseason testing and 10-day suspensions for first-time offenders, 30-days for second-time offenders, 60-days for third-time offenders, and one year for fourth-time offenders, all without pay, in an effort to curtail performance-enhancing drug use (PED) in professional baseball. This policy strengthened baseball's pre-existing ban on controlled substances , including steroids, which has been in effect since 1991.  The policy was to be reviewed in 2008, but under pressure from the . Congress , on November 15, 2005, players and owners agreed to tougher penalties; a 50-game suspension for a first offense, a 100-game suspension for a second, and a lifetime ban for a third.
The common side effects of oxymetholone include depression , lethargy , headache , swelling , rapid weight gain , priapism , changes in skin color, urination problems, nausea , vomiting , stomach pain (if taken on an empty stomach), loss of appetite , jaundice , breast swelling in men, feeling restless or excited, insomnia , and diarrhea .  In women, side effects also include acne , changes in menstrual periods , voice deepening , hair growth on the chin or chest , pattern hair loss , enlarged clitoris , and changes in sex drive .   Because of its 17α-alkylated structure, oxymetholone is hepatotoxic .  Long term use of the drug can cause a variety of serious ailments, including hepatitis , liver cancer , and cirrhosis ; therefore periodic liver function tests are recommended for those taking oxymetholone.