Experts devoted to eliminating drugs in sports say it's a three-part problem, one that involves finding an effective test for human growth hormone, staying ahead of those creating new illegal drugs and, most important, changing the drug culture in baseball.
Don Catlin, one of the world's foremost scientists in the fight against doping, said he has made some headway with the $500,000 that Major League Baseball gave him to begin work on finding an effective urine test to detect human growth hormone.
HGH was identified in the Mitchell Report as one of the biggest problems, in large part because it's nearly undetectable. Only blood tests currently can detect signs of HGH use, and they aren't considered advanced enough to catch cheaters who use any measure of sophistication.
A urine test is thought by some to be years away, though Catlin is trying, and has had enough success that he is considering asking for more money to move the studies forward.
"But let's say we get that contained tomorrow," Catlin said. "The next day, there's going to be another one."
For instance, Catlin said he was starting to get word of new designer types of EPO that are essentially undetectable to a type of testing that baseball doesn't currently perform anyway.
EPO is a banned substance that increases the amount of oxygen that blood can carry to the body's muscles.
A number of experts were most encouraged by the Report's recommendation that baseball find ways to investigate and punish drug users who don't test positive, but are linked to receipt and use of drugs nonetheless.
Going after these so-called "non-analytical" cases is an increasingly important step in the U.S. Anti-Doping Agency's effort to keep drugs out of Olympic sports. Track star Marion Jones lost her five medals from the 2000 Sydney Olympics as the result of legal issues and evidence that did not include a positive doping test.
"One of the strongest recommendations is that there be an investigative side," said Richard McLaren, an attorney who helped Mitchell draft the Report. "There needs to be more involvement with law enforcement agencies."
But baseball would have to be willing to rely on law enforcement and inside information from those in the sport, and thus far, the sport has been reluctant to use that information to mete out punishment.
Meanwhile, most of the recommendation section of the Mitchell Report looked like a direct suggestion to hire a company very much like USADA, which touts its independence, transparency, adherence to due process and strong educational component as the cornerstones of its operation.
"You'd have to ask them that," said USADA's CEO, Travis Tygart, when asked if baseball might come to the agency for help. "Our position remains the same, which is, we're willing to assist any entity in whatever capacity that wants to have a truly effective program."
Catlin and Dick Pound, chairman of the World Anti-Doping Agency, say they'd be shocked if baseball went to USADA or any other similar organization. Other experts think baseball, and especially the union, will be reluctant to turn over its drug-fighting operation to an independent group.
"I think they've been appalling in how they've gone at this whole thing, and I wouldn't expect much to change," said Pound, a longtime critic who points much of his criticism at the players' union.
Of course, even if baseball were to contract with an independent agency and take other steps to improve its ability to catch cheaters, many agree there's no chance for thorough change until the culture of cheating is eradicated.
Catlin figures as long as athletes are looking for an edge, regardless of the moral consequences, people will find new pharmaceuticals to give them that edge.
"You just don't hear about the newest things out there because users aren't going to tell us, and why should they?" Catlin said.
U.S. Olympic Committee spokesman Darryl Seibel says "you can't put a specific timeframe on" how long it might take for the culture to change.
"But is it possible? Absolutely," he said. "But it'll take athletes, coaches, trainers, agents, administrators and fans. Everybody who participates in sport at any level has to play a role in the solution."