Alfonzo was the first player to be suspended for a second time under the auspices of the drug policy. A six-year veteran from Venezuela, Alfonzo was suspended for 50 games after testing positive for a PED in 2008 while playing in the Minor Leagues for the Giants.
Rays designated hitter Manny Ramirez also tested positive for PED use this past season, but he retired rather than face a suspension for 100 games. The Ramirez positive was not counted in the report because he quit rather than go through the process.
As a member of the Dodgers in May 2009, Ramirez was suspended after testing positive for the use of Human Chorionic Gonadotropin, a female fertility drug that is often used to help mask steroid use. He was suspended at the time for 50 games under the penalties provided by the program.
This year, the other 12 were for the use of stimulants and the names were not released under the privacy provisions of the agreement between MLB and the MLB Players Association.
The survey was one of the recommendations made by Sen. George Mitchell in his 2007 report analyzing the recent use of drugs in MLB to give more transparency to the system of checks and balances regarding the ongoing testing of players. Dr. Bryan W. Smith, who is in charge of administering the program, is required to submit the report and remain completely independent of MLB and the union.
Since MLB began disciplining players for positive tests in 2005, 28 have been suspended. The high was 12 in 2005.
Two players were suspended in 2010 for the use of performance-enhancing drugs, resulting in 50-game bans to Reds pitcher Edinson Volquez and then-Marlins catcher Ronny Paulino.
The stimulants that contributed to positive results were Adderall (eight times), Clobenzorex, Methylhexanamine, d-amphetamine and Oxilofrine. Adderall is an amphetamine that is used to control Attention Deficit Disorder. Methylhexanamine is used as a dietary supplement and nasal decongestant. D-amphetamine and Oxilofrine are classified as stimulants under the category of amphetamines.
Smith noted that 111 therapeutic use exemptions were granted, 105 for ADD, two each for hypertension and post-concussion syndrome, and one each for hypogonadism and narcolepsy.
Under the terms of the drug agreement, which has been opened and renegotiated several times since its implementation in 2003, a player can't be suspended for the first-time use of a stimulant. Instead, he goes into an administrative tract and his name is kept private. Upon a second positive test, he's suspended for 25 games and the information is released.
As far as PEDs are concerned, a player is suspended 50 games for the first positive test, 100 for the second, and after a third is banned for life with the possibility of rescission a year later.
Human Growth Hormone, which has been on the banned list since 2005, will be subject to a mandatory blood test for the first time this coming Spring Training. A player testing positive is subject to the same penalties as any other PED.