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The physical standard is now quite difficult or impossible to obtain without the use of steroids. If you don't have the body, you don't get the work. You're an independent contractor, so if you don't get the work, you don't get paid. Once you get the work you have to convince the McMahons to invest in making you a star if you want to make much over the minimum. That means, for most of them, maintaining less than 4% bodyfat on a 260 pound frame, while on the road more than 250 days a year (covering your own travel and lodging expenses, every step of the way).
Also, keep in mind that the guys you're working with, and who you're competing with for TV time, pay per view slots and house show bookings are all using steroids. How else do you keep up with them? This is why we're finding out that everyone in the Tour de France is blood doping - the standard to compete is now so high that it's physically impossible for anyone to do it clean.
The bottom line is, no matter how "out there" the performers are (and let's face it, it's not a typical way to make a living) the McMahons created a product that demands its performers use steroids and they work so hard a schedule in a tough physical job that painkiller use is normal. It doesn't have to be this way.
The McMahons could have chosen to push a different, physical type of performer (the spectacle has been popular before without overblown bodies) and they could have chosen to be like every other form of sport, entertainment or circus and have an off-season so that its performers would have adequate time to rest, heal, and train naturally.
I think that last point should be undeniable. Football players, sitcom actors and circus clowns all get time off, but not these guys. Why? Because the McMahons wanted to run a public company with quarterly earnings goals. People are dying over that decision.